One of the hardest things for new nurses is dealing with difficult people – whether it be patients and family members, doctors, and even fellow nurses.  As a self-proclaimed extrovert, even I had a difficult time managing the boisterous personalities that are found on the nursing units. It took some time, but I finally found my voice.  Below are several tips for standing up for yourself and managing as a new nurse.

Dealing with Difficult Patients/Families

I have since left the patient bedside, but I can remember days when I’d have four patients – and every single one of them would be on the call light, for the entire shift.  I’d be getting someone to the bathroom, while another patient needed water, another needed pain medication, and the other was nauseous.  All.  Day.  Long.  Finally, the shift would end and my feet would be aching. The worst part?  Often, the patients were awful.  It seemed like those were the days that my patients were not grateful for a thing that I did and I was berated for not being fast enough, or happy enough, or something. As a new nurse, I didn’t ask for help all that often.  I felt that it was a sign of weakness or an inability to manage my time.  At an evaluation, my supervisor noted multiple strengths, but one singular weakness stood out – I lagged on very busy shifts because I didn’t ask my co-workers for assistance. New nurse, I implore you – when your day is especially tough because patients and/or family members are being difficult, ask for assistance from co-workers, whether it is to grab a call light, bring a water to 704, or administer pain medication to Mrs. Marshall at the end of the hall.  Not only will YOU feel better, your patient will as well – although they may not admit it.

Dealing with Difficult Doctors

There will always be mean doctors – doctors that live in infamy and even the bravest nurses quiver when they have to call them at 0300 because the patient in 204 has a blood pressure of 72/34. I can remember one specific night when my patient went into a third degree heart block and was symptomatic (understandably so!).  He was on the telemetry unit for chest pain and was going to the cardiac catheterization lab that morning for probable stenting.  I had to call the cardiologist on call; when the operator told me who it was, tears sprung to my eyes. “Hi Dr. Johnson – per telemetry, Mr. Morrison is in a third degree heart block…” (Name obviously withheld to protect the identity of the cranky.)  Before I could even rattle off his symptoms, vital signs, and pertinent medical history, he cut me off, “What?  That’s impossible.  It’s THREE IN THE MORNING!” LONG PAUSE “Well, it sure looks like it.  Can I order an EKG?” LONG PAUSE “I suppose so.  Have the tech fax it to my house.”  CLICK. Ultimately, the cardiologist couldn’t disagree with the EKG report.  The patient was transferred to the coronary care unit for transcutaneous pacing and a subsequent pacemaker placement later that morning. The point is – even though a doctor may be difficult and rude, we are our patients advocates.  The physician may have had extra education but we are the ones at the patient’s bedside twenty-four hours per day, seven days per week.  We have the responsibility to advocate for our patients – eve if it is 0300. When dealing with these personalities, it is best to be firm and unrelenting, but still kind.  Getting annoyed, rude and sarcastic escalates the situation and the doctor will be less likely to listen to what is being said.

Dealing with Difficult Co-Workers

In LPN school, I was warned that nurses eat their young.  I’ve found that this is true – mind-boggling to me because we are all educated professionals.  We have picked this profession because we are kind people who want to make a difference in other’s lives,  yet we are mean to each other. This is especially hard for the new nurse.  For me personally it seemed silly that I was in my first nursing job in my twenties, yet the drama was just as exhaustive as high school. Whether it is a single nurse or multiple nurses who are “eating their young” it is best not to engage.  Engaging “fuels the fire.”  Most workplaces have anti-bullying policies as well, so while it may be difficult, report incidents to supervisors. A tip for all of the above situations: Kill them with kindness.  I use this in all difficult aspects of my life.  I have found that when anyone is being difficult, whether it is a patient, doctor, co-worker, cashier, friend, or someone on the street – being overly nice when the person is being overly rude can be confusing and diffuse the situation.