Patient's "right" to abuse nurses...I need your opinion - page 6

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... Read More

  1. by   SVRegisteredNurse
    My second comment; many times there are psychological issues that need to be addressed. Again The MD needs to be in the loop. Concerning actual physical abuse, I knew a nurse who was kicked in the face just as she finished putting a foley in. Without thought she immediately hit the patient in the upper thigh. She was fired.
    Years ago, I bent over to look at a pump that was delivering cardiac drug 200x the rate I had set it. The patient, a 20something young man, reached from the bed and grabbed a handful of my hair. I was bent all the way over and he was twisting my neck. I pled with his elderly parents to pull the bell out or go in hall and yell. They were frozen in shock. Before he twisted my neck so far I fell...I kicked him in the stomach. It was him or me.
  2. by   billswife
    My Quote function is not working properly. I apologize. Regarding the previous poster's statement below:

    "Regarding voice recordings, yeah I say never do that. At the very least we'd have to get permission from the patient since recording a patient without it would violate HIPPA and probably some other state laws and/or hospital policies. Taking that recording home would not be good either since it could be lost or compromised; Even the IDEA that it COULD have been lost or compromised would make a nurse look bad.

    I've seen patients accuse both male nurses and female nurses of innapropriate actions. I've even been accused of things that were laughably untrue. Coworkers might get a good laugh about it too, because some claims are outrageous.

    Back to the OPs topic that patient is a pretty good example of someone who, if they dont get their way, might make a false accusation. When an accusation is made it is annoying and you'll end up doing some paperwork for your side of the story. That's why you want to be sure you take good notes and keep a timeline.

    Obviously if numerous complaints come in over time, and from different patients, well then you have a history...and a serious problem."[/QUOTE]






    I certainly understand the points made by the previous poster; however, in the current climate you need protect yourself against false accusations of abuse and molestation. The existence of an audio recording would never need to be known about by anyone but yourself, unless a false accusations is made, and in that case HIPPA will be the least of your worries. Careers and lives are ruined by frivolous, but false, accusations. After 25 years of nursing I know that ridiculous claims are sometimes believed by co-workers, management, the press, and the courts. Protect yourself, quietly.
    Last edit by billswife on Nov 9 : Reason: Quote feature isn't working
  3. by   NunNurseCat
    I certainly understand the points made by the previous poster; however, in the current climate you need protect yourself against false accusations of abuse and molestation. The existence of an audio recording would never need to be known about by anyone but yourself, unless a false accusations is made, and in that case HIPPA will be the least of your worries. Careers and lives are ruined by frivolous, but false, accusations. After 25 years of nursing I know that ridiculous claims are sometimes believed by co-workers, management, the press, and the courts. Protect yourself, quietly.

    Ugh, I wish that wasn't true. Perhaps there are cases when a recorder would be useful. I can only speak for myself, but I wouldn't care if you recorded interactions for personal protection reasons. I worry about such things a bit more since the friendly note in my box and emails regarding the use of private devices and their needing to be registered with IT, HIPAA worst cases etc. (you all know the drill).

    I too have been lunged upon, hit, threatened, once I even dodged a fist only to have the person hit a coworker seconds later. Most of the incidents had mental/psych issues. I don't ever take it personally. Certainly a psych consult is a good thing, but still any patient who hits or is continually violent for any reason poses a serious risk to themselves and others. Security and the physician should definitely be notified immediately. Restraining a violent patient who isn't AO really is terrible work, but sometimes its necessary and I don't consider it assault. However if they are AOx3, then they are aware of their actions and, even with a background of bipolar issues, it is unacceptable behavior and has to be firmly addressed.
  4. by   NunNurseCat
    Too late to edit my post above but I wanted to delete the part about restraints. It's not really on topic. Also it sounded like I dont consider restraints assault. To clarify my vague statement I don't consider a person who is not oriented, and who attacks me, to be assaulting me.
  5. by   Stitch22
    As a nurse for 20 + years I have always believed that patients should treat nurses with respect. I have had patients that have thrown things at me cussed me out and I was reprimanded for standing my ground ( pancreatitis patient that wanted food) my boss came up took her side and even walked her to the cafeteria. It is ALL about " HCHAPS " and the patient experience . Long story short I made the mistake of taking a director position and during that time I found out very quickly the nurse is ALWAYS wrong it's always the patient and no matter what the patient says the nurse is the one that ends up getting the raw end of the deal. The nurse is expected to smile and take it! Upper management does not care about the nurses they only care about the reimbursement and the scores and no excuses are excepted. Yes I was hardened from this experience and even consider quitting nursing once you have seen the dark underbelly of the Hospital corporation it's hard to go back. Your supervisor was NOT joking, this is how the upper management is being taught the patient is ALWAYS right no matter what! The patient is throwing something at you or cussing at you then you must've done something wrong especially if they make a comment on their HCHAPS survey, this is how they think! It's true insanity! Or maybe this was just my expirence and it is abnormal , I hope that is true! Continue to set limits with these patients and stand your ground! Good luck!
  6. by   billswife
    Quote from Stitch22
    As a nurse for 20 + years I have always believed that patients should treat nurses with respect. I have had patients that have thrown things at me cussed me out and I was reprimanded for standing my ground ( pancreatitis patient that wanted food) my boss came up took her side and even walked her to the cafeteria. It is ALL about " HCHAPS " and the patient experience . Long story short I made the mistake of taking a director position and during that time I found out very quickly the nurse is ALWAYS wrong it's always the patient and no matter what the patient says the nurse is the one that ends up getting the raw end of the deal. The nurse is expected to smile and take it! Upper management does not care about the nurses they only care about the reimbursement and the scores and no excuses are excepted. Yes I was hardened from this experience and even consider quitting nursing once you have seen the dark underbelly of the Hospital corporation it's hard to go back. Your supervisor was NOT joking, this is how the upper management is being taught the patient is ALWAYS right no matter what! The patient is throwing something at you or cussing at you then you must've done something wrong especially if they make a comment on their HCHAPS survey, this is how they think! It's true insanity! Or maybe this was just my expirence and it is abnormal , I hope that is true! Continue to set limits with these patients and stand your ground! Good luck!
    Stitch, it is not just your individual experience. What you said is spot on! My heart and spirit have slowly broken over the course of these changes in nursing. I pray for the future of our profession, and for the welfare of our patients.
  7. by   nursesherry7
    If your not working a psych unit, those pt. have rights and RESPONSIBILITIES. I'm saddened by the reply you received from the "higher up", and I personally wouldn't put myself in that position again.ps. CHART those behaviors and your attempts to modify by explaining that the call light is for real needs, CHART it all.
    Last edit by nursesherry7 on Nov 11 : Reason: Amendment
  8. by   RescueNinjaKy
    We've all had that challenging patient and certainly it can be testing, but make no mistake. Patients do not have the right to abuse you. Nobody does. And if any management tells you different then they need a reality check and a visit from HR. I would not tolerate anyone telling me that the patient can abuse me.

    For me this is how I deal with these patients. I like to be up front and real about things. If they keep calling me for narcotics, I'll tell them that they are not due for it and it doesn't matter how many times they call me, I cannot give it to them earlier than scheduled. If they are appear to genuinely in need of it through my assessment then I will page the doctor and suggest a change in pain management. As far as the neediness, patient satisfaction is not first no matter what. I'll tell any administrator that in their face. Patient safety and care is number 1. So if I'm busy with another patient then the needy one is just gonna have to wait. We didn't go to school and get tested on those painful priority and delegation questions for some suit to tell me that o have to drop everything for my more urgent patient to go cater to someone who is not actually in distress.

    Another thing is that when you give them the response that they want, they are conditioned to believe that they can do it all the time. If they get upset they get upset. I tell them I was busy with another patient and that they're not my only one. Most patients understand but those that don't, doesn't bother me at all. Also assaulting anyone is not okay and should be reported. Management is at serious liability when they do not prevent that from happening so if the patient is that aggressive then either restraints need to be used or hospital police needs to be present.

    I also agree with other posters that the assignment needs to be rotated. Spread the hate is what I always say when I used to make assignments.
  9. by   anewsns
    That is completely unacceptable !!!! Id prob flip out or something if another nurse said that to me. And im not a flipper outter but good lord! I'd probably say "I missed the meeting where they said that , let's go together to ask the manager." If they were unable to address this at all, the patient AND that awful coworker, then I'd seriously be looking for a new job. No , just no. That lady needed rounds by staff who know what the hell theyre doing, and they needed to give that patient to other nurses, one of the few cases where I'd change the staff every day so no one gets burnt.

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