YIKES, night owl-- Sounds like the resident set you up for that tirade-- Lousy and unfair treatment, but sounds like you handled him well!
A few months ago, I introduced myself to a patient during first rounds at 4 p.m. and he mentioned that wound care had not been done by day shift and he'd like it done as soon as possible as it was overdue by a few hours. I explained that I would get to it as soon as I could, but I needed to see all my patients first. I then hung an IV antibiotic that was due and as I assessed him, we chatted and had a friendly conversation. When I finally got back to him around 45 minutes later, I began looking for the Curasol gel that'd recently been ordered, but didn't see it anywhere. Just to be sure, I started to search his room to see if it had inadvertently been put in with his hygeine supplies. As I reached up to a shelf to look in the basin, he snapped, "It's NOT in there!" I then walked over to his bedside table thinking it might've been placed in the drawer. As I reached to open it, he yelled, "I TOLD YOU IT *WASN'T* THERE. WHY WON'T YOU *LISTEN* TO ME?!!" His face was practically purple and he was shaking in anger.
I apologized and slowly backed out of the room, but was extremely taken aback and surprised at his outburst. I realize I shouldn't have checked his drawer without asking-- I was rushing (as usual) and not thinking about the fact that I was invading his privacy-- I just wanted to find the confounded Curasol!
It turned out that there was no gel in his room because no one had gotten it from the wound care nurse. I eventually got a tube, and when I finally got back to him to do the wound care, he was apologetic and I forgave him, but I was "on guard" the rest of my time with him. I was very careful with him in the future, sensing a great need for control, and have also learned to be very careful with patients' personal items and privacy...:imbar Patients lose so much sense of control in their lives when they're sick and especially when hospitalized (or in a LTC facility). I try to give them as much feeling of control as possible-- I knock most times before entering, ask permission to assess them, negotiate prefered times for wound care, etc. And some patients need MORE feelings of control than others, so I try to be sensitive to that. I'm not excusing the outbursts we sometimes deal with, and no nurse deserves to be treated lousily; I'm just trying to understand and be compassionate if possible, and not take it too personally (often easier said than done).