Almost lost my temper today

TazziRN, RN · Apr 17, 2008

I'm sorry......he's swearing at you and punching you hard enough to leave bruises and you don't get to pick your assignment???

You have every right not to be abused by pts. I don't care if he's demented or alert, he does not have the right to act like this. No wonder his family appeals the discharges. Do not accept him the next time someone assigns him to you. If you refuse the assignment it is not abandonment.

Queen216 · Apr 17, 2008

I believe for difficult patients EVERYONE should share the chore. It's only fair.

linzz · Apr 17, 2008

This sounds rough. If he is hitting you, you should not have to put up with that. I would start by reporting this to the charge nurse, although I am sure you have done that by now. Sounds like he needs to see the Dr. as it is not fair that you are being abused like that.

imanedrn · Apr 17, 2008

Been on what I call the geriatric wing all last weekend and this week. Lots of completes, and I usually don't mind, except for one patient who I swear, hates me. He is difficult at best, and impossible at worst.
He has been in for almost 3 weeks. He's supposed to have been discharged twice, but family members keep appealing the discharge and we keep him.
I have to feed him as he cannot feed himself. He's on mechanical soft (and yes, I know the food looks/smells/and probably tastes rotten. I sure wouldn't want to eat it either). Mealtimes are like a battle zone... He screams and pitches a fit because I'm feeding him, swears worse than any sailor and truck driver I've ever known, throws punches, etc. The only thing I can seem to get into him is the ice cream or sweet dessert the kitchen sends up, and even then it's usually one or two bites, and then he starts screaming for me to get the (swear word) out of his room.
This morning, I was trying breakfast, and we went through the eating battle yet again. I had to step into the bathroom and count to 10 before I went back in to attempt to get another mouthful in him.
Bathtimes are no problem except that he swears at me through the whole thing.
I've had it.
I'm tired of this assignment.
I don't mean to whine, but it's very frustrating and draining, not to mention the bruises from the punches.
He is really sucking the life out of me.
How do I suck this up and not let it bug me?
I really don't want to care for this patient anymore, but I don't have a choice. I don't get to pick my assignments or my patients.
This one is really bugging me because I'm the one who seems to be able to turn all of the difficult patients around, but not this one.
Sorry for the vent.

I had a patient like that -- feeder too. Complained about everything! The bites were too small, I wasn't keeping the spoon in his mouth long enough, I wasn't giving him a drink frequently enough or I was giving it too much, blah blah blah. Then, when I'd do it wrong, he'd say, "Oh my God! I can't believe this. What the h*** are you doing?" or some variation thereof. He'd also wanted me to stay in his room and change the channels on his TV one day.

I finally got tired of dealing with it. He may be upset about being hospitalized for so long, and I treat my patients with respect because I know they're in a tough spot, but this was beyond acceptable.

I finally said to me, "Don't say 'Oh my God' to me! I'm here feeding you, being nice to you, and you're just being mean! I'm sorry if the bites aren't the right size, but you're not capable of feeding yourself, and I'm feeding you, so you need to bear with me." He shut up. Later that day, I made a comment to him about something, and he told me, "You're not as dumb as I thought you were." Of course, I took that as a compliment from him.

Regarding the TV, I told him, "I have 5 other pts, and you can push the button!" He says the button doesn't work. I started pushing it with little effort (he can use his fingers just not move his arms well), and say, "Oh yes it does. Look!" Then I put the remote underneath his fingers, and he starts yelling at me. "Dont put it there. Oh my God!" I say, "Ok, well I'll just leave it on the side here, and you can get it then." He says, "No no, don't do that! Oh my God! What is wrong with you?!" as I walked out. Of course, as I'm walking out, he begs me to come back in and put a certain channel on, so I did, and he was nice after that.

Bottom line is that, yes, you should treat your patients with respect. You should NOT, however, have to be insulted in the process. If someone's going to hog up your time by being disagreeable, then leave them to their disagreements alone!

Also, you should NOT be leaving work with bruises, unless you're bumping into things!

HM2VikingRN, RN · Apr 17, 2008

Has anyone thought about asking for a psych eval? He sure sounds like a candidate for some type of psychiatric care....He may need an antidepressant and/or a prn for agitation...

donsterRN, ASN, BSN · Apr 17, 2008

Ditto about the bruises. If you're being hit in any manner, especially in one that leaves bruises, you should be documenting it to your management. Dates, times, incidents... take photos!

No one has the obligation to put up with any abusive situation.

Hugs to you.

leslie :-D · Apr 17, 2008

i can't believe you're letting this guy hit you!

where the heck are the nurses?

and yes, he needs a stat psych eval.

the primary or charge, need to be involved in this.

no way should you be handling him alone.

absolutely refuse to care for him until he is properly medicated or restrained!

dang.

leslie

casi, ASN, RN · Apr 17, 2008

Don't put up with it.

If you have to go into his room for anything at all demand someone else enter with you. It's not safe for you to be in there alone.

Dolce, RN · Apr 17, 2008

I never fail to be astonished at the abuse we allow as healthcare providers. That this is being allowed to continue day after day is amazing to me. In any other setting he would be reported to the police or evicted from the premises. But since he is in a healthcare facility the abuse is okay?

I'm very sorry for the way you have been treated. It is completely and utterly unacceptable. Please discuss this with your manager right away. Your employer is not protecting your safety and I think that you could have grounds to sue them for that.

jessiern, BSN, RN · Apr 17, 2008

IMO...If he can punch his nurse, he can feed himself!

RunnerRN, BSN, RN · Apr 17, 2008

In what other profession would it be considered "okay" to be abused in such a manner by a client/customer for any period of time? None, of course. Talk to your charge nurse or manager immediately, and tell her that you are tired of being beat up by this patient on a daily basis, and that you will not accept that tx from him anymore. IMO, it is better to say something up front so they have the opportunity to assign him to another nurse in the first place.

Good luck!