Yes, set boundaries. "I can't stay in the room when you use foul language, I'll leave for 5 min so you can calm down, then I'll come back and we'll continue with this." Every time foul language is used, use the same statement, leave, and come back at the time you said you would.
They do often feel frustrated and unheard, so that using a previous poster's statement, "What can I do to make it better?" and then listening carefully and trying to hear what the patient is really saying (not the words, the message behind them) often will help.
I know that some people are just a waste of oxygen, but most patients are just scared and disoriented and in pain and can be brought around to behave more appropriatly .
When I have a patient like that, I usually drop a note or email to my boss preparing her for the troublemaker's complaint that I'm sure will come. I can be more exact and express some of my frustration in a nonofficial note like that than I can be in the chart. Tell her what you did, how the patient responded, what you did to try to remedy things, and how that worked out. You know, just like the nursing process: evaluation, intervention, reevaluation and so on.
To keep yourself sane, you can be thinking up things you'd love to say to the patient but can't, "You do realize, don't you, that it's really stupid to be this mean to the person who is in control of your pain medicine." Then come back here to allnurses and share your brilliant and witty unspoken responses in the thread "Things I wish I could say to patients, but don't" OR something like that. It's here in General GAbbery
As an L&D nurse, my favorite unspoken comment is "My Lord, if you'd carried on this much nine months ago, you wouldn't be in this situation now!"