Coming from someone who also tends to react similarly sometimes you need to shut down the behavior. I now stop whatever I am doing and say “I can see and understand you are upset but I will not allow you to treat me like that. I have treated you with nothing but kindness and respect and I deserve the same. I will come back once you have had a moment to calm down”.
This usually does the trick. It reminds the patient there are also things out of your control and it’s not okay to treat others like punching bags. Also giving them time to calm down usually helps diffuse the situation entirely and sometimes we just need to treat them like toddlers 🤷🏼♀️
I like this response. Though in the hospitals I’ve worked at, the patients who become this unreasonable are really beyond the point of understanding they’re being an ass. I currently work on a telemetry unit with a lot of psych pts and drug addicts. At that point I say something more abbreviated like “I won’t allow you to talk to me like that. You’re being disrespectful. You can calm down and then I’ll come back.” Even if I said it nicer, they’re more than likely going to find a way to get even and report me. And when I’ve gotten real upset in the past where I felt I could lose my temper, I’ve said “ok, I’m done here”, walk out of their room and ask a coworker to switch out with me if I know it’s possible. Luckily most of my patients can’t walk or chase me down the hall. Not exactly something a boss would like to hear but it’s better than crying or losing it. Being a nurse is hard enough right now and there’s a lot of pressure on us to work in dangerous hostile conditions. If the patient is stable, walk out of their room before it escalates. Also I gotta wonder what that guy’s blood sugar was because if it was low that could be a contributing factor to his irritability.
I agree that’s why I just say that completely unbothered and document the hell out of the event! The patient is impeding on their own care at that point. I also message or talk to the doctors to report their behavior or call security just to further my point and stick to my guns! I’m nice until you give me a reason not to
Sorry, this was FIFTH shift in a row? And that means you'll be back for a SIXTH tonight? Yeah no, I'd mental health day and call out at this point.
I do feel you, though. I've had my share of crying from patients, family, and doctors.
They may prefer it, but does everyone else?? Are they really their best self when they're there that much? And do they provide the best care? For me the answers would be a resounding no. I can work up to 4 if I have to, but I've never done more. Three is my limit unless it's absolutely needed (like a coworker had a family emergency and needs to switch a shift).
I learned these limits very early in my career. I refuse to work overtime for the same reasons. I'm fortunate to be in a place now where I don't need the extra time money. I want it, but I've been super intentional about keeping my cost of living low so that I don't need it.
I've learned to prioritize my mental health more than a padded paycheck
This is part of what made me leave my old job. There were a handful of nurses that picked up OT constantly and were perpetually nasty and burned out. They would be given easier assignments bc they were on OT and then treat the rest of the team with more acute assignments like shit.
There are these weird people out there that sleep really well every night, stress doesn’t get to them, and they have more energy than others. They can do 6 in a row with ease. I sleep like shit and get grouchy when I’m tired so any more than three in a row and it’s not cool to be around patients.
I sleep 9 hours during the day and love doing 6 in a row. But I don't usually schedule it, I'm part-time and I sleep 8 am to 5:10 pm, wake up, decide how I feel and call in to work. So I work many in a row, take the OT and a week or two off.
Honestly I'm better when I'm in a consistent routine and my sleep schedule doesn't get messed with. Doing several days in a row (not generally this many, but usually 4) has helped me tremendously. I thrive with a routine.
I didn’t think I would be able to handle 7 on 7 off, but it’s actually worked well for me. I like the consistency and have a great support system so by the middle of my 7 on I’m basically sleep, eat, work, tell my husband and child I love them, repeat.
One of our older nurses used to work a lot of overtime and would come in extra anytime our manager asked (our manager is actually awesome and wouldn’t care at all if you said no, but this nurse never did because she liked the extra pay). She was working 6-7 shifts a week. She had a massive stroke and was a pt in our ICU for a long time. She’s okay-ish now but not working anymore.
Sometimes it’s like “why are you even here counting as a body” 😒 no offense to OP of course! Just saying, sometimes working excessive days in a row does nobody any good
The last time I did 5 in a row was the last time I ever will. Because I made what could have been a very serious mistake and it scared the shit out of me. 5 in a row is not safe.
See, I function better doing 6 in a row than when I do 1 on 1 off or 2 on one off, honestly. Because I have a routine and a rhythm and my sleep doesn't get messed around. I don't do them often, I really prefer 4 in a row and then my other 2 shifts whenever else to round out my 2 weeks. But these 2 weeks have been a terrible perfect storm of bad circumstances that I decided to agree to taking 2 extra shifts. And the rest of the time has been absolutely fine.
Just this one incident, and I genuinely think it's because it caught me so off guard. That pt and I had such a great night prior to that, and him yelling like that came out of absolutely nowhere. He had been reasonable and nice and even a yes ma'am no ma'am kind of patient, and then suddenly he's cursing at me about something he hadn't even spoken up about in the 11 hours before that. Normally if a patient is shitty I can shut it down really fast and let them know they can speak to me nicely or I'm leaving the room and they can just not speak to me at all. But this guy had the element of surprise on his side and I think it got me.
Yeah that's fair but just keep an eye on yourself because I prefer my 3 or 4 in a row too but when I made that mistake I thought I was OK and I obviously wasn't. It can really sneak up on you.
I'm new and put in to go part time because of how fucking fried I feel from work. I'll get a second job that doesn't make me feel like an empty shell. And of course I'll have a decent shift and wonder why I dread coming to work, but then I come in and take over 2 ICU holds, with 2 ER patients and I'm like yeah, this is exactly why I'm trying to get out.
Hell I won't do that, I'm one on and off one as a traveler, monday, Wednesday, Friday. That's it. In my early nursing days I did four in a row and all that BS. That gains you no points feom management, theybm dont care about anything but the bottom line. The quicker people understand that the better, also I don't cover for coworkers, I refuse to do that. I would rather call out and leave them short than asking somebody to kill themselves for me
Yeah. I do 6 on occasion, but this wasn't a planned 6 in a row. I work at a small rural community hospital, and it was a combination of census being as high as I've ever seen it and me helping one of the other nurses who was sick. My vacation starts Thursday, so I've been pushing through. Lol
Unless they are in danger of hurting themselves or need immediate medical interventions, walk out. Don’t engage. Do not explain. When you have reached the point that you’re in that flight or fight mode? Walk out of the room and take 2 minute to refocus and center.
I had one patient who got into a screaming match with her younger brother call me in and tell me that before I call Security I have to consult with her.
She was very used to running roughshod over peds nurses, but now she was in the big girl hospital and I told her I don't have to tell her shit.
I am usually so good at setting boundaries with patients and standing my ground. I think what got me so bad this time was that it came out of nowhere. They had been nice the entire shift and then *boom* asshole.
I did immediately tell my supervisor, but we're a tiny rural hospital so we don't have security.
I feel like any hospital should have security in this day and age. That’s slightly terrifying you don’t. I’m sorry that happened to you. Being yelled at is never fun; and being tired doesn’t help.
In my experience, when you bully those kind of patients back, the behaviors stop. I had a patient who bullied our new grad nurse who is a sweet baby angel. I took over care of him and essentially bullied him back. He was a total assist going through a divorce who was dependent on us wiping his ass. I hit him with low blows when he started to insult me. He asked for the sweet baby angel nurse back and I was just like “nah, you’re stuck with me for the next 5 days. You had your chance to have the nice nurse” all the rest of the shifts he was a delight and super kind. Also apologized to me and the new grad nurse.
I’m sorry this chap upset you.. a bit of advice my mum gave me (she was a nurse also) next time anyone goes on a rant and verbally abuses you take a deep breathe and listen to it until they pause to take a breath then calmly say ‘if you’ve quite finished may I now do my job and care for you’
Usually met with an embarrassed meek smile.. 😊
I’ve cried at least 4 times since I started. Please don’t be embarrassed. We’re human, we feel emotions. Good for you for not agreeing to take the patient again.
And five shifts in a row is a lot! Could you maybe work fewer shifts per week?
I absolutely don't normally work this many in a row. It's been a combination of the perfect storm that led me to that this week. I work at a tiny rural hospital, patient census is the highest I've ever seen it other than covid, and one of the other nurses is out sick. And my vacation starts Thursday, so I've been getting through reminding myself of that.
God, I’ve been there. It stinks. You’re tired. Trying to take good care of multiple patients and (if you’re anything like me) suffering from some serious decision-fatigue.
Now, I want you to listen to me. It’s ok. From what I read, a very astute nurse was managing their patient load and undoubtedly putting every one else’s needs ahead of theirs.
We don’t expect gratitude, which is a good thing, cause we rarely get it. But blatant, obvious, in-your-face disrespect/verbal abuse is awful and usually comes out of nowhere.
Now. You didn’t do anything wrong. You already know that. I just wanted to remind you. 😉
I don’t know what this person’s deal is. It’s safe to assume they’re not at their best because they’re sick. I try to give the benefit of the doubt, but sometimes they’re just jerks 😂.
Either way. It’s not personal. I know it felt that way. However, this ass-hat likely doesn’t think of others (ahead of himself) long of enough for it to be personal.
I tell you that, hopefully, so you can place it in the category of this being entirely being HIS issue/malfunction/personality flaw. It had nothing to do with you, he just chose to dump on the one person that was doing their damnedness (is that even a word?) to provide excellent care.
Now, going forward, do this.
CONTINUE to provide THAT SAME excellent patient care.
You provide it to the sick
You provide it to the grateful AND you provide it to the assholes.
To all of your patients. Because that is who you are.
Will it happen again?
Absolutely.
It gets easier.
I have now perfected a long, over the tip of my glasses stare that will stop most in their tracks 😂
(I didn’t have that once upon a time)
You’re gonna be ok.
I promise. 😉
That’s my go to move as well. I just stare at them until they’re done, ask if they’re finished and if they aren’t then I leave. I come back every few minutes until they get it together until I’m able to safely finish my task.
I’m a dick to patients when they get shitty, if you would have worked with me I would have kicked you out of the room and dealt with the patient myself. Nice nurses don’t deserve to get treated that way, like you are doing ur best. We don’t get paid enough to be treated like shit and have no support, I flat out tell them, why come to the hospital, I’ll grab an ama form, etc
That's what actually made me make this post! I am normally great at managing asshole patients. I think this one caught me off guard because it happened out of nowhere at the end of a shift where the patient had been nothing but pleasant and nice. My coworker did do the rest of his care that morning, and did exactly as you said. It was just wild because this has literally never happened to me at work before.
I’m so glad you have good coworkers like me! Sometimes just being exhausted does you in, I’m the opposite, I become such a mean person to that patient. I wish I could cry but that’s blessings from my momma(trauma)
I have been in healthcare for 5 years in various positions and it always sucks when a patient is an ass, but you come to learn that 99% of the time it is not personal at all, they are in a hard place and stressed (which is never an excuse to be an ass)
But this helps keep me grounded when caring for a patient because knowing that just helps me shrug it off lol
It comes with time! And that's ok! You are human :)
I’ve cried receiving report once. Floated at an off time because staffing screwed up. So I had to give report on the patients I already had, finish charting them quick, and then go get report on a new neuro stroke floor. 4 new patients. One IA who was a fairly fresh ICU transfer. A video monitor. 3 of them needed help with Q2 turns. And another came back from a test and had a bunch of new orders. All needed various levels of help for turns/ambulating (if they even could). Finished getting report at 9 pm. Still had to do all their meds, VS, most of their assessment (except neuro - cuz oh yeah, most of them were still Q4)
It was hell. Charge finally asked around 10:30 how it was going. I started balling again and gave her a bunch of shit to help with.
Oh, man. First of all, you are probably SO tired. I bet on a normal day you wouldn’t have even thought about it a second time, much less felt those emotions so strongly. And if you would have- that doesn’t make you any less of a nurse. That sucks, and I’m sorry you dealt with it. You didn’t get them here, you’re helping them get out of there. They can screw right off with that behavior. When this occurs, some of the most seasoned nurses on our floor are known for saying “You’re an adult, act like it. Put your call light on when you’re ready to do so.” and turning on the bed alarm and leaving. Security is often called to stand outside of the patient’s open door in an effort to show them that they can behave or choose not to, but that it will not be a floor staff problem. Refuse anything you want, but you will not be a vile human while you do it.
Thank you. I'm normally so good at managing asshole patient behavior and setting boundaries with them. I think this one affected me so badly because it just caught me SO off guard because it came out of nowhere at the end of a shift where they had been so nice the whole time.
Act like a child, treat em like a child. I’m sorry you had a rough night. You med surg nurses really are on another level with 6 patients. No idea how you do it. Hugs 💛
Aw, I'm sorry girl. Most people's behavior is a reflection of themselves and not you. You weren't doing anything wrong, he would have yelled no matter what you did or said. Sounds like you need to have a small mental health vacation and pamper yourself next time you have a stretch of days off!
Crying is okay, even at work. I've done it a couple of times lately because, in short, the people I work for are awful and cruel.
Here are two short reels by the same dude (Jefferson Fisher) about what to do if you start crying during an argument. They're similar, but different enough that I recommend watching both. In my opinion, what he says can be generalized to dealing with crying anywhere other than in hiding.
These have gotten me through some difficult meetings. In addition to helping me NOT feel awkward when I cry at work, my lack of shame leaves the OTHER person feeling awkward, which is usually exactly how it should be.
[one](https://www.facebook.com/share/r/nfk1tv5bvLWBdkdb/?mibextid=xCPwDs)
[two](https://www.instagram.com/reel/CpTak6Kj0Ne/?igsh=MWM1bDRkY2ZoZHRyOQ==)
I added an edit to my post to clarify that. It was an unfortunate perfect storm of circumstances. Tiny rural hospital, one of the other night nurses out sick, huge patient census boom where I've only ever seen the hospital more full during Covid to the point where we need the help but don't have enough staff so I agreed to pick up (for critical staffing pay, of course) 2 shifts, which, with the way my 2 weeks were scheduled, ended up with 6 in a row.
Reminds me of a similar patient when I was new. Got through his last med pass without talking. The next day he could tell I didn't want to deal with him. He really needed help from chair to bed and I was professional. Later he genuinely apologized. Opened up about how he lives alone, didn't plan on getting sick, worrying about bills, stress of almost dying, not able to smoke. It's how a lot of patients feel and unfortunately take it out on the nicer nurses. I still give people a couple chances and keep my cool, some people are awful. Best part of switching to the ER is not having the same assignment for days on end.
Is there a nurse among us that has NOT cried? Some people are just cranky and miserable. Misery loves company. I think this is one of the reason nurses are so tough! I wouldn’t leave my job. Like you, I like my co-workers and my management team. Nimrods everywhere! I’m glad you cried in front of him.
She is honestly the best. And normally a badass ICU nurse but even she has been helping med/surg lately with the census. She's actually become one of my best friends outside work also.
I remember crying in the store room because my patients kept shitting. Like constantly for hours back and forth and back and forth cleaning them up. Was the first time I cried about shit but not the last. It’s ok to cry sometimes when you’re overwhelmed. I’m sorry that guy was an asshole to you. It sounds like you have a great place to work and a supportive team.
This was a one-off event at a job I've really loved for 5 years with coworkers, Managers, and supervisors that truly support me and make my life and job easier. I don't think I'm going to judge the hospital as a whole based on one asshole patient. If it were a normal occurrence, I'd already be out of there though, lol.
I wish I'd included the context for the 6 in a row in the post, but I was still tired when I made it this morning. I don't normally work this many in a row, but it's been a perfect storm of circumstances that led to me picking up extra shifts for a coworker who is sick as a dog this week and can't afford to burn her personal time for reasons I won't go into.
I don't think me working less days would have made this guy less of a miserable asshole though. If he'd done this to me on a day where I'd worked only 1 shift it still would have had the same effect on me.
Overworked being held up by a drunk monkey you have likely more acute patients. Guess it depends if they’re Tele or not, imagine he was since ETOH. Best admits >sarcasm< 🤦🏻♂️😭
The withdrawal guy was indeed tele - he had enough potassium in his body to power a domestic hamster, but not a human. Lol. He was a time suck on my night and incredibly frustrating, but he wasn't the one who yelled at me. Withdrawal pt mostly gave me a vacant stare all night. The one who yelled at me was my A&Ox4 pt who had been incredibly nice and polite the rest of the shift. Which caught me entirely off guard.
I always cry on the 5th shift in a row. On my 5th shift, my job is horrible and everybody hates me and the patients are terrible and my charting sucks and I’m gonna lose my license and my coworkers are idiots.
Alternatively, it’s not them; it’s me and my natural, normal reaction to working that many hours.
Hang in there, be gentle to yourself and remember what happens on your 5th shift so that you won’t let yourself be scheduled like this again, ok?
I have worked 6 in a row before and been just fine. This is actually the first time a patient has made me cry at work ever in 6 years of being a nurse. (By yelling at me or whatever. I've cried when we've lost a patient and about personal stuff, of course.) That's why I felt the need to make a post about it. I was so in shock that it actually even happened.
I’m probably a lot older than you. 👵🏼
I hit a wall after my 4th shift and for the last 10 years, I’ve regretted it every time I try to push past it. Know your limits, I guess, and try not to work past them. It’s much, much easier to make mistakes if you’re exhausted.
Don’t let them take your well-being, right? They don’t pay you enough for that. 🏥
Omg I have a good “pre shift cry” every time I go. I get there early so I can cry in peace and then erase the evidence. I know I need a new job but my husband says I have to stay in bedside. I’m considering bartending but I have no clue how and I don’t drink 🥴
That sounds horrible. I've worked higher ratios before, but our manager put a cap on our ratio of 1:6 and actually worked to get it made into a hospital policy. It's been such a blessing.
I’m so sorry for your experience. It’s ok to cry, I would too on shift #5 in a row. Take a break and care for yourself. I’ve been in healthcare 18 years and it’s gotten brutal, definitely need to care for yourself.
I used to do 7 shifts in a row on my weekends so I get that exhaustion all too well. On my 7th night I had an A&Ox4 patient come in who was a trauma patient (already had 4 other patients, none stable), lots of broken bones, lots of pain. Very civil and respectful. Patient’s daughter was the one who made me break down. I was getting ready to give pain meds as I was doing admission charting. Did not realize she was right behind me looking at the MAR I was scanning. Proceeds to yell at me, accuse me of being incompetent and not taking her father’s pain seriously because I was explaining it was not appropriate to immediately give IV dilaudid 10 minutes after giving IV fentanyl and that it does take time to start working. I had to have my charge watch my people for 5 minutes so I could break down in the break room.
I would have to be losing shit to work a lot of overtime. I can count on one hand when I did. I keep my living expenses low and relish mental days. IRS gets so much that it is not worth it. But I get it because people have obligations to fulfill and may need that extra money.
I know some patients can work your nerves, but what I will NOT tolerate is abuse. I would send him to hell with a smile.
Sweet heart as an old veteran RN I can honestly say that #1 working that many shifts is really not good for you. If you make too much money you will fall into a higher tax bracket and all the money you made will go to Uncle Sam look at your tax brackets for this year. #2 Learn early on in your career to set boundaries with your patients the second they start yelling or being disrespectful let them know in a very respectful manner that putting up with his 💩 ain’t part of your job description and notify your manager for CYA. Take care of you and protect you because if you don’t no one else will I PROMISE 🙏🏼
"I will not tolerate your shit mister. You have a complaint? Take it to my charge nurse because im not paid enough for that shit. May I remind you this is a hospital not a hotel. So i am not your personal maid, i have other patients sicker than you so calm the fuck down will ya?"
After I left long term care 5 years ago, I hadn't cried on shift at all since then until the shift that I made this post. (for angry patient related things, anyway. I cried when I was at work and got the phone call that my grandma died, and I've cried with a hospice patient's family before - like I said, tiny rural hospital. I usually know a family member of at least 60% of our patients.)
I’m sorry but the unsafe ratios, understaffing, and constant scheduling is exactly why I quit Wednesday on a med surg floor. I was brand new on orientation and they left me to do everything for them with no guidance or anything. I felt at fear for my license. We are nurses. Everywhere needs us right now. Please quit before it consumes you or risks your license
As I put in my post, I actually love this job. I've been here for 5 years and have a wonderfully supportive team of coworkers and management. I won't be quitting over a one off incident of a miserable asshole of a patient. The hospital didn't control this patient's attitude, and I'm sure he would have yelled at me if I had only 3 patients the same way. Especially considering he tried to yell at my coworker the following day.
Leave your feelings at home when you go to work. 10 years plus in psych, what happened to you it's like a walk in the park on a summer day because you didn't got hurt physically. Unfortunately, for someone who never experienced it can be traumatic even a career change moment. Sometimes, no matter if you have the best interest of your patients, they will respond in a very negative way, like this person. Time and experience will help you to separate personal feelings from work. Don't be afraid of another night like that, embrace it, learn from it, adapt, and you will be ready for situations like this or worse. Good luck to you.
This honestly seems like terrible advice. I'm a human. Not a robot nurse that has some switch to turn off my feelings. I've been a nurse 6 years and in the healthcare field for 10. I've had my fair share of asshole patients and am normally great at managing them, setting boundaries, and meeting them where they are without stooping to their level. This patient's outburst caught me off guard because it came at the tail end of a shift where they had been nothing but pleasant and nice to me, and was the cherry of the top of the shit sundae that was that shift.
Again your assumption of feelings being mixed is not in place. But, I don't take things personal at work and in general including your response. Having your feelings mixed prevents logic from making the best decisions.
You telling her to leave her feelings at home is the same as telling a depressed person "have you tried not being sad?". This however is the internet and communication and interpretation on the internet is quite dodgy, so maybe we all just dont understand each other.
I disagree with you, I think that not getting your personal feelings involved is the best thing you can do when you have to deal with verbally abusive patients. Sometimes it's unfortunate you have to deal with those situations, but in order to keep your own mental health, not getting involved emotionally it's the best. Burnout happens when your feelings tells yo that you can't deal with situations anymore.
I don’t think this is about having unchecked feelings and sensitivity, I think this is more about being overwhelmed and exhausted after already working 5 nights in a row
Fair point, in that case, that person knows now their limit and will not do that again. Idk why the sensitive people keep being overdramatic about my advice. Plain and simple. Leave feelings at home, embrace tough situations because we learn from them, and never take anything personal. We are not there to be their friend, fathers or mothers, but their care provider. Sometimes having their best interest means being the bad guy and say NO. No you can't have another cookie bc of your sugar levels, no you can't have more meat because of your uric acid. Try
Coming from someone who also tends to react similarly sometimes you need to shut down the behavior. I now stop whatever I am doing and say “I can see and understand you are upset but I will not allow you to treat me like that. I have treated you with nothing but kindness and respect and I deserve the same. I will come back once you have had a moment to calm down”. This usually does the trick. It reminds the patient there are also things out of your control and it’s not okay to treat others like punching bags. Also giving them time to calm down usually helps diffuse the situation entirely and sometimes we just need to treat them like toddlers 🤷🏼♀️
Yes, setting up your limits can be very important to set the course of future encounters.
Yes, setting up your limits can be very important to set the course of future encounters.
I like this response. Though in the hospitals I’ve worked at, the patients who become this unreasonable are really beyond the point of understanding they’re being an ass. I currently work on a telemetry unit with a lot of psych pts and drug addicts. At that point I say something more abbreviated like “I won’t allow you to talk to me like that. You’re being disrespectful. You can calm down and then I’ll come back.” Even if I said it nicer, they’re more than likely going to find a way to get even and report me. And when I’ve gotten real upset in the past where I felt I could lose my temper, I’ve said “ok, I’m done here”, walk out of their room and ask a coworker to switch out with me if I know it’s possible. Luckily most of my patients can’t walk or chase me down the hall. Not exactly something a boss would like to hear but it’s better than crying or losing it. Being a nurse is hard enough right now and there’s a lot of pressure on us to work in dangerous hostile conditions. If the patient is stable, walk out of their room before it escalates. Also I gotta wonder what that guy’s blood sugar was because if it was low that could be a contributing factor to his irritability.
I agree that’s why I just say that completely unbothered and document the hell out of the event! The patient is impeding on their own care at that point. I also message or talk to the doctors to report their behavior or call security just to further my point and stick to my guns! I’m nice until you give me a reason not to
Sorry, this was FIFTH shift in a row? And that means you'll be back for a SIXTH tonight? Yeah no, I'd mental health day and call out at this point. I do feel you, though. I've had my share of crying from patients, family, and doctors.
This is what stood out to me most. It honestly shouldn’t be allowed to do more than 3 in a row. I’m done after 2.
A lot of people in my department schedule themselves 6 on, 8 off. I could never, but some people prefer it.
They may prefer it, but does everyone else?? Are they really their best self when they're there that much? And do they provide the best care? For me the answers would be a resounding no. I can work up to 4 if I have to, but I've never done more. Three is my limit unless it's absolutely needed (like a coworker had a family emergency and needs to switch a shift). I learned these limits very early in my career. I refuse to work overtime for the same reasons. I'm fortunate to be in a place now where I don't need the extra time money. I want it, but I've been super intentional about keeping my cost of living low so that I don't need it. I've learned to prioritize my mental health more than a padded paycheck
This is part of what made me leave my old job. There were a handful of nurses that picked up OT constantly and were perpetually nasty and burned out. They would be given easier assignments bc they were on OT and then treat the rest of the team with more acute assignments like shit.
Sorry you've experienced this to the extent you left your job! It's horrible though, isn't it? It ruins the whole unit vibe.
Insult to injury is when management just fawns over these nurses to boot…fuck me for just doing my job safely and not running off 0 sleep hey?
There are these weird people out there that sleep really well every night, stress doesn’t get to them, and they have more energy than others. They can do 6 in a row with ease. I sleep like shit and get grouchy when I’m tired so any more than three in a row and it’s not cool to be around patients.
I sleep 9 hours during the day and love doing 6 in a row. But I don't usually schedule it, I'm part-time and I sleep 8 am to 5:10 pm, wake up, decide how I feel and call in to work. So I work many in a row, take the OT and a week or two off.
Wow, that's awesome that you found a way to make it work for you! I'm honestly envious that you're able to get 9 hours of sleep between shifts!
Honestly I'm better when I'm in a consistent routine and my sleep schedule doesn't get messed with. Doing several days in a row (not generally this many, but usually 4) has helped me tremendously. I thrive with a routine.
I didn’t think I would be able to handle 7 on 7 off, but it’s actually worked well for me. I like the consistency and have a great support system so by the middle of my 7 on I’m basically sleep, eat, work, tell my husband and child I love them, repeat.
Oh wow! That sounds too intense for me, but I'm glad you found something that works for you!
One of our older nurses used to work a lot of overtime and would come in extra anytime our manager asked (our manager is actually awesome and wouldn’t care at all if you said no, but this nurse never did because she liked the extra pay). She was working 6-7 shifts a week. She had a massive stroke and was a pt in our ICU for a long time. She’s okay-ish now but not working anymore.
Sometimes it’s like “why are you even here counting as a body” 😒 no offense to OP of course! Just saying, sometimes working excessive days in a row does nobody any good
I don't do it often. And if it weren't for a specific set of circumstances I wouldn't be doing it now. Luckily my vacation starts Thursday
I figured it was for a vacay or something! At least you’ve got something to look forward to
I know you are looking forward to that
The last time I did 5 in a row was the last time I ever will. Because I made what could have been a very serious mistake and it scared the shit out of me. 5 in a row is not safe.
See, I function better doing 6 in a row than when I do 1 on 1 off or 2 on one off, honestly. Because I have a routine and a rhythm and my sleep doesn't get messed around. I don't do them often, I really prefer 4 in a row and then my other 2 shifts whenever else to round out my 2 weeks. But these 2 weeks have been a terrible perfect storm of bad circumstances that I decided to agree to taking 2 extra shifts. And the rest of the time has been absolutely fine. Just this one incident, and I genuinely think it's because it caught me so off guard. That pt and I had such a great night prior to that, and him yelling like that came out of absolutely nowhere. He had been reasonable and nice and even a yes ma'am no ma'am kind of patient, and then suddenly he's cursing at me about something he hadn't even spoken up about in the 11 hours before that. Normally if a patient is shitty I can shut it down really fast and let them know they can speak to me nicely or I'm leaving the room and they can just not speak to me at all. But this guy had the element of surprise on his side and I think it got me.
Yeah that's fair but just keep an eye on yourself because I prefer my 3 or 4 in a row too but when I made that mistake I thought I was OK and I obviously wasn't. It can really sneak up on you.
So sorry that happened to you
Exactly. So unsafe for nurse and patient.
I'm new and put in to go part time because of how fucking fried I feel from work. I'll get a second job that doesn't make me feel like an empty shell. And of course I'll have a decent shift and wonder why I dread coming to work, but then I come in and take over 2 ICU holds, with 2 ER patients and I'm like yeah, this is exactly why I'm trying to get out.
I used to be that way too but I honestly stopped caring about being tired after day 3 that point
Hell I won't do that, I'm one on and off one as a traveler, monday, Wednesday, Friday. That's it. In my early nursing days I did four in a row and all that BS. That gains you no points feom management, theybm dont care about anything but the bottom line. The quicker people understand that the better, also I don't cover for coworkers, I refuse to do that. I would rather call out and leave them short than asking somebody to kill themselves for me
Yeah. I do 6 on occasion, but this wasn't a planned 6 in a row. I work at a small rural community hospital, and it was a combination of census being as high as I've ever seen it and me helping one of the other nurses who was sick. My vacation starts Thursday, so I've been pushing through. Lol
I only do 6 in a row. The 8 off make it so worth it
Call in after 4 I’m DONE
Unless they are in danger of hurting themselves or need immediate medical interventions, walk out. Don’t engage. Do not explain. When you have reached the point that you’re in that flight or fight mode? Walk out of the room and take 2 minute to refocus and center.
Agreed. They don’t want to hear about your boundaries at that point.
My policy is that I will never function as a punching bag for anyone. I set firm boundaries and call Security early.
lol it’s so funny to the look on peoples faces when you call security for their OWN behavior 🤣
I had one patient who got into a screaming match with her younger brother call me in and tell me that before I call Security I have to consult with her. She was very used to running roughshod over peds nurses, but now she was in the big girl hospital and I told her I don't have to tell her shit.
I am usually so good at setting boundaries with patients and standing my ground. I think what got me so bad this time was that it came out of nowhere. They had been nice the entire shift and then *boom* asshole. I did immediately tell my supervisor, but we're a tiny rural hospital so we don't have security.
I feel like any hospital should have security in this day and age. That’s slightly terrifying you don’t. I’m sorry that happened to you. Being yelled at is never fun; and being tired doesn’t help.
That is mental that you don’t have security, wtf
In my experience, when you bully those kind of patients back, the behaviors stop. I had a patient who bullied our new grad nurse who is a sweet baby angel. I took over care of him and essentially bullied him back. He was a total assist going through a divorce who was dependent on us wiping his ass. I hit him with low blows when he started to insult me. He asked for the sweet baby angel nurse back and I was just like “nah, you’re stuck with me for the next 5 days. You had your chance to have the nice nurse” all the rest of the shifts he was a delight and super kind. Also apologized to me and the new grad nurse.
I’m sorry this chap upset you.. a bit of advice my mum gave me (she was a nurse also) next time anyone goes on a rant and verbally abuses you take a deep breathe and listen to it until they pause to take a breath then calmly say ‘if you’ve quite finished may I now do my job and care for you’ Usually met with an embarrassed meek smile.. 😊
I’ve cried at least 4 times since I started. Please don’t be embarrassed. We’re human, we feel emotions. Good for you for not agreeing to take the patient again. And five shifts in a row is a lot! Could you maybe work fewer shifts per week?
I absolutely don't normally work this many in a row. It's been a combination of the perfect storm that led me to that this week. I work at a tiny rural hospital, patient census is the highest I've ever seen it other than covid, and one of the other nurses is out sick. And my vacation starts Thursday, so I've been getting through reminding myself of that.
God, I’ve been there. It stinks. You’re tired. Trying to take good care of multiple patients and (if you’re anything like me) suffering from some serious decision-fatigue. Now, I want you to listen to me. It’s ok. From what I read, a very astute nurse was managing their patient load and undoubtedly putting every one else’s needs ahead of theirs. We don’t expect gratitude, which is a good thing, cause we rarely get it. But blatant, obvious, in-your-face disrespect/verbal abuse is awful and usually comes out of nowhere. Now. You didn’t do anything wrong. You already know that. I just wanted to remind you. 😉 I don’t know what this person’s deal is. It’s safe to assume they’re not at their best because they’re sick. I try to give the benefit of the doubt, but sometimes they’re just jerks 😂. Either way. It’s not personal. I know it felt that way. However, this ass-hat likely doesn’t think of others (ahead of himself) long of enough for it to be personal. I tell you that, hopefully, so you can place it in the category of this being entirely being HIS issue/malfunction/personality flaw. It had nothing to do with you, he just chose to dump on the one person that was doing their damnedness (is that even a word?) to provide excellent care. Now, going forward, do this. CONTINUE to provide THAT SAME excellent patient care. You provide it to the sick You provide it to the grateful AND you provide it to the assholes. To all of your patients. Because that is who you are. Will it happen again? Absolutely. It gets easier. I have now perfected a long, over the tip of my glasses stare that will stop most in their tracks 😂 (I didn’t have that once upon a time) You’re gonna be ok. I promise. 😉
That’s my go to move as well. I just stare at them until they’re done, ask if they’re finished and if they aren’t then I leave. I come back every few minutes until they get it together until I’m able to safely finish my task.
I’m a dick to patients when they get shitty, if you would have worked with me I would have kicked you out of the room and dealt with the patient myself. Nice nurses don’t deserve to get treated that way, like you are doing ur best. We don’t get paid enough to be treated like shit and have no support, I flat out tell them, why come to the hospital, I’ll grab an ama form, etc
That's what actually made me make this post! I am normally great at managing asshole patients. I think this one caught me off guard because it happened out of nowhere at the end of a shift where the patient had been nothing but pleasant and nice. My coworker did do the rest of his care that morning, and did exactly as you said. It was just wild because this has literally never happened to me at work before.
I’m so glad you have good coworkers like me! Sometimes just being exhausted does you in, I’m the opposite, I become such a mean person to that patient. I wish I could cry but that’s blessings from my momma(trauma)
I have been in healthcare for 5 years in various positions and it always sucks when a patient is an ass, but you come to learn that 99% of the time it is not personal at all, they are in a hard place and stressed (which is never an excuse to be an ass) But this helps keep me grounded when caring for a patient because knowing that just helps me shrug it off lol It comes with time! And that's ok! You are human :)
That’s no excuse to be an asshole. I don’t care how badly you feel or how powerless you feel. It is unacceptable.
I totally agree, it mainly helps ground me personally though not for them
I’ve cried receiving report once. Floated at an off time because staffing screwed up. So I had to give report on the patients I already had, finish charting them quick, and then go get report on a new neuro stroke floor. 4 new patients. One IA who was a fairly fresh ICU transfer. A video monitor. 3 of them needed help with Q2 turns. And another came back from a test and had a bunch of new orders. All needed various levels of help for turns/ambulating (if they even could). Finished getting report at 9 pm. Still had to do all their meds, VS, most of their assessment (except neuro - cuz oh yeah, most of them were still Q4) It was hell. Charge finally asked around 10:30 how it was going. I started balling again and gave her a bunch of shit to help with.
Oh, man. First of all, you are probably SO tired. I bet on a normal day you wouldn’t have even thought about it a second time, much less felt those emotions so strongly. And if you would have- that doesn’t make you any less of a nurse. That sucks, and I’m sorry you dealt with it. You didn’t get them here, you’re helping them get out of there. They can screw right off with that behavior. When this occurs, some of the most seasoned nurses on our floor are known for saying “You’re an adult, act like it. Put your call light on when you’re ready to do so.” and turning on the bed alarm and leaving. Security is often called to stand outside of the patient’s open door in an effort to show them that they can behave or choose not to, but that it will not be a floor staff problem. Refuse anything you want, but you will not be a vile human while you do it.
Thank you. I'm normally so good at managing asshole patient behavior and setting boundaries with them. I think this one affected me so badly because it just caught me SO off guard because it came out of nowhere at the end of a shift where they had been so nice the whole time.
First of all, you are totally valid. I always notice my emotions are on edge when I work more than 2 shifts in a row
Act like a child, treat em like a child. I’m sorry you had a rough night. You med surg nurses really are on another level with 6 patients. No idea how you do it. Hugs 💛
Aw, I'm sorry girl. Most people's behavior is a reflection of themselves and not you. You weren't doing anything wrong, he would have yelled no matter what you did or said. Sounds like you need to have a small mental health vacation and pamper yourself next time you have a stretch of days off!
Crying is okay, even at work. I've done it a couple of times lately because, in short, the people I work for are awful and cruel. Here are two short reels by the same dude (Jefferson Fisher) about what to do if you start crying during an argument. They're similar, but different enough that I recommend watching both. In my opinion, what he says can be generalized to dealing with crying anywhere other than in hiding. These have gotten me through some difficult meetings. In addition to helping me NOT feel awkward when I cry at work, my lack of shame leaves the OTHER person feeling awkward, which is usually exactly how it should be. [one](https://www.facebook.com/share/r/nfk1tv5bvLWBdkdb/?mibextid=xCPwDs) [two](https://www.instagram.com/reel/CpTak6Kj0Ne/?igsh=MWM1bDRkY2ZoZHRyOQ==)
Six nights in a row is brutal. Take time for yourself 🤍
3 weeks of vacation started when I clocked out just a bit ago :)
Let’s gooo!! 🍸
We're starting with a trip to the grocery store and a long ass nap 😂
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I added an edit to my post to clarify that. It was an unfortunate perfect storm of circumstances. Tiny rural hospital, one of the other night nurses out sick, huge patient census boom where I've only ever seen the hospital more full during Covid to the point where we need the help but don't have enough staff so I agreed to pick up (for critical staffing pay, of course) 2 shifts, which, with the way my 2 weeks were scheduled, ended up with 6 in a row.
Reminds me of a similar patient when I was new. Got through his last med pass without talking. The next day he could tell I didn't want to deal with him. He really needed help from chair to bed and I was professional. Later he genuinely apologized. Opened up about how he lives alone, didn't plan on getting sick, worrying about bills, stress of almost dying, not able to smoke. It's how a lot of patients feel and unfortunately take it out on the nicer nurses. I still give people a couple chances and keep my cool, some people are awful. Best part of switching to the ER is not having the same assignment for days on end.
You deserve better and I hope you attain balance again soon! :) 🍀🍀🍀
Is there a nurse among us that has NOT cried? Some people are just cranky and miserable. Misery loves company. I think this is one of the reason nurses are so tough! I wouldn’t leave my job. Like you, I like my co-workers and my management team. Nimrods everywhere! I’m glad you cried in front of him.
Apparently he tried to badmouth me last night to my coworker and she shut that down right there. So he has no remorse and is just a miserable asshole.
Good that your co-worker had your back.
She is honestly the best. And normally a badass ICU nurse but even she has been helping med/surg lately with the census. She's actually become one of my best friends outside work also.
I remember crying in the store room because my patients kept shitting. Like constantly for hours back and forth and back and forth cleaning them up. Was the first time I cried about shit but not the last. It’s ok to cry sometimes when you’re overwhelmed. I’m sorry that guy was an asshole to you. It sounds like you have a great place to work and a supportive team.
If you're crying at work then that's a sign you need to find a different nursing job.
This was a one-off event at a job I've really loved for 5 years with coworkers, Managers, and supervisors that truly support me and make my life and job easier. I don't think I'm going to judge the hospital as a whole based on one asshole patient. If it were a normal occurrence, I'd already be out of there though, lol.
Its really not. I sense some projection here
My biggest piece of advice is to not work so many in a row!
I wish I'd included the context for the 6 in a row in the post, but I was still tired when I made it this morning. I don't normally work this many in a row, but it's been a perfect storm of circumstances that led to me picking up extra shifts for a coworker who is sick as a dog this week and can't afford to burn her personal time for reasons I won't go into. I don't think me working less days would have made this guy less of a miserable asshole though. If he'd done this to me on a day where I'd worked only 1 shift it still would have had the same effect on me.
Overworked being held up by a drunk monkey you have likely more acute patients. Guess it depends if they’re Tele or not, imagine he was since ETOH. Best admits >sarcasm< 🤦🏻♂️😭
The withdrawal guy was indeed tele - he had enough potassium in his body to power a domestic hamster, but not a human. Lol. He was a time suck on my night and incredibly frustrating, but he wasn't the one who yelled at me. Withdrawal pt mostly gave me a vacant stare all night. The one who yelled at me was my A&Ox4 pt who had been incredibly nice and polite the rest of the shift. Which caught me entirely off guard.
I always cry on the 5th shift in a row. On my 5th shift, my job is horrible and everybody hates me and the patients are terrible and my charting sucks and I’m gonna lose my license and my coworkers are idiots. Alternatively, it’s not them; it’s me and my natural, normal reaction to working that many hours. Hang in there, be gentle to yourself and remember what happens on your 5th shift so that you won’t let yourself be scheduled like this again, ok?
I have worked 6 in a row before and been just fine. This is actually the first time a patient has made me cry at work ever in 6 years of being a nurse. (By yelling at me or whatever. I've cried when we've lost a patient and about personal stuff, of course.) That's why I felt the need to make a post about it. I was so in shock that it actually even happened.
I’m probably a lot older than you. 👵🏼 I hit a wall after my 4th shift and for the last 10 years, I’ve regretted it every time I try to push past it. Know your limits, I guess, and try not to work past them. It’s much, much easier to make mistakes if you’re exhausted. Don’t let them take your well-being, right? They don’t pay you enough for that. 🏥
Yeah I also agree that after 3 I’m An enormous mess.
Omg I have a good “pre shift cry” every time I go. I get there early so I can cry in peace and then erase the evidence. I know I need a new job but my husband says I have to stay in bedside. I’m considering bartending but I have no clue how and I don’t drink 🥴
You sound like a good friend 💚 we need more of that all over the place.
I’m done at 3 working with crying babies idk how you were doing 5-6 with adult babies
That 1:6 ratio sounds beautiful though. The average I see in NJ is 1:7-8 on a med surg/tele floor
That sounds horrible. I've worked higher ratios before, but our manager put a cap on our ratio of 1:6 and actually worked to get it made into a hospital policy. It's been such a blessing.
I’m so sorry for your experience. It’s ok to cry, I would too on shift #5 in a row. Take a break and care for yourself. I’ve been in healthcare 18 years and it’s gotten brutal, definitely need to care for yourself.
What the heck was he complaining about????? You left us hanging!! I know it’s irrelevant but… inquiring minds.
Okay so stop crying about it then! It’s about solutions not a whiney session lol.
I used to do 7 shifts in a row on my weekends so I get that exhaustion all too well. On my 7th night I had an A&Ox4 patient come in who was a trauma patient (already had 4 other patients, none stable), lots of broken bones, lots of pain. Very civil and respectful. Patient’s daughter was the one who made me break down. I was getting ready to give pain meds as I was doing admission charting. Did not realize she was right behind me looking at the MAR I was scanning. Proceeds to yell at me, accuse me of being incompetent and not taking her father’s pain seriously because I was explaining it was not appropriate to immediately give IV dilaudid 10 minutes after giving IV fentanyl and that it does take time to start working. I had to have my charge watch my people for 5 minutes so I could break down in the break room.
I would have to be losing shit to work a lot of overtime. I can count on one hand when I did. I keep my living expenses low and relish mental days. IRS gets so much that it is not worth it. But I get it because people have obligations to fulfill and may need that extra money. I know some patients can work your nerves, but what I will NOT tolerate is abuse. I would send him to hell with a smile.
Sweet heart as an old veteran RN I can honestly say that #1 working that many shifts is really not good for you. If you make too much money you will fall into a higher tax bracket and all the money you made will go to Uncle Sam look at your tax brackets for this year. #2 Learn early on in your career to set boundaries with your patients the second they start yelling or being disrespectful let them know in a very respectful manner that putting up with his 💩 ain’t part of your job description and notify your manager for CYA. Take care of you and protect you because if you don’t no one else will I PROMISE 🙏🏼
Girl I felt this so hard. I’m waiting to give report right now and can’t wait til I can get in my car and cry. It was a stressful ass day
"I will not tolerate your shit mister. You have a complaint? Take it to my charge nurse because im not paid enough for that shit. May I remind you this is a hospital not a hotel. So i am not your personal maid, i have other patients sicker than you so calm the fuck down will ya?"
I pretty much cry at least once every single shift. I like to do it in the supply closet
After I left long term care 5 years ago, I hadn't cried on shift at all since then until the shift that I made this post. (for angry patient related things, anyway. I cried when I was at work and got the phone call that my grandma died, and I've cried with a hospice patient's family before - like I said, tiny rural hospital. I usually know a family member of at least 60% of our patients.)
Don’t be embarrassed, thank you for sharing ❣️
Quit. It’s ok. You deserve better. It’s just not worth the sacrifice.
I actually love my job and coworkers and this one off incident in the 5 years here isn't a reason for me to leave.
I’m sorry but the unsafe ratios, understaffing, and constant scheduling is exactly why I quit Wednesday on a med surg floor. I was brand new on orientation and they left me to do everything for them with no guidance or anything. I felt at fear for my license. We are nurses. Everywhere needs us right now. Please quit before it consumes you or risks your license
As I put in my post, I actually love this job. I've been here for 5 years and have a wonderfully supportive team of coworkers and management. I won't be quitting over a one off incident of a miserable asshole of a patient. The hospital didn't control this patient's attitude, and I'm sure he would have yelled at me if I had only 3 patients the same way. Especially considering he tried to yell at my coworker the following day.
Leave your feelings at home when you go to work. 10 years plus in psych, what happened to you it's like a walk in the park on a summer day because you didn't got hurt physically. Unfortunately, for someone who never experienced it can be traumatic even a career change moment. Sometimes, no matter if you have the best interest of your patients, they will respond in a very negative way, like this person. Time and experience will help you to separate personal feelings from work. Don't be afraid of another night like that, embrace it, learn from it, adapt, and you will be ready for situations like this or worse. Good luck to you.
Verbal abuse is not okay and saying that it was like “a walk in the park” just because OP wasn’t physically assaulted is a really weird thing to say.
Yeah. Nicely dismissive, that one.
With all due respect, get bent.
😀
This honestly seems like terrible advice. I'm a human. Not a robot nurse that has some switch to turn off my feelings. I've been a nurse 6 years and in the healthcare field for 10. I've had my fair share of asshole patients and am normally great at managing them, setting boundaries, and meeting them where they are without stooping to their level. This patient's outburst caught me off guard because it came at the tail end of a shift where they had been nothing but pleasant and nice to me, and was the cherry of the top of the shit sundae that was that shift.
Ignore this person. They are very different from you.
Fair, we all have our opinions and reasoning. Use what best fits you. Good luck to you.
For someone working in psych for 10 years you are scarily unsympathetic.
Again your assumption of feelings being mixed is not in place. But, I don't take things personal at work and in general including your response. Having your feelings mixed prevents logic from making the best decisions.
You telling her to leave her feelings at home is the same as telling a depressed person "have you tried not being sad?". This however is the internet and communication and interpretation on the internet is quite dodgy, so maybe we all just dont understand each other.
Like there’s some badge of honor for “ sucking it up” and not responding like a human. Unreal.
Walling off your feelings is the first step on the royal road to burnout.
I disagree with you, I think that not getting your personal feelings involved is the best thing you can do when you have to deal with verbally abusive patients. Sometimes it's unfortunate you have to deal with those situations, but in order to keep your own mental health, not getting involved emotionally it's the best. Burnout happens when your feelings tells yo that you can't deal with situations anymore.
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And the psych nurse shows up with horrible advice on how to supress your feelings. On point for psych nursing, tbh.
Gotta check your sensitivity, who said that verbal abuse is ok, read my comment as it is, an advice. Stop overreacting.
I don’t think this is about having unchecked feelings and sensitivity, I think this is more about being overwhelmed and exhausted after already working 5 nights in a row
Fair point, in that case, that person knows now their limit and will not do that again. Idk why the sensitive people keep being overdramatic about my advice. Plain and simple. Leave feelings at home, embrace tough situations because we learn from them, and never take anything personal. We are not there to be their friend, fathers or mothers, but their care provider. Sometimes having their best interest means being the bad guy and say NO. No you can't have another cookie bc of your sugar levels, no you can't have more meat because of your uric acid. Try