Urinals Fly, Boundaries Apply: Real Talk on Handling Difficult Patients

Conflict is inevitable in healthcare, but how you respond to it defines your nursing practice. In this raw conversation, Colby and Christopher tackle the challenging reality of patient aggression toward nurses – from verbal abuse and name-calling to physical threats and inappropriate touching.

Drawing from their combined experience, they share powerful stories that illuminate the daily challenges nurses face. Christopher recounts being called racial slurs by patients, while Colby describes an incident where a confused patient attempted to pull her into bed. These aren't isolated events but common occurrences that nurses traditionally accepted as "part of the job." The hosts challenge this outdated thinking, emphasizing that healthcare professionals have rights and deserve safety.

The conversation delves into practical conflict resolution strategies that maintain professionalism without sacrificing personal boundaries. Using Brené Brown's principle that "clear is kind," they discuss how direct communication with patients about inappropriate behavior often leads to better outcomes than avoidance. The hosts examine the critical thresholds that indicate when it's time to request reassignment: when your safety is threatened or when you cannot provide safe care due to your emotional response.

Two compelling spotlight cases illustrate these principles in action. In one, a patient with endocarditis refuses critical antibiotics while demanding only pain medications, escalating to verbally abusing staff. The hosts explain how documentation and proper protocols led to an "administrative discharge" – a rarely-used but important tool for healthcare facilities. In another case, a patient experiencing steroid-induced psychosis leaves the hospital without notice, later falsely claiming a nurse had threatened them.

Whether you're navigating difficult patients or workplace conflicts with colleagues, this episode provides essential guidance on maintaining your professionalism, knowing your rights, and protecting your wellbeing in challenging situations. Subscribe to continue learning how to thrive in nursing's most challenging moments.

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Episode Transcript

Speaker 1 (00:00):
Welcome to Nursing Life 101, the most important
nursing class you never got totake.
In nursing school we will betraversing different objectives
like interviewing, what to do innursing school, boundaries
burnout and so much more, ifthis interests you.
I hope you are taking goodnotes because class is now in
session.

Speaker 3 (00:45):
Hello and welcome to Nursing Life 101.
We're so excited to have youhere with us as we dive into the
world of nursing, sharing ourexperiences, insights and a
little bit of fun along the way.
I'm Colby and I couldn't behappier to introduce my co-host,
hey guys, it's Christopher.

Speaker 1 (01:02):
Together, we'll be bringing you real stories,
practical tips and discussionsabout all things nursing,
Whether you're a fellow nurse orjust curious about the life
behind the scrubs.
We're thrilled to have you joinus.

Speaker 3 (01:15):
So the topic today is conflict resolution.

Speaker 1 (01:19):
And this kind of delves a little bit into what's
kind of pertinent today, withsome interesting stories about
patients attacking nurses alittle bit.
It's not as in-depth as it willbe That'll be a different topic
for a different day but it was.

Speaker 3 (01:41):
It is kind of like a hot topic that is being talked
about quite a bit right now.
I see it on social media everyday.
There's like a big movement andjust making it more well known
the treatment that nurses faceon a shift to shift basis every
day because you interact.

Speaker 1 (02:02):
it's very much in terms of customer experience and
customer service as arestaurant, because I mean, yes,
it's different because they'repaying for a service, they're
paying for a food and it's notnecessarily their health, but
you have to be mindful of, like,how you interact with a patient

(02:22):
because of this whole patientexperience.
And then that also builds intoMedicaid and Medicare and how
the hospital gets reimbursed butpeople.
People are mean and can be mean.

Speaker 3 (02:37):
Yes.

Speaker 1 (02:38):
And it can be even worse because they're sick Now.

Speaker 3 (02:41):
Granted, they're probably being a jerk and have
always been a jerk, but evenwhen, it doesn't change the fact
that when someone's acting acertain way that they it doesn't
change the fact that they needmedical care Right, and
ultimately, that's what we'rethere to provide.

Speaker 1 (02:58):
Yeah, and so I guess you know that comes up with the
question of like.
When a patient doesn't like you, how much do you take Like?
When's your breaking point?

Speaker 3 (03:10):
I mean I'm not.
I think every nurse has theright to feel safe in an
environment.
So the second, that if it'simmediately that person feels
unsafe, you can take absolutelynothing and be like nope, I'm
not doing this today, I'm goingto get a reassignment and you're
totally.
I totally support that and I've, as charge nurse, have made

(03:31):
quick assignment changes, um,when needed, and just you know
you have to explain to peoplewhat's going on.
But I mean, that's just part ofthe job.
Unfortunately.
I think probably every singleperson has faced something
sketch, at the very leastsketchy, if not actually scary
um, that works in health careand so everybody's understanding

(03:52):
when something like that popsup, but outside of like your,
your, your feeling of safe beingthreatened, um, I mean, I think
you have to always remainprofessional and remind yourself
that you're there to perform ajob.
But at some point, like again,even if you don't feel like your

(04:14):
safety is being threatened, youcan, you can just say I can't
do this anymore, like, and Ihave also done that personally
and have or been on the otherside again as charge nurse and
remade an assignment.
Everybody is individual and Idon't think that like my, my
point of break of telling myselfokay, I can no longer care for

(04:34):
this patient because their,their treatment of me is going
to like, diminish my ability tocare for them, so I I know when
to walk out.

Speaker 1 (04:44):
But I mean I get that and I do understand, but like
there's a point where we have tobe a little bit tough skinned,
I mean you can't.
Legitimately I've been calledthe N-word, I've been called all
kinds of words under the sunthat was derogatory to me, being
a black male.
And now, granted, I probablyshouldn't have taken it and I

(05:07):
should have changed myassignment.
That you know like I shouldhave said something.
But I one know who I am and I'mvery confident in who I am.
And them saying something is notgoing to change how I deliver
my care.
But there are points where evensomething as simple as or
simple as like you're slow, youknow like people, and people

(05:33):
have allowed themselves to nothave as tough of a skin because
people are more willing tochange an assignment.
And I'm not saying you as acharge nurse, was doing the
wrong thing, I just feel likethem just doing a simple like

(05:54):
you're taking forever today.
Or you know, like people Idon't know, maybe you haven't
had that happen I've seen peopletry to change an assignment
because it was something assimple as that.

Speaker 3 (06:03):
That's silly, honestly.
You know it's silly, but itdoes happen.
Now that I'm thinking about itLike it's, I've definitely seen
people try to like tiptoe itthat way and be like they don't
want me to be their nurse todayand I'm like, you're still their
nurse today.
Like there's sometimes peoplelike if it's a patient that's
like a particularly difficultpatient and where we like, we'll

(06:24):
rotate, we'll like quoteunquote rotate those patients so
like nobody has to take care ofthem more than just one shift.
But I definitely have hadnursing staff go into a room and
like purposely say somethingthat's like just a little off to
piss off the patient, yeah, andthen be like, oh, they don't
want me to be there anymoretoday and I'm like, come on, man
, you provoke that, right.

(06:45):
But I've also seen people notnecessarily provoke it, but the
patient just is already startingas soon as they open up their
eyeballs and start saying stufflike that and I'm like, no, like
I'm not redoing the assignment.
So, and sometimes the patientswill be like I want a different
nurse as soon as they open theireyes and you have to set
boundaries with them.
That was like you don't evenknow this person.
They haven't.
You haven't even given them achance.

(07:06):
We're not going to do thistoday.
Like you can't fire every nursethat comes into your room.
You're here because you needmedical.
Like you have to remind thepatient, like one, why they're
here and what our job is andthat we are doing our job.
And that's annoying andunfortunate that we have to, but
that's reality.

Speaker 1 (07:24):
It is, and that's why I was like, like, how much do
you take it?
Like I know you also have gonethrough a very tough situation
and have toughened your skin andhave allowed yourself probably
to go a little further than whatyou probably should have.

Speaker 3 (07:41):
Yeah, I would say in the past, definitely, probably
should have.
Yeah, I would say in the past,definitely.
But also because of my role inas the save champion, which is
situational awareness of violentevents and basically are just
kind of like the safety champion.
It's like, you know, going toall the meetings at the
hospitals, changing policies andall this stuff is just like
bringing it back to the floor.

(08:02):
That's basically what thechampion role is, and then we
have some like with differentlike subjects I guess.
But anyways, as my that was atangent but in my role as the
save champion, I think we'retrying really hard as a health
system to change the narrativeof nursing, just kind of like

(08:22):
taking abuse from patients,right, and just kind of the old
mentality of it's just part ofthe job.
So I am actively trying to kindof change people's thoughts on
that and like, yeah, I, I have.
I've been a nurse for 10 plusyears and, yes, I've had a
urinal full of urine thrown atme, I've had been spit on, I

(08:44):
have been cussed out, I havebeen my life has been threatened
.
Patients have lunged at me,I've been hit, like it, and at
one point it was just, it iswhat it is, but we have rights
as staff, and so I just likedfor people to be educated on
that and like what the hospitalwill do to support us if
something was to happen.

(09:04):
To be educated on that and likewhat the hospital will do to
support us if something was tohappen.
What laws are there?

Speaker 1 (09:08):
to protect us that kind of stuff.
Yeah, and I you know it's it'sdefinitely a difficult line to
to cross and there I appreciatethe the save committee because
it does.
We as staff members have rightsand we as humans have rights.
Like I mean, you, just youcan't, can't go threatening
somebody.

Speaker 3 (09:27):
Yeah, you can't walk into a grocery store and tell
somebody that I don't even knowsomething crazy.
I honestly I'll.
I'll use an example of what.
Something that actuallyhappened last week on our unit.
I'll say what happened, but putit in the case of going to the
grocery store.
Oh, interesting week on ourunit.

(09:52):
I'll say what happened, but putit in the case of going to the
grocery store.
How interesting.
Okay, you can't go to thegrocery store and grab the
cashier and pull her into youand kiss her neck and say hurry
up and come back, so I can do.
Quote unquote oral sex on youlater yeah, and the and the
nurse that got told that didnothing to provoke it was only
being professional, and thispatient was just like to do that
is disgusting.

Speaker 1 (10:12):
Yeah.

Speaker 3 (10:12):
Yeah, if you can't go to the grocery store and do
something like that, what makesyou think you can grab a nurse
and do that?
That is gross, so disgusting sogross yeah, absolutely
repulsive, like were they okay?
Yeah, luckily, but, like the,in the way that I would have

(10:32):
highly considered pressingcharges oh, I would have
probably just punched them and Imean yeah, uh I don't like
being touched in the first place, so yeah, like Just absolutely
disgusting.

Speaker 1 (10:47):
But yeah, wow, I can't believe people so like,
how do you, how do you setboundaries?
Like there's a point where weas nurses and all of you know
there's something called thedaisy and those things are
somewhat coveted as a nursingachievement.

(11:08):
You were able to get this daisyand were seen as a nurse that
does above and beyond just thenormal call.
So how do you set thoseboundaries to get the daisy but
also not lose your sanity?
Like we said this in the firstepisode or second episode,

(11:32):
you've never gotten one oh, I'vegotten one since then.

Speaker 3 (11:35):
Oh, my first daisy boundary is setting and like
when is when it?
Like when do you give up thedream of the daisy right?
and just like I need to getthrough this shift I mean, let's
be honest, the patients thatare giving us the hardest times,
they weren't gonna write us adaisy regardless.
But let's be like, let's bereally honest.

(11:58):
But no, I mean it's mostimportant to send boundaries
like immediately.
And I'll give you anotherexample like we had this old man
.
He was a little bit confusedand honestly he might have just
been like milking the kid couldnot hear thing, like refuse to
hear where he is and just actedconfused.

Speaker 1 (12:17):
Selective.

Speaker 3 (12:18):
Yeah, selective deafness, like he did it to a
few different staff members.
And then I went in and I, youknow, checked on him how are you
doing, how are you feeling,having any pain?
Yep, you know.
And he said no, no, no, I'mgood.
Okay, you look like you'reenjoying breakfast.
Is there anything else I can dofor you?
And he was like well, and thengrabbed my hand and kind of

(12:39):
pulled me a little bit and saidyou can get in this bed with me.
And I was like, sir, I met yourwife.
What do you think she would sayif I told her what you just
told me and three other staffmembers today?
I don't think she'd be veryhappy.
And he said, oh yeah, you'reright.
So sometimes a little shame isnot frowned upon.
You should just go ahead andshame them.

(12:59):
I mean, but read the room,because obviously somebody else
isn't going to respond to thatbut like there are little ways
that make it less awkward ormake the person feel like I mean
not to say that you shouldn'tmake them feel this way, but
like you can say things thatwouldn't make them feel like

(13:20):
accused of doing something bad,you know, because sometimes
that's going to further, likesnowball into a more difficult
or, you know, it will continueto get worse.
Right.
If you say the wrong thing tosomeone, so like a confused-ish
old man who thinks he's beingkind of cute like you can kind
of let me be real cute rightback I want to tell your wife on

(13:43):
you and it's okay.
But then there's some peoplewhere you do have to have like a
more direct conversation, right?

Speaker 1 (13:53):
yeah, and it all depends on the person, right
like it.
If it's a person that's an oldman, he probably is very much a
old timey person.
So by this time if they'restill married, divorce is
probably not a thing and sayingsomething to bring up that he is

(14:17):
married is going to bring shameonto him and his name right.
But if it's just a 20-year-oldwho you know had just got
married and is thinking aboutgetting a divorce already, like
he doesn't care if you're goingto tell his wife, so you sit and
you say, sir, this is not howyou're going to talk to me.
We are going to be here foryour professional as a

(14:41):
professional, taking care of youand making sure that you are in
a healthy state and you beingsexually aggressive is not
appropriate.

Speaker 3 (14:54):
Shut it down Right.

Speaker 1 (14:56):
And that's okay.
And you didn't say anything outof the way.
You didn't say any slander.

Speaker 3 (15:01):
Yeah, you just put it out there, just out there
there's a.

Speaker 1 (15:05):
There's a um inspirational speaker slash
author, who her name is BreneBrown, and my manager absolutely
loves, yeah, okay so both Colbyand my manager love Brene Brown
and one of her her sayings isclear is kind.

Speaker 3 (15:25):
Clear is kind?
Yes, it is.

Speaker 1 (15:27):
And so being very clear and telling people because
really and truly, we as nursesand I think we've said this
before we have to build trustwith our patients.
And building trust with yourpatients means that you are
going to tell them how it is inthe best way possible that you
can tell it, and the best waypossible is for you to be clear.

(15:48):
So you're going to set thatboundary and say this is not how
I'm going to be handled and I'mgoing to be professional and
ensure that you get the bestcare that you can, but you
saying this is not allowing meto do that.

Speaker 3 (16:07):
Right.

Speaker 1 (16:09):
And, as you're clear to them that, honestly, it might
at first seem like it's cuttinga bridge or tearing down a
bridge, but they're going to belike, oh you know what, I'm sure
they're probably going toactually take care of me because
they took guts to say stop that.

Speaker 3 (16:27):
Yeah, a lot of times you'll find like after you kind
of just like are verystraightforward.
It's almost like, oh, okay,I'll respect them now.

Speaker 1 (16:35):
Yeah.

Speaker 3 (16:37):
And this is so annoying, like we shouldn't even
have to have theseconversations.
You'd think people would justbe normal human beings, but
apparently the normal is thatthey're all weird, like my
normal is not the majorities no.
Is what we learned.

Speaker 1 (16:56):
And it's interesting because there are so many nurses
that truly want a daisy.
They truly want a daisy.
They truly want a daisy.
And those, those patients thatare sexually aggressive or
sexually inappropriate or juststraight nasty are not.

(17:17):
Don't be the ones that writeyou a daisy more than likely.
So you know just forget aboutthat.
You know, really focus and putyour energy in the ones that are
nice and probably will writeyou a good review assignment,
but like how do you, how do yougo?
about asking for a newassignment and I guess think of

(17:48):
it as a Clin 1, who is probablynew and is kind of timid and
like oh my gosh, I'm picturinglike a Clin 1, just like not
asking and like praying thatsomebody helps them.
And goes home and like criesthemselves to sleep I it's like
I had the worst day ever.

Speaker 3 (18:06):
I need to quit this job.

Speaker 1 (18:08):
I'm out, which is not what we want.

Speaker 3 (18:10):
No, I hope that, as a new grad nurse or graduate
nurse or Clin1, whatever theycall you at your facility, like
I hope that you have some likefaith and trust in your
leadership.
I mean literally, yeah, um,like faith and trust in your
leadership.

Speaker 1 (18:24):
Mm-hmm.

Speaker 3 (18:25):
I mean literally.

Speaker 1 (18:26):
Ooh.

Speaker 3 (18:27):
Yeah, because really, I mean, if you were just
getting off orientation andyou're having you got like a
shit assignment and you likesomebody is just cussing you up
and down and you're frozen likeI'm seeing it, like you're
frozen Right, you don't knowwhat to do, I hope somebody's

(18:47):
watching you like I hopesomeone's looking and and not
like watching you like we'rewatching you get yelled at, I
mean, like I always feel likesomebody's.
I hope someone is like mamabearing you or papa bearing you
like, like keeping an eye outand watching you throughout your
day and checking in so that ifthey, if that way, you either

(19:07):
one felt comfortable enough tocome tell that person, whether
it's a charge nurse or anothernurse that's just working, or
your manager or your sisternurse manager like I hope that
you have at least one personevery shift that you were like
this person's looking out for me, like that you could tell and,
at the very least, that you,that your charge nurse, is
actually looking out for youbecause that's a part of your

(19:28):
job as charge nurse is to watchthe like watch everybody, but
keep an extra special eye on onthe new grads that are off
orientation and now flown thecoop and are out there, you know
, floating like trying to hangon like doggy paddling.
They're doggy paddling out thereand you just need to make sure
you know you can throw liketrying to hang on.

Speaker 1 (19:43):
They're doggy paddling.

Speaker 3 (19:44):
They're doggy paddling out there and you just
need to make sure you know youcan throw them a bone if they
need one.
So it's like I definitely keepa close eye on my grad, like my
new grad nurses, once they'reoff orientation and if I and I
work, my unit split to two units.
We have a big unit and like a12 bed unit and this isn't just
go for my new grad nurses.

(20:04):
Like I have walked in on rooms,like my ears, my hearing is
great, like if I hear a voiceraised, you better bet I'm
walking.
I'm doing a drive by at leastLike are you handling the
situation?
Do you need backup?
Because I'm here and I'll walkin.

Speaker 1 (20:23):
Well, yeah, and you know, the interesting thing is
that you, you, you are, you've,you're.
I have worked under you one ascharge and then two.
I've seen how you just areinteracting with other patients
and coworkers and it really isinteresting how quickly you're

(20:47):
able to like analyze a situationand be like, yeah, I'm stepping
in, Like I'm not doing that,your unit, like I said once
again, my unit is just so muchbigger.

Speaker 3 (21:01):
Yeah, I know, yours is geographically massive, right
bigger.

Speaker 1 (21:07):
Yeah, I know yours is geographically massive, right,
yeah, and so like it is sodifficult to have our church
nurses be as attuned, becausethere there's no way your ears
can hear that yeah um, but therewas a time where one of our new
clint ones came up and was like, after it was like a day or two
, and I just happened to hear itfrom someone else, and she came

(21:29):
into my office and was like youknow talking.
I was like hey, I heard patientso-and-so, was like really rude
to you.
And she was like yeah, and shetells me the story.
I was like I am so sorry thatyou didn't feel comfortable
enough to come and talk.
You know to tell me that, butnext time do not allow that to
happen.

(21:49):
And please come and get me LikeI'll roll up and because that's
not, that's not appropriate andthat is not fair to you, that
that's ridiculous.

Speaker 3 (22:00):
Yeah.

Speaker 1 (22:01):
And you know I really did.
I felt really really sad that Idid not like I failed her yeah,
you do.

Speaker 3 (22:11):
You feel I can definitely imagine that because,
like, where your heart's at iswanting to protect everybody
right and then you feel likethat person.
Not that you didn't know aboutit in time, so you couldn't but
like that that person wasn'tprotected by someone like oh,
that kills you you're like thisis crazy.
That's bullshit.
You should never had to gothrough that.

Speaker 1 (22:30):
I'm so sorry, you really shouldn't.
Yeah, and, and you know wewe're really focusing on clint
ones, but clint twos, threes,fours, experienced nurses,
however you want to callyourself everybody experiences
the abuse, yeah.
And you shouldn't have to takeit.

Speaker 3 (22:46):
Yeah.

Speaker 1 (22:48):
Even if you're the veteran on the floor like you
are looked up to, but you shouldstill have like you might.
You might be the charge nurse,but you should be willing to
talk to your assistant nursemanager or your manager director
, somebody, because that is notsomething that you should be

(23:12):
experiencing or putting up with,like the occasional name
calling, if it's the.
You know it's hard to say namecalling is mild, but I guess it
really does boil back to whatyou said at the beginning, colby
If you feel like your safety isin jeopardy, you should not.

(23:35):
That's the line.

Speaker 3 (23:37):
Yeah.

Speaker 1 (23:38):
If you're jeopardy, if your jeopardy is in danger,
if your safety is in danger,then pull the plug, pull the
cord.

Speaker 3 (23:50):
Yeah, that's it.

Speaker 1 (23:51):
That's it.
That's all you have to reallyfocus on If you do not feel safe
or if you don't feel like youcan give safe care.

Speaker 3 (24:01):
Yes, because that can be different.
I was just going to say that.

Speaker 1 (24:04):
Yeah, that can be different.

Speaker 3 (24:06):
Yeah, if the treatment on you is making you
feel like you know what, I don'tthink I can deliver optimal
care to this patient at thispoint because I'm so upset or
I'm so angry or I'm so hurt, I'mgoing to step away, right?
Unfortunately, you willexperience that if you don't

(24:28):
know what we're talking about,it's going to happen Like you
can be the best nurse in theworld, but if somebody does or
says something to you, you'regoing to hit.
You're going to hit your walland you're going to know when it
is, and you're gonna be likeyou know what.
I physically can't go back intothis room again.

Speaker 1 (24:47):
I'm one of those people that internalizes a lot
of stuff and just lets it sitand fester.
I've gotten a lot better, butwhen I was younger I could just
remember and my dad I'm sureremembers this story and if he's
listening he probably will kindof chuckle but I had just

(25:09):
gotten over a labral repair, hadjust finished that, and it was
kind of rehabbing my arm and mydad and I played baseball and so
we were playing baseball anddoing all these things and I was
rehabbing in the hallway of ourroom of our house and I'm

(25:32):
rehabbing, rehabbing and notdoing things right, and dad was
like you know, take a break.
And I was so pissed and it justlike everything up until then
had just really boiled and Iwent to go hit my dad and I was
like that's not the right thing,thought better and so I punched
the wall and punched a hole inthe wall.

Speaker 3 (25:50):
Oh no, that wasn't good either, yeah.

Speaker 1 (25:52):
I was like well, had to patch it up.

Speaker 3 (25:56):
Learn a lesson Whole thing, lesson learned.
But let that be your lessonlistening to us today and not
let yourself get to a pointwhere you explode like that,
because then you're breakingyour professionalism.
You're not there delivering thecare that your job is.
The patient has now won.

Speaker 1 (26:13):
Right.

Speaker 3 (26:14):
Basically.
I hate to say it like this, butthat really is what it's like.
It's like they're like oh, Iwon.
You are a terrible personYou're.
You're scaring me.
You were brought to the edge bythis person.
It's you.
You have to recognize whenyou're getting to a point where
that's it.
We're not doing anything elsehere.

Speaker 1 (26:32):
Yeah, and you know it really also is finding and
we'll talk about this later toois finding a way to mentally be
able to heal yourself and makesure you're healthy in spite of
having all these terrible thingsgoing on Codes, people dying,
abuse by patients, co-workersthat get on your nerves, like

(26:54):
all those things build up andyou can't allow it to just
fester.
You have to find that outlet ina very healthy way and do
things outside of work, Even inyour 30-minute break, because
I'm going to emphasize thatagain, you need your 30 minute
lunch break, because that needsto be a time where you
decompress for that first halfof your day and because, who

(27:17):
knows, you might have threepatients that code on you in one
day and you have to still work.

Speaker 3 (27:23):
Yeah, you have to keep going.

Speaker 1 (27:25):
And you can't break down.
Nursing is a strong professionbreak down, you've you nursing
is a strong profession.

Speaker 3 (27:35):
You have meaning that you have to be strong, right,
um okay, so is getting a newassignment mean your failure?
absolutely absolutely not.
Let me make that not a littlebit louder.
Absolutely not.
I mean honestly.
If anything, it means that youare, you are in tune with
yourself, right One, like youknow.

(27:57):
Ok, I've got to step away fromthis.
You should be proud of yourselfto know, like when, what your
boundary is, because it's hardto find, especially as a new
grad.
So much stuff that I shouldn'thave, and I've seen coworkers
take way more than what theyshould have.
Um, and seeing you knowleadership, step in and be like
you.
Don't.
We're not doing like, you don'thave to do this anymore.

(28:18):
We'll figure it out Like we'llreassign Um yeah and really and
truly like.

Speaker 1 (28:34):
It's not a failure on your part and it's okay to
spread the love.
Like it it's not love, but likein terms of like.
If you can only take care ofthat person for one shift, if
you genuinely know tomorrow willbe the shift that breaks, you
go ahead and tell the chargenurse, you know, if you can just
remove me from this assignment,if you want a whole completely

(28:55):
new assignment which colbytalked about a couple of shifts,
or a couple of shifts a coupleof podcast episodes ago, but
also if you're just like I can'thave room five anymore, like
that's okay, that's totally fineyeah, we do it all the time.

Speaker 3 (29:11):
There's always notes at the charge desk that says
room five no, blank, blank,blank, like all these names
because we were rotating them.

Speaker 1 (29:19):
Like it's just, we can only do one day otherwise
we're gonna quit this job kindof situation and there are one
and done patients is what wecall them one and done one and
done, that's okay, and to thosethat make that one and done two
or three days more power to you.

Speaker 3 (29:34):
Yeah.

Speaker 1 (29:35):
But you don't have to , especially if it's known that
this patient is difficult.

Speaker 3 (29:41):
Yeah, and that's the mentality in every hospital that
I've ever worked at.
It's like it's the mentalityand the reality of life is that
there's always going to bedifficult people, whether that's
someone you're passing by onthe street or the patient you're
assigned to to take care of forthe day.
And I think it really, itreally like helps to realize,

(30:02):
when you realize that, that youdon't feel that like guilt for,
oh, I can't take care of thispatient, the like.
Does that mean I want everyoneelse to suffer?
No, that's not what's going on.
We are all of the same mind, weall understand what that
person's going through and wejust expect it and sometimes we

(30:24):
make changes on the fly.

Speaker 1 (30:25):
That's healthcare, it's true, and in order to keep
you safe, it's okay to documentsome of these things.
I know certain healthelectronic health records allow
you to put in notes and thenkind of hide it from patients to

(30:45):
make sure that they don't seeit in their personal like mobile
record where they can see theirmental medical records on their
phone, and it's okay to putthose notes in and being like
patient was verbally aggressive,stating blank, blank and blank

(31:05):
yeah, it's always good to quoteright because that's what they
said right, and if it's, if it'scurse words, put those
explicits in there, like it'sokay I do, yeah, okay, I'm like
oh, that's what you want to sayto me, and our personal
electronic health record hasbehavioral flags and it's
able to really emphasize thewhat this patient is doing.

(31:28):
That's inappropriate and in acourt of law, if something was
to happen, if you were to presscharges on someone you need that
information there because youtake care of so many patients
you might not get that courtdate until months after.

Speaker 3 (31:49):
Yeah, documentation is super important.
You just you need to create apaper trail when yeah, when
these adverse behaviors startdeveloping, um, and what you did
to try and mitigate it.
Education that you provided ummedical team.
Notifications of the behavior,like these are all.
It's all important to provethat, like, if, like, if their

(32:12):
behavior is um adverse, uh, likeadversely going with their care
plan, then and they don't wantto participate in their care
plan, and then they're doing.

Speaker 1 (32:24):
You know what I'm saying like I know this story
okay oh well, this is.

Speaker 3 (32:28):
This story is for every single patient oh okay,
never mind but and when I sayevery single patient like any,
when we're talking aboutdocumentation, this is what I
mean.
Like most of the time, thedifficult behaviors that we're
running into are impeding carethat they're there for.

Speaker 1 (32:45):
All right, it's time for this episode's spotlight
case, where we write, break downreal-life nursing scenarios
that left a lasting impact.
Some cases challenge us, someteach us lessons the hard way
and some, well, they remind uswhy we love or question this
profession.

Speaker 3 (33:03):
And today's case is definitely one to remember.
Picture this you're mid-shift,everything seems somewhat under
control and then, out of nowhere, things take a turn fast.

Speaker 1 (33:14):
So let's set the stage for each of us, and here's
what happened.

Speaker 3 (33:19):
Okay, well, literally , quite like I just said,
everything was fine and thenwe're going awry real quick.
We have had this particularpatient quite a few times on our
unit, which often you will findwhen dealing with a patient who
is admitted with infectiousendocarditis related to IV drug

(33:40):
use.
Unfortunately, this patientcame back again for the first I
don't know maybe the third orfourth time this past year with
worsening infection.
I don't think that they evertruly cleared it.
As you can imagine, a patientwith a history of IV drug use or

(34:02):
abuse can have pretty difficultpersonality traits to deal with
.
At times the patient had beenwith us probably for about four
weeks and intermittentlymanipulating team members,
medical team members and nursingstaff into getting what they

(34:22):
want.
Often, for an example, wouldstart screaming and yelling at
staff and refusing toparticipate in the care plan.
He refused medications,telemetry monitoring, vital
signs, the patient was adiabetic, refused glucose checks

(34:46):
, insulin, ended up on aninsulin drip because their
sugars got so bad.
So fast forward, that's to setthe scene.
Yeah, it's a lot, a lot everyday doing the same thing over
again, arguing and trying toeducate and convince and it

(35:07):
feels like it's not worth it.
It feels like it's not worth itevery day.
Yeah, and it feels like it'snot worth it.
It feels like it's not worth itevery day.

(35:27):
It all came to a head after I,on track over the last few weeks
.
I'd been off for a couple ofdays apparently.
The day before things gotpretty heated.
He was out in the hallwayraising voice, screaming, using
cursing language, and I don'teven know, I don't even remember
what about.
It could have been anything,truly, and it was usually like

(35:50):
the smallest things and then, inorder to get him to calm down,
staff was just going downstairsto the cafeteria to get him a
meal that he would prefer, likesushi or which came out of the
unit budget.
Yes, it comes out of the unitbudget.
It's not like the hospital likepays for it right all right, so

(36:13):
he would do things like this.

Speaker 1 (36:14):
We're not that fancy, yeah we are not that fancy.

Speaker 3 (36:18):
He would do things like that, like refuse
antibiotics until he got thesushi that he wanted for example
, and it would be a knockoutscene.

Speaker 1 (36:29):
Oh yeah.

Speaker 3 (36:30):
So the day I come in, Oscar winning Sorry.
Oscar winning scene.
Every time, the day I come in,the nurse that was assigned I
was in charge the nurse that wasassigned to take care of him
went in to give him hismedications, to which he
immediately replied I'm nottaking any of it, except for the
suboxone and gabapentin oranything that'll treat my pain.

(36:53):
Refused the antibiotic, refusedthe antifungal, refused all
these important medications thathe needs to take for his blood
pressure and all this stuff, andthe nurse took all the
medications and said I'll beback when you're ready to take
everything.

Speaker 1 (37:12):
Which is a great boundary to set.

Speaker 3 (37:14):
Yes, and she was walking out of the room prepared
to go send the doctor a messageto let them know that the
patient does not want to takethe medications, except for the
ones that he the two medicationsthat he said that treat pain,
medications that he said thattreat pain um, and he followed
her out of the room aggressively, starts screaming calling her

(37:37):
offensive names, of coursesaying all kinds of crazy stuff
that she's like withholding hismeds because he just wanted the
pain meds and didn't want theantibiotics and all that stuff
that he had been refusing formore than 24 hours.
Documented.
The nurses just say charted,refused, let the doctors know.
The doctors were aware, likeeverybody's been letting this

(37:57):
man get away with all of thisfor multiple days in a row.
I was sitting there when hecomes out of the room and I said
his name and I told him youneed to go back to the room to
which he was then redirected,his anger and screaming towards
myself and I was not the one, no, but I did remain professional.

(38:22):
I told the patient again to goback to their room.
They refused.
I picked up the phone and Idialed our emergency number,
which got our operator to send abehavioral emergency response
team.
I also asked for the police.
The patient then realized that Iwasn't joking around and went
back to their room but was stillscreaming at us from the

(38:44):
doorway when the police came.
So did the doctors, ourhospital security, our nursing
supervisor, our assistant nursemanager and myself as charge.
We all went into the room.
The patient seemed to calm down, said that, then became
agreeable to take all of theirmedications and so I go in there

(39:05):
.
I told the nurse, you don'thave to go back in there, we're
going to figure this out.
And we told with the medicalteam, since this has been
greater than 24 hours just flatout refusing the medication that
he's been admitted and beingtreated for, let's get him on an
oral antibiotic and dischargehim.
So I said, great, I'll takecare of him until he walks out
the door.
I go in, I get all of hismedications, I gave him all of

(39:27):
the orals.
I go to hook him up to his IV.
And I had to go get the scannerfrom across the room and right
before I like right, as I'mscanning everything he is, can I
go to the bathroom?
And I was like, no, I'm goingto finish doing your medications
.
You can bring this IV pole intothe bathroom with you.
So you're going up to theantibiotic.

(39:48):
So, because of how sudden itwas, and it was right, after I
had given him his Suboxone, thenursing supervisor was also in
the room with security and youin the police, and she looked
into the bathroom because shewas like that was kind of
suspicious, observing was a boxlike a to-go food box, and so

(40:15):
she opened it up and lifted upthe washcloth, and in the to-go
box was white pills in amedicine cup, a cut straw no and
a used saline syringe that wasdirty, so it was very apparent
that the patient was crushingsome sort of medication.
I don't know if it was somethingthat he had been getting at the
hospital or if it was somethingthat he had when he came in, or

(40:40):
was it brought in.
That's all.
We're not sure, but it was veryclear that they were using it.
Based off what the syringe andthe straw.
So I got him all hooked up.
He goes to walk into thebathroom and the nursing
supervisor asked him if he hadanything else in there that they
need to be aware of, and he gotvery activated, of course he

(41:02):
did.
Because you know, his secretstash was found and was
screaming all over again.
We all exited the room for oursafety at that time, but then
that did prompt, like per ourhealth system protocol, that his
whole room need to be searchedbecause there could be other
paraphernalia or drugs in therewe work more closely with the

(41:28):
residents and then, you know,they go up their chain of
command.

Speaker 1 (41:36):
The attendant came onto the floor and was like I'll
tell you what we're not goingto do today Not having this.

Speaker 3 (41:39):
We're not doing this.
So he's going to go in.
I'm going to tell him what theplan is and if he disagrees,
then you can imagine.
The patient did not consent tothe search and did not want to
consent to completing hisantibiotic and participating in
his care, and so the doctor saidthat's fine, you will be

(42:01):
discharged.
Then Did he sign out AMA, whichhappens a lot of times.
But I learned that day after 10plus years that there's
something at our health systemcalled an administrative
discharge and it's like when youhave multiple documented
accounts of behavior like this,you know physical and verbal

(42:26):
abuse to staff that the and theydon't want to participate in
getting better and getting thetreatment that they require the
hospital attending can dischargethem from the hospital.

Speaker 1 (42:38):
I wonder if that's something that's done in all
hospitals, because I feel likeif they don't have that there's
a problem.
I mean it should be somethingthat all hospitals should have,
should use absolutely.

Speaker 3 (42:51):
I think sorry.
Should be something that allhospitals should have.
Should use Absolutely.
I think Sorry go ahead.

Speaker 1 (42:54):
No, no, no, and the fact that you have been here for
10 plus years.

Speaker 3 (42:58):
It's the first time I've ever seen it.

Speaker 1 (43:00):
Right.
I was like what, that's aproblem.
I mean, I also had never heardof it until and I was like, oh
my goodness.

Speaker 3 (43:06):
Yeah, I was like I'm keeping that in my back pocket.
I feel like in this day and age, physicians LIPs.
They're so scared of gettingsued, which rightfully so.

Speaker 2 (43:22):
I mean, that's a word , that's a terrible, that's a
nightmare.

Speaker 3 (43:24):
But I think it's almost to their detriment that
they keep patients or beg themnot to leave because of the fear
.
And it's like these patients.
There's so many documentedaccounts of them not wanting to
participate in their care plan.
Why are we begging them to stay?
It's a waste of my time, it's awaste of your time, it's a

(43:46):
waste of their time, and there'sa hundred patients waiting for
a bed in the ED right now.
So what are we doing here?
That's crazy.

Speaker 1 (43:54):
Get them out.

Speaker 3 (43:55):
Get them out.

Speaker 1 (43:56):
Yeah, and it is funny because we do have so many
people that are sick and arewilling to have their care being
given to them.
Where we do, we cater to theseaggressive, combative people and
it's like nah yeah if you needmoney, if the hospital needs

(44:21):
money, there are plenty ofpeople that can give it to you.
Yeah, so my interesting case isI was charged also, so this was
when I was on the floor and Iwas just a wee charge nurse.

Speaker 3 (44:35):
I had just started.

Speaker 1 (44:38):
I think it was literally my first shift off of
orientation as charge.
It was either my first orsecond.
It was within the first weekand I had a newer nurse who was
taking care of a patient who hadjust had rejection of their
organ and they were going on anddoing steroids, pulse steroids

(45:17):
and rabbit or antithymocyte,antithymocyte globulin and they
were going through and gettingthe steroids, but they also had
diabetes and so they were on aglucobander or insulin drip.
And so I'm going in and I havea lot of the times I either wear
my hair in cornrows or boxbraids and I was wearing my hair
in box braids at the time, andso I had beads to kind of help

(45:42):
lay and bring the hair down andmake sure it didn't curl up.
And it makes noise kind of likejingle, like yeah, yeah, that's
my nails, that.
It makes noise kind of likejingle, like yeah, yeah, yeah,
that.

Speaker 3 (45:53):
That's my nails.

Speaker 1 (45:55):
That.
And so I went in and talked tothis patient.
I was like, hey, how are you?
You have this insulin drip andI was changing it.
So I was like telling theclient, the patient, excuse me,
what I was doing and why I wasdoing it.

(46:15):
And I was like, oh yeah, you'regonna be almost off of it in
like two hours because we hadjust given the nph and blah,
blah, blah, blah blah.
And I went ahead and didleadership rounds.
It was like, how are you doing?
How's your care?
They were like oh, it's great,blah, blah, blah, blah, blah,
blah.
And I was like, okay, cool, andso I leave.
You know, yeah, and walk outand continue my leadership
rounds on the rest of thepatient and patients.
And I come back out and my, Idon't think they were clint two

(46:42):
yet.
So my clint one was likechristopher and I was like
what's up?
And they were like patient inroom 25.
I can't remember which room itwas.
I can't find them.
And I'm like what do you mean?
You can't find them.
And the nurse was like I haveno clue.

(47:04):
I checked the bathroom.
Their stuff is gone.
They're not in the bathroom.
Outside of the unit I had my PCTrun down and like, look at the
the cafeteria and make sure theydidn't just like wandered out
to the cafeteria and I was like,oh my God, are you kidding me?
And I had gotten to the pointwhere I was like, oh my gosh, so

(47:29):
what do I do?
And I luckily had anexperienced charge nurse this
was night shift, by the way.
I had an experienced chargenurse that was there and I was
like, what do I do?
And we had to walk through thiswhole process and I intercom
the entire hospital to make surethey were not around the
hospital.
And then we were starting tocall the hospital.

(47:51):
And then we're starting to callthe patient.
We're like call the patient,call the patient, call the
patient.
No answer, none whatsoever.
So much so that they started to, like you know, ignore the
calls.

Speaker 3 (48:07):
Oh, they were just sending them straight to
voicemail, yeah straight tovoicemail.

Speaker 1 (48:09):
Wait, did they take?

Speaker 3 (48:10):
their IV pole with them, or did they take?
So they were just yeah,straight to voicemail.
Wait, did they take their ivpole with them, or did they take
?

Speaker 1 (48:13):
so so so they had just gotten off of the okay,
yeah, they had just gotten offthe insulin drip because of the.
It was like, right, when he hadfinished, uh, the insulin drip
okay.
And so I finally, and I finally, we were like we've got to do a

(48:33):
well check.
I mean we've got to, yeah,because they still have the IV
in.

Speaker 3 (48:39):
Yeah, you know they still have an IV.

Speaker 1 (48:41):
Yeah, they don't have the drip, but they have an IV
in.

Speaker 3 (48:45):
Mm-hmm.

Speaker 1 (48:46):
And so they go to this person's house, which is
over an hour away.

Speaker 3 (48:53):
Oh, gosh Okay.

Speaker 1 (48:54):
And the patient's there.

Speaker 3 (48:57):
They were like bye.

Speaker 1 (48:59):
And I'm like long story short.
This patient said, I quote,christopher the charge nurse
threatened me and I didn't feelsafe so I left and I'm like
there goes my job oh my gosh,that's crazy.

(49:20):
I'm like I am done that's socrazy, as you can probably what
a dirty little liar.
Oh my god it was awful, I was.
I was petrified.
Yeah that I was going to losemy job.
Yes, Like what.
Luckily, this person had haddocumented accounts of there you

(49:43):
go.

Speaker 3 (49:43):
Documentation.

Speaker 1 (49:44):
Steroid-induced psychosis.

Speaker 3 (49:46):
Okay.

Speaker 1 (49:47):
And so they were able to deduce that it was the
steroids, because we were givingthem such huge amounts.

Speaker 3 (49:57):
How did they get home , though?
Did they drive themselves they?

Speaker 1 (49:59):
drove themselves.
Oh Lord, I know.

Speaker 3 (50:02):
Yikes, so did they call an Uber.

Speaker 1 (50:06):
No, no, no, no, because they came in for
rejection treatment, so theydrove themselves here yeah, so
crazy wild.

Speaker 3 (50:15):
This made no so did they get brought back by the
police?

Speaker 1 (50:19):
they didn't.
They actually came, they wentto their local hospital, because
there was a local hospitalthere, uh-huh, and then from
there they got um shipped to uswhich we no longer had a bed for
them.
Oh no, because it was, I mean,within I mean, yeah, someone

(50:40):
leaves, there's a.

Speaker 3 (50:41):
Yeah, there's a person right there, it's a
protocol that we just yeah givethe bed away, and so, yeah, I
that wasn't.

Speaker 1 (50:49):
I'm sorry, that's just a free little story there.

Speaker 3 (50:52):
I mean it does tie into, like the.
I mean unfortunately.
Unfortunately, there was like atrue medical cause for them to
have this thought or idea.

Speaker 1 (51:03):
Right.

Speaker 3 (51:04):
But it does tie into like accusing you of something
that's not true which you'll runinto.

Speaker 1 (51:10):
I was like, oh my gosh, and I was.
I was terrified.

Speaker 3 (51:14):
I would have been too .
But obviously I was okay,because I'm now the there were
no marks on his background checkafter that.
I still have my license.

Speaker 1 (51:25):
I'm now the assistant nurse manager, I think.

Speaker 3 (51:26):
I'm fine now.
Yeah, no red marks on theresume Wow, that's so crazy's
wild.

Speaker 1 (51:35):
All right, so that wraps up the the segment break.
I'm not gonna give you another.
Another case.

Speaker 3 (51:40):
That was the one I was thinking on.

Speaker 1 (51:42):
We'll stick to it yeah, so like to kind of like
wrap this up.
Interestingly enough, patientsaren't the only ones that really
test your patience.

Speaker 3 (51:55):
Patients aren't the only one that tests your
patience.
Sometimes your problem could bewith your coworker Right.

Speaker 1 (52:01):
So when a coworker doesn't like you, what do you do
Like?
How do you handle it?

Speaker 3 (52:09):
Me personally, I just avoid them and I think honestly
that's good advice across theboard Like don't.
If so, if you know someonedoesn't like you, for whatever
the reason is, like Just avoidthem whenever possible, and
maybe that I mean maybe someoneelse would say something
different.
Like you should try and figureout why say something different.

(52:33):
Like you should try and figureout why.
But honestly, as someone whodoesn't like certain people, I
avoid them.
So I appreciate it if they knowthat I don't like them that they
avoid me, but that's not to saylike if they need help, I'm
going to help them.
That's your job.
You're there for your job.
You're not there for personalrelationships.
Sometimes your coworkers becomesome of your closest friends,

(52:57):
but that's not a necessary partof the job.

Speaker 1 (53:04):
I mean that's true.
I told you that I read thisbook called the Five
Dysfunctions of a Team.
The bottom foundation or thefirst dysfunction is lack of
trust, and I'm learning andgrowing and I'm not perfect with
this at all, this at all butsomething that I'm starting to

(53:28):
emphasize is that to be a team,we have to learn to trust each
other.
That means that even in themidst of us not liking each
other, if we come to you with acorrective or a criticism, that
is conducive.
And what is the actual C wordthat I'm looking for?

Speaker 3 (53:46):
Construct.

Speaker 1 (53:47):
Constructive.
Okay, if I come to you with aconstructive criticism that
doesn't, it's not a.
It's not a plight on your, yourcharacter, it's not a attack on
your pride.
It is for the ultimate goal ofdelivering excellent patient

(54:08):
care, and so there has to be alot of trust that you, as the
one that's giving theconstructive criticism, aren't
doing it to just be mean or justbecause you think your way is
the best way or the highway isthe other way, and then you as

(54:32):
the receiver have to understandthat I am going to receive this
constructive criticism andattempt to adjust, because I
know you're doing it for thebetterment of the patient care
that I'm delivering and so ifthere is a patient or, excuse me
, if there's a co-worker thatdoesn't like you, you still are
able to give that constructivecriticism.
Yes, you might have to stayaway from them, you might have

(54:52):
to, you know like, but if yousee something that they're doing
that ultimately is notexcellent patient care, you have
a duty as a teammate.

Speaker 3 (55:04):
Yes, you have to step in and say something, and it's
not easy.

Speaker 1 (55:09):
Like I said, I am nowhere near perfect.
I just had a conversation andI'm the assistant nurse manager.
I just had a conversation withone of our teammates yesterday
about something that was broughtup to me And'm like I've got to
deliver this case, this, thiskind of feedback, and it's not
easy.
I don't like it.

Speaker 3 (55:29):
Yeah, they're all.

Speaker 1 (55:30):
It's awkward and you feel bad because you're like I
know you're a good person, butit has to be.

Speaker 3 (55:36):
You know it still has to be delivered yeah, yeah, I
think that was a way moreprofessional way um to give an
answer than me when I just saidavoid them, which?

Speaker 1 (55:47):
is interesting because you're one to not avoid
people Like you're callingpeople out on things.

Speaker 3 (55:54):
Oh yeah, I mean, when it comes to patient safety and
care, I'm going to call someoneout if something needs to be
addressed.

Speaker 1 (56:06):
I think I was taking it more of like a personal
relationship approach, which waswhen I was saying, like avoid
them, like you don't have tolike sit and giggle with people
or try to like figure out whysomeone doesn't like you because
you're there for a job, you'rethere to take care of a patient
yeah, but I think there's and Isomewhat agree with that I think
there's a point where not everyfamily member likes each other,

(56:32):
right, true, but really andtruly, sometimes you spend this
time with your coworkers andit's exponentially more than you
do with some of the people youlive in the same house with, and
so like you've got to find away to coexist coexist.

Speaker 3 (56:52):
Yeah, no, I agree, I think in the sense of yes.
We spend sometimes more timewith the people we work with
than we do our families or thepeople that we live with.
Yeah, you have to find a way tocoexist, because if you don't
and we've talked about this inpast podcast episodes as well
like, what do you do when youhave, like, a disagreement with

(57:14):
a co-worker?
and like how should you handleit?
Um, you need like, you need toget, you need to get some beef
out of the way sometimes, butultimately you need to remember
that it's the patient thatyou're there for, and so you
have to leave it at the door andgo into.
You know, go to perform yourpatient care to the best of your

(57:37):
ability.

Speaker 1 (57:38):
Right For the patient .
Really and truly, you, almostyou've got to.
This sounds terrible, butyou've got to treat your
coworker as a patient.
Okay, explain, elaborate onthat so ultimately, you don't
know this person from Adam.
You really don't really want to, don't want to get to know them

(57:58):
, but you still have theconversation of hey, how's your
day, where are you from?
You know you get to build thatrapport, yeah.

Speaker 3 (58:08):
It's not.
You can be colleagues right,yeah, well, but you need to be,
you need to be right you need tobe colleagues, you don't have
to be friends right so you canbe professional with one another
and just treat people withgeneral kindness right that
whole old saying like treatpeople how you would want to be
treated golden rule that is agolden rule, right, and I think,

(58:29):
even if you don't like someonelike that is, you still have to
treat them with kindness yeah,and you know overall, if that
happens.

Speaker 1 (58:38):
and somebody interestingly enough, somebody
said something about this theother day.
They were like, um, oh, it wasOkay, people who have Down
syndrome.
Okay.

(58:58):
Are the kindest people in theworld.

Speaker 3 (59:02):
So true.

Speaker 1 (59:03):
They're so kind, they're so loving, they so like
non-judgmental, they just are sokind.
If the world had everyone withdown syndrome, we would.

Speaker 3 (59:18):
there'd be a lot of differences a lot of happy
people, a lot of happy people, alot of happy people.

Speaker 1 (59:25):
But we can learn from that, yeah for sure.
Like these people who have farless abilities than someone who
doesn't have Down syndrome, areso great role models of just
being kind to any and everyonethat they meet.

(59:47):
And so you know, I'm using thisas an example, but like for
real, like you, you, you've gotto learn how to not be sarcastic
like all the time.
Like sarcasm doesn't get youanywhere, it really doesn't, I
don't like it.
Like sarcasm doesn't get youanywhere.
It really doesn't, I don't likeit.
It rubs me the wrong way allthe time.

(01:00:08):
But I but here's the hugecaveat here I understand when
people use it and I don't takeoffense to it.
I don't like it and it does rubme the wrong way.

Speaker 3 (01:00:27):
I feel like you just said the opposite.
I feel like you just said thatyou don't like it.

Speaker 1 (01:00:32):
But you're like I don't take offense, but I don't,
I don't, I don't like it.
It's not something I appreciate.

Speaker 3 (01:00:38):
Okay, okay, yeah, it's not that deep, I got it.
I got it.
It's like man you're justcalling me out of my.

Speaker 1 (01:00:49):
Just funny how you ordered it.
I might just take this out, um,sorry, I'll think about it
really quick.
But really and truly is whatI'm trying to say is that there
are things that people do thatmight not be the same way you
would deliver or say things orhandle things and it rubs you

(01:01:10):
the wrong way.
But you still have to.
You still can be kind, youstill can find a way to
understand that person, notbefriend them.
You don't have to befriend them, but understand them to the
point where you're like, uh,that's just colby, I mean you
know like yeah that's just romanin my dog's name, um, and you

(01:01:34):
just kind of live your life withthem.
But what it?
How do you like avoidretaliation?
Like, is there any point whereyou're like man, they're
actually gonna come at me?

Speaker 3 (01:01:48):
Oh God, I hope it doesn't get that bad.
Well, I think, and notnecessarily not like coming at
you with a knife, not likephysical, but like maybe they're
like trying to get you fired orsomething.
Yeah that.

Speaker 1 (01:02:00):
Or they're like oh, did you hear so-and-so,
so-and-so did something this way.
Like we should gang up on themor you know, we shouldn't
befriend them.

Speaker 3 (01:02:10):
Okay.

Speaker 1 (01:02:10):
Maybe not gang up.

Speaker 3 (01:02:11):
I think that's like such mean girl mentality.

Speaker 1 (01:02:16):
This is a very sexist statement and I will probably
edit it out after this, but thenursing is mostly female.
Mostly women.

Speaker 3 (01:02:23):
Yeah, no, that's true , true and that's just a fact.
You don't have to edit that outat all.
And I do think it's like it.
Just that's the.
This is.
I'm a woman, so I can say it,but that's the nature of women
like it gets catty.
I would definitely say thatI've like seen, I've witnessed
like people be mean to eachother for no reason, and I've,

(01:02:44):
I've, and again, I I also saw ita lot more when I was younger
and I would, I would feel likesometimes I'd be like involved
or like in the middle ofsituations when I was, or my
earlier days in nursing, or Iwas just like younger, I was in
my 20s, and I feel like it wasthe same kind of mentality that
like high school or collegesnooty girls had and it I don't

(01:03:04):
know.
And now that I'm older Iobserve the younger staff kind
of getting catty with each othersometimes, but I'm, I think,
with like wisdom, I'm like it'snone of my business and I I
personally maintain professionalrelationships with everybody
that I work with and I'm notfriends outside of work with

(01:03:24):
very many people anymore becauseof experiences I had when I was
in my early 20s in nursingwhere, like the staff, just I.
It was like so involved witheach other's lives in and out of
work, and then when somethingwent awry, it was too it muddled

(01:03:47):
with work and it was too much,so what happened then?
I mean, it was pretty likeself-contained.
I don't think that likemanagement got involved or
anything.
Never, it didn't come.
It didn't affect patient care.
I guess the in the experiencesthat I had, I think the

(01:04:08):
unfortunate thing is like unlessit's affecting patient care, it
doesn't really get talked aboutright, like yeah, because you
kind of like, and I would evenlike imagine from a manager's
standpoint you're like it's noneof my business, I don't want to
get involved, like.
as long as the patients aregetting what they need, then I
don't want to look away andthat's maybe not the best way to

(01:04:32):
handle things, but it'sprobably how I was, unless it
was like brought to me.

Speaker 1 (01:04:38):
Yeah, I don't know.
I went through this whole the75 hard made me really go
through this, likeself-developmental management

(01:05:05):
and and I'm learning thatmanagement my unit that has made
team culture a differentchallenge that both my manager
and I are learning to navigate.

Speaker 3 (01:05:23):
Yeah, it's an ongoing journey, though for everybody I
mean.
So in a manager role like youhave to figure out how to deal
with these situations.
It's just part of your, yourjob.
I think if, again, like ifyou're on the floor and we
talked about a little bit aboutthis when we talked about our
tech nursing aid episode Like ifyou're having a situation with

(01:05:47):
your coworker and you're gettingless help from them than
they're giving others, or youfeel like you're drowning every
shift and nobody's willing tohelp you, like these are things
that you need to speak up.
You need to tell yourleadership that these are your
struggles, because if whateveryou're doing isn't like getting

(01:06:12):
resolved, whatever's happeningto you or whatever you're doing
isn't getting resolved, thosesituations again are just going
to trickle down to the patientcare and then the patient's not
getting their needs met yeahneed to talk to your leadership
for sure

Speaker 1 (01:06:28):
and ultimately we are .
We are here for you and or,excuse me, ultimately management
is supposed to be there for you, and there are times where
things from upper management oreven just the health system in

(01:06:49):
general can allow middlemanagement to get so drowned or
muddied in things that uppermanagement and health system
needs them to do that we canlose sight of those that we're

(01:07:09):
actually there for, which is usstaff members.
I think that's what has beenthe.
The hardest part for me isbecause, now that I had stepped
back on the floor, I'm like whoayeah you know, like there's
that shift to the other sideit's kind of striking right

Speaker 3 (01:07:28):
I would also like to say, like we talked, like you
mentioned, like you have to havetrust in your co-workers in
order to have like a like, agood like work, balance,
relationships, make, make theteam flow, the teamwork.
You need to have trust.
I would say if you're in asituation where you feel like
you don't have trust, and Iwould say if you're in a
situation where you feel likeyou don't have trust and I mean
not have trust with any coworker, with anybody in your upper

(01:07:51):
management, in your middlemanagement, hr, human resources
is a great place to reach out toand that's at every health
system or any job.
They're going to have a humanresources department and part of
their role is conflictresolution.
They hire people specificallyin the subject and they'll help

(01:08:12):
be mediators or just listen towhat you have to say, to try and
resolve your leg and find asolution to whatever's going on
and that, like your problemmight be with your manager, to
whatever's going on, and that,like your problem might be with
your manager and you, maybe youfeel like you brought something
up and there was a situation ofyou feel is retaliation against

(01:08:33):
you.
Human resources is there tostep in as like a third
non-biased party and look at asituation almost like an ethics
consult for a patient where,like their role is the ethics,
the situation that's going on,and they're there to protect you
.
If that's what you need to needis protection or help work to

(01:08:54):
find a plan that's going to helpget you back on track with the
position, if that's what youreally want to do, you're
passionate about that andthey'll help you walk through,
like, if you decide you want toleave the position, like they're
literally there to your benefit.

Speaker 1 (01:09:11):
Right, all right, class dismissed.
That's a wrap for today'ssession of Nursing Life 101.
We hope you found some usefultakeaways to bring back to the
floor.
Remember, nursing is a lifelonglearning journey and we're here
with you.

Speaker 3 (01:09:24):
Remember, nursing is a lifelong learning journey and
we're here with you.
If you want to connect, find uson Twitter at NurseLife101, or
on Facebook at NursingLife101.
And don't forget to subscribeand share with fellow nurses.
Conflict is a part of any job,but especially in nursing.

Speaker 1 (01:09:37):
Remember how we handle.
It says a lot about ourprofessionalism.
Until next time, keep learning,stay resilient and make a

(01:10:03):
difference.