[LeahJet]

It depends on the situation. If I really felt physically threatened, then I would refuse, as the OP did. Now, if it's just some mouthy jerk that's out to hurt only my feelings....ppffttt...whatEVER. I just get this flat affect and monotone voice and do what needs to be done.

[LoriAlabamaRN]

I think this is the first time that I have ever disagreed with Ruby... but I think the op did exactly right. Noone deserves to be treated that way. How terrifying to have someone that large screaming and cursing in a threatening way toward you. I give you props for keeping your cool and handling the situation professionally. If any of my nurses were to find themselves in that sort of position, I would expect them to do the same thing. I realize the draw was a stat, but that does not mean that we need to put ourselves in a dangerous position. I would have gone in to take the blood myself (after introducing myself as the facility supervisor) and would have had at least one if not two of my large male staff members with me just in case he became violent. I speak from experience, I once had to draw a stat potassium on a very violent man, he muttered and cursed but let me slip the needle in his vein, then as the blood started to come up toward the tube, he suddenly ripped the needle from his arm and threw the entire works at my head. If I hadn't ducked I would have received a bloody needle in the face. You did good, OP. I'm sorry you were put in that situation, but you handled it well.

[canoehead]

You handled it perfectly. I would consider his response a refusal of the blood draw at that time. Even stat bloods do not get drawn if the patient is not comfortable with the procedure. It's possible that someone else would not be refused, or that in 5 minutes you could do it, but at that moment he definitely and vehemently declined.

[Lesli61]

I'm going to side with Ruby on this one. If I were in that situation, I would have smiled, looked the guy right in the eye, and said 'Not to worry, I haven't missed yet!' OR 'I'm sorry to hear you're having a rough time here; try not to worry, we will do our best to take care of you.'
Has anyone tried to put themselves in this guy's place? He must be in some sort of crisis, and feels scared and feels like everything is out of control. Maybe this is the way he reacts in a situation like this. He might lash out at everyone. Let's try some TLC first. Not everyone is a polite pussycat when they are in trouble.

[RunnerRN]

I don't really think it matters how this patient was feeling emotionally - he was verbally abusive and trying to intimidate a staff member. If we just let that slide and say "now how does that make you feeeeel" I think we perpetuate the behavior and tell him that it is okay to treat staff in that manner.
I think the OP handled himself well. When I have patients that respond like that, I say "I'm sorry you feel that way. I will not force this on you, but I will also not return to your room until you are speaking more respectfully. I do need to tell you though that this is a stat CBC and these are the reasons you need it." I think it is important to assert yourself - with the birth of patients as customers (gag) and the wonderful survey scores, everyone is afraid to put the customer in his place - but at the same time he needs to be told the consequenes of his actions. If my patient is going to be an ass, he will be an informed ass.

[lannisz]

I think you did the right thing. Bullies continue to be bullies because they get away with it. Being calmly assertive about what you will not tolerate when an individual is threatening and inappropriate is the correct response. I think you showed maturity in this situation.

[Blee O'Myacin]

If he refuses the blood draw, then doing it would be assault. "So does this mean you are refusing the procedure/test/labdraw and are signing out AMA?"

Don't be allow yourself to be bullied by people threatening to "sue you". I've had a few experiences along those lines, and I calmly make sure that they are consenting to whatever it is I have to do and then I write a nice long note in their chart. I would also tell your supervisor when these things happen to protect yourself against any complaint.

As for your appearance, enjoy being carded and whatever else. It doesn't last forever! I work with some very young nurses who have way more experience than I do and it is all in how they carry themselves. "I have good genes" and thanking a patient for noticing your youthful appearance goes a long way.

Take care,

Blee

PS - I also agree with Ruby Vee, if the patient didn't outright refuse to have the lab drawn, I would have finished the draw. "Gee sir, talking to me like that is making my hands awfully shaky..." (OK, so maybe I wouldn't say that... or maybe I would - depends on the shift...LOL)

Originally Posted by Trauma_Team_1

Im not a nurse (yet), but I work as a phlebotomist, and I only have about 3 weeks TOTAL experience working in a hospital. Im 24/m and I look 16 ( in the face and in the body 6'0'’ 150 lbs) and it seems that I am having trouble having P.T’s treating me like an adult and not someone who is out of H.S. I really do believe its because I look so young so its not really all their fault for that I guess. Anyways today I had a STAT C.B. for a P.T. that was about to be discharge, but he started spiking a fever so the STAT was ordered. The guy was prob 6'5'’ 300lb football player looking guy and just seeing him scared me to death lol. As I was drawing him he told me " if you miss my vein im going to sue you little boy" ( he did this in a cruel way not a playful way) I immediately stopped the procedure ( and I did miss his vein, but he didnt know that) and told him "if you threaten me like that again I will stop this procedure all together, and this will cause you to stay longer because I will not draw you, and will alert your nurse about this incidents" I said this as politely as I could ( but I was visibly shaken I am not a confrontational person at all by nature) he then SCREAMED "F*** Y** you skinny rail mother ****** ill sue you’re a** off b****" I said nothing just took my gear and left told the nurse that I refuse to draw this guy ( it was a STAT so I was ticked off that I had to make the doctor wait, but im not drawing someone like that) It basically ruined my day , but is that the best way for me to handle that? Any advise from nurses who have experience with difficult P.T.’s would help me a lot. Thanks.

[PeachPie]

Originally Posted by Lesli61

Has anyone tried to put themselves in this guy's place? He must be in some sort of crisis, and feels scared and feels like everything is out of control. Maybe this is the way he reacts in a situation like this. He might lash out at everyone. Let's try some TLC first. Not everyone is a polite pussycat when they are in trouble.

Well, most sane people don't get violent, and they certainly wouldn't be as polite about being threatened as you are expected to be to them. If you're such an angel in white, why don't you let them hit you so they can get their frustrations out? If "this is how they get their frustrations out," do you think that battered women should stay with their boyfriends and husbands because "they're decent people inside, that's just how they get their frustrations out?" I'd hate to work with you, as you seem like the type who, if a staff member was hit, would immediately give a lecture on what you should've done to prevent it, and that it's the staff member's fault for somehow provoking the customer, er, patient, even if the patient was mentally ill, demented, or anything else that has no logic.

I think that you did the right thing. That bully needed to know that he's not always going to get his way, especially when he's acting like an elementary school kid demanding lunch money. You acted in the interest of self-preservation, and prevented a potetially nasty situation. Better safe than sorry.

If you're concerned about looking young, I agree that a haircut can make all the difference. Facial hair can too, as long as you don't look like Shaggy from Scooby-Doo.

[Luv2BAnurse]

Originally Posted by NurseErica

If my patient is going to be an ass, he will be an informed ass.

WOW. Actually, that was well stated.

[truern]

Originally Posted by Trauma_Team_1

As I was drawing him he told me " if you miss my vein im going to sue you little boy" ( he did this in a cruel way not a playful way)

I agree with Ruby on this. Where is the above statement did he threaten anything physical? It was only after your reply to his statement that he verbally abused you.

Heck, another nurse and I were taking care of an elderly patient the other day that SPIT on her, then turned to me and said, "You're next!!". After telling him "I don't think so.", we simply put a mask on him and continued with our care.