Cussed out by a family member

[jschut]

Remember the ethical issue that I asked about in a previous post? The child wanting to pull a g tube on a resident?

https://allnurses.com/forums/f8/pulling-g-tube-329001.html

Today, after being off for 2 days, I go in to work and give the resident the 12 noon Cardizem as perscribed. Res began to cry saying stomach hurt. Everything was fine previously.

Less than 2 minutes later, the child walks in, and begins to verbally berate me, cussing me up one side and down the other, sticking a finger in my face, and telling me that he/she was tired of my smart a** looks, and that was his/her parent and they'll do whatever they want to, and it wasn't cared abou tif I liked them or not, and so on and so forth, and that my attitude wasn't appreciated, and blah, blah, blah....

I ddn't say a word, and let this person treat me this way.

I get up to the nurses station after the verbal assult, then the child followed me there, insulting my nursing skills and abilities, and demanding that I do something....

So using an order obtained by another nurse on the 29th I sent her to the hospital for eval. Yes, doc on call was telephoned and we let him know what was going on...

Ambulance came within 15 minutes, and resident was fine again, laughing and joking with drivers, and asking for a cigarette.

Question being, I made a copy of what happened and what the CNA heard (she was standing next to me when the major assult hit)- gave a copy to the DON and one to the Admin. Documented fully in the nurses notes...

I also requested that this person be kept away from me. Am I allowed to do this in a LTCF?

I enjoy my job, but I sure do not enjoy having to deal with this person on a daily basis.... nor do I like being berated and treated like a fool.

Advice anyone?

[jschut, BSN, RN]

Woody~

I was not physically assulted, per say, but to talk to this person in another room may have resulted in such.

And the anger was not directed at anyone else, it was directed AT ME, and only me. Child said I gave a "smart a**" look when it was said that he/she wanted the parent gtube pulled a few days before.

And as far as calling the police, apparently, this person has raised enough ire in our facility, that now it is ok to call if this person acts up too much, and is asked to leave.

I had been off for two days, for pete's sake... sure didn't expect to walk into that mesS!

Thanks for your idea though.. it's a good one.

[miko014]

I would calmly ask the person to step into another room with me. And once there, I would have validated the person's anger but also asked what they were so upset about. And asked what we could do to change the situation or help the resident.

I don't think I would be willing to take that chance. He did all that with the CNA present - could have easily become violent in a secluded room with nobody else around.

As if nursing isn't stressful enough, we get to deal with all this too. No wonder healthcare workers have some of the highest assault rates of any profession. I wouldn't have stood there and taken it the way you did. I have been in a similar situation, and I stopped the guy, told him that it's not okay to talk to any of us the way he talked to me, and that I would be talking to my charge nurse and changing the assignment - I wouldn't be back. The next day he saw me in the hallway and he apologized, and was nice after that. But the night he was yelling at me, he actually jumped off the couch and advanced toward me - if his wife's bed hadn't been in the way, I think he would have hit me. All over something the day shift nurse had told him and within the first five minutes of me meeting them. He was probably in his 40s, and a big guy - he could have really hurt me. Honestly, I understand people getting upset, but I don't care what the reason is, you should not be able to treat ANYONE the way they treat us! I have called security before, and I have asked people to leave. It's not good for us, and it's not good for the pt. Back to the guy who was screaming at me, his wife (the pt) was mortified that he acted like that, and was yelling at him the whole time he was yelling at me. I don't think that helped her situation much, do you?

[Natkat, BSN, MSN, RN]

I'm so sorry this happened to you. You were probably too shocked to know what to do.

What you might do next time is warn the person that they are out of control and being abusive and if they don't stop their abusive behavior you'll call security. You don't have to put up with that kind of behavior. I'm happy to see that the management backs you up on this. It makes all the difference in the world if you work in a facility that does not tolerate abuse from patients and family members. I'm very happy to hear that.

[Vito Andolini]

For OP and for HollyBerry678: So how did all of this start?

[Vito Andolini]

I would take a different route from what many have suggested here. It is not pleasant to be berated by a family member, especially in front of others. But this gives you an opportunity to use all those excellent communication skills you learn in your program. I would calmly ask the person to step into another room with me. And once there, I would have validated the person's anger but also asked what they were so upset about. And asked what we could do to change the situation or help the resident. It could be something as simple as the person having a bad day or being overly concerned about a patient. Or it could be the result of another person treating the parent or visitor rudely.

The visitor stuck his finger in your face. He/she did not physically assault you or threat you. Calling the police is going a little out of bounds for me. It has been my experience, when a visitor is angry, he/she is not angry at me specifically but at another nurse or the physician or worried about their parent and feel very impotent. As long as a person does not physically assault me, I am willing to listen and even be blasted. And then attempt to resolve the situation. If the individual refuses to discuss the matter, I would warn him/her that such behavior would not be tolerated the next time. And would result in the removal of the individual from the grounds.

Woody:twocents:

Woody, you're a male, right? I personally would do what you have suggested but I think it's tougher for the ladies to do that, especially when the irate person is a big male.

What never ceases to amaze me is that no one ever yells at the physicians, only at the nurses.

[jschut, BSN, RN]

For OP and for HollyBerry678: So how did all of this start?

This person hadn't done this to me before... and as I stated in my previous post... I (as do many others in my facility) believe this person to be mentally unstable.

[northshore08]

Julie, do not isolate yourself with this family member. File an incident report with your administrators and request they meet with him to determine if there are any real unresolved issues causing this person's behavior. You are not the one that should do the interviewing. Social work/case management needs to step in on this one to prevent this happening to the next nurse who upsets this family member.

If you are assigned to this patient again with this family member present, I would definitely request a security escort. If not, at least another staff member must be present.

Good luck to you.

[CountyRat]

don't hesitate to call the cops. we've had to do it, and usually i found the cops will be there in a flash if we call saying we've got a pt or pt's family threatening the staff." "don't know what the cop said or did, but the guy didn't come back to see "grandma."

if anyone applies force to your body while affecting a threatening manor, retreat to a place of safety, dial 911, and ask the police to arrest him or her. (no, of course i do not mean this for patients with dementia, etc. please read this in context.) our commitment to patients and profession never includes a "duty" to passively allow ourselves to be victims of assault. no major statement of professional ethics obligates a nurse to accept attack as part of patient care. you are ethically, morally and probably legally (i am not a lawyer. i hope that someone who is will correct me if i am wrong) justified in interpreting screaming, a finger in your face, and especially, being followed by this person when you attempt to retreat, as threats to your safety. call security if you can, the police if you do not have security (as is often the case in ltnc), and have them removed, and if possible, arrested.

i worked with police officers for several years, and i found that cops and nurses have tremendous respect and affinity for each other. i can promise you that, if the police get a call indicating that a nurse is being threatened, or worse, they will be there at warp speed, and will, ahem, adjust the assailant's attitude with commendable efficiency.)

[woody62, RN]

No, I am a sixty-three year old grandmother, not a grandfather. If anyone thought I meant for someone to take an upset individual off into a secluded room, you have miss understood what I was attempting to say. But neither would I have this discussion in front of the patient, other patients or visitors. I am sorry but every time I read about a problem patient or family member, too many of the nurses seem all to ready to jump on the 'call the cops bandwagon.' Very few seem willing to do what I was taught was part of my responsibility as a nurse-use communication.

I realize I am among the few who believe that it is better to attempt to communicate with an individual then to call the police. Perhaps my upbringing shaped me, I have lived in two vastly different foreign countries, in their neighborhoods, in their schools. And have traveled extensively overseas. And my initial nursing experiences, in NYC, exposed me to many different beliefs, cultures and manners. I do not apologize for taking what may be considered the high road, it is what I was taught, by my parents and my nurse educators.

Woody:twocents:

[CountyRat]

I am sorry but every time I read about a problem patient or family member, too many of the nurses seem all to ready to jump on the 'call the cops bandwagon.' Very few seem willing to do what I was taught was part of my responsibility as a nurse-use communication.

Woody:twocents:

Woody; I am one of the nurses who advocated calling the cops, so you might be surprised by my response to your post; I agree with you. In 25 years of nursing, I have never called the cops in response to an angry visitor or patient (and no, that is not because I do not have experience with angry visitors and patients!) The difference between your advice and mine, I think, is one of context. I was responding to a description of an event in which a man (who I assume was stronger) was escallating toward violence against a woman (presumably weaker, physically, that is), even to the point of following her into a restricted area when she attempted to retreat in order to provent violence. I believe that, just like everyone else, nurses have a right to protect themselves from violence, and that, when de-escallation is not working, the safest, most professional way to do this is to use the established, civilized means of police and courts. Yes, you are right, a good nurse can usually de-escallate a criminal, most are good at it (we get a lot of practice, sad to say), and that is the first, and best approach. But if a nurse believes that she is in danger, she has the same right as anyone else to ask for protection, or even to protect herself in the most dangerous and extreme situations (but that is an entirely different discussion).

Thank you, Woody, for responding from the foundation of your long experience and wisdom. As my senior in our profession, you have my most profound respect, and I value your counsel. It comes from a deeper place than mine doses, and deserves the thoughtful consideration of all who visit this thread.

[bossynurse101]

I just want to say that I am sorry this happened to you. It happened to me not to long ago and I had to go to my car to cry. It HURTs when someone that I am trying to help turns on me (family or resident). I put SOOO much into my work how could it not? Know that these aholes -oops I mean family members are also hurting, angry, and feeling lots of guilt and it unfortunately comes out at you. You, on the other hand are a top notch, grade A, wonderful nurse. Nurse being the operative word. Here is a hug for you and for ALL nurses who put up with sh** (literally, ha ha).

:icon_hug:

[Jolie, BSN]

Woody and CountyRat,

I appreciate your conversation here.

I am also one who usually advocates taking up matters directly with the person involved, in a non-threatening way. I almost always believe that people deserve the benefit of a direct conversation first, followed by going up the chain of command if the first conversation does not yield satisfactory results.

But I believe this situation is different. The OP has started 2 threads discussing this person's behavior which has involved multiple episodes of intimidation and threats towards staff members, and quite likely, his own mother.

Based on Julie's descriptions of these situations, I believe him to be an unstable and potentially dangerous man who should not be approached directly. Management needs to be involved, and security/law enforcement if his behavior should escalate.