In all of my years of nursing I've never had to deal with what happened today. I have a patient who is coping with a life altering change and the spouse who initially seemed so supportive was absolutely horrible, making comments that would be sure to inflict pain. Not just one or two...every single comment was mean with no consideration whatsoever for the pt. It was all about what they thought and this person would not engage or show any support. The patient had even told the person to go home. I was livid. In a situation like this can we tell this person they should leave? Anyone with an experience like this and if so how was it handled?

Absolutely tell them to go home! Especially if the patient already did!

I've only seen that happen once, and I was so stunned that I had no idea what to do. The patient was struggling to breath and terrified while the girlfriend was screaming things like, "STOP ACTING LIKE THAT!" and, "DON'T EXPECT ME TO STAY HERE WITH YOUR STUPID *** IF YOUR GOING TO BE DOING THAT ALL NIGHT!".

In your case, at least the patient asked the visitor to leave. I would consider calling security for assistance if the family member didn't leave when asked to (by the patient). When the family member wants them there, it gets very complicated.

I would warn them first, then I would have immediately called security to remove the family member. The patient wanted them out, and out they shall go. Otherwise, if the patient had not sent them out, I would forbid shouting and verbal abuse, calling security as needed and conferring with our manager. Often, a show of force with multiple nurses descending on the area where the nasty family member is often helps. I don't allow my patients to abuse me, and i don't allow others to abuse my patients. Also, I document carefully and with many quotes. If family members want to act like belligerent drunks in a bar, then let me introduce our "bouncers," the hospital security staff.

I agree with calling security. Sure this is the way some people cope with life altering news but they need to so their ranting and raving elsewhere. When an opportunity presents itself (when the family member is calm or the next day) educate them. A lot of that reaction is fear of the unknown.

I think your job is to intervene when abuse is evident, even verbal abuse. Get a witness first and then tell the other party that you are concerned they are upsetting the patient and ask them to leave. If they refuse, leave the room and then call Security. This is someone who might physically attack staff.

What happened after the patient asked the family member to go home? If the family member had shown no inclination to do so, I would have taken them aside and said something to the effect of, "It would be a really good idea for you to go home and get a good meal and a little sleep . . . there's nothing much you can do to help your loved one right now. I'll take good care of him, and we'll see you tomorrow." If that didn't get them moving, I might ask the charge nurse to speak to them. Only after I had exhausted the "softer means" would I call Security.

I was the patient, but the nurse handled it beautifully. I had been taken ill and had to go to the ER, and to make a long story short the only person available to take me was an ex-boyfriend, who upon our arrival at the ER proceeded to give a demonstration of all the reasons why he was an ex. The nurse hustled him out of the room on the pretense of needing to perform a procedure and asked if I would like her to make him leave the area until I was done. I said yes, and I don't know what she said to him, but he was gone, stayed gone until it was time to drive me home, and had MUCH better manners on the trip home. If you aren't as skilled with verbal jujitsu as this nurse apparently was, I see no problem with enlisting security to persuade these people on their way.