Patient going to send nurse to Concentration Camps??

Nurses General Nursing

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It's another day and another dollar around here and the fun just never ends.

A patient was making a long rant about Hipanics, African Americans and Native Americans. We have been instructed that we cannot leave this patient's room until all needs are met even if this patient is speaking like this.

In an effort to get this patient to see that we are all human, I shared with the patient that I was Jewish. We spoke for 5-10 minutes about my Jewish heritage, my family and how we celebrate and honor this Jewish background of mine.

Two days later I entered this patient's room and I was just a few mintues delayed in answering the call light.

This patient says to me, "I am going to send you to the Concentration Camps because you are too slow."

I WAS STUNNED.

So I said, "Excuse me? What did you just say???"

The patient repeated it just as clearly the second time; "Yes, I am going to send you to the Concentration Camps because you are too slow."

I did not respond. I was taught that comments like this are not worth responding to because the person is obiously a completely ignorant bigot. I just went to the bedside and started addressing the needs of this patient, adjusting bedding, empty catheter bag ect...and then excused myself from the room.

I reported this to my supervisors and they have done absolutely nothing. Their reply is that this patient has the RIGHT to say whatever she/he wants and we cannot dictate what this patient says.

I completely disagree and I think this is a horrific thing to say to anyone.

Comments and thoughts are appreciated.

This is a long-term patient and I will be interacting with this patient for weeks to come.

Advice?

Anyone else gone through this?

To be frank, I deal with patient's only for a short amount of time (ER nurse). If someone is verbally abusive/screaming/yelling/acting inappropriate we will place them in a room, on the monitor, and shut the door partially. We deliver care and follow through on the MD orders, but if the patient refuses then we stop and again shut the door partially and continue to monitor the patient. If they are unable to control their actions due to medical diagnosis we will medicate them with haldol, geodon, ativan, or benadryl. We will place spit masks on the patient's that are biting/spitting, place pt's in restraints if they are physically aggressive. During all of this we do not engage/speak/attempt to placate the patient if it only furthers the behavior.

If the patient is alert and oriented, I will tell them to stop. I do not make demands, I will simply say: "That is unacceptable, you need to stop. There are children/other patient's nearby who are sick and this is not fair to them." I will then deliver the ordered care without verbally engaging with the patient. If the patient continues to be verbally inappropriate, I have had the MDs discharge them from the ER and have security escort them out. Legally we have an obligation to ensure they aren't dying/treat obvious life and limb situations but we do not have to put up with harassment.

If the patient is sick enough that they need to stay, I will continue to provide care but will not go to the bedside unless security is present/at least one other nurse is present to protect myself from being both physically assaulted and/or to prevent the patient from saying I did something inappropriate/did not medicate at ordered/etc.

Yes, we are not allowed to verbally reprimand or anything like that. Better to just excuse ourselves under the pretense that we have to check a call light or something and then come back in ten.

This patient says horribly abusive statements to many of the staff and has the whole place in an uproar. Many staff are actually considering quiting and going somewhere else because they do not feel they have the backing of the administration.

When nurses feel they do not have any value where they work they get depressed. It's a very sad state of affairs. Makes me sad and depressed to think about it.

I am trying my best to see administration's point of view, they say this patient has the right of freedom of speech. However, Freedom of Speech does not include hate speech, rascist remarks or verbal abuse.

It's time for a change.

The patient has borderline personality disorder. Most administration's are afraid of this issue, due to legal problems. Feel free to change, but there will be another borderline patient at the next facility.

I found the best way to handle this was, let it go in one ear and out the other. Staring them down also works.

Best wishes with this mess.

Specializes in Surgical, quality,management.

Slightly off topic......

Pt admitted for a c scope day prior for prep. Is paraplegic. I was given the heads up by the elective coordinator, Head of Unit and manager of consumer liaison that he was coming in with a long history of complaining and verbal abuse to staff.

He point blank refused to drink the prep as in his words "it was in violation of the Geneva convention "

Next morning I went in with HoU to inform him that he would be discharged as we could not scope him as he had not prepped. His statement to me was " you fat b!$@& running a modern day Auschwitz" was the most creative insult I have ever had hurled at me.

He was a toxic, angry man who had tortured nearly every department in the hospital. He usually accommodated in his irrationality but I laid down the law and his demands had nothing to do with his admission so bye bye...

Specializes in ICU, LTACH, Internal Medicine.

This is why I stopped discussing any personal topics with patients and families.

My birthplace, my accent, where is my family, who is my husband, how many kids - I am sorry, sir/ma'am, I DO NOT WANT to speak about it. Change the subject. No excuses like "but I am just curious". Repeat as needed. If they want another nurse after that, better for me.

And I just wouldn't work in a place which puts someone' nosiness and something worse above it's own employees' safety and comfort.

Specializes in ED; Med Surg.

We had a patient recently who stated he wanted no provider of any kind who was not white or did not speak English. I was quite pleased when management told me to ask him what hospital he wanted to be transferred to. I have no tolerance for anyone who acts like this patient did and was glad the powers that be had our backs. Patient quickly back paddled.

Life lesson 101, don't argue with drunks or crazy people.

I would put this patient in the crazy people category. Smile, nod, say, "Uh huh, yeah", finish the patient care needs as quickly and efficiently as possible and exit the room.

Specializes in SICU, trauma, neuro.
Yes, we are not allowed to verbally reprimand or anything like that. Better to just excuse ourselves under the pretense that we have to check a call light or something and then come back in ten.

This patient says horribly abusive statements to many of the staff and has the whole place in an uproar. Many staff are actually considering quiting and going somewhere else because they do not feel they have the backing of the administration.

When nurses feel they do not have any value where they work they get depressed. It's a very sad state of affairs. Makes me sad and depressed to think about it.

I am trying my best to see administration's point of view, they say this patient has the right of freedom of speech. However, Freedom of Speech does not include hate speech, rascist remarks or verbal abuse.

It's time for a change.

Freedom of speech does NOT guarantee no consequences. What happens if someone calls in a bogus bomb threat? Consequences. What if they threaten a police officer? Consequences. What if you are in any other work situation, say in an architectural firm, and someone makes bigoted remarks? Consequences.

Heck a couple of years ago, at a time when my older kids and I needed internet access for school; we were in a new place with a new provider, and I was on my 3rd modem (already had made two trips to the store and had to take a number and wait to exchange it.) I let an f-bomb slip while on the phone with customer service. Not my proudest moment, but it wasn't even directed at her, but at the situation... I think it was something to the effect of "I've spent x number of hours on this, and we are paying, so I expect the ******* modem to work." She -- AN ACTUAL CUSTOMER SERVICE REP, NOT an RN whose management thinks is a customer service rep -- advised me that she would end the call if I continued to use foul language.

As far as I am concerned, if not an emergent situation we absolutely should be able to protect ourselves from verbal abuse.

I said in the thread "Verbal abuse -- what are my rights?" thread, that verbal abuse is verbal abuse whether coming from a patient or anyone else. In this situation, he is completely in control of his behaviors. His behaviors which would be unacceptable toward anyone else, are unacceptable toward you.

If management is okay with their staff working in a hostile work environment, I would go to HR and if necessary contact an attorney. You are experiencing racism at work. It's 2018 -- and it is unacceptable!!

Earlier in my career we had a frequent flyer on my floor who would say things to black staff that I won't even repeat. They stopped assigning black nurses/CNAs to her -- not because they wanted to make her happy, but to protect the STAFF from her vile behaviors.

As far as making a difference in his attitude, I'm reminded of the song from "South Pacific"

You've got to be taught before it's too late

Before you are six or seven or eight

To hate all the people your relatives hate

You've got to be carefully taught

Bigotry isn't natural. I mean look at very small children; they will befriend anybody. Tragically it becomes deeply ingrained, and as you've learned the hard way, isn't so easily un-taught. :(

Specializes in Case manager, float pool, and more.
We had a patient recently who stated he wanted no provider of any kind who was not white or did not speak English. I was quite pleased when management told me to ask him what hospital he wanted to be transferred to. I have no tolerance for anyone who acts like this patient did and was glad the powers that be had our backs. Patient quickly back paddled.

Love this.

Specializes in OB.

I'm confused---management will not allow you to set boundaries with this one particular patient, or any patients? Either way, seems odd for a nursing home. They usually aren't at a loss for requests for beds.

I actually disagree with people who are telling you you should be able to let it roll right off your back. To compare telling someone of Jewish descent that they are going to be sent to a concentration camp to a patient vaguely threatening a nurse with "I know what you did" is ridiculous. It's an extremely hurtful, traumatic, and horrible comment specifically targeted at a painful spot for you, and I can understand being at a loss for how to proceed. The key is to make him THINK it didn't bother you. Then go vent, fume, punch a pillow behind closed doors. People SUCK. Some don't, but more and more I believe that a whole lot do. I'm sorry you're going through this.

Specializes in Psych, Corrections, Med-Surg, Ambulatory.
I'm confused---management will not allow you to set boundaries with this one particular patient, or any patients? Either way, seems odd for a nursing home. They usually aren't at a loss for requests for beds.

I actually disagree with people who are telling you you should be able to let it roll right off your back. To compare telling someone of Jewish descent that they are going to be sent to a concentration camp to a patient vaguely threatening a nurse with "I know what you did" is ridiculous. It's an extremely hurtful, traumatic, and horrible comment specifically targeted at a painful spot for you, and I can understand being at a loss for how to proceed. The key is to make him THINK it didn't bother you. Then go vent, fume, punch a pillow behind closed doors. People SUCK. Some don't, but more and more I believe that a whole lot do. I'm sorry you're going through this.

In an ideal world, people just wouldn't think to behave this way. In a slightly less ideal world, management would have the backs of their employees. ("What hospital would you like to be transferred to?" I absolutely LOVED this.) In OP's world, not remotely ideal, there is a dirtbag patient and a cowardly management.

Of course it SHOULDN'T be this way. But it is. I think it would really help OP and all the other staff in that facility to remember that this person has no real power. He/she is just spewing vitriol. It is very unpleasant, just like a patient with c-diff. (Although it's a lot easier to feel compassion for the person with c-diff, still makes for unpleasant working conditions.) Ever see Monty Python's The Holy Grail? When the knight has his arms and legs cut off and yells "Come back and fight, you cowards!" It's funny in a movie and it really helps to learn to laugh at it in real life. I don't mean laugh openly at the patient, but try to see the ridiculousness of a powerless patient threatening to send someone to a concentration camp.

I don't know if this person actually has borderline personality disorder as some have suggested. But here's a clue: if you find yourself feeling someone's ugliness on a visceral level, that is a trademark of a borderline. They're good at making someone feel the way they usually do. I hope, with or without management's help, OP and crew can present a united front to deal with this person. Life is too short to be stuck with someone's ugliness.

Specializes in OB.
In an ideal world, people just wouldn't think to behave this way. In a slightly less ideal world, management would have the backs of their employees. ("What hospital would you like to be transferred to?" I absolutely LOVED this.) In OP's world, not remotely ideal, there is a dirtbag patient and a cowardly management.

Of course it SHOULDN'T be this way. But it is. I think it would really help OP and all the other staff in that facility to remember that this person has no real power. He/she is just spewing vitriol. It is very unpleasant, just like a patient with c-diff. (Although it's a lot easier to feel compassion for the person with c-diff, still makes for unpleasant working conditions.) Ever see Monty Python's The Holy Grail? When the knight has his arms and legs cut off and yells "Come back and fight, you cowards!" It's funny in a movie and it really helps to learn to laugh at it in real life. I don't mean laugh openly at the patient, but try to see the ridiculousness of a powerless patient threatening to send someone to a concentration camp.

I don't know if this person actually has borderline personality disorder as some have suggested. But here's a clue: if you find yourself feeling someone's ugliness on a visceral level, that is a trademark of a borderline. They're good at making someone feel the way they usually do. I hope, with or without management's help, OP and crew can present a united front to deal with this person. Life is too short to be stuck with someone's ugliness.

I agree completely with everything you say. I just don't think it's realistic for someone to be able to brush something like that off as soon as it's spewed at them. If you're able to do that, truly my hat is off to you, I wish I could be that way. And as I said, she definitely needs to make him think that she can just brush it off. But I personally would be affected by that comment, and I don't think it makes me unique, so I wanted to give the OP some reassurance if she was finding herself in the same boat.

Specializes in Psych, Corrections, Med-Surg, Ambulatory.
I agree completely with everything you say. I just don't think it's realistic for someone to be able to brush something like that off as soon as it's spewed at them. If you're able to do that, truly my hat is off to you, I wish I could be that way. And as I said, she definitely needs to make him think that she can just brush it off. But I personally would be affected by that comment, and I don't think it makes me unique, so I wanted to give the OP some reassurance if she was finding herself in the same boat.

When I find myself feeling someone's crappiness on a visceral level, that's my clue that it's really THEIR crappy feeling. It's like being slimed. Finding ways to laugh about it with coworkers and blowing off the ridiculousness of it is like taking a cleansing psychic shower. Of course, you have to laugh together in private. If someone overhears, you will be accused of not being compassionate.

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