I have a well earned rep as a nurse who -- while I do feel and show compassion for my patients -- feels that an emergency department is for emergencies and I do not have a lot of tolerance for shenanigans in the form of acting out, cursing, rudeness, etc.
Recently, I had a little old POIAGG who from the moment they were wheeled into the department was just rude and downright mean. Shouting at everyone, saying, "I don't even want to be here, that one (pointing to spouse) made me come in. I just want to go home!" POIAAG was brought in for shortness of breath, but it was hard to believe with the constant stream of just ugly comments that kept being shouted.
Thankfully s/he wasn't my patient.
However, s/he was the patient of my "neighbor". So, when that nurse was headed off to lunch, I got to deal with little Mr/s. POIAAG. My neighbor, being a stellar nurse, had just made sure all her patients were tended, vital signs up to date and no pending orders, so expected (and in fact suggested) that I would not have to engage any of them, just keep a lookout.
As it turns out, Mr/s. POIAAG started shouting out that nurse's name. I heartily wanted to ignore the shouts and heed my colleague's advice, but I just couldn't. You never know when something can go really badly. So, I took several deep breaths, said a prayer and pledged to myself that I would not allow this grumpy old geezer to get to me.
I went in the room to find the call light not in reach -- not this nurse's normal MO. I discovered why when I attempted to attach it to the siderail, s/he grabbed it and threw it onto the floor, saying, "Don't put that in my face." I attempted to explain that having the call light close would alleviate the need to shout for someone who may not be around and provide help from anyone who was available. S/he shouted at me and said, "I want out of this bed and I want to go home!" I said, "Well, you certainly have the right to leave and go home any time you want. But you have been short of breath, so you probably ought to see what's going on (s/he ended up being diagnosed with blood clots in the lungs). S/he said, I don't want to just lay here, it's not comfortable! My back hurts and I want to sit up!" As s/he had already refused to allow staff to keep monitoring equipment attached and had also removed the supplemental oxygen that had been placed, s/he was now an alarming shade of gray-ish
I kept my voice calm and soothing and made a couple of suggestions about ways we could make the patient comfortable and s/he had no inclination to do any of them. So, I very calmly said, "If you do plan to stay here, you have 2 choices -- allow me to help you become more comfortable or stay where you are."
Eventually we got the patient up to a chair, but in doing so s/he became very short of breath and actually reached for the oxygen tubing and replaced it.
I then heaped blankets on and let the patient vent for a minute about the ordeal they had suffered -- recent diagnosis of cancer and all the attendant fear and side effects from treatment and frustration at lost independence. I began to feel for this patient in a way I hadn't when it as just an angry voice screeching down the hallway.
S/he had also allowed me to put monitoring equipment back in place and update vital signs. After a few minutes, s/he reached up arms in the universal sign of "I want a hug" and pulled me close and cried. "I'm not a mean person."
Nah, s/he isn't. But, it was easy to believe s/he was when I had no idea what was prompting such ugliness.
Hurting people hurt people. I know this, but sometimes we need a reminder.
Don't worry, Nurse Bananahammock isn't becoming a bleeding heart, but sometimes I need reminding that everybody feels hurt and scared and vulnerable sometimes and sometimes they just need to feel that someone else gets it.