I'm concerned. You say 'everyone' is aware of this patient's abusiveness and threatening manner, so why is it being allowed to continue? He sounds alert and oriented; the only reason he gets away with acting out like this is because nobody---not the doctor, the nurse manager, or even the house supervisor---is setting limits on his behaviors. That puts you, the new staff nurse, in a highly vulnerable position, and that's not right........SOMEBODY in authority has to step in and make this man accountable for his actions, and to protect the staff who have to work with him.
While I'm sympathetic to the needs of all patients, there are things that no one pays me enough to put up with. I will not tolerate being cursed at, kicked, punched, threatened, slapped, or otherwise abused, and I have NO problem letting patients know it. It's one thing when they are mentally ill, or demented, or in agonizing pain; sometimes the only way to deal with them is medication, seclusion, even restraints.......but an A&O patient such as you describe, who sounds like he's just ****** off because his lifestyle caught up with him, has no excuse for being abusive. Do NOT put up with it......go up the chain of command at your hospital until you find someone with the courage to set some limits on this patient's behaviors.
A word to the wise: Some of the verbal stuff, you just have to learn to let run off your back; you can't escape it entirely, and the best you can do sometimes is to not take it personally (most of it
isn't personal). But at no time should you feel obligated to stand there while a patient calls you filthy names or makes derogatory remarks about your race, body size, personal habits, etc. At that point, you simply make sure he is physically safe, then tell him something like "I see you're pretty upset, so I'll leave you alone for a little bit. I'll come back in fifteen minutes, and maybe by then we can talk more calmly". Make sure you keep your word, though---patients need to be able to trust us---and if he starts in again, say "I want to help you, but I can't if you keep swearing at me and threatening me. If you like, I can bring in my supervisor and maybe she can help you with what's bothering you". (Sometimes mentioning an authority figure will calm people down.) Then go get her, and if THAT doesn't work, keep going up the line until you find someone who has enough
cojones to confront this patient and set some rules for him.
And if none of this works, or if no one is willing to deal with this patient, start looking for another job where the management and the doctors refuse to allow patients to abuse the staff. I work at a place like that; I once had an OB patient whose live-in boyfriend could be heard yelling and cursing all the way down the hall, and when I went down there to ask him to tone it down he began cursing me and saying he was gonna do what he wanted and no fat-*** nurse was going to tell him differently. I immediately called security, then the supervisor........within a minute there were three big security guards, the super, AND a couple of other nurses. The guy was promptly escorted to his car and forbidden to return, the police were notified, and charges filed.
We don't get paid enough to put up with crap like this. In a word: DON'T.