yelling at your patient

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okiemedic

BLS Healthcare Provider Instructor
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I'm guilty of this.

Anybody else come to a point where you've had a regular pain in the butt patient and had enough?

I had a patient today and two nurses came along. one was a brand new nurse and the other was a vet and were taking a patient to CT (i'm a transport tech in a hospital) This patient we had was a regular patient in the hospital and has a pretty large potty mouth and complains about everything.

The vet and I were talking about how she acts and the new nurse asked us "how can you talk about people like that? they are all my babies".

We get her down to CT. She's a double amputee with a severe open wound on her leg from lack of care caused by her own neglect. She starts cursing at us and telling us she's gonna beat the crap out of us if we move her to the table. She then pulls up her gown and demands I look at her vagina (wtf? lol)....

The vet nurse tells her we are going to transfer her now. She looks at him and says " Whats in it for me!!" He gets real close to her and says "How about your life!!!". That pretty much shut her up lol.
 
We have a regular drunk out here that gets transported all the time and he gets yelled at by every crew for abusing the 911 system and calling for no reason.
 
Ehhh, no point in really yelling at patients. I've seen some providers get worked up and yell over stupid things. The one time I will tell at a patient is if they are doing something that may or will injure myself or my partner.
 
Bad business to yell at customers. If people only called 911 when they REALLY needed it, most of us would be out of a job.
 
Out of curiosity, why is it that some people call 911 too frequently, and others not frequently enough?

One memorable call was that of a sister for her brother when he decided to have a sip of beer. She was convinced he was going to die.

Yet, it's too common to see vehicle collisions resulting from someone driving to the hospital with chest pain. Not sure how to convince friends and family members that chest pain should be 911, not drive. Worried that one of them could be next.

(Edit: scrubbed to make sure this cannot identify any particular individual's medical history)
 
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If you think yelling at these folks will do anything to change their lifestyle you may want to get checked for psychosis....

Be nice, and realize non-compliant patients may be a lot more nuanced than you realize.
 
Yell? No.

On the other hand I'm often more like...

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beano said:
Bad business to yell at customers. If people only called 911 when they REALLY needed it, most of us would be out of a job.
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I tell my buddies this all the time when they complain about all the "BS calls". Bottom line at if you have a 20-car system now you can probably run it with 8 cars if only true emergencies came in. The bottom 60% of the seniority list are employed due to non-emergent calls.

Can you take a guess where the majority of the complainers fall on that seniority list?
 
Yelling will only get you in trouble. Other than the absolute bare minimum amount of conversation in the first 30 seconds (complaint and what hospital), I simply sit in the Captain's chair behind the cot, and basically ignore the PITA patient. By "ignore" I don't mean facebooking on my phone, as I'm still keeping an eye on them, but if it's a clear system abuser situation, or if they're unjustifiably rude, nasty, and verbally abusive, I just refuse to speak with them whatsoever, not even one word, unless there is a legitimate medical/comfort need to address. My report gets done that much faster, too. This approach especially can drive the pt nuts, especially the 0300 attention seekers. You know them - they call for a non-issue, then expect you to fawn all over them, carry them when it's clear that they get around their home just fine on their own, and generally won't come up for a single breath of air since they're talking incessantly about irrelevant things during the entire trip, or asking you to adjust their pillow/cot height/heat/AC/more blankets/less blankets/the "where are we now" question every five blocks. If they ask me if I'm paying attention or something similar, I respond that I've been monitoring them, and am completing their chart. Nothing more is said after that.

I address them respectfully, determine their medical complaint, tell them what diagnostics I'm going to do, and then not a peep out of me until it's time for them to move over to the hospital bed. The more time I have to spend interacting with the PITA patient for non-issues, the longer it takes me to do the report. If it's a long trip, I'll bust out the protocol book and do some review to kill some time. If they turn around and see me with my nose in a book, I show them that it's a county issued EMS protocol book.
 
gotshirtz001 said:
I tell my buddies this all the time when they complain about all the "BS calls". Bottom line at if you have a 20-car system now you can probably run it with 8 cars if only true emergencies came in. The bottom 60% of the seniority list are employed due to non-emergent calls.

Can you take a guess where the majority of the complainers fall on that seniority list?
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I have to use that. It's very clever!
 
Yelling is completely unprofessional and I can't imagine a situation where yelling at a patient would be helpful at all.

I've been stern with some patients. I can think of one call where I had to raise my voice a bit. But yell? Never.
 
Depends on the motivation. Kind of like yelling at a child. If you're yelling, "Stop!" Right before the kid runs in the path of an oncoming car, it's a good thing. If you're yelling at the kid to turn some song or movie off that they've played 20 times in a row...then you are yelling because you are frustrated, not because it is in the best interest of a child. (Because you could have asked them nicely, and if they didn't, they could have been punished for being disobedient, but you still wouldn't need to yell.)

So...if you are yelling because someone is standing near electrified water and you yell, "Stop!" or they are combative and have low LOC and you're yelling for them to stop so that they don't hurt themselves or if you are yelling because they tell you to speak up because they are hard of hearing, then you are doing it because it is in the patient's best interest (and it comes down to what your intentions are). If, on the other hand, you yell because you are frustrated, then you are being verbally abusive, and people who are abusive to patients should receive compensatory education on the subject, be suspended or fined, and eventually lose the ability to practice in EMS, as it is not in the best interest of patients, the service or the community to continue to allow them to abuse people.
 
I agree with 46young. I simply don't interact with ****ty people. There's no point in that. I will be professional but will not engage with them whatsoever.

I saw a stupid paramedic once yell at a woman telling her to stop hyperventilating. She died of a PE about 5 minutes after I took her code 3 to the ER. Yelling at people can get you into a lot of trouble and accomplishes nothing other than getting you more upset
 
I've raised a tone to patients before but never yelled. I yelled at a driver on an MVA today because as I was walking to the rig to get a backboard and collar, he was speeding towards me and didn't stop until I stood there with my hand out, only stopping (and may I add this was a slammed stop, not a gentle coast) about 5 feet from me. I signaled for him to roll down his window, walked to the drivers side and proceeded to yell: "WHEN I TELL YOU TO STOP YOU STOP. DO I MAKE MYSELF CLEAR?" He tried to speak to back his case but I just yelled "DO I MAKE MYSELF CLEAR" one more time and he quieted down. Sure scared the heck out of me how fast he was coming though.
 
LightItUp98 said:
I've raised a tone to patients before but never yelled. I yelled at a driver on an MVA today because as I was walking to the rig to get a backboard and collar, he was speeding towards me and didn't stop until I stood there with my hand out, only stopping (and may I add this was a slammed stop, not a gentle coast) about 5 feet from me. I signaled for him to roll down his window, walked to the drivers side and proceeded to yell: "WHEN I TELL YOU TO STOP YOU STOP. DO I MAKE MYSELF CLEAR?" He tried to speak to back his case but I just yelled "DO I MAKE MYSELF CLEAR" one more time and he quieted down. Sure scared the heck out of me how fast he was coming though.
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You're an idiot, what if he hadn't gotten stopped?

Again, you're an idiot and lucky to be alive, you should've looked before you crossed the traffic lane, you're not invincible.

Like 46 said, I just ignore them. If I need to be stern I'll be stern. There's no point to take things personally at work.
 
LightItUp98 said:
I've raised a tone to patients before but never yelled. I yelled at a driver on an MVA today because as I was walking to the rig to get a backboard and collar, he was speeding towards me and didn't stop until I stood there with my hand out, only stopping (and may I add this was a slammed stop, not a gentle coast) about 5 feet from me. I signaled for him to roll down his window, walked to the drivers side and proceeded to yell: "WHEN I TELL YOU TO STOP YOU STOP. DO I MAKE MYSELF CLEAR?" He tried to speak to back his case but I just yelled "DO I MAKE MYSELF CLEAR" one more time and he quieted down. Sure scared the heck out of me how fast he was coming though.
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What, are you the po-leece?
 
okiemedic said:
I'm guilty of this.

Anybody else come to a point where you've had a regular pain in the butt patient and had enough?

I had a patient today and two nurses came along. one was a brand new nurse and the other was a vet and were taking a patient to CT (i'm a transport tech in a hospital) This patient we had was a regular patient in the hospital and has a pretty large potty mouth and complains about everything.

The vet and I were talking about how she acts and the new nurse asked us "how can you talk about people like that? they are all my babies".

We get her down to CT. She's a double amputee with a severe open wound on her leg from lack of care caused by her own neglect. She starts cursing at us and telling us she's gonna beat the crap out of us if we move her to the table. She then pulls up her gown and demands I look at her vagina (wtf? lol)....

The vet nurse tells her we are going to transfer her now. She looks at him and says " Whats in it for me!!" He gets real close to her and says "How about your life!!!". That pretty much shut her up lol.
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So you're an instructor and you tolerate this?
 
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