Patients Behaving Badly

An extreme example of a patient behaving badly:

OAKLAND, Calif. — An armed man burst into the emergency room staff of Oakland Children’s Hospital early Friday, pulling out a gun and threatening a staff member before surrendering to police and security officers, authorities said.

Cottrell Broadnax, an Oakland resident, was arrested on suspicion of carjacking, false imprisonment and possessing a firearm as an ex-felon, Oakland police Officer Jeff Thomason said.

Chief Nursing Officer Nancy Shibata told KTVU the incident began at 3:15 a.m. when a man ran into the hospital.

“He just ran into the front door,” she said. “He was disoriented and appeared to be impaired. He ended up pointing a gun at a staff member.”

She said in those early chaotic moments, the staff members tried to remain calm.

“Security called OPD, they quickly responded and the whole incident was over in about eight minutes,” she said. “It was a very quick event. The staff interacted with him. He was impaired and seemed to need help… I’m proud of the way the staff reacted.” [via Madness: Tales of An Emergency Room Nurse]

Now, though we don’t (usually) see guns in Acme Regional’s ED, this incident  got me thinking on the multitudinous and manifest ways patients (and their families) behave badly:

  • walking through the ambulance doors (when there are multiple signs clearly stating “Do Not Enter” or “Emergency Personnel Only”
  • walking through any door which says “Do Not Enter”
  • peeking behind curtains to look at other patients
  • threatening retribution (“I’m going to report you”}
  • wandering though patient care areas and pausing to watch the code blue in Exam 8
  • rifling though the charts
  • screaming and/or swearing at nurses/physicians/support staff
  • going behind the counter of the nurses station without permission
  • looking through supplies and/or helping self to same
  • visiting with patients unrelated or unknown to them
  • eavesdropping on report (yes, patients and/or family members will come up the nurses station during report to “listen in”)
  • expecting preferential treatment because of some abstract relationship to the hospital (“I gave a large donation to the Foundation” or  “My sister is on the Board of Directors, and I will have your job. . .”)

And this is the short list.

What I don’t get is none of this behaviour would be tolerated at a grocery store or bank, but if you’re at the hospital, it’s somehow A-OK. I mean, can you imagine going behind the teller’s wicket to look through the papers on the credit manager’s desk, or walking through the Employees Only door in the Produce Department and pocketing a few mangos?

They’d call the cops. In the emergency department, we just  – – – shoo ’em out of the way. Gently and apologetically.  Which is maybe, if we do anything at all. Taking abuse and putting up with shite is such an ingrained part of nursing culture we just add patients to the never-ending list of Those-Who-Crap-Upon-Us. Physicians. Other nurses. Managers. Professional Regulators. And so on, until it adds up to the highest rates of absenteeism of any profession and nurses pulping their licences by the truckload.

Maybe it’s time we stopped. No more crap. From anyone.

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  1. #1 by Cartoon Character on Monday 09 August 2010 - 1118

    I have to say, in the hospital near us, they have instituted a “law” that allows NO ONE to be with the patient when being attended to, which is all well and good in theory, but when it comes to barring a worried-sick spouse from finding out if her husband is ok….I think that is going to the extreme. Yes, there are people who push the envelope and definitely behave badly. And I don’t agree with or condone ANY abuse, because heaven knows I have been on that receivng end for many years as an RN….but if by trying to prevent the above list – because NOT every ER visitor is like those in the list above – a sweeping rule is instituted, as is in our community hospital – it doesn’t make things better for anyone working in ER and it doesn’t make for a good exchange. I get your point – I just don’t think a sweeping law is the answer, and I have also worked and sat in ERs enough to know that the behaviors indicated are not “multitudinous”. They might seem so because those are the ones that demand attention, but on the whole ….people generally will “behave”. If there is mass unruliness, then there are other problems that need addressing…perhaps stemming from the admin/provincial level and the staffing/funding of hospitals.

  2. #2 by atyourcervix on Monday 09 August 2010 - 1644

    Ah, it’s because administration (the idiots in suits) have decided that we need to just take the visitor abuse and theft in the name of good “customer service”.

    Oh wait, that’s right. They’re not freaking customers!!!!!

  3. #3 by Wanderer on Monday 09 August 2010 - 1651

    It’s part of the the job, right? Don’t we get paid to put up with all of the crap that would get you 86’d/arrested in ANY other business establishment?

    No, we don’t. And it is time that those that allow it to happen, administrators and clip-board nurses I’m looking at you, need to be called out on it. Customer service means nothing when your staff quits or is killed!

  4. #4 by Cartoon Character on Monday 09 August 2010 - 1717

    In Canada they aren’t “customers”….there isn’t the same system…and although the hospital admin still likes to keep on the good side of the public as a whole (which is important because if you only cater to the abusive ones you leave out a whole other compliant component of the public) there isn’t the drive to please as there is in the USA. I have worked both systems and I do notice a big difference.
    I think nurses have “taken it” for so many years..and had it drilled into them in training that patients react the way they do because of pain etc etc etc…..it is hard to think in any other way. It’s changing, but slowly. A lot better than when I started 34 years ago. I still say that it is the minority that cause a lot of the trouble. Most people, when treated decently – at least I have found – will be reasonable. But – squeaky wheel gets the grease I guess.

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