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Interacting With Patients
The “I Care” Mentality
How a new nurse serves cranky patients.

On the day of his surgery, Mr. Grumpafagus, the quintessential grouchy old man, was wickedly crabby. He griped about the cold food, the stiff bed, the spin on television, government conspiracies, and the overpaid doctors.

Most nurses avoided him, busying themselves with pre-op. Even the anesthesiologist warned Mallory, a second year surgical nurse, “Watch out for this one.”

Earlier, Mallory had picked up that he was in the military, so she asked him about his service.  As Mr. Grumpafagus began talking, he lightened up, his crankiness tapering. When the anesthesiologist returned, he couldn’t believe the change. “Who is this guy?” the doctor asked.

Mallory calls her approach with Mr. Grumpafagus the “I care” mentality. Certainly, most nurses care about their patients. But when it comes to difficult patients—the ones who really try your patience—sometimes caring is replaced with irritation, brusqueness, and hurried, impersonal care.

Tongue-in-cheek, Mallory often advises new nurses who are dealing with difficult patients to “Kill ‘em with kindness.” This is, of course, the opposite of what you feel like doing, as if you have nothing else to do on your shift and no other patients.

Mallory says she tries to anticipate the needs of the Grumpafagus-types before they voice them; discreetly touch their hand or shoulder to show her concern; sit down for a few minutes and ask them about their dog, children, grandchildren, likes and dislikes; or, empathize with their pain and fear.

Mallory says she also asks herself, “Is this the treatment I’d want my father, who’s dying of cancer, to receive?” While a patient may be Mr. Grumpafagus to her, he is also someone’s father.

Melissa Parks is the editorial director of RealityRN and has worked in publishing for 10 years. She did her post-graduate work in English literature at Loyola University in Chicago.

Read more Interacting With Patients articles

4 Responses to “The “I Care” Mentality”

  1. Katie Says:

    I routinely use the “kill’em with kindness” approach. In fact when I hear in report “Mr. so and so is such a pain” or “Mrs. so and so was on the call light all night long” I take it as a challenge to see if I can help make the patient’s next several hours more relaxing. You’d be surprised how much a patient can respond to a calm voice and listening ear.

  2. Angie Says:

    As a new nurse also, I can only comment from my limited experience, but I have found that these “grumpy” patients are often the most frightened ones who simply replace their fear with anger.

    Once I give them the chance to open up in a way that they still feel in control, the flood gates open up. I end up discovering that there are many more emotional layers to these patients than we realize and that they just needed kindness and a understanding. Of course, sometimes they truly are just plain grumpy but at least I know I gave them the chance!

  3. bbutler1027 Says:

    For a new nurse or a veteran I find when I start my shift and give my name and tell then I will be back soon. I really come back soon and just talk the first time they ring the bell I answer it personally and I tell them if I do not answer immediately it is because I am serving another client. Also when I go to lunch or on break I tell my patients and try to give them what they need prior to my departure. Patients are people in a abnormal situation I find this usually works. I also do no call my patients grandma. or any nick names I keep it professiona Mrs Butler and it keeps it fresh we still laugh and enjoy the day . My patients are the best thing about nursing really.

  4. ldybugg85 Says:

    i agree on this 100% i had a man die a few weeks ago and no one could stand him, but i stood up and started being nice to him and talking to him and telling him the things that we were going to and the care that was going be given to him. after awhile he started being more kind and happy with me, but i noticed that he wasn’t doing this to the other stna’s because they weren’t giving the care that he should have received. I see it the same way, I would want someone to do the same for me if I was in that situation, or if it was a family member.

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