When patients are rude...

Something that has been on my mind lately is how we deal with patients who are rude and uncooperative. How can we understand rudeness in our patients and their family members? I believe that the cause of these behaviors is the stress these people are experiencing. They are out of their usual environment, they feel they have no control over what is happening. Depending on their mental functioning they often don't understand what is happening either. Often their life as they knew it has suddenly been torn away from them and they have no idea if or when they will get back to it. They are expected to conform to the routines and rules of the institution, often with no consideration for the routines they have had at home. Of course they are stressed, frustrated, angry.

Occasionally, and unfortunatly much too often, I see and hear in my coworkers a lack of understanding for these reactions from patients. A tendency to react to rudeness with threats, withdrawal of care, retaliation. It concerns me, because we as caregivers are in fact in a position of power, and because of that we cannot, must not retaliate when being unfairly or meanly treated by our patients or their family members. In fact it is my experience that what the rude, uncooperative, anxious and needy patient needs is that we give them even more of our attention, listen harder, understand better, go the extra mile in caring because it is the stress and insecurity that is causing the behavior.

What is it then that causes excellent, compassionate nurses and aides to lose this perspective, and make it impossible to give the psychosocial care that is necessary to rude, uncooperative and needy patients and their family members? Could it be that this too is a symptom of stress, of being stretched thin, too many demands, too many hours. We are all trying to get through our routine tasks, as well as being alert for and react to medical emergencies and on top of that respond to our patients psychosocial crisis'. Could it be that when we as caregivers start to feel overwhelmed, our ability for understanding and compassion becomes compromised?

I too am struggling with burnout and with how to best cope with these kinds of patients. I too often just want to be left alone to do my work, and not have to deal with these issues. I'm not some sort of Supernurse, and recently, when a patient yelled at me, I just fell appart, and spent the next several hours (!) in my pod dissolved in tears, and while I was not exactly a burden to anyone, I was hardly a resource for either coworkers or patients.