Dealing with a patient who verbally threatens you - page 2

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... Read More

  1. by   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.
  2. by   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.
  3. by   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.
  4. by   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)

    Quote from 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.
  5. by   PeachPie
    Quote from 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.
    Last edit by PeachPie on Aug 15, '06
  6. by   Luv2BAnurse
    Quote from NurseErica
    If my patient is going to be an ass, he will be an informed ass.

    WOW. Actually, that was well stated.
  7. by   truern
    Quote from 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.
  8. by   Haunted
    I have told patients that I will not accept them on my assignment if they are threatening to sue me. I write up an incident report and have never had a problem with my supervisor. This has only happened to me a few times however.

    Ruby, I appreciate your opinion but can certainly understand how and why the OP felt and agree with the way they handled it.
  9. by   Medic/Nurse
    SIMPLE RESPONSES TO COMPLEX SITUATIONS!

    1. I'm gonna sue you. I'm gonna call my lawyer?
    RESPONSE: Okay.

    2. I don't want _____. There is no.....
    RESPONSE: Okay.

    3. I'm gonna hit you OR follow you home and kill you OR make you sorry you ever heard my name.
    RESPONSE: (None) Call 911 & security. File criminal complaint.
    RESPONSE: IF struck: Protect yourself. Patient GOES TO JAIL. You sue him.
    RESPONSE: Buddy, I'm already there! (about that being sorry thing) NO JUST KIDDING. See 1st two responses.

    I consider personal safety a right! I take it seriously!
  10. by   StNeotser
    We get a lot of blood draws on nights where I work. Sometimes with difficult patients the phlebotomist comes to the nurses station and asks that one of us come in with him/her when such a situation arises.

    I understand where Ruby Vee is coming from as I believe she is an ER nurse (correct me if I'm wrong) Sometimes the person that has to deal with that difficult patient is going to have to be you. However, calling for back up and that the nurses actually know the patient a bit better than you is always a good idea. Very often nurses are able to assess why the patient might be that way than a phlebotomist who just walks in for five minutes to do a lab draw. For example, do they have a dementia dx where they wouldn't really act on it, has the patient just been stuck somewhere else, have they just been told they have stage IV cancer, etc.
  11. by   TazziRN
    Quote from StNeotser
    We get a lot of blood draws on nights where I work. Sometimes with difficult patients the phlebotomist comes to the nurses station and asks that one of us come in with him/her when such a situation arises.

    I understand where Ruby Vee is coming from as I believe she is an ER nurse (correct me if I'm wrong) Sometimes the person that has to deal with that difficult patient is going to have to be you. However, calling for back up and that the nurses actually know the patient a bit better than you is always a good idea. Very often nurses are able to assess why the patient might be that way than a phlebotomist who just walks in for five minutes to do a lab draw. For example, do they have a dementia dx where they wouldn't really act on it, has the patient just been stuck somewhere else, have they just been told they have stage IV cancer, etc.
    I am an ER nurse. If I have a pt threaten me (even if it's just a perceived threat) I try to change assignments with my coworker. If an ancillary staff member (like a phlebo) were to come to me and say the pt threatened him, I would take the equipment and go draw the pt myself. I would not allow the phlebo to be put in a situation that scares him, just like I would hope others would help me get out of a similar situation.
  12. by   Nascar nurse
    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 would have calmly and matter of factly stated.. "You can refuse this now and we will notify your Dr. or you can be patient and hold still and I will do my best from there". Balls in his court.

    PS - I guess I really don't see this first part of the interaction as verbal abuse - just some guy running off at the mouth. He ain't the first and won't be the last.
  13. by   Natkat
    I understand you felt intimidated. I'm not a nurse but a dialysis tech, and I have had my share of mouthy patients. This is what I do.

    Ignore them.

    I just do my job and let them talk. I look at their mouths going "blah blah blah blah blah blah......" and I just do my job.

    I once had a situation where I was having trouble getting a patient's bleeding under control. I was getting there but still fumbling around a bit. After a few minutes the patient yelled "go get somebody" and I looked him right in the eye and said "I am somebody" and kept doing what I was doing. He didn't say any more.

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