[cat123]

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.

I'm sorry I must be missing something. at first he just threatened to sue you he didn't threaten you with bodily harm. It seems your reaction is what triggered him with the foul mouth. Maybe you just over reacted a little. People often under stress say things they don't really mean. The verbal abuse shouldn't be tolerated. But, as professionals we should have a little more understanding. just my 2 cents.

[Mary Austin]

Good for you! I AGREE with you all the way. We had a street person who injected meth into his shoulder. He was there for three weeks. He threatened everyone. I called the supervisor and he told me to "make sure the guy did not get between me and the door"! This was nightshift with only three nurses on! When I talked to a state person (Labor and Industries, Workmen's Comp) they wanted to know what hospital, what supervisor, and a full report on what happened. The state (WA) does not like threats made to nurses and they (hospitals) can be reported and cited for putting staff in dangerous situations.

[TazziRN]

Originally Posted by StNeotser

So, can I ask the posters who thought it was OK to have the man refuse (and that is his right) what they thought would happen next?

When we have people like this normally a nurse or someone else will go in with the phlebotomist or attempt to do the draw. If they still behave in the same manner or get more aggressive despite calming techniques we say OK, and chart refused. When you have someone threaten you and you switch assignments with someone else, why is it OK that person gets threatened for the rest of their shift?

I'm not trying to be difficult here, I just want to know how it works where you are.

Sometimes it changing assignments with someone else gets the message across to the pt that the behavior was not acceptable and he/she changes for the second nurse. I have actually seen that happen alot.

As for whether or not what the OP's pt said was threatening or not, the opinion of someone else who was not in the room (like all of us here) doesn't really matter. What matters is that the OP felt threatened and scared.

And, BTW, it was highly insulting for the pt to call the OP "little boy", no matter how young he looks. I have enough of a mouth on me that I would have turned around and called the pt "old man" but that's just me.

[vamedic4]

Originally Posted by cat123

I'm sorry I must be missing something. at first he just threatened to sue you he didn't threaten you with bodily harm. It seems your reaction is what triggered him with the foul mouth. Maybe you just over reacted a little. People often under stress say things they don't really mean. The verbal abuse shouldn't be tolerated. But, as professionals we should have a little more understanding. just my 2 cents.

Have to disagree with cat here...this guy is OBVIOUSLY an agitated moron, less moron, more agitated until proven otherwise. In this case you acted correctly. I deal with family members of children who've been stuck for IVs or labs numerous times and this happens often.
The best course of action (prior to your actual sticking) is to explain everything you're doing, and why you're doing it..if possible. This gives the patient a feeling that they are being cared for and that they are important.
Yes, they're under stress...but there's a limit to what you should and should not have to subject yourself to. You did the right thing. Now fill out an incident report and write down EXACTLY what happened..what was said by both parties, and what was done. CYA in all situations.
What you experienced is completely unacceptable and you did the right thing, short of pulling out the defibrillator and giving him some "accidental shock therapy". That would have shut his mouth
As for looking young...enjoy it while it lasts!!! As a 17 year old nursing student (mannnny years ago) my patients often wondered if I was able to be on the floor without a parent present..much less take care of their nursing needs. Enjoy it while it lasts. Your patient was a bit out of line with his "little boy" comment...but don't take such things personally. If you hold on to every bad thing any patient has ever said about you, you will not last long in this business.
Here's hoping your next shift goes better.

vamedic4
watching Lilo and Stitch with Austin

[goodasitgetts]

I have been a nurse for 16 years and I think that you handled that well! FYI- in the future if you EVER think that you are in danger while dealing with a patient you have the right to stop what you are doing and ask for help. I have seen nurses who were severly injured by patients and I know of an instance where a nurse who was actually raped by a patient during night shift! That is why hospitals have charge nurses and security guards. Your safety is important! One more thing- you should have at minimal documented what occured or requested that it be documented. Patients like that frequently are abusive to many staff but if it isn't documented than if is difficult to prove in case an incident occurs. Best wishes!

[redding-er-rn]

No one deserves to be verbally abused by anyone including patients. I think you handled the situation in a professional manner.

[beth50lpn]

I agree with the majority on this one. How are you supposed to do a procedure correctly when you are being threatened before you even begin? That would make me nervous, & I would be sure to miss the vein! If the dr. wants it STAT, maybe he should attempt the draw. I wager the pt. would not be so abusive to the doc! I work with the elderly & many have dementia, & I get threatened & even assaulted on a daily basis. I can excuse this behavior in a dementia pt., but not in an alert & oriented individual.

[MichaelLooney]

Originally Posted by Ruby Vee

I'm going to disagree with the previous posters. The blood draw was a stat, and someone had to draw the blood. Patients like that probably aren't going to be any more pleasant to the next person to attempt, so the next person is going to have to complete an assignment that you were given. And that person probably isn't going to want to do it, either.

When you work in a hospital, you get to take care of verbally and sometimes physically abusive patients. Someone has to take care of them. Sometimes, that "someone" is going to be you. Talk to your boss or a nursing instructor and get some help figuring out how to better handle patients like this without turfing your assignment to someone else. If you learn this lesson now, it's going to make the rest of your clinical experiences go so much more smoothly!

Since this has been stated, I'll post what happened to ME reguarding an abusive patient.
I not only was verbally abused by a patient, but physcially. And she was one of those 'grandmotherly'-types, so she looks all harmless until she's angry. Now, they tell me I can't refuse her any care under any curcumstances, then fired me the second time she hit me, claiming I was abusing HER.
(Now, I'm the one with the broken glasses, the bruses on my thigh, and the fracture in my wrist, while she comes out of it happy as a daisy and sparkeling as a diamond, and _I_'m the one abusing her.)
I think it really depends on the place you're working on, and their views on everything. The place I worked assumed that every time a patient became combative it was automatically the CNA or Nurse's fault, and they were consequently blaimed for the entire fiasco.

[beth50lpn]

I understand completely. Was it in a hospital or nursing home? In a nursing home, those residents with a history of dementia & combative behavior are known to administration, as we are encouraged to document every instance in the nurses' notes. Now, if a family member of one of those folks were to launch an abuse complaint, it would be investigated as any other, but the residents are not generally able to lodge complaints themsleves. I know of only 1 STNA who was fired over an allegation of abuse, & that was a set-up job. Another employee had a reason to want to make trouble for her, & so filed a complaint with administration, alleging they had witnessed abuse.No abuse ever took place, but the facility fired her as they didn't want even a hint of scandal. That's sad, as she was an excellent aide. I have a resident that's mean as a snake & I have to do blood sugars & insulin on her daily. I have been hit, clawed, spit on, kicked, elbowed in the stomach, & called everything but a nice person by her. It will happen again tonight. She makes me angry, but I have to remember she is not wholly responsible for her behavior. When it gets to be too much, I just walk away.

[bradleau]

I am a RN and only once, in my doctors office told the lady ATTEMPTING to take my blood to STOP. When she refused and said "I know what I am doing" , I walked out. Got my doctor to send in someone else. This one did do it right. The other one did not have a clue, nor did she listen to me. I told her I was a nurse, and offered to assist her in her attempt at getting my blood. No it is not difficult unless you are trying to get blood from my tendon instead of vein.