I snapped at a rude family member, and I'd do it again.

Some people look at the role of a nurse as entirely "customer service", but the reality is customer service is a only part of the role of a nurse, and certainly not the priority. While it's important to make patients and family as comfortable as possible to aid the healing process, there are plenty of inconvenient aspects to healthcare environments that patients just have to put up with or leave against medical advice (AMA). Overhead announcements for emergencies, safety protocols, uncomfortable beds, low-quality food, nighttime interruptions, privacy rules, etc. are all things everyone just kind of has to deal with if they want to be treated for their condition. In addition, the things we can control we don't always have time to deal with. Nursing is all about priorities. If we are too busy pushing meds and reorienting confused patients and rounding with doctors to get an extra pillow for room 215, then 215 will just have to tolerate one pillow until things slow down. With the nursing shortage, unfortunately that's just how things are.

Something I will never understand is patients and family members that come in expecting to be treated like they are the only patient and family in the hospital and no one else matters. I'm not talking about people who just ask for a snack and wait patiently for it. I'm talking about the people who demand a snack and then come out to the nurse's station yelling after waiting a whole 30 seconds and insult the staff for being slow and incompetent. Yes, those people exist and there are a lot more of them than you might realize. While to a certain extent, I always try to hear out patient or family complaints and do my best to accommodate them if I can, what I don't tolerate is unwarranted personal attacks or abuse, and no nurse ever should. Over the years, there have been a few times where I went head-to-head with family or a patient, and I regret none of them. But this one particular time stuck with me the most.

Ms. Laura was notoriously needy, but it was her daughter, Rachel, that quickly became a problem. Every nurse that cared for Ms. Laura or even helped in the room at some point learned that Rachel was insufferable, condescending, and entitled. We were never doing enough, everything was inconvenient for her and/or her mom, and she seemed to believe her mother was the only patient admitted in the hospital. The night I was assigned to Ms. Laura, Rachel was a nightmare from the start. Rachel frequently demanded the attention of the few doctors and nurses available at night over the smallest inconveniences or complaints. I remember working hard to advocate for the patient to a reasonable extent for night shift, while Rachel made snide, condescending remarks nearby.

One of her biggest complaints was the external female catheter leaking. You've seen those in the commercials, the PureWick systems. Well, while they do make our job easier most of the time, they are not perfect for everyone. Based on the patient's anatomy, activity in bed, weight, etc., these external catheters frequently become misaligned and leak. No biggie, we just change the bed pad and replace it properly. Well, Ms. Laura was quite active in bed so her catheter was frequently becoming misaligned, and as a result it was frequently leaking on the bed pad. Each time it happened, Rachel became more outraged, blaming the incompetent nursing staff for not placing it properly. Multiple nurses and techs tried placing it on Ms. Laura, but every time the same thing happened. She would move around a lot and dislodge it. Unfortunately, she was post-op and not able to get up to the bathroom yet and she wouldn't use a bedpan, so this was just the only option and that was that.

As the night went on, Rachel continued to complain and harass me about every. little. inconvenience. I put up with it for a while, telling myself she was just stressed about her mom being in the hospital. But around midnight, she pushed me over the edge.

She came out to the nurse's station and found me. Her complaint? The monitor was beeping in the room.

"We've already asked two other people to silence it and we are still hearing beeping. It's absolutely ridiculous my mom can't get to sleep for even a few minutes without some interruption. What is so hard about silencing the monitor?" she hissed at me like I was the most useless and incompetent person in the world. I stepped squarely in front of her, looked her directly in the eyes, and sighed.

"I don't know what to tell you Rachel, it's a hospital. Monitors beep in the hospital. I need that monitor on so I can watch your mother's heart rate. I need it to properly care for your mother. I have spent the majority of my night catering to you and your mom's every need, advocating on her behalf to the doctors, and doing my absolute best to make you both as comfortable as possible, and you have been nothing but insulting and condescending in return." The words came out of my mouth before I realized I was saying them, and her jaw dropped. But I wasn't done... "If you are going to keep harassing me and distrusting me in my care for Ms. Laura, then perhaps you would prefer a different nurse?" I paused for a response, but her jaw just hung open. She was clearly not expecting the pushback. After a couple moments, I added, "I'll see if you can have a different nurse." I spun around and walked away, leaving her in the hallway stunned.

I'll admit, I do regret that last part, and I feel a little ashamed for saying it. I do not think it was professional to ask my charge nurse to switch patients, and if I could do it over, I would have handled it differently. But these blog posts are supposed to reflect my actual experiences and lessons learned at the bedside. That was the lesson I learned walking away. What I do not regret though, is snapping at her. She complained to the charge nurse about what I said, which is fine. But the next night at shift change, the day charge told me Rachel was surprisingly respectful and calm all day, and she continued to behave the rest of her mother's admission. That is the reason I do not regret snapping at her, and I would do it again if necessary.

• Bella, RN