Why do patients abuse nurses?

mondkmondk · Sep 17, 2008

The first 10 or so years of nursing, I worked in an Alzheimer Unit. Most of those residents were physically and verbally abusive. I thought it was really sad...if they really knew what they were doing, I'm sure they'd be ashamed of themselves.

I just had to remove myself from several situations, step into the med room, close the door, and count to 10 along with some deep breaths. Sometimes the situations struck me as funny...the verbal abuse coupled with child-like behavior...so I'd step into the med room and turn on the radio and laugh until I cried.

Anyway, I've been on the receiving end too so you are definitely not alone!

Blessings, Michelle

nelcoy4 · Sep 17, 2008

When pt's get like this I get annoyingly polite. I look like a crazy nancy nurse. They want to act crazy on me, then I will get crazy back. But if the pt is really irrate, I walk out and say I will not accept this behavior.

luv4lpns · Sep 17, 2008

I feel as thought it is just easier to go off on us than the dr

iluvivt, BSN, RN · Sep 17, 2008

I give the patient a chance . I try all the kindness, understanding and any therapeutic technique I can think of. If that does not work....lets face some people are ***holes.Once I have determined that anything they do just rolls right off my back as I refuse to let someone I am trying to help ruin my day. Then I switch into a setting of limits mode,,,,I tell them what I will and will not accept. I do not even care a bit if they complain...Let them as their behavior reflects on them ..never on you. Another thing that we do often is to bring in another nurse with you....I have discovered that a lot of patients back down when 2 assertive nurses come in to provide care. You may also consider just changing your assignment. Your charge nurse or house supervisor needs to go speak with the patient and also demand better behavior from them. Do not let them get to you....b/c they will keep at it!!!!!!! Hang in there b/c there are more out there.

Nurse Salt · Sep 17, 2008

Kmoonshine, swearing with a smile! I like that... I always take a cue from Miss Scarlet O'Hara and believe you truly can catch more flies with honey than with vinegar...

StrwbryblndRN · Sep 17, 2008

I love my "crazy" pts. I find them a challenge and try my best to get to the root of the issue. If that does not help I end up blunt and tell them what I need to do and usually ask permission. The minute they refuse, with education of course, I do not think anything about and document refusal.

I have a had a few pts change their tune when I do not give them what they want nor appease their attitude. It is all in the way I handle it. I do not generally get frustrated easily and I guess it shows.

I am known to take on pts that everyone despises. Other nurses tell me I have a way with the rough around the edges pts. I tell everyone they are like family. My family is blunt and to the point and when they are sick they get mean. But I love em.

ShayRN · Sep 17, 2008

I tend to just walk out of rooms of abusive patients. They start cursing or yelling, I am out of there. Usually within an hour or so they need something, I then say, Good, now that your calmer, let me do what I need to do, then I will get you what you want. If they start yelling again, I leave again. Just make sure you document, document, document.

RedSox33RN · Sep 17, 2008

I'm sorry about your grandfather.

Why can they? Because they KNOW they can, because hospital management is almost ALWAYS on the patient's side, because this is one of many places that society - or the law - thinks that human beings don't need to be responsible for their own actions. It su*ks! Because somehow it was decided that even when patients abuse us and ridicule us and scream at us, they are not responsible for that, but we have to be the ultimate professional and not tell them to cram it up their behind, and that we will deal with them professionally when they treat us like the professionals we are.

Yes, I had a very bad night in the ED.....even though it was Tuesday, it apparently was Friday night somewhere with all the ETOH and abusive garbage I had to put up with. So I'm a little "soured" on patients right now too. Luckily my night ended on a good note with a family shaking my hand and saying "thank you".

I'm so sorry this happened to you and your new preceptee.

TigerGalLE, BSN, RN · Sep 17, 2008

Hey everyone. Thanks for your responses. That particular patient has been on our floor for almost a month. I know he is sick and I know he is frustrated. He's tired of not having any privacy and no control. I understood these things and I've actually been his nurse for the past 7-8 shifts. We had a good relationship. He was mean to other people and he used to vent to me and I would listen. Yesterday I guess he just felt really bad. He had to go for an EGD (he was actively GI bleeding). He was mad b/c he was NPO, he was hurting, and he was sick. All morning I took care of him without any problems really. Right before he was supposed to go to the GI lab he started demanding something to drink. I didn't give him anything and he became outraged. Demanding to talk to the doctor. I told him the Dr. was downstairs in the GI lab and a few minutes later they called for him. I took him to GI and when I got him there I hung out for a few minutes b/c he was refusing to put on a gown or get on the stretcher until he talked to the doctor. So they went and got the dr. and when the dr. came he was raising cane and told the Dr. that I was a crappy nurse who hadn't done a dang thing for him all day and that his IV was bad and I refused to restart it and all this other stuff. (of course he was cussing and yelling.) His IV wasn't bad I had just flushed it so I have no idea what he was talking about. When I chimed in and said his IV was working he turned around and called me a stupid you know what and told the Dr. I was lying..

So all the GI nurses looked at me and told me I needed to just leave, so I did..... He hurt my feelings then by lying and making me look bad. When he came back from GI he was really outraged, screaming, demanding to eat, throwing stuff, slamming doors and cussing me. That is when I got his Dr. to go talk to him. I almost had to call security.

I think this pt just got to me more than others since we had once had a good relationship. I'm usually good with the bad pts b/c I'm real with them and tell them how it is. I try to be their friend instead of their enemy or superior. He betrayed me and lied about me. Then he treated me crappy and like I said before with my granddad being sick I just could handle it.

I try not to let the stress of work get to me. But somedays being a nurse is so overwelming. No one ever told me I would have days like that. How do you deal with that pt and then you have to next door to your sweet LOL pt who is soo sick and hold her hand while she cries and tells you that she loves you. Nursing is just an emotional rollercoaster and it is so hard not to take these things home with you.

Tiger

rita359 · Sep 17, 2008

Surely I'm not the only nurse that has experienced this. I had a young 40 yr old male pt today that called me every name in the book. He slammed the door in my face, cussed me out, called me names and was uncooperative. He got mad if you knocked on the door and mad if you didn't, mad when u turned on the light and mad when u didn't. You couldn't make him happy at all. After one of his temper tantrums I went and got his MD at the nurses desk and demanded that the MD go talk to his patient. He did and the patient said he'd behave. Well of course nothing changed. He slammed the door in my face about 10 minutes later. Here I am trying to precept a new nurse and I tried not to lose my cool but I definitely did. My granddad is in the hospital so I have been extremely stressed. This pt made me so mad that I actually started to cry in the break room. Here I am with 6 very sick pts. This guy acting like this and all I can think about is that my granddad is sick and I'm not with him b/c I'm here taking care of this unappreciative jerk!! I probably looked pretty stupid to my orientee....

Solution. Do not stop with dr talking to pt. Immediately go up the chain of command. People like this need to be talked to by someone who will put their being in your hospital on the line. They either shape up or are gone from your institution. Nurses need to let superiors know what is going on in instances like this and the chain of command needs to deal with it. Sounds like he has too many issues for a psych consult to do any immediate good.

Nurse Salt · Sep 17, 2008

If older men are rude to me I remind them that I am a lady and I disevrve respect. That usually gets their attention!

I had a young man (about 22) once call me a "stupid a**", to my back!!! The little jerk waited until I was walking out of the room, I was furious! I was sweet as pie to him all night even though he was being noncompliant (DI, fluid restriction, drinking from the faucet by his bed-- we eventually turned the water pipe off, etc!). Anyway, all other nurses were refusing to take care of him, but I didn't mind, until this! I bit my cheek to stop myself from tearing into him, then turned around and scolded him-- yes, like a child because that is how he was acting. I told him we were there to make him well, and if he didn't want to follow our rules he could check himself out AMA and make himself sick at home but he wasn't going to do it on my watch. Yes, this was one time where my sweetness had an end! When I walked out I was fuming and the Chief of Neurosurgery overheard me. I began to feel bad about my behavior until I went back into the pt's room and he (looking down and defeated) appoligized to me for his behavior. Apparently the Chief had gone in after hearing me and scolded him further for his behavior! 1 Triumph for the nurses!!!

nrsang97, BSN, RN · Sep 17, 2008

Hey everyone. Thanks for your responses. That particular patient has been on our floor for almost a month. I know he is sick and I know he is frustrated. He's tired of not having any privacy and no control. I understood these things and I've actually been his nurse for the past 7-8 shifts. We had a good relationship. He was mean to other people and he used to vent to me and I would listen. Yesterday I guess he just felt really bad. He had to go for an EGD (he was actively GI bleeding). He was mad b/c he was NPO, he was hurting, and he was sick. All morning I took care of him without any problems really. Right before he was supposed to go to the GI lab he started demanding something to drink. I didn't give him anything and he became outraged. Demanding to talk to the doctor. I told him the Dr. was downstairs in the GI lab and a few minutes later they called for him. I took him to GI and when I got him there I hung out for a few minutes b/c he was refusing to put on a gown or get on the stretcher until he talked to the doctor. So they went and got the dr. and when the dr. came he was raising cane and told the Dr. that I was a crappy nurse who hadn't done a dang thing for him all day and that his IV was bad and I refused to restart it and all this other stuff. (of course he was cussing and yelling.) His IV wasn't bad I had just flushed it so I have no idea what he was talking about. When I chimed in and said his IV was working he turned around and called me a stupid you know what and told the Dr. I was lying..
So all the GI nurses looked at me and told me I needed to just leave, so I did..... He hurt my feelings then by lying and making me look bad. When he came back from GI he was really outraged, screaming, demanding to eat, throwing stuff, slamming doors and cussing me. That is when I got his Dr. to go talk to him. I almost had to call security.
I think this pt just got to me more than others since we had once had a good relationship. I'm usually good with the bad pts b/c I'm real with them and tell them how it is. I try to be their friend instead of their enemy or superior. He betrayed me and lied about me. Then he treated me crappy and like I said before with my granddad being sick I just could handle it.
I try not to let the stress of work get to me. But somedays being a nurse is so overwelming. No one ever told me I would have days like that. How do you deal with that pt and then you have to next door to your sweet LOL pt who is soo sick and hold her hand while she cries and tells you that she loves you. Nursing is just an emotional rollercoaster and it is so hard not to take these things home with you.
Tiger

Tiger,

What bothers me the most is no one would call security on this guy. He was acting like a complete a$$. I understand he was sick and frustrated, but the moment he started throwing things security gets called. He was mad at the world and not you. I think you were his punching bag for the day. The pt can be mad at the world but he has no right to curse at you and throw things at you, and slam the door in your face. The first time door slamed in my face I would talk to him. The second time I would flat out refuse to go into that room without security. The supervisor should also have been called as well. Document Document Document his behavior.