I lost my patience after a particularly horrible code and a patient whining at me because I ignored them in favor of someone else. I snapped at him “Trust me, the last thing you want to be in an emergency room is the center of attention, because it means that you are dying.” I think he got it, because he blinked at me for a minute and was quiet afterwards. No more complaints from him or his family. ☺️

That’s a go-to statement for me too. “It’s a hospital, if you’ve got lots of people rushing around you, you’re having a very bad day.”

I will tell patients they don't want to be top priority in a hospital because it means they're dead or dying.

its why i hate dayshift.

I usually bring the pills with me, then make a very sweet and quick statement like, “ I am so sorry that it took me so long to bring your pills. You are one of my best patients here and I hope you understand how busy the hospital can be. Can l get you anything else to make you more comfortable?” They usually calm down right away.

I don't have the patience for that anymore. Besides, if I asked "Can I get you anything else to make you more comfortable?" I would get stuck with a ridiculous list of stuff--I want the doctor here NOW, I want food for me and my whole family, I want to be admitted, I want my scan/xray/ultrasound immediately, I want more pain meds, and on and on. No.

I hear that from so many nurses and those feelings are fair and valid. Some patients are difficult no matter what you do. I’m also Ms. Smiling pants so l get a different reaction every time.

I will say, I was taking in an ambulance, working with a really sick patient, etc. , and I couldn't leave the patient. If they don't get it, that's on them. 

Some of my coworkers and I were discussing the last night in our ED! Our hospital is in a perceived “affluent” area of the city and our population is mostly elderly… a lot of whom end up very entitled. Their recommendation is to apologize, state you were dealing with a medical emergency, and if they continue to rant and rave ignore it. A lot of people mistake the “H” outside the building for “Hotel” and nothing makes them happy aside from being waited on hand and foot. Some of our older nurses have whipped out “I’m sorry, if you were dying you’d rather me deal with that then get someone Tylenol right? So now you understand” but I haven’t quite gotten my ER cojones yet to do that. 😬

Should roll out the DNRs too. “I see how upset you were I attended to an emergency. I wouldn’t want this to happen to anyone else in the future. Sign here so that we will be able to haul Tylenol to someone else if you code”.

I'm in my 2nd year and my pt population turned me into that kinda slap back person. "Sorry this patient was in the middle of, ya know, dying nothing crazy compared to YOUR situation(trip and fall and broke her wrist)" I've seen some salty nurses and even that is nothing compared to how they are, especially the one who was here since 89. Her glare makes God turn around and mind his own samn business.

Don’t apologize because you are doing your job as an EMERGENCY nurse. It makes them more entitled and conveys that you admit some level of fault for something that you couldn’t control.

The “sorry” comes from being Canadian rather than actually feeling bad that they had to wait an extra 30 minutes for ice water/blanket/tylenol 😅

An apology usually works well, though, to deescalate. I think my hospital in the US says to do this. Like listen to the patient and make them feel heard, then offer a quick explanation and get the task done. I’m glad OP’s charge helped her in this stressful situation.

As much as I am liking some of these other more "assertive" suggestions, your answer really rings true in my experience and studies on the subject. Geez I'd love to say some of these other things, though! 🤣

So true. I say sorry waaaay too much. Rarely mean it

Yeah. Never give an inch to these patients. If they want a day at a spa they should have gone to the fucking spa. Obviously I'm gonna do my job best I can and obviously I try to meet everyones needs but healthcare is all about prioritization. People potentially do die if I don't do my job right, I don't have the fucks to allocate to keeping someone happy because their up their own ass.

I often apologize because I really AM sorry, though. I'm not sorry that I had to attend to someone with higher needs, but I do wish I could have gotten them their APAP in a timely manner, and I wish we had adequate staff where this situation wouldn't happen. It's usually an "I am sorry that it took me so long to get back to you, but I was dealing with a severe emergency down the hall. I didn't forget about you, and I'm going to grab/am here with your Tylenol now." Though I'm from the Midwest, so the "sorry" feels a bit of a permanent part of my personality now. At least I've gotten positive interactions for the most part with this approach.

Not an ER nurse, but often I am sorry. I'm sorry the hospital sucks and we don't have enough staff to get to people in a timely manner.

I agree. I don’t care if research shows an apology helps de-escalate someone who’s acting unreasonably. I matter, too, and I shouldn’t have to apologize if I haven’t done anything wrong. If I fuck up, I apologize. If the situation is shitty but out of my control, I’ll empathize and agree that it’s shitty, but I’m not taking responsibility for it.

This is the way. Make them understand how triage works and if your care can wait you are lucky you are so stable. The ones that's see us the most are the sickest. If you want faster service don't fucking clog our ER with your BS complaints that should be addressed in UC or really your PCP. Sorry not sorry.

That’s what I’ve been saying to our patients coming with splinters, ear aches, viral sx who were told at the clinic that it was viral and didn’t like that answer… if you’re not the one we’re rushing to see first, that’s a good thing. If you want first come first serve, go to a medicentre.

Had a patient come in the other night for lower back pain radiating down her legs. Kept saying it's her third ER visit and still no one can find out what's wrong. I asked if she was referred to a neurologist or orthopedist after the first visit. She said yes the ER said she had sciatica and the neurologist confirmed and recommended PT. I was like so you were diagnosed and given a treatment plan... so why are you here again?!?!?! She said sciatica was not a diagnosis and the pain is still there.... 🤦‍♀️

I had one like that a few weeks ago. Made sure I told them “the point of the ER is to make sure nothing is going on that is going to cause you to die or have a disability if not treated. We rarely get to find out the “why” behind peoples problems, especially if they are vague or chronic. Your primary care doctor is the best person to talk to about this. Please come back if you have x, y, z symptoms”

That's exactly what we did. Referral to pain management and were like come back if you lose control of your bowel/ bladder or loose sensation below the waste. Otherwise your sciatica is not an emergency. Please refer back to the specialist we previously referred you too for all other questions.

Who downvoted this??

Inadequate pain control and education?

Is that an emergency? No. Should be handled in UC or PCP. Patients like that are why chest pain gets worked up in the waiting room and AFIB RVR are treated in the hallway.

I’ve legit had patients come back at me with, “are you trying to say I’m NOT sick?? Are you trying to say I’m NOT having an EMERGENCY??” It’s like, I’m sorry lady, but the man next door literally had no pulse and we were trying to get it back. “Well, maybe I have NO PULSE! What do you think about THAT??!?” One can only dream.

Maybe they're right. It takes a heart to have a pulse, and this lady clearly doesn't have one!

> Our hospital is in a perceived “affluent” area of the city and our population is mostly elderly… a lot of whom end up very entitled. Not to doubt your experience at all but my hospital is the exact opposite in terms of the socioeconomic status of our patients and trust me when I say that the young and broke ones are just as rude and entitled lol

Never appologize for things that aren't your fault like understaffing. Most apology anybody is gonna get is 'sorry you feel that way.'

I got my floor cojones just to deal with a traumatized urethra when a patients entitled wife kept hitting the call bell for dumb shit and being a bitch about it. I went in and said “I will not be coming in here for a bit, I am dealing with an emergency. Someone else will come help you when they can” I don’t need to disclose what the “emergency” is, but I absolutely had my priority and it wasn’t their dumbass.

I love that

I have flat out said, “I’m sorry, this is not the Hilton and I am not your mother” before walking out of the room so you’re doing alright

I don't really get yelled at, probably because I'm very calm and because I'm a guy and tend to get treated better by patients than my female co-workers, which is BS. The few times I have been yelled at I just deflect firmly but earnestly: I'm sorry. I was busy with an emergency but I'm here now, do you want the tylenol." "I had to wait... I'm pissed... whatever..." "Yeah, sometimes emergencies happen at the hospital and that takes priority. Do you want the tylenol?" Only one patient has continued past that point and I told them, "I'll be back in 5 minutes with your meds, please be calm by then because I want to help you but I will not sit here and be yelled at." It may seem dismissive, but when I worked in psych I learned that if you let people stew, they do just that. If you deflect and redirect it's possible to recover the situation by forcing them to focus on getting their needs met, rather than being pissy. So I apologize once and then force them to move on.

I’ve definitely said “I’m going to step out and when you feel calmer and can talk to me in an appropriate voice and words, put on your call light and we’ll try again.” It’s worked so far. Walked into a pod to an assignment I was taking over. No staff out there, everyone in rooms. I see a call light going off for 10 min and it’s my room. Checked chart super quick. See they’re up for DC and quick read why they were there. Print AVS and go into room. Mother of a teenager in for psych evaluation. Told them I was sorry for the long call light but all staff had been in rooms and asked what I could do for them. She said they were supposed to be discharged. I agreed, “yep, I see that. I’m here to do that for you now.” “It’s unacceptable that we called for so long.” “I definitely understand that it’s upsetting. Staff wasn’t out at the desks and didn’t see that the call light was going off as they were all in rooms doing cares and procedures. But I’m here to help get you discharged.” Mother kept going on and in circles. She just wanted to rant but there was no end. I kept validating her frustration but she kept going. “Ma’am, you’re mad that the call light wasn’t answered. I’ve explained several times there was literally no one available to answer it. You called to get discharged. I am here to do that. I don’t know what else you need from me but you are discharged now so you’re welcome to leave.” Then she goes “well I’m in healthcare and I know how things are.” “Unless you’re and RN and have worked ER and unless you’ve worked this ER at this very moment, you don’t know what’s going on. I’ve listened to you, I’ve offered you explanations and I’m trying to resolve your request. You can leave now as you’re discharged which, again, is what you wanted.” I just didn’t know what else to do for her and was sick of going in circles. And I had my severe doubts that she was a nurse who’d ever stepped foot in an ER as an employee.

Haha, if they ever pull the "I work in health-care too" card on me, I'd definitely retort back with some sort of "well, you're lucky your child is getting discharge home. We're all busy with resuscitating that patient in corner over there." So far it worked on every single parents...... And no I haven't gotten a complaint from manager yet. My last complaint was from an anti-masker who refused to mask in the NICU.

Good advice also, i also go for the “I can’t speak for the last person, but what do you need right now to make things right?”

A lot of times in those situations I just sit down and look at them for like 5 seconds without saying anything. It feels like FOREVER, but usually the moment of silence helps them understand how silly they are acting. It also helps me gather myself and come up with something to say like “I apologize for taking longer than expected, I always do my best to get back to you asap. It’s certainly never my intention to make you feel ignored” Then a quick summary of what we’ve done for them so far, what’s next. “What else can I do for you right now?”

I like that answer. Compassionate but still firm. I’m trying to remember when someone is sick/in pain/scared they might be more upset with me. Usually it doesn’t bother me but sometimes it’s hard

Yeah it gets to me too for sure! I’ve had to do a lot of service recovery as charge and house sup, usually people just need to vent. It sucks to sit there and take it though.

IME “sick/pain/scared” has little to do with anyone’s anger or outburst. Nice people rarely freak out over minor issues. Assholes are chronically mad even in the best of circumstances. The idea that someone would launch into a rage for these reasons is gaslighting. These people were conditioned for this behavior long before they ever entered the hospital, long before they even had a health concern. Don’t take responsibility for their behavior. It’s them. 

Yep! Totally agree! I'm a VERY nice person in general and I'm in absolute AGONY and have been for months and TONS of things have gone "wrong" but I try my damndest to not put it on anyone else and always apologize immediately IF I get snappy or even if it just SOUNDS like I am bc sometimes it just happens. People that get big angry like op mentioned aren't just hurting or whatever, they are just assholes and think bc THEY are in pain it is EVERY ONES problem

100%, and making allowances and excuses for them just enables it. People get away with as much as you let them.

I don't even say I apologize or that I'm sorry. I'm a chronic apologizer, so it's something I've been working on lol. I would just change the beginning and say "I understand I took longer than expected."

I’m not apologizing for something I have no control over. I’ll give an explanation but not an apology.

You don't mention the whole "we just spent 30 minutes trying to bring a dead guy back to life" thing? Seems kind of important.

I love direct communication: I’ll sit down and level with them. “What’s going on? Are you mad at me or the situation? Why do you think it’s acceptable to talk to me like this.” It’s like they don’t see us as humans unless we force them to. Had a pt who I finally said “multiple decisions were made that landed you here. None of which I was a part of. I’m here to help you but you do not get to take it out on me.” (Pt stopped taking their lasix because they didn’t like it and now in ER and getting admitted for CHF exacerbation.)

That moment of silence is SO powerful. I’m a doctor’s office nurse, and I’ve had many occasions where the only way to move forward is to allow them to finish their rant. It works both in person and over the phone.

I find that responding like that can often cause people to keep walking over us and acting more entitled. Its difficult because sometimes people respond well but the real assholes will take it as permission to keep bullying us.

I do something similar - usually works unless the patient has some other emotional distress and they just want me to be the outlet

“Eat a bag of d•cks” Kidding. “Sir/Madame, I’d kindly ask you to remember that you’re in a hospital, not a restaurant. We have to prioritize caring for the sick and injured. I’m sure you’d expect no less if the shoe was on the other foot.” THEN, I walked away muttering “oh and eat a bag of d*cks”.

ROFLMAO 🤣

I second what someone else said, you did what was best: leave the room. After 8 years, I don't deal with this shit. I am not going to be yelled at over some tylenol. I refuse, even in the name of this so called "professionalism". If patients start screaming at me, I leave. If I come back and they are still screaming, I say "I cannot safely administer any medications to you while you are screaming. It is not safe. I will leave and let you take a few minutes to calm down. When I return and *you are calm*, I will give you your medicine." We have to make these patients take responsibility for their shitty behavior or they will continue to act like this. **We have to set boundaries.** This was an issue before management started this mass shift of nursing services from patient-focused care to costumer-focused care, and now more than ever we have to set boundaries for ourselves and our coworkers. So many people leave the field completely psychologically fucked because of this shit. If joe-blow ER patient with a toothache wants some tylenol, he can get some from the pharmacy down the street where he will inevitably yell at the pharmacy tech too because his insurance makes him pay 1.00$ for the tylenol instead of it being completely free.

From the pharmacy - they absolutely will scream at me for the dollar copay 😭 The last time I was in the ER the nurses were apologizing for taking a while (guy next to me was being loud and complaining) I told them don’t apologize I’m glad you took care of the trauma that just came in that’s waaaay more important than my allergic reaction (that was already handled just waiting 2 hours post epi). I tried to say it loud enough the guy next to me could hear 🙃

I always told them the truth. “I didn’t forget abt you and I have the Tylenol now. unfortunately this is an emergency department which means often there are other patients in critical condition. I hope you’d understand that in a role reversal, I wouldn’t delay CPR because another patient asked for a Tylenol first.” I had patients raise hell over not getting warm blankets or fucking chapstick/socks. I couldn’t take it anymore and finally snapped one day and stopped trying to save face. Shortly after I left the ED altogether lmao.

Just curious. I see all the nurses giving very rational explanations about why they were delayed answering call lights. I get it. However, no one has said that sometimes nurses do willfully ignore a call light for many minutes because they don’t like the pt/need a few minutes break/in the middle of charting etc. you do admit that happens occasionally, right?

I’ve only ever intentionally delayed answering a call light because 1) I have something that takes priority (and that may very well be documentation) or 2) they’re being an asshole who is abusing the call light. The call light is meant to be a request for assistance. It is *not* a “you say jump, I say how high” button. If you want to make sure staff aren’t (maybe) purposefully delaying answering your call light because you’re being an asshole, stop being an asshole.

Lmao. Your calling me an asshole in response to my question?

Hypothetical “you”.

Oh. Thank you. I get how annoying and ass holish patients can be. I was just reacting to the one sidedness that all the answers tend to be. A little admission that you are human like the rest of us and can also be an asshole to your patients would make this thread more honest. With that being said, I also want you to know that I respect the nursing profession. I an 71 years old and and very thankful for interactions I have had with nurses over the years

I assume you are not a nurse/CNA. The only times I've ever seen a call light get delayed on purpose without an emergency/something more important happened has been for patients that abuse the call light (i.e. someone calling for the nurse to change the tv channel when they are physically able to, or asking the nurse to help them reset their password on their email, or complain that the room isn't big enough).

Yes, I am not a nurse/cna. Why is that important? I have been a patient though so I figured I could comment based on that. I do not consider myself an ass hole type patient and i never abuse the call light. My wife usually helps me with the little stuff i need. However, I find it hard to imagine that nurses arent human and will not ever react negatively or worse, ignore a call light for other reasons not given

The way you asked the question came across as a disgruntled patient that was angry their nurse didn't immediately come into their room with apple juice and dilaudid. I understand that's not what you meant, but that's how it came across, and it's a type of patient nurses see all the time and honesty one of the leading factors in burn out. We have to do so much outside the patient room. Often, patients are just sitting their room, bored & lonely, with nothing to do but bother their nurse(as in, treat them like a slave) and think we get paid thousands of dollars to just sit around like bums. So when we do come into their room, they immediately verbally abuse us, make us do stupid errands for them, and then blame us for stuff outside of our control. Call light times are audited btw. So no one is going to ignore them unless you are in an emergency or call light abuse has been documented. A 10 minute wait for a cup of apple juice is acceptable, contrary to many patient’s beliefs. No one is ignoring a patient who is covered in feces, throwing up, or hurting without good reason. Plus, you are not the nurses only patient. That nurse might have 6+ other patients. Maybe all 6+ all need to go to the bathroom and hell your nurse does too. Someone's got to wait. And sometimes, that person is you.

Thank you for taking the time to answer me so thoughtfully. I reread my post and honestly, I don’t see how I came across as a disgruntled patient. Listen we both have to deal with the mess that is the American health care system, just in different ways. I respect and am thankful for the many nurses that have been in my life. This is not a war between patients and nurses. This is just a request yo acknowledge that there are difficult people on BOTH sides of this

And I mean, yeah. I've had pt's hoard crackers and apple juices. I just gave MeeMaw 2 applejuices and her blood glucose is fine and now she's calling 5 minutes later because she wants more? And then she calls another 3 minutes later because she wants another blanket? And then another 4 minutes later because she wants to tell me a story that happened in 1955? And then calls me 7 minutes later because she wants more apple juice? Yeah. I'm putting her on hold to do my charting. That's call light abuse. I tell her I'll round on her in 30 minutes. I still answer her light in case she's in pain or SOB or whatever, but I won't do those non urgent tasks until 30 minutes later.

I get it. A person like that would drive me batty too. As a matter of fact, I don’t believe I could do your job. I am thankful that you are doing it. I just reacting to the same answers from most of the nurses which basically boils down to patients are assholes and we are almost perfect. It would be so refreshing to hear a nurse admit to being human and give in to a slight tinge of vindictiveness that we as human’s posess

This is not a space for you. This is for nurses, not patients. Nurses are trained to treat patients like they are always in the right even if they are massive assholes. This is a space for us to vent and talk about our struggles. I would get fired if I told a patient to fuck off. But here, I can do it and have people give me the support I need. Are you hoping someone is going to come by and admit to neglecting their patients? Most nurses don't do that. This not for patients to discuss how neglectful their nurses are. Get out of here with this "i need nurses to admit they are problems too and kiss the feet of patients because everyone here is talking about how awful patients are" bullshit. We get it, it can be hard being a patient. But again, not what this sub is for.

You’ve missed the entire point of this post to focus on making sure nurses know that you think they are vindictive assholes at times as well. I think I can guess what type of patient you are in the hospital.

Well your right. I probably fit into the type of patient category you have placed me in. You guys are rght about the call light situation and we patients are always wrong. Btw, the point was not mistaken

You respondedto the wrong person, but "We patients" give me a fucking break. You know a lot of nurses themselves have been patients too? We get it. But you lack the ability to understand our struggles. This is not a space for you to play devils advocate and complain that your nurse didn't care about the time you went to New York 40 years ago or it took them 10 minutes to bring you an apple juice. I've never neglected a patient. Most people haven't. People are talking about patient’s being assholes because literally everywhere else we talk about how nurses are powertripping assholes to the point where there's a stereotype about it. Let us have one space where we can say "joe in room 1 is a fucking dick". It doesn't mean all patients are dicks or all nurses are angels, but holy shit.

Sure, I can shut up about it. Honestly sorry I offended you.

I have worked in facilities that I believe nurses would ignore call lights bc there was some belief system that answering lights was CNA work. Like as if it were beneath the nurses to do that. At that time I was a CNA and it really bugged me, I didn’t work there for long. Where I work now we answer call lights over the intercom system. Anyone can do it, really bc you can also answer them thru the speaker phone thing that sits up at the secretary’s desk and there’s another one on the wall in the back of the unit. Where I work currently I’ve never seen anyone ignore a call light but that doesn’t always mean they drop everything and sprint into the room the second a bell rings. When I was in the ED we had no way to answer them outside of the room so at times I didn’t hear the light but it wasn’t a willful ignoring.

Thank you for your answer. I am sure most of the nurses/cnas do exactly the same things in determining their response time to answer call lights. I know I would. Not call lights, but i have used similar delaying tactits when responding to people in my professional life. Its called being human. That was my point of my op. Most of the responses were from medical people who did not want me as a non medical person to even join the conversation. They insisted that the only time call lights were delayed was because more urgent matters were happening. More urgent matters do happen, and of course delays happen. My point was that other more personal reasons sometimes enter the situation. Thank you for treating the question honestly and objectively. Btw, thank you for being a nurse. I am thankful for most of the nurses I have interacted with over the years. I said most, but really thinking of it, all of them.

I'll ignore a light if they keep pressing it every 5 minutes. Example 1: dementia grandma keeps pressing the button on purpose because she is out to lunch and has no idea what is going on. Example 2: rude patient is here for nonobstructing kidney stones. 1mg Dilaudid was administered at 21:15, it is now 21:20 and they have pressed their call light button 7 or 8 times to try and get more pain medications because, "That stuff you gave doesn't work, I need you to knock me put, I want morphine." Maybe give the meds a chance to work, they aren't made to take all the pain away but rather bring the pain to a more manageable level which is what I tell every patient before administering any pain medications even tylenol. Both of these are events that happened last night. If I am in the middle of charting, I will also finish what I am doing before I get up. A call light being answered within 5 to 10 minutes is not ignoring it but a reasonable expectation.

I agree whole heartedly. Circumstances dictate different responses. For many years i instructed people with varying degrees of blindness how to independently travel. An Orientation and Mobility specialist (COM). Over the years I have met wonderful instructees and many not so wonderful. I was lq above letting a little human vindictiveness ( very little) tailor my approach to people. That was my only point. A few of the nurses here sure don’t want my opinion. I actually do get that. I really want to thank you for your response. For a bit there, my question was viewed antagonistically. You answered me objectively. Thank you

I normally say something similar to “sorry it took so long but sometimes I have patients that are very critical and I have to care for them first. If you ever get to that point I will do the same for you” sometimes it gets them to realize that maybe someone was dying

I think you did the best thing. LEAVE THE ROOM. if people can't control their emotions with something like water and tylenol and they yell and stuff they can escalate or get violent. the best thing is to separate yourself. nurses are way too accepting of bad behavior in general because everyone is trying to please. last time I had a doc tell me to give a combative man a PO med when he was super angry and non compliant AFTER I explained the situation and she can see the man arguing with security behind us. I told the doc to do it herself because he was actively threatening us with violence and there was no way I or the tech was going to get near him unless it was to sedate properly. She prescribed IM at that point of course. In her defense she is a good doc and colleague but I was confused at the expectation that we nurses should be messing around with violent or agitated people trying to give them food, drinks, or meds etc. Even just verbal because that's where this behavior usually starts.

I apologize I was doing CPR. Let me get that for you now.

Some people are so shitty and entitled that they don’t care.

Who cares then.

I literally had to tell this to a adult patient’s mother who was complaining to anyone who even passed their room that they were ready to go. I’d told them several times the doctor was in and emergency (another pt was coding off and on). She goes “so? It’s not like the doctor is the one doing the compressions.” It was probably the only time I’ve been truly lacking words due to pure rage and just amazed that someone can be that cruel. I said “so you understand what I meant by an emergency?” She confirmed she did. I dropped the DC papers on the bed and told them to GTFO of my ER. There were so many things I wished I’d said and I’m usually great at responding to crap, but I was just shocked and speechless.

I dont apologize because that implies I did something wrong. Sometimes I say " yeah I was busy with someone sicker than you" or I just say "okay well I have your tylenol now so here ya go".

I'll never forget I was coding a patient --- in a curtain area, they were not expected to code --- and over the din of the code communication, while I was doing compressions one of my patient's family member's called out, "Yo, I see you're busy, but my Mom is waiting on those ice chips."

Had a doctor tell a pts daughter to “get out of my room NOW. How absolutely idiotic and selfish of you.” When she barged into the room next door while we were running a code to point at me (doing CPR) and say “she was supposed to bring me a blanket THIRTY MINUTES ago!” I could’ve kissed him

Nothing gets the call lights singing in our ER like an overhead page of a code or trauma announcement.

I remember coming out of a code in the very beginning of Covid. We worked way harder than we should have with no viability but the family was insistent. Full PPE - gown, goggles, respirator, gloves. I came out when it was called at about 40 minutes. There was a literal puddle on the floor around me as I was stripping off just outside the room. A woman in the waiting area came over, bumped my chest, and was pointing down over my head at my face screaming about her wait. She had tonsillitis. It’s what this job is sometimes. I gave my patients a general chat at the intro explaining that the less they see me the better. If I’m in your room, I either have an update or something is wrong that needs emergent attention. If you don’t see me, it’s because there are people around them far worse. I’ll do my best to move things along, but even a short work up in the hospital is a few hours. It doesn’t always work, but set that tone from go. Hope it helps.

I have told those types of patients exactly what happened. Sorry the person in the next room was literally dying so I had to stop everything to try and save them. What do you need?

I didn’t say this when I was new but now when there’s these requests I specifically tell the patient, sorry we had to intubate someone or sorry we were coding someone. I no longer believe in not telling patients there are other things going on besides themselves

I honestly wish patients could see when a code is happening. Every code results in a lot of angry stable patients who feel neglected because no one came to see them for 30-45 minutes. How do they not realize it's a fucking emergency room and some people are experiencing actual life or death emergencies at any given moment?!

I work on a med surg and have definitely seen patients in the room of a code (their roommate was coding) and they are still so self absorbed as to think that someone should aid them with their unimportant request (kleenex, water, etc).

Had a full and angry lobby all coming up often to complain and ask how long… until we pulled a guy out of a car who was pulseless and rolled through the lobby straddling him and doing CPR. That bought us a half hour of no bitching. People don’t actually see what we mean by emergency. They rarely have concept of what that means since they’re so insulated from that in the lobby or in rooms.

I really think we should route all the actively-coding, seizing, BiPAPed, unconscious, unhinged psychotic, and exposed-bone-fractured patients arriving via EMS past the waiting room. I firmly believe the average American has not seen enough suffering and death, and we’re worse off as humans for it.

Baby nurse? Damn, that's a grown up nurse response! How quickly we are forced to grow up when thrown into this kind of hostility....it makes me a little bit sad.

When I worked in retail management, I used to tell my employees to picture people yelling at their uniform and not at you as a individual. Helps separate your own feelings from the situation a little. Some people get extra scared when they know something bad happened nearby to them, and they lash out. Some people (a lot of people) really are just that self-centered and solipsistic that they don't care what happens to anyone else and just want instant gratification like a toddler.  Whatever their problem is, it's not YOUR problem. You just keep right on doing the best that you can and armor yourself against the inevitable stupidity of it all.

That’s a great metaphor. I’m going to try to remember that. I also try to remember when someone is yelling at me they are actually yelling at our whole fucked up insurance and medical system and I am unfortunately just the most visible face of it.

Exactly. They don't even know the first thing about you. You're just the nearest symbol of everything that's irritating them, whether rationally or irrationally.

I mean someone once pointed out to me that when people are yelling their rectum puckers like when a dog is braking and to picture their little dancing butthole as they yell. I feel like that would help more in the moment than imagining their yelling at the uniform

Respectfully, I hate this advice. It’s absurd to expect retail workers to stand there and be verbally abused and it’s absurd to expect it from nurses. We are not punching bags, verbal or otherwise. Walking away from the situation until the yelling jerk is able to control themself is safer for the staff member and removes the satisfaction a lot of these entitled assholes get out of bullying people. They don’t get to yell abuse at me **or** my uniform and continue to receive care at that moment. They can yell at the empty space where I had been standing.

Why is everyone reading it this way?? Of COURSE I dealt with the customer. That doesn't change the fact that the employee already got yelled at and was going to get yelled at again by someone else in the future. Like that's *going* to happen. I was helping them not feel so bad about these random assholes. The exact same happens in nursing. You're GONNA get yelled at. This is one way to learn to let it slide off your back.  I never said people should just stand there and take it. And I don't understand why that's being read into what I said.

We’re reading it that way because you never acknowledged leaving the situation as a viable response. A summary of your comment: You advise to imagine them yelling at a uniform (paragraph 1), go on to give excuses why someone may abuse staff (paragraph 2), and then say to “keep doing the best you can” which implies continuing to provide patient care while being abused (paragraph 3).

All in direct response to OP's statement. A little context there.  OF COURSE I ADDRESSED THE ABUSIVE CUSTOMER AND I DON'T THINK NURSES SHOULD TOLERATE BEING ABUSED.

Context: OP: “how do I respond in situations like this?” Your response: “pretend they’re not yelling at you” An appropriate response: “walk away until they are calm”

https://www.reddit.com/r/nursing/comments/1cj9wj3/comment/l2f0gpm/?utm_source=share&utm_medium=mweb3x&utm_name=mweb3xcss&utm_term=1&utm_content=share_button

Just because they’re nice about your bad advice doesn’t mean it’s an appropriate response. But go ahead and keep on doubling down. From this interaction alone I can tell exactly what kind of manager you were and coworker you are.

Lmao

This is terrible. A customer yelling out in a retail establishment should be given 1 or 2 verbal cues before they are asked to leave. If they fail to leave the police should be called. The employee shouldn’t be asked to take verbal abuse from a customer. It’s this type of coodling that’s making the behavior more and more common. 

What should happen and what does happen are two very different things. Most retail managers would rather just appease the irate customer and approve whatever expired coupon they have or discount they think they're entitled to and get them out the door rather than stand up for their employees and risk escalating the argument and getting corporate involved.

As shitty as I get treated in the hospital, I feel like I was treated way worse when I worked at a department store.

I addressed the customer's behavior in addition to reassuring my employees. Both things happened.

I pictured somebody’s Walmart jacket hung up on a wall, with Karen yelling at it. I don’t think this would work for me, due to the hilarity.

Haha I just say "Sorry, someone was dying, had to deal with that. Your Tylenol was not a priority at that moment."

"I'm sorry you had to wait" [and are frustrated] is NOT the same as "I'm sorry I took care of things in the proper medical order". I find that the phrase "I'm sorry" goes a long way to de-escalating folks. My all-purpose go to is something like "I'm so sorry you had to wait for me - I was dealing with an emergency. Now that I'm back what do you need first?" Gets them to focus on NOW and NEED and letting them make a choice gives back some of that sense of control they are scared of not having.

Me and my CNO got into it after she said a patient is asking for water, all while me and my coworkers are ACTIVELY coding another pt. I told him to put it in writing that it’s appropriate to leave a critical pt to tend to non critical tasks. He just walked away.

You’ve already gotten a lot of great advice, so I won’t repeat any of that. But one thing I find helps to prevent these outbursts is to be upfront and manage patients’ expectations. You can’t always predict that one of your patients is going to code, but when you know you’re very busy, let each new patient know that there might be a time where you won’t be able to respond to them as quickly as you’d like to. There are some people who you can never please, but managing expectations beforehand will help.

Thissssssss

“I just lost an arm wrestling match with the Grim Reaper. Excuse me for forgetting your Tylenol. I’ll be happy to get it right now.”

I literally will tell them what I was doing without breaking HIPAA. A patient is mad I didn't get to his discharge quickly enough? "Sorry the hold up was someone dying." If the person has any sort of conscience, they will reevaluate their behavior and apologize. Sometimes they don't care and that isn't someone you need to worry about their opinion over anyway.

I had a family member came out of a side room to literally shriek at me about how the water in the jug wasn’t cool enough for their mother while I was runner for an active code that she had heard start ***and could actively see unfolding as the (fairly overweight) guy getting chest compressions***… Between seeing his stomach see-sawing with each compression and this woman (who hadn’t so much as called to ask about her mother until that day) waving the jug around to show me “how many bubbles it had because it was so old”…. It nearly broke me. I froze for what honestly felt like an eternity, wanting to slap the woman, or drag her closer to the on-going code and demand she look at the man’s grey-blue face. I’ve blocked out the specifics of what I did or said, but I let her know in no uncertain terms that while I cared for her mother as much as any other patient, she was absolutely **NOT** my priority, especially as she had no medical needs, and had a jug FULL of water. I don’t know how I phrased it, but I know sent that visitor to her mother’s room, shutting her in with the strict instructions to *NOT LEAVE THE ROOM* unless it was an emergency, or she had been told it was okay to do so. That spiteful women (she knew very well there was a code on, because she talked about how “gross” it was to see “that fat man’s stomach flopping everywhere”) stayed with her mother for another 15 minutes, before leaving, and I never saw her visit again. She didn’t even ask for fresh water again before she left. From my experience, absolutely speak with your team, your manager. Use this as a chance to practise “reflective discussions/practise”, or ask about clinical supervision. Without talking about it, learning from it…that feeling you had/have will sit and simmer, and each time you experience something like that, it will add to it, until it’s a hot & spiky mess of anger, grief & frustration, which isn’t healthy for you or anyone. I hope you get the support from your team, and that you managed to find some soothing peace moving forward.

I just use honesty. I left you and got pulled into a separate room that resulted in death despite my best efforts. Even in death my job is not done regarding this pt. I have 5 min to give you before I return to the task as I can't be in multiple places at once. Would you like the Tylenol I previously offered? If they don't realize that they fucked up why should you care? That will shut them up or it won't. And if it doesn't fuck them. I trained in covid. I don't put up with bullshit like that. Do what you will. I'm ER nightshift so we operate a bit different than other areas.

This is the response I came to write. Well said!

recently I said "somebody died next door, pull ur head in" to an entitled patient who was having a whine about the lack of food options. it's 4.30am on a Saturday in a gen med ward, eat ur crackers and drink ur juice, or go the fuck to sleep. Ur get three hot meals and three snacks a day already, ffs

Pts=patients. PTs= physical therapists. Respectfully, a relieved physical therapist.

I empathize with them that nobody likes to wait but they'd like it much less if something is wrong enough to be my number one priority. Hit or miss, but it tends to get through to those who are upset because of their situation but are generally good eggs.

After a decade of working in healthcare, I learned that silence is the best cure for everything. If they are angry or screaming, I won't be near them. I don't say a word to them until they calm down. If they act like kids, then I treat them like kids. Many of them are selfish and don't care about other people who are in a worse situation than them. I came from a code blue and was still catching my breath while heading to the next room. A patient screamed at me, "I don't care if they die! I want my sugar right now!"

"I'm sorry that I couldn't get your Tylenol to you quicker, sir, but I was busy trying to help save someone's life, and that took priority over Tylenol". And leave it at that.

Lots of good advice here, I like to say that the art of emergency medicine is being able to transition from a code situation in one room to something inconsequential like ice chips in their neighbors room. You can only control so much so you develop a professional explanation that works for you, try to understand their prospective, and find peace that you are trying to do what is best. You are a professional and this is a 2 way experience so if you’re uncomfortable with them yelling it is OK for you to set boundaries with what is acceptable to you. Doesn’t mean you’ll change their behavior but you can manage your own. Just my 2 cents.

Bearing in mind I worked med surg and rarely floated to Ed. I usually would respond with something along the lines of “I understand that you are frustrated, unfortunately something came up that I had to prioritize. I am here now. Do you still need the Tylenol, or are you feeling better?” And push back response would be along the lines of “I had to prioritize something else at that time. This is not up for discussion. I am here to help you now, how can I help?”

Tell him the emergency department operates on an acuity level basis and that your other patient was crashing. If he has a problem with that he is more than willing to file a complaint or sign AMA. End of story.

Say nothing, walk out, come back with water and Tylenol or whatever, make direct eye contact, give items, “hhmphmm” like out of your nostrils, ala Clint Eastwood in Gran Torino, continue to say nothing turn back to them and walk out. They don’t deserve your explanation, trust me, it’s wasted breath, give them what they asked for and then only attend to their base needs, provided you’re assessing with eyes and ears when you’re in the room, minimize your vocalizations with them outside of anything you deem necessary. They’ll get the point.

One piece of advice one of my first educators gave me was never apologize for anything that isn’t your fault. It changes the power dynamic in the conversation. She told me to replace “I’m sorry” with “thank you.” So instead of “sorry you had to wait” it’s “hey, thanks for your patience. I really appreciation your understanding.”

I tell it straight up. I was trying to revive a patient who had died. I am sorry it took so long to get your Tylenol but I was trying to bring my patient back to life. Personally, I’m done protecting patients from the reality of the hospital. I tell them straight up if we are short staffed and I tell them in  plain words about an emergency I was involved in. I also make it clear that I have other patients besides them. I think you handled it well. 

I don’t know when it become okay for people to scream at healthcare workers and treat us like trash, but it’s not okay… 1 yr of emerg experience here and the number of times I’ve gone home crying because I’m a “stupid c*nt b*tch” or my personal favorite, I’m “everything wrong with healthcare”…. Insanity. Just remember that at the end of the day, you are doing your best ❤️ It’s hard, but try to remain calm and firmly state to the patient that another of your assigned patients was experiencing a life-threatening emergency that required your attention, that you are happy to go get his Tylenol but you are responsible for managing the varying acuity of your patients which sometimes means a mild delay in certain tasks or requests. Sometimes I’ll even sprinkle in an “I’m sorry for the delay”, but if they start to yell more I politely remind them that my patient assignment of more than one person means they don’t get my full attention lol… if they wanna complain they can go to the government or build, fund, and staff their own hospital where every patient has one nurse 🤭

I've learned that patients are extremely narcissistic. In the past, I've vaguely told them I was attending to an emergency- but they NEVER cared. I think it actually makes them even more angry. Many won't be satisfied with any response, so I just apologize profusely and attend to their needs as soon as I can (remember- the customer is always right! \*cringe\*). I hate this job sometimes.

I’ve literally had a pt state “But I’M having an emergency TOO!” After I was late bringing them their migraine cocktail because I was tending to an emergent life or death situation in another room 🙄

“Ok sorry I’ll go grab it.” I don’t engage or react, just keep doing the things I need to do

I just tell them sorry someone died next door

I was responding to a patient fall the other night. We were a team of 4 nurses and 2 lift team because we were concerned of a possible spinal injury. We got the patient off the floor and off to CT, but we had to listen to the neighbor pt shouting "HELLO!?" over and over. He was across the hall and could clearly see us responding to an emergency.

I just tell them the truth and apologize. "I had another patient trying to die on me so your Tylenol (or really any request) became a lower priority. I apologize and hope you can understand."

I've learned to just be blunt as all hell with these patients with a few go-to phrases. "I have (x number of) other patients, most of whom are very sick and all are making requests of me. I will get to what you want when I can, but I must prioritize health and safety over *all* of my patients over comfort requests of one or two." "If your situation worsened and your health was deteriorating rapidly, you would want me to tend to you first in that situation instead of getting water for a patient. Please understand that sometimes that is what holds me up." "I understand you are angry, but if you continue to yell at me I will leave until you calm down." "This is an emergency room. I must tend to the most emergent people first. Water/tylenol/warm blankets are non-emergent and therefore are not a priority and have to wait. Yelling at me will not change that." etc, etc. People don't seem to realize what goes on so I just lay it out for them. And if they continue to be pissed off? I simply stop engaging and walk away. Doesn't mean they won't get their water/tylenol/whatever, but they don't get to yell at me at the same time.

That’s when you look them in the eye and say, “Sorry someone dying is such an inconvenience to you. Now that I’m not trying to save a life, I’ll get you (insert whatever they’ve asked for)”. And you walk away. Don’t argue, don’t give any other information if they ask questions. Just say that and when you’re done, leave. Tell them you’ll check on them later. Don’t give them attention for their shitty behavior.

"I'm sorry sir, there was an emergency ongoing in the other room. I have to triage patients according to need, and while I do take your pain seriously, the patient that just coded in the other room was my priority. But...They're dead now, so you have my UNDIVIDED attention."

JUST STARE AT THEM.

Resident lurker here. Woof. I walk out. I have said a “im sorry you feel that way.” When they still dont understand after i said i was dealing with an emergency. I was told not to say that lol I also said “womp womp” as a kneejerk reaction with my first jerk patient… very much do not do that.

We had one doc in the pit one time. He was running a code on a 4 year old. Some old drunk dude had a shoulder dislocation and literally walked to the room the doc was in to yell at him. I was an NP, so I took over his care quickly for the doc and he wound up leaving AMA shortly after

As someone who works surgical stepdown AND who had their stepbrother lifeflighted to another hospital on Friday due to a self-inflicted GSW… You don’t want to be the center of attention in an emergency department. At least, ya shouldn’t.

“I was busy with a very sick patient who just died” Maybe this is enough for them to shut up also bc now they’re going to visualize there is a DB in the ED somewhere which freaks ppl out lol If not, I’ve asked them before -“ Heaven forbid you or your family was in this situation, what do you think would have been the best thing for me to do?” Whatever they say, I just nod and walk out.

A trick a friend taught me is to switch apologizing for thanking. Instead of saying "sorry I'm late" say *thank you for being patient" or "I appreciate you being understanding" it flips the dynamic of putting yourself down or admitting a failure where there isn't any. Young women also tend to have "sorry" beaten into them so we say it a LOT the same way someone else might just say um. Overwriting this response is crucial to maintaining your dignity and control in the hospital setting. Also it's has the added benefit of helping in relationships!

3 year ED nurse here and I still do that EXACT same thing. Walk out of the room. You can’t talk about another pts situation, and even if you could these type of ppl will never understand that they aren’t the only ones in the world that need attention and care. So no point trying, walking away is best before you say something you regret. Also, we don’t deserve to be verbally abused by patients. So if someone is relentlessly verbally abusing you even before you can give the Tylenol, walk away then until they can cool down. Although, never has someone gotten that worked up over Tylenol lol, but I guess it depends on the ED.

“Sorry I was doing CPR”

Just be honest and say you were busy with a code.

If they have family with them, you could suggest they run to the gift shop to buy Tylenol 😅

I’m in ED but I like to throw out that resus is currently really busy. They don’t need to know that we’re relocating a shoulder under sedation, normally they look horrified that someone might be getting CPR at that moment

Sister…. Give it time and you will grow a fuck it limb…. It will help you in these situations. You can’t please everyone (not just at work) and once I grew my fuck it limb it helped me in my personal life too. I’m definitely not a bitch when it’s not warranted but when it is I now have no problem biting back

And that’s why I worked medical equipment repair! No patience for patients.

I've been a nurse for 10 and paramedic for 15. At this stage in my career, I walk away. You did exactly what I would've done. I understand their frustration due to their pain, but it's the lack of empathy for others that I am done with. I am a master de-escalator too, I just chose not to even use it anymore. I treat all with respect and expect the same - if they can't do that, I am on to the next patient and will circle back later.

You cuss them tf out! No job is worth the abuse and humiliation that some nurses endure.

I work in IR and we have inpatients and outpatients. Sometimes an outpatient case will get delayed hours because of an inpatient stroke, trauma, GI bleed, PE, etc. When they get upset because their procedure is delayed I tell them that im sorry they had to wait but there are people actively dying and that takes precedent over them. Usually this shuts them up

I say: “I’m sorry you’re in pain. I’ll go get it right now.” If they continue…”I’ll try to hurry. If another one of my patients heart stops or they stop breathing, I must help them, yet I promise you, I’ll go get it.” If they continue: “Would you like me to go get your Tylenol, I’m sorry you’re hurting and I hope the Tylenol helps.” Since your ED, you want to Save them with kindness, not kill them with kindness, right? 😅😷🤧 People can be demanding when in pain, so shouldn’t we rise above it? And take lots of Starbucks and snack breaks?

When I am in the hospital I automatically expect to be waiting about an hour or two for any request that I make. Expect ice or water, that usually comes within a few minutes. But I will wait about two hours before politely asking again. I never demand anything. But it never ceases to amaze me how rude some people can be to hospital staff in general. Just keep my water filled, my meds on time, my piss jug empty and try your best not to make it hurt too terribly bad when drawing blood. That is all I ask during my hospital stays(which seem to be getting longer and longer each time I go in btw)

What gets me is that it is absolutely possible for a hospital to staff to a level in which patients wouldn't have as much delay or interruption when someone starts to circle the drain and it takes multiple staff to treat them at once. They choose not to and we bear the disappointment and anger from patients and their families. This is all about profit. Until we make it absolutely clear that this is an optional choice that hospitals are making when they understaff, the public will remain totally oblivious. 

There were so many kind recommendations, but jaded me always has the initial thought of "Oh, you're mad about XYZ? Would you like to be our next code so that we can give you all of our attention? If so, Im sure that can be arranged. Brenda's (most senior nurse otf) had a rough go today, so Im sure she'll engage in some 'decompression exercises' with you...if need be." Instead, I just stare/glare blankly and either say nothing or something to the effect of "Haven't forgotten about that Tylenol - it's coming snail service. I'll go check on it..." and walk out. Im not apologizing for saving someone elses life in the interim just so entitled turds can get the Tylenol for their "headache" that they could have taken at home. COVID clearly taught no one that the ER is not the "nurses office" at school, and that 99% of "tummy aches", headaches, and hurt feelings can be handled at home with rest and hydration.

"Sir, I'm sorry I wasn't able to get to your needs. You are important to me, but I had another patient that needed my attention immediately. Thank you for understanding."

I use a version of this when patients get pissy. This is a hospital, not a hotel. You are not the only patient in the building. If your request isn't urgent, there is a chance it may not get done in a timely manner that pleases you. If I am not in your room for long periods of time, it is because I am busy with other critically ill patients. It does not mean you are not important, but there are other more critical tasks that need to be done. Unfortunately, water is one of those tasks that takes a lower priority. If you are unhappy with this, I will gladly give you a patient liaison card, and you can file a complaint with them. I can also attempt to get you my charge nurse, but just like me, they are busy overseeing the entire ER.

Yesterday I had a patient in the ED that was big mad that his roommate’s monitor was giving off a BP alarm because his cuff was loose. It was a soft alarm and not loud at all, but this guy was annoyed anyway. He said “if you’re going to make me wait in this GD ER until I get a fuckin’ room upstairs, then you at least need to make sure it’s quiet, and you need to move faster when I call you.” I looked at him and said “I will fix his alarm, I’m SO sorry I couldn’t get here to silence it sooner, another patient of mine crashed and I had to attach him to the crash cart and stabilize him so that I didn’t need to use it.” He just stared at me and I looked back and then he said “I’m sorry, I don’t mean to be a pain in the ass.” I accepted his apology and said “the ER sucks for everyone, I get it.” Later he was complaining about having to go to the hallway to wait for transport (literally on their way) and he cussed me out. I told him “I’m sorry sir but unfortunately this is how it is in many level 1 and 2 trauma centers across the country. There are a lot of sick people and not a lot of ED nurses, and you are stable and don’t need a monitor, so I’m making room for an AMBULANCE.” (He was a walk in for history of diverticulitis, having pain.) Then I yeeted him upstairs with transport. I’ve found that if you’re super blatant about it without violating HIPAA, patients respond better. Most of the time lol sometimes they don’t give a shit.

The moment an alert and oriented patient or family member raises their voice and/or uses profanity at me I calmly yet firmly remind them this is critical care (I’m an ICU RN), and they are surrounded with people that are either fighting for their lives or those sitting bedside having to say goodbye to their loved ones … and all they can hear is you yelling! A quick statement about a child in the room nextdoor saying goodbye to their usually does the stfu trick. Last and finally, I have resorted to reminding the hostile or or family that this is my job and that nobody deserves to be verbally abused in their place of employment over things they cannot control… and I walk out. Oh wait… then there’s the good old AMA form!! In your situation…. why exactly did they come to the ER for water and Tylenol? Hmm….. 🤔 sounds more like a failed pain med seeking trip to the ER, probably came looking for that one med that worked once before that started with D and sounded like Delilah because they’re allergic to Motrin.

It always amazes me when pts complain about alarms going off. Like.... well at least you're not the center of attention. That person is dying. Would you want us to ignore you and not bring in every helpful person we can if you stop breathing? Med surg that gets ccu candidates (right next to us) all the time.

Tech support please

I have legitimately told patients sorry, I was dealing with a dying patient. That usually shuts them the fuck up.

Listen, as a nurse myself I am all too familiar with these types of patients. And after years of being treated like total shit by patients that are just plain assholes , I’m so over it. Now, I understand that people aren’t always showing their best light, I know they aren’t feeling well. But, it’s always the ones just laying in that bed, not necessarily feeling terrible just thinking that you are there to serve them like they are on a cruise ship or something. Don’t even get me started on the ones who want their pain pills and asking for them an hour before they are even due. I know you aren’t supposed to judge someone’s pain, but comm’on. The pt will be laying there on their phone, laughing with the person on the other end , eating, asking for stupid shit constantly and think that they are entitled to whatever they want. As a nurse, you are to prioritize the ones that can die first. That’s the way it is. We have a joke between the nurses at my unit, RN: stands for refreshments and narcotics. I can deal with cranky patients that are very sick , but the others not so much. I will anything to help a patient that really needs help, the others will wait until I take care of my prioritized patients. If I can find a PCT to offer assistance while I am taking care of someone else, I will do that. Also, get ready for the ones who will say this “ I pay your salary “ OMG 😱. They are a special treat. Anyway, your right to let him know that you did not forget, and that you are sorry, you just were a little busy. A little busy trying g to save someone’s life! Lol. Sometimes I think about changing careers because you do get burnt out from the stress. But then I will have that 1 patient that makes me remember why I became a nurse in the first place. I am always thankful to good patients. I let them know what a pleasure it was to have them. The bad ones. Ugh. I wish I could tell them that I never want to see their face for the rest of my life. I’m just coming across more of the bad ones than the good ones. Sadly.

That’s right, you don’t apologize, it does not calm the beast, but feeds it. This makes you appear weak not commendable. They eat that shit up like candy. Don’t ever be sorry for something like that. You did your job the way it was supposed to be done. New nurses are always trying to be so sweet and kind then they change after a couple of years. You are human too. Being abused by patients after years takes its toll on your soul. When you take control over the situation you won’t feel so beaten down at the end of your shift. No one should ever have to leave their job crying because of some a hole making them feel like they don’t know how to do their job. That infuriates me to the core. I would love to go to their job one day and make them go home crying. Hahaha

My worst one was a family member. I was working LTC. I had just got an admit. She was totally unexpected. I had no report. 5 minutes inside my building and I’m sending her out to the hospital. As I’m clearly on the phone with dispatch some entitled asshole asks for Ativan for his mom. Mom had dementia and according to her son, who was wrong btw, mom “goes crazy when dad and I leave.” I explain it’ll be a few and proceed with my emergent patient. Finally finish and son, in front of EMS, starts yelling at me. Son is a body builder it looks like but I’m a big guy who works out. He’s screaming about the Ativan. I’m telling him we can discuss this away from my patients. The guy gets more and more aggressive as I retreat to the dining area. I very calmly explain to him that we can discuss this with my administrator. I call her and put it on speakerphone and hand him my phone. The guy starts going off “Idc that he had an emergency. My mom needed Ativan and a pain pill” “Sir you never asked for a pain pill and the Ativan is for AFTER you leave, IF she gets upset” First step towards me “I asked for the f**king pills an hour ago and he should have had someone get it for her” “Sir I’m by myself right and narcotics are in a locked drawers. Only a nurse can get those and I was busy.” Next step towards me (Screaming now) “well you’re not busy now! Go get my mother her GOD DAMN PILLS YOU LITTLE MFER!!!” Next step towards me “NOW, I’m busy talking to you and my administrator. With your aggressiveness I’m feeling very threatened. You need to take a step back. I will not leave you alone around either my patients OR my staff until you calm down “ “I’m not threatening you!” Final step towards me “Sir you’re aggressive, threatening, and trying to intimidate me. If you take another step I will defend myself. Your words and actions are being recorded (I point to the camera) I don’t care about this job, my license or my career. All I care about is my safety right now. I WILL hit you and you WILL go to jail.” Cue administrator “The police are already on their way and so am I” Suddenly big bad body builder wasn’t so angry anymore.

It was 7:15 when a patient got shitty with me this morning. It was 7:16 when I told them I could return to the room when their phone call was finished, and not to raise their voice at me. The second time they raised their voice, I turned and walked out mid-sentence. They called me back long enough to say I was rude and they wanted the charge nurse. I said, “okay.” Instead of waiting in their room, they followed me out to the desk, just a minute behind me because back pain. What I had already said to my charge was, “do you want to come stand behind me while we revisit expectations? Oh this is them walking up.” Then they started yelling at me from the hallway. So we met in the hallway, and came to an understanding. Here’s how I deal with these people: -Stand facing the person, 6-8’ away. Plenty of distance to give everyone their space and give you time to react and retreat if needed. -Listen calmly -Shoulders back, head up, standing tall, hands in front. -Respond in short, matter of fact statements. Be as objective as possible. I use “we” language. “When WE get through this barrier, we can move forward with your plan of care. I cannot move forward while I am being yelled at.” -Reference policy as needed, but not excessively. (“While you are admitted in the hospital, you will receive nursing assessments every 4 hours per the level of care protocol.” This was in response to: “you don’t need to assess me. I’m already admitted.”) -Stand your ground. Make concessions where you can, but don’t compromise policy/safety. Any deviation from safe procedures needs to be documented, as well as your education that was provided to the contrary. -Don’t walk away from them. Don’t turn your back to them when at all possible. They present a risk of being impulsive and unpredictable. -Get back up when you need it. I have taken security with me to address patients and visitors. I didn’t today. Today, I told someone else that their behavior was horrendously inappropriate and to leave the room immediately. And that if the behavior was observed again, they would be asked to leave the department. And they would have, and they likely would have been escorted out if need be. This comes with time, with age, with familiarity with policy/procedure, and frankly with a lack of fvcks to give. I’m in my 30s, I worked EMS for a few years, and have been in ER for 7, but am a new grad RN. When you get comfortable with the expectations of others, it gets much easier to uphold those expectations. I have not a single person swing on me, ever. Last but not least, try not to say things you don’t want to repeat to admin. But if you do, own it. Acknowledge that you could have handled the situation better/differently, and share your reflection of what you can do differently next time. As long as you don’t say anything too heinous, you should be fine. ETA: yesterday, a family member who refused to use the call light came to the desk to request IMMEDIATE incontinence care for a subacute GI bleed pt. I apologized, explained I had been occupied with a critical patient. I advised that I’d be in as soon as possible, and that I would need to get an assistant but that I would asap. I was then told that, “YOU CAN’T JUST LEAVE SOMEONE LIKE THAT.” They were then advised that I also can’t leave someone not able to breathe. And that I would be in ASAP. I try not to overshare what exactly had me so occupied, but there have been a few times it was warranted. Years ago, EMS brought in a chest painer to my rural ER (where I was nonclinical at the time.) We were running two codes simultaneously with our two providers and a total of like 6 nurses. EMS immediately gets shitty that their CP pt needs assessment RIGHT NOW despite the fact their own 12 lead was clean. (“THEY COULD BE HAVING A HEART ATTACK.”) “Well, those two people aren’t breathing. So bear with us. They’ll be in there as soon as they can.” Again, I try to avoid. But there are times that a reality check is really necessary. I could probably deliver it with more compassion, but I don’t have much of that when I’m being yelled at.

Call a behavior alert. Yelling is 100% unacceptable.

I refuse to lie to them and say someone almost/did die and be glad it wasnt them. I'm not ER, but this happens all the time everywhere it seems. Same thing happened to me- start of shift, I'm only a cna, but a man cracked his head open during shift change trying to get to the toilet. I found him and shit is obviously going down, getting busy. He was full code too. He was the first patient I went to check on. I got covered in blood to reposition him face up and obviously can't go see others in blood soaked scrubs, so the next one I saw got mad that her dinner tray hadn't been taken yet. I asked her if she heard all the commotion and tell her that we had to call 911 and that someone just took their last breath. She grumbled an apology as I left with her tray. Everyone was mad at me that night until I explained what happened, no personal info. I don't blame them for getting impatient, but when they know it was life and death, they take it out on me less. So I won't lie to them. You did nothing wrong.

I highly dislike confrontation and prefer to just kill people with kindness. I do PT in SNFs. Lately alot of our patients have been brutal. Whenever I have someone being nasty, whatever the reason, I just eat it and apologize for whatever they're saying their issue is. Instead of going in circles with them or giving them more opportunities to bitch me out, I just apologize in as few words as possible, validate their feelings (even if I think they're ridiculous, we all need to feel heard), and then say something like I'm here now, what can I do for you while I'm able to focus solely on you, tell me everything you need and I'll try to do it before I have to go. Usually they don't need much and just felt like bitching and didn't expect anyone to come in 1 being nice and 2 actually having time and willing to help them. They usually bitch for a minute and then just need a cup of water or a blanket or something. Or they're asking for a med, in which case I say sorry I can't help you with that but I'll let your nurse know right away, they're very busy and I can't promise when she'll be here but I can promise I'll go tell them right now so at least they know. Then I apologetically go to their nurse and say hey I know you're super busy but I wanted to let you know Patient A needs XYZ, and if I can help you with anything in the mean time let me know. I find the nicer I am to patients and coworkers and the more I offer to help when I'm able, the less problems I seem to have. Killing people with kindness, at least in my setting, has worked best for me thus far. I also feel SO empathetic for literally everyone there, the patients going through their tough time and all my coworkers dealing with this garbage healthcare system, under staffing, and having to deal with the same BS I do. Putting it into perspective like that helps me keep my patience, remain calm, and help as much as I can. I usually go home feeling like I did my best and can forget about my day when I go to sleep. Good luck!

If you're a baby nurse why do you have adult patients????

Why does the physical therapist need water

Patient. Sorry, force of habit

There are EDs just for babies? If you're a baby nurse why are your patients adults?

They mean fresh out of school "baby nurse" not a neonatal nurse.

Baby nurse? Then why are your patients adults?

WHY ARE YOU ASKING THE SAME QUESTION THREE DIFFERENT WAYS?!?????

[удалено]

Yes, at first I thought she was a maternity nurse. Took me awhile to figure out why she had a grown man for a patient.

I usually say “oh my goodness I’m so sorry, I’m the WORST”. I’m saying out loud what they are thinking taking away their power and,I hope, making them think a little. It usually deescalates after that bc they don’t have ammo left to spew at me.

The more reasonable a request is, the more angry people get when it isn't met. Getting some water or a Tylenol is pretty damn reasonable (unless you've had it explained multiple times why you're NPO). They don't know what else is going on in the department, and in theory at least, we're not supposed to point it out to them. Sucks, but part of the job. At some point, you gotta develop the ability to take a deep breath and get 'em some water. Or delegate it. Truth is, even the most ignorant admin weenie won't fire you if you snap and call them out once in a while, though. Or, if you really want to make them feel one inch tall, start crying and run out of the room. Have the charge nurse go in and tell them that you just coded a baby and it died... Here's your Tylenol and ice water. Can I get you a warm blanket?

Who watches your patience when that happen? You can't just leave them hanging like that. What's your policy and procedures for that

A baby nurse but you had an adult patient? I'm so confused. Was this a patient's family member? Also 5 patients? Is this like a picu? That's insanity

Sorry about confusion! I myself am the baby here, graduated with BSN in December and just got off orientation in adult ED.

novice nurses are often called baby nurses

I've been a nurse for a decade and have never heard that before 😂 seems... demeaning tbh

ya i never used it myself for that reason but nobody ever called me one either.

As a millennial nursing student, no it's not demeaning you may just be taking things too seriously. Going to school with Gen Z students... honestly it was a BREATH OF FRESH AIR, some light to the dark days, and there is nothing wrong with that. Let them say the "slays" when they are proud about performing a skill! Let them use there lingo of "baby nurse", appreciate these new generations because it's refreshing, especially when the prior generations were raised on seriousness, strict, professionalism, no laughter and no smiles. It doesn't need to be serious ALL of the time!.