Saturday, March 5, 2011

ER staff abuse and douchebags

So in my wandering around the internets I came across this blog entry that someone had described as offensive to ED workers in that it seemed to blame ED violence on the employees. I actually found the post itself to be relatively neutral- there was a blurb about verbal de-escalation and basically responding calmly and with compassion when someone acts a fool, which I really do believe in- I've dealt first hand with many an agitated patient who I've been able to talk down by apologizing and showing concern. No, I got all irritated by some troll who is supposedly a patient advocate who thinks that if all emergency medical staff are not Jesus incarnate that they should just shut up and GTFO of the medical field.

I won't sit here and quote this hateful person who obviously has some serious issues with med professionals and ED staff particularly, but I do want to address this idea that I've seen brought up multiple times, almost always by someone in health administration, that if medical staff were just kind and compassionate enough that all our patients would stop acting out and being violent and verbally abusive.
Theoretically this doesn't sound so offensive, but think of it in any other scenario. What if my husband comes home after a really awful day. Work sucked, he got sick, the car broke down. Let's say in this scenario that I reply in a less than chipper tone about his request to get him a drink, to which he responds to by hitting me and calling me a series of obscenities. That's wrong, isn't it? Now, what if he does to the gas station attendant on the way home instead because the line is too long and they had an attitude? It's a felony, isn't it? Would anyone say to either of these people, "If you had just been a little nicer and more understanding, you wouldn't have gotten beaten. You should have known he was upset and treated him better"? No. Because that is victim blaming and excusing abusive behavior.
I have no idea why people think that it is then acceptable to act that way in a hospital setting. Look, I understand that people get agitated and frustrated, that they're having the worst day of their lives and most people in the ED just want to know what is going on, be made comfortable and be listened to. I make it a point to address those needs for each patient I take care of every time I come to work, to the extent that I often neglect my own basic needs like eating, drinking and going pee. I give everyone who walks into my room the benefit of the doubt about being sick and in pain, and even if I'm suspicious I still treat them with respect and kindness. Despite all that, guess what? The ER is a pretty good representation of the world in that most people are just there minding their business but some people are assholes. Some people lie to and manipulate the staff trying to help them to try and get something. Some people are high or drunk or just abusive and think it's acceptable to grope the staff. Some people have minor ailments but are abusive and threatening about waiting behind the sick and dying.

There are the cases where a patient is so sick that they're hysterical and rude and very difficult to deal with. I have a great deal of patience for people like this. I fall short with them sometimes and when I do I apologize. This is very seldom the case, though. As I'm sure many other ED doctors and nurses have observed before, the sickest patients are generally the most sweet and polite. A good friend of mine still tears up telling the story of the dying cancer patient she took care of last year-despite her horribly painful condition, she was so grateful for her care that she gave my friend a hug and a kiss for just bringing her some orange juice.
On the other end of the spectrum, I got cussed out the other day by a completely pain free, healthy and ambulatory patient because I relayed the message from the NP that she would have to get a urine sample prior getting the pelvic exam she demanded. I can't speak for anywhere else, but where I work this is usually where the problems come from- mostly healthy people who use the ED as a clinic who have figured out that aggressive and abusive behavior goes unpunished, as opposed to fragile sick people at the end of their rope.

There's no way of knowing whether violent behavior could always or ever be prevented with better communication. Ultimately it doesn't matter. Unless you have some kind of neurological problem, you are still responsible for your actions, and that kind of behavior isn't okay. I invite anyone who says otherwise to try to work a shift with me in the hood for one day.


  1. Amen. I am so with you. Most nurses I know go out of their way to be respectful to all patients and give them the benefit of the doubt as to their condition. And it is the sickest ones who are the nicest! The worst cussings out I have gotten were from the drunk drivers who were fine, but who I was not letting off the backboard yet until clearance. Oooh they could come up with some nasty combinations of swear words that I had never even thought of before.

  2. Amen times two. Honestly, some of the abuse I have seen (and been on the receiving end) in my 35 years of nursing, I hate to say it but I am so glad to be DONE with hospital nursing. I will NEVER go back. My girlfriend lost all her front teeth when a patient hit her with a phone. I have been punched, kicked, spat on, yelled at (not only by patients but by MDs too) cursed and have seen the most awful displays of behavior for absolutely no reason. I have never been anything but polite and accommodating, and most people will tell me they can *tell* I love my job.....but due to those out there that do all the abuse...I am so DONE.

  3. Bravo! I'm so tired of people thinking we are supposed to be kissing their ass while trying to help them.

    Violence should never be tolerated.

  4. That "patient advocate" is funny. We in the medi-blogosphere call people like that THE CRAYZEES. Or borderlines, whichever.

    The dumb part about that post is that Kevin thought hospitals in Detroit and Boston etc. should forgo metal detectors and increased security for "empathy". Like empathy INSTEAD of metal detectors, as if the two are somehow mutually exclusive. I just found that to be pretty hilarious personally.

    "Well, my ER has a metal detector, looks like I can just treat everyone like sh*t now."

    Randomly, one time I stopped in Detroit on the way to Canada to take a leak, and, in the time from the gas tank to the gas station and back (grand sum of probably 100 feet), I got asked x 1 if I wanted to buy drugs and asked x 1 if I was wanting to perform fellatio for some money. This was just at the GAS STATION! God help the poor ER nurses there.

  5. I guess I just overlooked that as hyperbole when I was reading the post but going back over it, that is hilarious. Also, your response post was fucking gold. Yeah, my stupid ass hospital had bullet proof glass at the triage desk but some fucktard in management decided it should be taken down because it "didn't feel welcoming". I guess once they took it down all the staff had to be more compassionate for fear of getting shot in the face.

  6. I have to agree that the nicest patients are often the sickest, and the rudest, most obnoxious and impatient are the ones who come in for a hangnail or the like.
    on the other hand, ive had my shortcomings. my patience jar sometimes comes close to empty because people assume that RN = maid = never ending smiles = never ending patience = unlimited niceness. uhm no. you cannot be rude to me/yell at me/curse me out/talk shit about me to another patient bc of something i have no control over. sorry, but i the RN at the end of my name doesnt mean i will take that abuse.


  7. However, I was abused in a hospital ER by an RN. I had the bruises to prove it. She got away with it. I was the one who spent time in jail for self-defense. I have been in and out of hospitals a lot in my lifetime for health issues. I have never been treated so badly, or ever have I had a nurse to be uncompassionate, hateful, disrespectful, or uncaring. There are great nurses and hospitals. However, one bad apple can ruin the bushel.
    I know in my heart she will pay for what she did to me.....She is a liar,and her day will come. That is my peace with her actions!

  8. to the person who posted the only negative comment about their nurse abusing them. First of all if you choose to work in the healthcare profession chances are you have no reason to just abuse someone unless it comes in the form of neglect. I am sorry but there is a reason im sure she "got away with it" and you did not. Probobly because you feel entitled and of course you will deny it. Also a majority of people who are IN AND OUT of hospitals all their lives did it to themselves and probobly from all the meds you are on for so long. I am also guess you have been diagnosed with firbromyalgia or some chronic pain sydrome and are overweight and expect those poor 90lb nurses to move your fat ass from bed to bed because you cannot/will not. As a paramedic i have nothing but respect for a HOSPITAL nurse, especially in the ER. Lay the blame for your bruises on someone else. You went to jail dumbass, that means either a judge or a group of YOUR OWN PEERS even found you at fault. I hope you are a very very lonely person.

    1. To the one whom posted above.........YOU HAVE NO IDEA. First of all you don't know me nor do you know the situation at hand. I do have various health issues. However, you don't know the whole story, but when a nurse grabs you and bruises your arm. Is wrong. I was taken via ambulance to ER for heartattack. As I said before never have I been treated with such disrepects.....I AM NOT over weight, and I have also worked in a hospital myself. So, I see you also have not compassion! You know where you can go!!!!!!!!

    2. In defense of the person that you are bashing with hate and cruel comments. Let me say this~I doubt very seriously that you are a "paramedic" due to your attitude. If you are a real paramedic you would have more compassion and understanding in your heart. You would also realize and understand that bad things to happen in hospitals. You were not part of the situation therefore, you have no right to make such comments to someone who went to an ER for assistance in the time of medical attention. I have the upmost respect for health care professionals. However, you are being unprofessional as a health care "paramedic." I would suggest that you find another profession due to your hateful attitude. Because those who depend on you for assistance will be in danger. You should never wish upon someone to be a (very, very lonely person). Just remember what goes around comes around. It does not matter the size of a person when they need medical attention. You speaking out of turn about someone's weight is unprofessional as a "paramedic." There are a lot of people who are overweight due to health conditions beyond their control. Not eveyone in this world is "90 lbs" as you say. I doubt the nurse in this sitution was a 90 lb person either. Would you like to tell your weight? If you think there is not abuse, medical malpractice, sexual assualt in health care facilities in this country you need to listen to the news and do your research. I will pray for you and your patients as you do your "paramedic" duties. "DO NO HARM TO THOSE WHO ARE SICK" I wish you peace & happiness in your life and stuggles.

  9. Nurses and doctors are some of the most abusive people I've ever met. Many have huge chips on their shoulders as they proclaim, "I'm not here to kiss your ass" and other such comments. No one wants them to kiss their asses. We just want the verbal abuse to stop. I've witnessed so much abuse by nurses and a couple doctors in nursing homes that I've stopped working as an PN and turned to bartending as I refuse to shut my eyes and mouth to patient abuse and patient abuse is rampant in hospital and nursing home facilities. I also tired of my fellow nurses STEALING the patients benzo and pain medications. I'm sure that some hardened nurse will deny all I've said here and proclaim me to be a "troll". I assure you, I'd NEVER leave a loved family member alone in a hospital or nursing home to become a victim of some hysterical, stressed-out-nut who slyly takes out their frustrations on some poor , sick elderly person when they thought no one was looking. Nurses like to project that they're saint's. Many are far from it. The truth hurts.