[Ms.RN]

Hello

I have a patient who is very belligerent and verbally abusive to staff. This person called CNA a "N" word and if he is trying to help him in the bathroom, he would yell at him and tell him to get out.
My question is what is the best way of dealing with patient like that? Do you think we should just leave him alone or do you think we should put up with it and provide care?

[CapeCodMermaid]

We have the duty to keep our patients safe and the responsibility to keep our staff safe. Have the resident seen by psych. Is he demented? Try changing to a different CNA. Maybe 2 staff people will have to go in to care for this person. If he's not demented have someone go in and tell him that his behavior is inappropriate. Don't forget to document everything. Just be careful of escalating behaviors....it might start with the staff and carry over to other residents.

[mesa1979]

There are questions concerning this pt. Is this pt young or old? Is he in his right mind? Has this been reported?

Look up your facility policies on this issue and go by the book. If this is a GRAY area in you facility, based on the pt's status, I would use my professional judgement in handling this situation.

Good Luck!

[catlynLPN]

Does he have family?
Maybe the responsible party or wife needs to know what is going on and they could talk to him.

[classicdame]

Does he have dementia or any organic reason for his behavior? Somehow that makes it easier if "they can't help it". I agree that there should be policies in place to provide you a safe work environment that does not include verbal or physical abuse.

[kmoonshine]

Depending on the situation (and if the patient is decisional), I usually tell verbally abusive patients something along the lines of "your behavior is unacceptable and if you continue such behavior, there will be consequences". Again, there are some people that enjoy fighting and confronting them only adds fuel to the fire. However, I've found that when I confront a patient, many of them actually apologize for their behavior. If I get a negative response, I'll also say "I don't respond to negativity, so when you feel able to control yourself, I will be back"; I might also throw in "I respect you, and I therefore expect the same from you in return". I don't put up with abuse in any form, and neither should anyone else!