New nurse here! I’ve noticed that specifically male patients tend be a little more disrespectful and it’s really frustrating. Im new, I’m quite young (and I look even younger lol) and I’m just an overall “soft” person. They’re more demanding and aggressive with me Vs my male preceptor. It’s really annoying. What can I do to establish a mutually respectful relationship?
Woah. I really feel like I needed to hear this...especially the last part.
(-signed, student nurse who lurks so she can learn how to be a grown nurse)
*mileage may vary with dementia patients lol
SAME LOLLL!!!
You gotta find your own nurse authority, it’s inside you already.
I’m a six foot tall youngish dude, I work in the ER, but came from medsurg tele. My preceptor was amazing, super smart, patient, a great teacher. She is also, mid 20s female, maybe 5’3”, 100+ lbs. PD would bring in a big dude, in full meth-mode, 4 point restraints, spit mask, flailing. Basically, this guy is too much a flaming hot meth mess for jail, please help us. My preceptor would tell the resident what meds she wanted and start drawing them up while telling this crazy person what behavior she was not going to tolerate.
I found my strength and authority watching her. You gotta find it for yourself, no one else can do it for you. You gotta set the tone when you go in, like, this is how it’s gonna go. You can always back off later, but you can never regain that first impression. You’ll get there.
Same! If they are behaving in a way that is not acceptable you have to tell them that you will not tolerate that and it will stop (unless they have dementia, then you can expect to keep having that conversation multiple times 😂). For example, I just had a 25 yo male in for gallstone pancreatitis and he would call the nurses “sweetie”, “honey”, “babe”, and yell out for us to “bring his piss jug”. So when I went in to do my first assessment of the shift and he started pulling that crap I told him that his behavior is unacceptable and that I will not be tolerating that. He was pissy about being called out and ramped up his behaviors. I think he figured out that I am not a nurse to be messed with when it took me a little longer to go to pharmacy and get the refill for his dilaudid PCA. He stopped acting like a douche and we got along better. It made the next three nights go more smoothly 😊
I had a guy who would just yell orders at us. One time he rang and when I came into the room he just snapped "water!"
I just looked at him stone cold and said "water, what"
Totally blank look from him.
"The word you're looking for is please"
His attitude disappeared after that. Hilariously, when I went to see the other person in that room they were absolutely cackling and said "that was great, I've been waiting for someone to do that".
My charge nurse did that to one of our worst patients... he would not use his call light. He would just yell out, “Nurse!”. All he would want would be stuff in his room moved around, or just really really small things and things he could do on his own. It wouldn’t be so bad if he wasn’t so rude about it. We had to set limits, and had everyone adhere to them.
A coworker just had a patient like that, except the patient addressed staff by their names, which is better than being called Nurse at least. Every 5 minutes she yelled, "Jessica! JESSICA!"
We had a patient for the longest time, cute little old man with dementia. He really liked me, so no matter who his nurse was that day, he would just call my name.
One time this old lady was being so rude to me and I turned around and snapped, “I didn’t hear any manners!” Which is something I say to my nieces and nephews. She actually did get nicer after that.
A word of advice OP, stating that you're not "tolerating" certain behaviours, can be interpreted as a challenge. When that happens, you'll need to decide what your actions of intolerance are going to be. You can't just go in a situation like that of an agressive, potentially dangerous patient, and act like a badass. You need to be one - and make sure you remain fair throughout. And the only way to do so is to weaponize your knowledge, and practice making it clear as day what the self-inflicted consequences of certain behaviours will be. And only then you can act like a badass.
This is what I’ve encountered a lot. What kind of consequences do you normally rely on?
if you attempt to hit me we will tie you down and inject you with so many medications you'll never want to get high again
A squad of nurses and techs, four point leather restraints, a mesh bag for spitters, and multiple syringes filled with lovely meds to be injected into the thighs with 18G needles. Good night, sweet prince.
It depends on what type of behavior they are exhibiting and what is important to them. Kind of the same principle idea of limit-setting with children. Depending on the situation I have told patients things like: I will not allow you to speak that way to myself or any other staff in this hospital. If you are unable to speak respectfully, I will walk away and come back when you have had time to think about your behavior. (Of course, this cannot be used when the patient is in acute distress but there are situations where it is useful.) Typically, when I come back they apologize and are much more respectful.
Or like with psych patients in the ED, if they want something from you like a chance to take a walk or smoke, etc but then act out in an inappropriate way, I do the same sort of thing like: I would have been happy to take you on a walk (or whatever is being demanded) but due to your behavior I do not think I can safely do that now. We will revisit this in an hour (or an appropriate amount of time) and if you can demonstrate that you are able to restrain yourself and behave appropriately we will go for a walk then.
Or if it’s the family member acting out, I explain that they cannot behave like that in my ED and if they continue I will be forced to have the officer in the waiting room escort them out.
And I think most importantly, and why this tactic works for me, is that I make sure everyone on my team is on the same page and aware of the boundaries I have set because if they go in and give the patient what they are demanding all of your effort is for nothing, and also, when I return, I sit with them and try to make sure I understand the reason behind their behavior and I help the patient identify it and find appropriate ways to express that feeling. Like, a lot of the time it’s fear.. fear that their illness isn’t being taken seriously or that they genuinely think they are dying because they do not have the same knowledge we have or maybe they had a family member die of a disease that they believe is causing their symptoms. For me, getting to the root of the issue is essential and typically ensures that the rest of my shift will go without that behavior from that patient. Though, a caveat here is that some people are just assholes and that is the actual root of the issue and with those ones all you can do is set clear limits with clear consequences, stick to them, and do your job. Get in, get out, provide them with same care you would any other patient healthcare wise and take no bullshit.
My mom was a high school math teacher and she gave me the same advice when I asked her how she lays the ground rules with students and how she decides to be strict or not. She said you can always become more lenient, you can never become more strict. So start off strict and loosen up from there. Harder to reestablish respect once it’s lost
My father and I are both nurses. When I asked him this question, he told me I should do as he did as a young nurse craving respect and grow a moustache. Am a girl Thanks, dad. So instead I try to radiate moustache energy 🤷🏻♀️
You could radiate tattoo energy, that's what I did. A middle aged woman with a half-sleeve definitely gives off a 'I ain't playin" vibe.
Oh, mah pearls.
Sweats nervously
No, but I desperately want to get heavily tattooed. It's just hard to justify the money when I'm still scrounging every penny to finish remodeling my house :(
Go wild with stick on tattoos. You can change them however often you want!
Lol Definitely.
It depends on the patient but you’re going to have to do some soul searching and decide on your lines.
-With patients who are short with me, I usually let it go. They’re in a bad place if they’re with me and I don’t need them to pretend to be happy about being there.
-If they don’t stand in the way of me doing my job, it’s fine. If they’re questioning my every decision, I drown them in information until they get the point. I’ll tell them everything I’m doing and why until they understand that I was doing all that critical thinking in my head before they started asking.
-If they’re being a little more rude, I’ll let them know, “I am a well trained nurse who is working very hard on your behalf. I understand if you have questions or concerns and I am happy to address those but I would never walk in to your place of work and speak to you this way. Please try to have a little more respect for the work I do.” Most people are so embarrassed by being called out directly that it stops.
-If they are outright nasty, I give as good as I get. I’ll start with, “we will not be doing this today. I have a right to be treated with respect and I absolutely will not be spoken to this way. I am on your team but I am not obligated to be your punching bag. If we need to get security and patient advocate in here to talk this out, let me know so we can get that out of the way early.” I have also been known to throw their crass comments back at them if it’s sexually inappropriate comments/behavior. They are trying to make me uncomfortable and I will call their bluff and be just as bad.
Edit to add: I also try to set other nurses up for success with these kinds of patients once the assignment is made. At evening med pass I’ll say something like, “Sarah is going to be your nurse tonight. She’s great. She’s quiet but she’s one of the smartest nurses I know,” or some other appropriate positive front loading.
I started out as a petite, blonde, 22 yr old. Speaking from experience, first impressions are so so important. You will need to figure out which patients need you to put on “big girl pants,” and which ones do not. You can usually tell right away if they are giving off this confrontational, “I’m in control” vibe. Always start off confident, respectful, and firm. Don’t be really sweet, eager to please, or unsure of yourself.
My “big girl pants” are a combination of things, but language is the biggest one. Try to use your best serious, voice. I don’t want to say deepen it, but use your lowest tone in your natural range. Speak with volume, but don’t yell obviously. Whatever you do, don’t up-speak! if you don’t know what this is, please look it up. It is so important, especially for women. Try not to say “like” “um” or “you know?” Talk in concise, clear sentences and try not to seem bubbly, sweet, or unsure of yourself.
As you get to know the patient more, you will be able to assess if they are really trying to be aggressive and take advantage of you or not, and you can adjust yourself accordingly. I find that many people start out a bit aggressive/confrontational because they are nervous about being in the hospital and that is their defense mechanism. Some do it just to test you and see how you will respond. But if you meet their level of intensity and give it right back (respectfully), they often relax and tone it down. This develops trust. Once you establish this, you can be more yourself, too. If you seem too soft or unsure from the start, their aggression will continue and they will walk all over you and not trust you.
Good luck! Everyone has big girl pants you just have to find them!
Great advice. Works with surgeons too!
Some very good advice here. One thing that helped me just in general way before I got into medicine was a realization. When people are rude and condescending, they’re working from the assumption that not only are they above and better than you, that you see them as above and better too. They intend, even if subconsciously, to be insulting. I found that when I keep in mind that they are wrong and that their personal opinion of me is meaningless, that attitude and confidence shows through in how I carry myself and react to them. Typically, that flips the dynamic pretty quickly. It doesn’t work on everyone but it works on most people. And for those it doesn’t work on, it doesn’t bother me because I really don’t value their opinion. They’ve not given me any reason to.
I straight up just say I will not tolerate it. We are nurses, not doormats, human beings who deserve respect just as much as everybody else, you got this!
I work in psych. When patient's are rude to me I tell them to approach me again when they're ready to speak respectfully. It actually works, I even get an apology some times.
This, darling, is a craft that takes practice. Be yourself just make sure you set up boundaries and don’t negotiate. It’s your way of the highway! People will respect u more when they realize you don’t bend. Being a nurse isn’t just about treating people it’s also knowing what their personality is, we become quite gifted at reading people based on behaviors and emotions.
You'll eventually reach a breaking point and develop an "I'm so fucking over this shit" set of armor. This attitude is pretty easy to spot and is actually a pretty common way to deferentiate between veteran nurses and newer ones.
This isn't a dig at you. This is the pattern with pretty much everyone. I was the same way.
What doesn't change is the patients. They will be shit no matter what, forever and ever.
The ER I started out in wasn't ghetto PER SE, but it was the hospital where LE would bring the drugged out window brakers, the off meds homeless, the perpetrators that the K-9s brought down, the drunk out of their minds and hit a pedestrian patients, etc. As a 5'1" white blonde new nurse who still put on mascara before a shift (HA!) I saw myself as kind of a secret weapon. Any male nurses / older nurses / "go get Greg" staff precipitated aggressive, bowed up behavior from these patients, where I was decidedly a non-threat. Of course I had to use my judgement as to my safety, and there are patients who cannot hold a reasonable conversation or make good choices with whom this would not work but if it was possible, I took on the role of "Hey look, I'm just this innocuous person and that doctor says I have to take your temperature and blood pressure reading. Can you just work with me so I can do my job?" Nine times out of ten, this established rapport. Now I'm "the only one who will listen" and become the person to whom they could tell all their woes and issues to. That's where you become the negotiator they will listen to. "No I cannot let you leave because the police rank higher than me. But we can try to get you in and out of here asap" "Yes, I can get you a cup of water, blanket, bring you to a bed instead of the hallway, but you have to work with me and let me do my job" and it also gives you the opportunity to assert the boundaries, "please do not call him that word in my presence" "please lower your voice, there are people here trying to rest.""If you threaten another staff person, they will put you in restraints, and that's up to you and your actions, not theirs" Stand your ground with the small things (FOLLOW THROUGH) and you can avoid fighting over the bigger things. Some people come through the doors I think there's no chance in hell they'll let me take their blood, let alone take vital signs, but this rapport/boundaries thing works. The DUMBEST things can establish rapport when you get right down to something they want that you can provide: warm blanket, OJ, sitting on the side of the bed, a phone call from you to a family member. These things are free and simple but go such a long way, but in the beginning YOU show respect. "Sir / ma'am, I'm trying to be respectful to you, but when you... you're not showing me the same respect."
I'm a giant guy so I dont have the same problem per cest, but I occasionally still do get challenged. I found for me that silence is golden, people hate it. If they are being horrible just wait in silence until they are done. They pick up on that pretty quick. I also found it's good sometimes to leave the room, esp. If you think you are going to lose your cool. Just tell them that they are being inappropriate and you'll be back in a bit so they can have some breathing room. I've never had anyone in my upline have an issue with either of those two things. And both I picked up from my 5'6" female preceptor back when i was a new nurse.
It’s in you. You’ll find her. And when you do, everyone will know. 🔥
“I’ll come back in five minutes and you can try asking me that again.”
“My hearing is fine, you don’t need to yell.”
“I won’t be spoken to that way. I’ll come back later when you’ve had time to calm yourself.”
“I understand that you’re frustrated and angry but I’m trying to help you.”
“Sometimes safety takes more priority than comfort.”
I’m a 27 year old mildly attractive RN. When I first started I was sweet and soft spoken and I quickly learned you can’t be that way with everyone. I’ve had patients be sexually aggressive and violent towards me - both physically and verbally. If you don’t feel safe around a patient you can always report it to your charge nurse, but I grew into a no nonsense person. You are there to care for someone and you have to set boundaries. It’s uncomfortable to stand up for yourself in a setting surrounded by patient satisfaction but you don’t deserve to come to work uncomfortable. There is nothing wrong with telling a patient this is a professional relationship and we have certain expectations from the patient just like a patient has with medical staff, and if it escalates security can be involved.
I also like to be straight forward with patients because sometimes there are underlying stressors that cause them to freak out on strangers. I try to get to the root of the actual problem, and if they’re just a bad person i set limits.
I hope you find your voice. Medicine can be brutal, but then you find the patients that make it all worth it. 💕
This is the exact same evolution I went through! At some point, you’ve got to be taken more seriously and the cuteness needs to stop. So you lower your voice, talk more directly, and have boundaries. I still slip into it sometimes and I mentally kick myself but it’s practice :)
Be confident! You will find your nurse attitude, it just takes time. Don’t put up with bullshit. Call them out on it! If they’re being a jerk, say “I’d appreciate if you didn’t talk to me like that” or “We can continue whenever you’re ready to be polite”. That’s the warning shot... I was a small-ish early 20s ER nurse when I started, trust me when I say you will get there! The patients will continue to be jerks, but you will figure out your own way to stand up for yourself.
I agree with the those who made the 2 following suggestions. First is you have to stand up for yourself. If a patient, family member, visitor, even physicians, are rude to you they must know they can’t talk to you like that or treat badly. You are allowed to stand up for yourself and you don’t have to be rude about it. Simply saying, “You cannot talk to me that way”. is often enough but don’t cave be strong. 2nd , as you gain experience you’ll start to be more confident and that will outwardly show in the way you speak to people and they’ll see it. Be the authority in the room when dealing with your patients They’ll respect you for it.
Hey! I’m in a similar situation. I started out on the floor and as I gained more knowledge and confidence in what I was doing it started to show. I don’t mean in a cocky way. When nursing confidence shows through to the patient, I think that is when it changed for me. I also try to give off the “I’m your nurse not your friend” kinda vibe in hopes that the patient will take me seriously not like a waiter at their dispense.
Student nurse here but what I have to say might be helpful.
I'm a big soft guy, a gentle giant compared to most of my classmates. My first port of call is to be friendly and create a rapport. If that doesn't work, I rather bluntly say, "I know well enough you want to leave this hospital, but you gotta bear with me and give me an inch so I can do my job and get you home." Usually this works with the elderly customers and most others.
For the aggressive, disrespectful and possible violent. My tactic is to to stand my ground and not give them an inch to work with. I've had patients threaten awful things on me but because I stood there, in a relaxed manner making eye contact, it tricked them into thinking I could take them down - when I most likely couldn't.
It's all buying having body language which projects that you are comfortable, confident and in control. Next is tone of voice. If they don't take heed then, they will when the police come round the corner to put them in their place.
I find old dudes are kinder than old ladies. It's probably a personality thing. If an old dude is grouchy, I fuss back at him. They tend to get a kick out of it and we become pals. Old grouchy ladies are just old grouchy ladies.
I like to validate the old grouchy ladies. “Look, Mildred, we both know this sucks, but I’m trying to help you get out of here and stay out for a long time. Here’s why the doctor ordered [whatever I’m about to do] it will help you because [reasons]. Now, let’s be brave and get you better. It works ~70% of the time for me. Turns them from the victims into the heroes.
(sometimes you’ve got to remind them why they want to get better too)
It seems so daunting now but all of this advice is amazing! It will take some time but you will naturally become more confident as you go!! Practice and repetition will help a ton. Mimic other people's approach slightly until you find what works for you. I started very similar to you and I used to have a much higher tolerance for BS and was more "soft." I'm also really more naturally soft spoken. Don't beat yourself up for that either. Now, I stand my ground and I may come off "bossy" but I go in with a more take charge attitude when necessary, and I get that respect from how I carry myself.. I look so super young that when asked how old I am or how long I've worked there- my mom (who is a nurse too) always told me to just say-"old enough to be your nurse." Because I feel like age can be a way to demean your skill set, try not to let it! Show them what is appropriate. Absolutely call them out and say that you are not there to be their punching bag and that you are doing all you can for them.
- Don’t make assumptions. 2. Talk to your patient and set firm boundaries about how you are feeling.
Sir, I am here to take care of you. My name is Nurse Nancy. Who/what/where/when. Be firm and professional. Don’t be rude but don’t tolerate disrespectful behavior
I’m cute but I’m also former Special Ops so I’ve no problem with being nice AND setting boundaries. People feel vulnerable in a healthcare and some will try to overcompensate by bullying those who they think can be bullied. You are competent and in charge. Don’t get mad, just be professional and firm if you come up against this attitude in all its many forms. ❤️
Prison rules. Next time you show up to work find the biggest, meanest patient and beat them up.
That’ll force the rest to respect you
You just gotta learn to be a bitch sometimes lol. Straight up
Set boundaries and maintain them.
Set bounrdies . Even if you have to say them outloud . If a patient makes you feel uncomfortable then consider if your hospital has a behavioral agreement . But I often will say” I am going to step out for a moment because I will not be talks to as a professional in such an unprofessional way. I will return once we can find a mutual respect. “ I usually return to a patient who has realized that has had a moment to think , breath and calm down . After that I chart it and contact my charge nurse if I feel like the patient has blurred the lines between my job as a nurse, I am not anyone’s punching bag and even my family doesn’t get to talk to me like trash so.... for sure not in the hospital while I am working . Nurses are among the most likely profession to be assaulted in the job , often because hospitals allow a culture where nurses feel they cannot speak up or that nothing will be done.
Bite one. Word will spread fast. Repeat as necessary.
An awesome quote to keep in mind: “You teach people how to treat you.”
With that it’s time for a rectal exam. Sorry we are out of lube.
It's important to remember that some people will just try to push your buttons for fun. As a male nurse I often get asked why I didn't become a doctor or why did I choose to work with a bunch of women.
I just respond by telling them "I get to know my patients and save their lives its very rewarding" and then follow up with "what do you do for a living?" 9 times out of 10 its something dull.
You can be civil and kind while also setting your boundaries.
I have straight up told patients “I am the only person here who is willing to take care of you. That’s how rude you’re being.” OR “The more you act like this, the less I’m coming in here. I have too many other things going on.” You have to be very straightforward with certain patients- especially those with borderline-type personality traits. Of course I only say things like that if other communication attempts have failed and they’re being extreme. Go into each room with a purpose. Have a plan of what you’re going to do. This makes you seem competent and the patient will put more trust in you. Explain everything you’re doing too.
A lot of patients go through the grief process when they get sick. They are grieving the loss of health, independence, their sense of immortality, and they are angry. But they do not know how to vent that anger and so it often times gets directed at a nurse. Be blunt. Tell them you understand they are angry about being sick but that you do not deserve to be treated like shit. And also try killing them with kindness. Or thank them for giving you an opportunity to learn from them. Its all about diffusing and redirecting.
I’m a new nurse. I’m 5’10 and pretty petite. I work in the ER and people on my unit know me to be nice and quiet. However, I don’t take bullshit from patients. I will respect them so long as they extend the same courtesy to me. The moment they don’t, I let them know I will not be treated that way and sometimes I’ll walk out. I understand people are in pain and they’re scared, but I tell them that’s no reason to mistreat the person who’s trying to take care of them. You’ve got to have a back bone or patients will walk all over you and take advantage of it. Call them out when they’re wrong.
I have a similar “soft” vibe, and I don’t think we can help the initial reaction, but I set my boundaries and I hold firm to them and I see patients’ disrespect change very quickly. Once they see they’re neither getting demands answered by me nor changing my overall demeanor it’s usually like night and day. The second they insult me or curse at me I say “okay sir, because you are insulting me I’m leaving your room now.” and I leave. Once or twice and they start to realize that polite requests get them attention and rudeness gets them ignored and they adjust. Humans in hospitals are scared creatures lashing out in whatever ways they think will protect them. Laying boundaries also gives them a sense of safety just like it does for kids- or anyone in a power dynamic that’s skewed to one side. You don’t have to be “tough” to lay your boundaries, just consistent.