Do you stand up for yourself to patients?

[evolvingrn]

I am just shocked with a conversation I had with a co-worker. I had a pt family member that was being rude and I asked the family member to stop talking to me that way (nicely). I was relaying the story and she said 'oh you can't do that " I said huh? I have a right to not be verbally abused and she said "no .......I don't think you do as a nurse, we have to meet pts and their families where they are"

Really? I don't think that is true. I am one to set boundaries, just like I did with this family member and usually it turns out really well and we have workable pt/nurse relationship. Not in this case, they then even got more irate and rude and I got the charge.

But I stand by my right to not be verbally abused. What do you think ? Do you stand up for yourself or do you believe its okay to let people tear you down and be verbally aggressive to you and that is our role as a nurse?

[mariebailey, MSN, RN]

Dear felow nurses:

Please do not use your facility's position as a point of reference on how you should deal with abusive people in the workplace any more than you would care about whose side your boss would take if your partner physically abused you. It does not matter. Abuse is abuse, you will not be fired if you set your boundaries professionally and calmly. Let your documentation depict an objective description of the altercation, use quotes. It is the only ally you need. Supervisors and bosses are not there for you emotional support, let alone to be your friends: they represent the hospitals as a business, and "the client is always right".

Signed,

Been there, stopped that.

Having someone above you step in and address an out of control situation is not using a boss for "emotional support". I have been yelled at by a patient before and been unable to calm her down. I decided the issue was better dealt with by management, and so I deferred to my boss. There is nothing wrong with that. Not all of us have your rockin' interpersonal skills.

[SaoirseRN]

Having someone above you step in and address an out of control situation is not using a boss for "emotional support". I have been yelled at by a patient before and been unable to calm her down. I decided the issue was better dealt with by management, and so I deferred to my boss. There is nothing wrong with that. Not all of us have your rockin' interpersonal skills.

That's not what the poster meant. Obviously it is okay to have someone step in if need be. What the poster meant was don't let a "customer is always right" policy dictate whether or not you should take abuse from patients.

[mariebailey, MSN, RN]

That's not what the poster meant. Obviously it is okay to have someone step in if need be. What the poster meant was don't let a "customer is always right" policy dictate whether or not you should take abuse from patients.

I just re-read it. My bad.

[nursel56]

Used to be, in the olden days, we were trusted to use the brains in our heads to assess each situation as uniquely different from every other situation and to know when to let it go or kick it upstairs to the next level on the food chain. That way, we never had arguments that represented only one of many possible reasons for someone's verbal outburst. Could be they are scared and need to dump on you so you are performing a vital service in that role, could be a side effect of their meds, could be . . .well shouldn't we trust most nurses to act appropriately? Nurses now get no back-up from their managers and are told they just need to shut up and take it? This is just sad.

[joanna73, BSN, RN]

If someone is rude because they are very ill, or scared, I may let it slide. Sometimes abrasiveness is a mask. However, if someone is rude and demanding just to be difficult, I have said, "I'm here to help, but I will not tolerate rudeness." Just yesterday, I said this to a patient, and they responded, "Sorry. I don't even realize I'm like that sometimes." Fine, no problem. We reached an understanding. I am not there to be abused.

[PunkBenRN]

I cannot believe some of these replies! Enough with the self-depricating nurse who not only allows this behavior, but expects it as part of the job! You need to stand up to people like this; you wouldn't let them talk to you like this outside the hospital, why is it ok when you come to work? Where do you draw the line (swearing, slurs, violence)?

9.99999 out of 10 times, management will 100% back you up. Don't take this the wrong way - you won't be supported if you come back at them with the same childish attitude or fervor. Just be professional and establish firm boundaries. You should not be subject to insult and redicule, and if you don't set boundaries the behavior continues, and who knows how many people they talk down to this way. When it comes to personal insults and racial slurs: absolutely unacceptable. If someone raises there voice, this is also unacceptable (regardless of context). It is within your power to tell them that it is unacceptable. I'd say about half of the time, people don't realize they are doing it and would normally not speak this way - tempers/emotions flare and people get a little nuts. It happens. When you call them out on it, they will apologize. People are not inherently evil.

If you are not coming across to the family, get security involved. Its what they do. Being in the room with the patient is a privilege, not a right. My concern is my patient, and if family is interfering with that, then they are gone. If you don't work in the hospital or don't have security (or the situation has escalated out of control), threaten to call the police. I don't quite understand why people feel they have diplomatic immunity when they come into the hospital, but they are subject to federal and state law like everyone else. If they are disturbing the peace, make it known to them. If the threat of calling the police does not de-escalate, then follow through and call the police. The police are on your side, and I have never had an officer be rude or condescending when calling from a nursing home or hospital.

If this abuse/inappropriate behavior is coming from the patient, you are well within your right to set boundaries. Make it known that the behavior is inappropriate. If it continues (and pt is of right mind, or course), tell the patient that you will notify security/police if it does not stop. If it continues, notify security/police.

Also, if you see someone else taking this kind of abuse, step in and say something. It is not always easy to stand up for yourself, and being the third party grants you power. You have a second person in agreeance with you, which gives you confidence. It is also not your direct situation, i.e., not a patient you have to see the next 12 hours. It can be really uncomfortable doing patient care with someone you were just arguing with. When management asks what happened, your story can be verified by two people (very important for many different reasons).

I don't know why nurses feel they have to fall victim to this. It is not in your job description. Even someone who is confused has no right to treat you like that. If you have self-confidence issues or self-esteem issues, do some soul searching. Practice what you would say when someone is unreasonable. Write down how you would respond, it will help you gain confidence when the time comes. And most importantly, if your manager will not back you up in a situation like this, is this really somewhere you want to work? It will make a hell of a story in your next job interview

[SleeepyRN]

Absolutely stand up for yourself in a professional way. That's my opinion

[SaoirseRN]

If someone is rude because they are very ill or scared, I may let it slide. Sometimes abrasiveness is a mask. However, if someone is rude and demanding just to be difficult, I have said, "I'm here to help, but I will not tolerate rudeness." Just yesterday, I said this to a patient, and they responded, "Sorry. I don't even realize I'm like that sometimes." Fine, no problem. We reached an understanding. I am not there to be abused.[/quote']

I suppose I would handle those two cases differently, but I would still say something.

In the first case, I may say, "I know you are scared, but there is no need to speak to me that way." Followed by "Would you like to talk about it?" or something similar.

[joanna73, BSN, RN]

We did talk about it, and in the end I had her laughing and smiling. I'm not writing the whole play by play conversation here. But this particular patient has a reputation for being a terror. Sorry, but the boundaries are going to be firmly established immediately, with all of my patients. She knows just how far she can go with me.

[kgoode0919]

You should definitely take up for yourself! I do often, and they usually change their tone and respect you afterward.

[amygarside]

It can really be a hard situation for nurses when they are verbally abused. It will depend if you have rules against abusive patients and relatives. But for me, we have to stand and be firm about maintaining our dignity and self-respect.

[DoeRN]

I stop the abusive behavior immediately. I calmly tell them I am here to help but under no circumstances will they abuse me. Most of the time this works. I have had to call security on a couple people when I was in management because someone was threatening my staff.

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