Rude nurses. How to deal with them?

[Clipper1]

So being busy means you get to be rude?

Is it possible being impatient could also be interpreted as being rude?

When was the last time you had 10 patients all wanting something at the same time and probably at least one of them who should be one to one in an ICU? Do you normally see at least 60 patients a day and maybe pass well over 100 medications?

 

[Clipper1]

So then how should I react to the eye rolls I get when I treat my patients using current guidelines rather than something from the 1980s?.

It might be your own attitude with your protocols if you are getting eye rolls. If you are unhappy with your current guidelines and prefer to go back to what you had been doing, talk to your medical director. But, change is sometimes good and you need to move forward especially in medicine.

Professionalism goes both ways. Implying that EMS forums are only good "for amusement" is a serious lack of professionalism on some people's part as well. But when you hide behind one or more aliases online I guess it's easy to lack professionalism.?.

Did you happen to notice the names used on this forum? That alone is good for amusement. Of course I use an alias on here just like everyone else. If you want a professional forum you join a professional organization which has a secure forum and one which requires you post your real name and where you work.

As for the OPs question. Try to chat with the nurse outside of the patient's room and find out exactly they're upset about and take it into consideration. Having a good relationship with the receiving staff makes everybody's life better. However, if they're asking for stuff that is detrimental to the patient, stupid or illegal....forget it. You're accountable to your medical director and management, not the nurses.

What in a report would you consider to be illegal, stupid or detrimental? Would you consider an RN asking about the patient's home life to be stupid or illegal? What if they noticed signs of abuse? Do you consider asking about drugs illegal? Are you going to bring a patient into a hospital and not give any info which might help in the treatment because you thing it is illegal or stupid because of your own personal beliefs?

 

[Clipper1]

Seems fair... I read AllNurses when I need a little humor in my life.

Read my previous post about forums. Nurses on that forum also know by the aliases they use it is a public forum and not really a professional one. Many posting on there are EMTs. It, along with others are sometimes thought to give those in the profession a black eye. Do you really think this EMT forum represents professionalism in EMS? Read some of these posts. Does bragging you drive your ambulance 100 mph or that your smear nitro paste on a co-workers toilet seat show your professionalism?

 

[Clipper1]

This is just.... Ugh. I say please and thank you during a code. Unless someone is elbow deep in an open chest "seconds" don't mean jack crap. In 10 years I am extremely hard pressed to think of a case that was so life and death there wasn't time for basic decency.

The focus should be on the patient. One should not have to worry that they thanked everyone before getting the patient to the cath lab or OR. Professionals know they are there to do a job and not win a beauty contest. Co-workers in a code would rather know you can get equipment, open airways and do the meds rather than hanging around saying nice things to everyone and smiling over some patient's body.

You might be able to stick around and thank everyone because you only have to do charting on one patient for the short time you were with them. You don't have 4 - 10 other patients still wanting things, meds to be given, procedures to get to, phone calls to make, labs to draw and their charting to be done. Also even after a code is called, the work does not stop for a nurse or doctor. The family and care of the body still has to be taken care of along with more charting and phone calls for that. How many EMTs and Paramedics are going to be in a foul mood because they had to wait to deliver their patient in the ER or divert because the staff was hanging around seeing that everyone got thanked?

 

[sir.shocksalot]

I would agree that's what I would want if I was in their shoes. My confidence level is low at the moment with barely any experience and I know I keep bringing this up but it's true. Maybe that's why I get the stink eye from RN's when giving a report. I'm not very comfortable doing things I'm not used to doing and book smarts really don't mean much. One thing about my NREMT class was that we didn't get very much hands on experience, and I knew after I got through the course and passed the exam and practicals that I wasn't going to feel alright at first. But I want to get better. I suffer from social anxiety, slight speech disorder, and ADD. It's a shame, and I know I know, some of you will probably say I don't belong in this field but I love helping people and I want this to be my career. I'm no idiot, I just have a lot to work on and things to get over. But I'm doing my best.

Book smarts do mean a lot, applying them is a process of hands-on instruction and practice. No one is comfortable dealing with something new and many people struggle to give a good report when they are stressed. Getting the stink-eye from the nurse or medic is definitely going to make your reports suffer. As some others have said, develop a good format that covers everything the nurse wants to hear and omits the things they don't then practice, practice, practice. Come up with scenarios and then practice how you'd give your report.

As a side note, I too have ADD and feel I'm a relatively successful provider. Know your weaknesses and develop ways to cope. For my hand off reports I ensure that my whole focus is on the report before I start to give it. If I have to coordinate getting everything untangled and the patient moved while I give a report I know I will lose track of what I'm saying or will forget to say things entirely. Many with a variety of issues are very successful in this career, the only things that should indicate your "belonging" in this field is your willingness to learn and adapt as well as you desire to genuinely care for the sick and injured. Give yourself a break. As long as you work on it you'll get there with time and practice.

 

[wanderingmedic]

I have found it makes a big difference if you are able to make friends/build a professional relationship with ONE nurse. After that everyone else seems to follow.

There tend to be LOTs (depending on where you live of course) of ED staff that were EMT's or Medics. Find them, make friends, and ask good questions when appropriate. Don't come off as incompetent, but be eager to learn. I have found RN's who were EMTs or Medics are usually very willing to teach, you just have to be willing to learn, and be smart enough to ask questions at the appropriate times. Some humility and a sense of humor goes a long way.

Also realize that RN's are human and can have bad days too....so their grumpiness might not be personal....all the time.

 

[Tigger]

Is it possible being impatient could also be interpreted as being rude?

When was the last time you had 10 patients all wanting something at the same time and probably at least one of them who should be one to one in an ICU? Do you normally see at least 60 patients a day and maybe pass well over 100 medications?

I am not even going to respond to this. It should have been obvious that my comment was not addressed to you but rather to another poster who stated that because EMS works less it's ok for RNs to be rude to EMS. Please, stop trying to make arguments that do not exist, it does not provide for any productive discussion.

 

[WTEngel]

I am a little bit surprised by the number of people here who seem to think that if their workload is high, or the patient is critical, it gives them license to be as crummy and ill tempered as they like.

I have been in sme pretty hair raising situations, and I can count on one hand the number of times that I have lost my composure and said something disrespectful or displayed an attitude that was not appropriate. I can also say that each time that happened I have personally made an effort to apologize to that person when the smoke cleared.

I am particularly disappointed in a few of the nurses on this board, who seem to embrace this attitude of "I don't have time for niceties, if someone is offended by my behavior, they don't have any idea of the stress I am under or the gravity of the patients's condition."

Most of the physicians, nurses, and paramedics I have worked with that display the type of attitude above are either very new, not entirely confident in who they are clinically, or just need to get over themselves.

Losing your patientce with someone, being short and catty, or acting like you don't have the time of day are all characteristics of weak leaders. The best clinical leaders I have known are cool under pressure, respectful to everyone from the CEO all the way to the janitor, and always make an effort to make colleagues and co workers feel appreciated.

Even when someone has screwed up or needs to improve at their job, there is rarely a time where tact and decorum can not be used when dealing with those around us.

Anyway, this is just my opinion. This is the type of paramedic I have been, and this is the type of physician I hope to become. There is no single person on the team who is so important that they get to be polite only to those they deem worthy.

 

[cspinebrah]

One thing I LOVE to do in those situations is just bare with the rudeness and at the end in a soft tone of voice and a huge smile look at them and say,"Thank you for your time and have a WONDERFUL day."

It makes them more angry but all you did is say something polite.

anddd you leave being the bigger person.

 

[firecoins]

We aren't the politeness police. Give them a precise report and move on. If they are nice, great! If they aren't, just move on. I found those nurses have personal problems and are like that with everyone including the other ER staff. It's not personal ....usually.

 

[VFlutter]

I am a little bit surprised by the number of people here who seem to think that if their workload is high, or the patient is critical, it gives them license to be as crummy and ill tempered as they like.

I am particularly disappointed in a few of the nurses on this board, who seem to embrace this attitude of "I don't have time for niceties, if someone is offended by my behavior, they don't have any idea of the stress I am under or the gravity of the patients's condition."

Personally I never said it was justifiable to be outright rude or unprofessional regardless of the situation. That being said, I am not going to stand there and sugarcoat the situation or not voice my concerns. But there is an appropriate way to do so.

I am human. I am extremely busy and taking care of multiple critical patients. I never take a full lunch, rarely get to sit down, and am constantly bombarded with phone calls, alarms, and emergencies. My time is precious. Does this give me permission to be rude or unprofessional? No. Does it make me short tempered or inpatient at times? Yes, unfortunately.

When I am admitting a transfer patient I have certain expectations for the person giving me report. I expect that they know basic relevant information and a decent report. If they do not then not only is it annoying but it delays the transfer to higher care which is not good for the patient. I will still be polite and professional but if it seems that I am impatient or annoyed that is because I am.

 

[WTEngel]

Maybe taking the time to educate the person transferring care about exactly what you want and need when taking a patient from them would be a better expenditure of your time, rather than sitting and being annoyed.

I know it is an expectation that people should know their job, and in many cases I too find it frustrating when being unnecessarily delayed by somebody else's lack of preparation or job knowledge.

When possible, I try to take the time (less than 2 minutes in most cases) to explain to the person in question exactly how they can prevent testing my patience when we cross paths in the future. It helps them out, it helps me out, and it helps the patients out.

I can do what I mentioned above in a very productive manner, and usually everyone leaves feeling really great about the encounter.

If it is not possible at that very moment, I try and follow up if I can, or work with the education department to implement processes which directly address the issue.

This is just me though. I can understand that not everyone would be willing to go to these lengths.

 

[jrm818]

Dear OP,

Suck it up, crybaby. This is clearly a problem with you. Healthcare in general is well known to be full of nice, well-adjusted, benevolent people who work well as a team. The problem is clearly you. [end sarcasm]

Seriously, I think lots of people missed some basic kindergarten skills regarding playing nice in the sandbox. Maybe these people can come hand out T-shirts in some units:

http://www.youtube.com/watch?v=6ZjipbU0Pk4

Hospitals are supposed to be a theraputic environment. Do you think patients feel all warm and fuzzy when they see staff being jerks to each other? Can you really tell me that you can instantly shut off the attitude when switching from interacting with a colleague to interacting with a patient? I call BS, and anyone who is honest in reflecting on their healthcare experience knows that malevolent attitudes spill over onto patients all the time, not a plus for the whole healing process thing.

More seriously, being a jerk is dangerous. Do you think you get a more efficient report when you smile, say hello, and make the person handing off to you comfortable, or when you bark? Which attitude do you think encourages double checking, quick disclosure of errors, and collaborative work to solve problems?

Even more seriously, depression, suicide, drug use etc. are all overly prevalent among healthcare providers. Yes the job is stressful by its nature, but do you really think that everyone trying to prove that "my job is really really hard...you can tell by how irritable I am" and being aloof or outright offensive with one another has nothing to do with these problems?


You don't' have to go around giving foot massages to everyone you meet....but simple (basic - KINDERGARTEN!) human interaction skills like saying and responding to "good morning", smiling when you see other people, not intentionally humiliating people when they make mistakes, and being supportive of new people could go a long way to making hospitals less miserable hellholes. make whatever excuses you want, but if you are not pleasant to be around, YOU are part of the problem. It takes..well...zero extra seconds to smile, 0.2 sec to say "Hi", etc.

Everyone has off days, but in my experience many people in healthcare make it a pattern....and it's time to call it out as a bad thing.

edited to add: in summary, I don't mean to argue: "be civil" or "be professional"....I mean to suggest a more radical idea...try being actually overtly, obviously, conspicuously, gregariously NICE. It's a goal we can all work towards, and I promise, it won't hurt a bit....

Plus a million to WTEngel's post too.

 

[Akulahawk]

When giving report... I'm going to lead off with something like "Good morning, I have a..." and give a quick & concise report about the patient so that the receiving person has a good idea what's going on and where to start doing their own assessment. I conclude it with (as a prehospital provider) "my full report will be along shortly, any questions? See you in a few minutes." all that added a whopping 6 seconds to my report while providing the nice-nice stuff that people look for. And yes, I'm all business when I give or get report.

When getting report from an nurse (when doing any sort of IFT, even if to the ED), I make life easy for them. I ask them to give report as if they were giving report to another RN. Why? It's something they're used to and something I can translate... I've met too many RNs that don't quite know what I need when giving report to transport, so I accommodate their unease.

Some people might be amazed what you can get others to do if you simply ask them, and say "please" and "thank you" while doing it... Yes, I can let my inner a-hole out if necessary, but if I'm having to do that, something's failed and I have to give orders, not requests. Doing that also means I'm going to generate a LOT of complaints. On the whole, it's better to be "nice" even if you're having a bad day.

 

[Clipper1]

Maybe we should look at some of the numerous rants on this forum made by EMTs and Paramedics who have no patience for patients or other professionals like FFs and Police.

How many have bragged about slamming narcan on a patient because the didnt like getting called to some junkie? How many have treated NH patients and staff rudely because the got a BS call rather than a cool trauma? How many times have you dumped the patient off in the ER at 0300 while being in a foul mood because you were awakened? How many have taken out their frustration on the patient and ER staff when you got a call during a game or when you were in the middle of writing some rant on EMTlife?

We see over 50 ambulances come through our ED in a shift. I can tell you less than half are all rosy cheer when they come in. Many times we get half assed reports because the patient was just some BS waste of your time to you.

For every EMT story who has been so wronged by an RN, the RN can probaby give over a dozen stories right back at you. The posts by some of the members of this forum are so filled with such a dislike for nurses, FFs, police and patients that this is almost a laughable topic.

 

[Clipper1]

Maybe taking the time to educate the person transferring care about exactly what you want and need when taking a patient from them would be a better expenditure of your time, rather than sitting and being annoyed.

I know it is an expectation that people should know their job, and in many cases I too find it frustrating when being unnecessarily delayed by somebody else's lack of preparation or job knowledge.

When possible, I try to take the time (less than 2 minutes in most cases) to explain to the person in question exactly how they can prevent testing my patience when we cross paths in the future. It helps them out, it helps me out, and it helps the patients out.

I can do what I mentioned above in a very productive manner, and usually everyone leaves feeling really great about the encounter.

If it is not possible at that very moment, I try and follow up if I can, or work with the education department to implement processes which directly address the issue.

This is just me though. I can understand that not everyone would be willing to go to these lengths.

You seem to have a lot of extra time. Maybe you should try to mentor the EMTs and Paramedics working in your own agency instead of expecting RNs to do this. Get involved in their education and field orientation. Too many EMTs are set up to fail by their own companies by not being given enough orientation or education.

 

[WTEngel]

I guess that makes it alright then clipper. Since there are so many unprofessional EMTs and paramedics hanging around, and nurses have to put up with them all the time, it makes sense that everyone should just go ahead and be a jerk to one another.

You're right, the topic is laughable. The point that is laughable, however, is your insistence on clinging to the losing argument of "EMTs and paramedics do x, so who are they to question anything anybody else does."

I briefly went ove this thread with my wife, a charge nurse with 10 years experience at one of the largest pedi ICUs in Texas, and she said, in no uncertain terms, that if any nurses acted the way some of you are "defending", whether it be because of a bad day, or just their generally poor disposition, their attitude would be corrected post haste. In a professional environment, this type of behavior simply shouldn't be tolerated.

I may only speak for myself, but if my colleague ever acted the way some of you describe, I would be embarrassed to ride with them and report them up the chain of command immediately.

You keep bringing up these anecdotal stories of EMS personnel doing unprofessional things, yet it has nothing to do with the OP. No one is trying to generalize all nurses here (at least I'm not anyway) so I see no reason why you should generalize all EMS personnel.

Since you seem to have so much disdain for what goes on around here, what keeps you coming back?

 

[WTEngel]

You seem to have a lot of extra time. Maybe you should try to mentor the EMTs and Paramedics working in your own agency instead of expecting RNs to do this. Get involved in their education and field orientation. Too many EMTs are set up to fail by their own companies by not being given enough orientation or education.

I am actively involved in the second largest paramedic education program in North Texas. I also FTO'd and precepted for years. Additionally, when I finish medical school, I plan on becoming an EMS medical director. Suffice it to say, I am effecting change in my profession, and plan to continue doing so.

As far as extra time goes, I have a feeling I spend far less time coaching those around me than you do complaining about those around you.

Your attitude is poor, your interpersonal skills lacking, and your argument happens to be a losing proposition. These are all signs that you are outmatched, outsmarted, and ultimately out of your league.

The time for coaching is long gone in your case. You happen to be the rare exception that proves the rule...nearly everyone can be coached, but some people just aren't worth it.

 

[ffemt8978]