The Customer is NEVER Right - A Nurse Practitioner's Perspective
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My reply to an article titled "One liner to diffuse escalating situation with patients".


Is it not interesting you do NOT hear your septic crashing patient yelling that you save her live? Is it not interesting that you do NOT hear your septic crashing patient yelling because he fears of dying? Is it not interesting that you do NOT hear your septic crashing patient throwing a tantrum because of the anxiety she may never see her loved ones again? Is it not interesting you do NOT hear your septic crashing patient being belligerent because of his loss of control and powerlessness to staying alive?

But your septic crashing patient is YELLING, quietly, not in an inappropriate manner but CHEERING that you and your peers and colleagues are able to save her life. Actually, your septic crashing patient is doing an end zone dance, arms flaring, feet scooting and bootie shaking. But he does so quietly while laying there ROOTING you and your teammates allow him another day he can spend on the planet with loved ones.
There is not a shred of evidence, NOT ONE, that shows anyone has EVER died of pain, EVER.

Here is The Knitted Brow’s one liner to diffusing escalating situations with patients—All of us are here to help. We are not here for you or anyone with you to be inappropriate to us. These are your choices (1) you remain appropriate and let us help you or (2) you’re discharged.

That one liner without mention of other patients or that we are trying our best, are understaff, the computer crashed, that I was too short to play football or that there is a full moon outside. Nothing. I do not offer a single excuse as to why patients and/or families act inappropriate. Why? There is NOT a single reason, much less an excuse, for such behavior.

Those are the choices because neither I nor anyone on the shift with me is a punching bag to anyone. Not a verbal punching bag. Not a physical punching bag. We ARE NOT punching bags. Not to patients. Not to families. And not to administrators either.

Again, NO ONE HAS EVER DIED OF PAIN. NO ONE.

Nor have they died because it is too noisy at the nurses’ station, the hospital food sucks or whatever favor of the week it is.

As long as healthcare continues to be a doormat not only will others walk all over you, they will wipe their feet on you as well.

Putting an inappropriate patient and/or family in their place is NOT a lack of compassion or caring either. It is purely NOT acceptable behavior, the operative word being NOT. And behavior we would not accept at home from our loved ones. So why should we accept such venomous behavior from those we are helping. NO!

Septic crashing patients NEVER complain, even if they succumb, not because they are unable to but because they appreciate us for the care we are giving them. The only ones who throw tantrums and complain are those with EXAGGERATED UNREALISTIC EMOTIONAL EXPECTATIONS.

And if after my one liner the patient continues to be inappropriate, as in this case because of a kidney stone, I return with a prescription of Percocet, Flomax and Zofran, kidney stone discharge instructions, a urology referral and tell the patient they are discharged.

I, then, without another word, go see the next patient. As most, like 99% of most, patients value, trust and appreciate us for the care we give. The 1%, or even less, who are rude, entitled, abusive, demanding and those with EXAGGERATED, UNREALISTIC, EMOTIONAL EXPECTIONS I dismiss. I dismiss outsiders (JACHO, Magnet Status, HCAPHS, etc.) who have taken healthcare down the wrong tracks as well.

That means I ONLY side with employees, coworkers and peers over petulant, unreasonable, angry and demanding patients or outsiders looking out for their own interest. This is not about us versus patients. This is about convincing patients we are looking out for their best interest and if they desire our help they must stand with us. If they decline they MUST leave. Because asking to be catered to until they get what they want is manipulative and not what we are here for as it only divides healthcare workers trying to help others.

On this, healthcare must stand in solidarity and not waiver otherwise those who annoy us will not change their behavior as long as they can find tolerance elsewhere.

I know. I know. Critic will suggest I find another career but the 99% who appreciate the care we provide disagree and it is because of them, the 99% who appreciate us, that I stay and now its been over 30-years. No one fatigues from compassion. What we fatigue about and are frustrated with are the eggshells we must walk on to keep our jobs of helping others. Don’t be a punching bag. Don’t! Just my two sense [sic].

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