Patient's "right" to abuse nurses...I need your opinion

[MsNewbee]

Hi, everyone. I'm a year out from graduation and have been working my job so I haven't posted or been on in a while, but a topic came up on the job and it just rubbed me the wrong way. I didn't want to ruffle feathers at the hospital so I decided to turn to my peers on allnurses for guidance.

I recently had a patient that really tried my nerves. I'm a super patient person and she made me question why I chose nursing (which I thought would never happen!). She would ask me for pain medication and as soon as I would leave her room she would be on her light again asking for the same thing. She literally rang her light 15 times in 10 minutes. I counted because I would answer her. She did this everyday for at least 3 hours every morning for the 5 straight days that I had her. She was cognitively intact. She wanted to go smoke outside, but needed staff with her and no sooner that she went outside by herself (while I was with another patient) she broke her wheelchair then demanded that I go with her. I only had 8 other patients to take care of, no big deal right? She complained about everything from the food, to the other staff, to the other patients. Her room was next to the nursing station and she would scream my name down the hall while I was charting because I was in her line of sight. I started hating my name just because of the shrill way she would scream it and she did this constantly. If I left to tend to another patient she would scream my name louder. I could hear her screaming for me while I took lunch breaks. She yelled at other patient's family members as they would passed by her room. I got so frustrated I told her we were human beings that should be treated the way she herself would want to be treated and her behavior was not acceptable. I didn't know what else to do or say to her. Eventually, she hit my tech and started smoking in the room and that's when administration said she had to go on the 5th day with me.

I made a sarcastic comment and said, "Can someone take the light and just put it somewhere, she knows I'm coming." The nurse supervisor who was getting off of work said, "it is her right to abuse you." I just looked at her back as she sauntered off to the elevator with my mouth open because I couldn't believe what she just said. I thought a better response would have been, "she needs to have her call light in case she has a need that hasn't been addressed." or something along those lines, but she was serious. I determined at that moment I would not pick up any more shifts because I was begged to come in that day and that was what I got. I felt like the "higher ups" really didn't care about me or my mental well being.

My question is do patient's have the right to abuse us? Am I just being a baby and should suck it up because this is my life/job now? I am really dreading going in tomorrow. I loved my job until I had this one crummy patient. I woke up crying in the middle of the night on my third day with her because I knew she was going to do this every time I showed up. I was fighting back tears for those 5 days at work and I cried once in my car on my lunch break. How do ya'll keep the fire that inspired you to go into nursing from going out?

Please help, I'm feeling sooooo helpless and drained .

[luvmyc]

Absolutely not. I'll tell patients that they have right to talk to me that way/treat me that way. Life is too short to be verbally abused at work.

[JBudd, MSN]

luvmyc said:

Absolutely not. I'll tell patients that they have right to talk to me that way/treat me that way. Life is too short to be verbally abused at work.

I think you left out "NO right" LOL (yes, yes I did SMH)

[MrNurse(x2), ADN]

I hope that she was! She works the opposite shift of me so I've never worked with her directly before. The patient's behavior was so consistent. The nurses on the night shift would comment how awful this patient was until I started working with her and then suddenly she could sleep at night. I thought it was because she expended so much energy hollering at me all day.

That's why I didn't say anything to any supervisors or bring it up because it could have been a joke, but I was curious to see how the patient's underlying behavior for the comment should have been addressed and how I can keep going on if I'm smiling through tears stinging my eyes.

During a meeting we were informed that reimbursements were based on patient satisfaction and now we wouldn't get paid if patient's weren't happy and then this lady showed up and they assigned her to me. She was there 8 days and I had her for 5. I thought the whole situation was a cruel joke.

It could be that your personality and punctual response made her happy. These manipulative beings have a huge insecurity that their needs won't be met. That is fair, as I have worked with numerous veteran nurses who make pts. wait extended times under the "busy" guise. I am assuming a lot, but I suspect she is a FF to hospitals. Limit setting is a huge part of management of these patients and calling your charge or manager in to discuss this will go far. It is frustrating and demoralizing, but you were exactly what she needed. I explain to patients that I round hourly, maybe not on the minute but between 50 and 70 minutes with few exceptions. I will take care of your needs then and please call for emergencies.

[Cat365]

I must be lucky. Neither of the hospitals I've worked for would tolerate that behavior. First if you wish to go outside you can sign yourself out AMA. Otherwise you stay in the hospital. If you choose to smoke in your room we claim your cigarettes and lighter. If you do not wish to do this you can leave AMA. Challenging patients are rotated. No one gets them for 4-5 shifts in a row. No charge I've worked with would do that.

[workinmomRN2012, BSN]

3 answers...NO she does not have the RIGHT to abuse staff!, NO she shouldnt be going ourside to smoke (we immediatly start patients on a patch for those who smoke) and last but not least...ROTATE the patient to other RN's, share the misery, lol

[Apple-Core, ASN, BSN, RN]

Nobody has the RIGHT to abuse anybody. If your manager really did mean that (it could have been a case of super-dry "humor"), then that is taking the whole PC thing too far.

[Julius Seizure]

There are Rx tobacco inhalers?

[NurseSpeedy, ADN, LPN, RN]

This is the type of patient that will typically get passed around to a different staff member each day/shift like a ping-pong ball. No one has to take the patient more than one day at a time if they don't want to and just about everybody gets their turn to share the love. Hopefully they are discharged within this time frame. If not, the cycle repeats until they have been released. The super fun patient is well shared on the unit....at least where I work now.

Years ago I worked for a facility with a frequent flyer that was dropped off at our ER every few weeks and would stay with us for at least a month at a time. The patient would be perfectly fine but if mom said he had x diagnosis then that's what he got admitted with. The MD went along with it. Anyway, the patient would always talk nasty (sexual content) to a female staff member if she were in the room and would try to grab inappropriately any chance he got. He was a total care patient with tubes and everything so we were in the room a lot. For some reason I seemed to always get assigned to this patient and I worked 5 days a weeks so I would sometimes have him several days in a row, get one day off, and get him back when I returned for another several days! To make it worse, I was only a few years younger than him and the rest of my unit (we were very small) were old enough to be his mom so I got it pretty bad. I would go home and immediately take a hot shower. This was also the patient that would have a discharge order but the caregiver (mom) would go MIA or would be on her way but something always came up for about another couple of weeks. I don't know of any hospital that would put up with that kind of crap today but way back when I first started nursing, this was the case where I worked. I solved this problem by going FLEX pool and agency. I chose when I wanted to work and where, and if I knew that special someone was in for their resort stay and I had had all I could take, I booked somewhere else until I thought it was safe to return. This is one of the great things about being pool or agency, the chance of getting the same crazy assignment 2 days in a row is very slim.

[LovingLife123]

After a couple of days of her, I would have told charge I would not take her as a patient anymore. She does not have the right to abuse you. At all.

I've given a couple of difficult patients some tough love before. Some of them need it. You can be firm, but in a caring manner. If she still is acting crazy, I will be firm, but not caring.

Let them give me a bad survey score. I don't care. The good ones make up for the couple of bad apples. But I will not tolerate someone treating me like their servent or disturbing the unit.

[mushyrn, BSN, RN]

No. No. She has zero rights to abuse you. The person who was hit by her should be filing charges against her with the police. And you should never take a patient downstairs to smoke, leaving your other patients on the floor covered by other nurses. The ONLY reason I go with a patient off my unit is because they are a critical care patient going to CT/Xray/MRI/etc... not to smoke or see the Christmas tree downstairs. Nope. Not happening. AMA.

Never let a patient or family member or coworker or ANYONE abuse you as a nurse. You have to stick up for yourself. Please always do this. I would give her the pain medication if ordered, close her door, and let that call light ring for an hour before answering it again.

Bye Felicia.

[jaderook01, BSN, RN]

That AMA paper would have been printed off and presented to her. Also, I would have fired her. However, I would have also called the doctor, explained her outrageous behavior and gotten her discharge underway.

[nursej22, MSN, RN]

There are Rx tobacco inhalers?

Yup, the brand we used was Nicotrol. They look faintly like a cigarette and they have a nicotine ampule that is inserted, and crushed upon activation. You only get a puff or two per ampule, but the patient gets the oral stimulation of drawing in, and demented patients seem to like holding them.