Is it okay to tell a patient to not disrespect you - page 4

I had a patient who was questioning me and even though I attempted to answer her questions, she wasn't happy with my answers. She told me that I am a terrible nurse and to get out of her room. I said... Read More

  1. 1
    I generally (if the patient is safe and stable) will offer to have the charge nurse or manager speak to them. I'm not confrontational enough to say "hey don't disrespect me!"
    Last edit by Janey496 on May 1, '13 : Reason: Reconsidered
    NutmeggeRN likes this.

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  2. 0
    I don't think I would ever say, "Don't disrespect me," but you can get that point across by setting limits. It sounds like this woman just didn't trust you for some reason and no amount of limit setting is going to fix that. Sometimes it is best to bring in someone else (charge RN or MD) to see if they have a better rapport and can help the pt feel reassured.

    I once had a pt I was so nice to but she just didn't care for me. I had the charge RN speak with her and had someone else pass her meds later that shift. She was being unreasonable, but she was in a vulnerable position and maybe the only control she had all day was firing me. Nothing I took personally.

    The only time I have ever really needed to set limits is with some aggressive drug-seekers and dementia patients. I don't take it personally and I don't say it to them in a nasty way, but I will tell confused patients that it is not. okay. for them to touch/hit/yell at/pinch me. They don't always remember that and sometimes just telling them in an even, unemotional tone is enough to stop them.
    Last edit by dandk1997RN on May 2, '13
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    When a pt is that upset its really difficult for them to hear what you're saying. Remaining calm despite the ranting and raving, dropping your voice level down are very important. Set limits and give choices (I need you to stop screaming and cursing. If you can't do that x will happen). Now in my case I work inpt psych, so the "x" in my case would be a trip to the quiet room, which I am sure many of you floor nurses could probably use on a day to day LOL.
    mc3 likes this.
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    I wouldn't have said anything in your situation or would have told them, "I'm sorry you feel that way" and walked out.

    I have dealt with a lot of difficult patients in the past. I remember one who was extremely rude to everyone. The patient wanted a bath (and desperately needed one) but again, they were being extremely rude. I finally had enough of it and told them, "I'm willing to help you but I won't until you stop acting that way and start being nice" (the patient was grossly obese and definitely needed help with bathing). I left the towels with them and walked out. Maybe I shouldn't have done that, but the patient's attitude changed after that!
    NutmeggeRN likes this.
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    I think what you said is perfectly ok! Very rarely but occasionally I get a patient who will just lay there cussing up a storm. I quickly remind them that this is a hospital, not a bar and that there behavior will not be tolerated and to cut it out immediately or I WILL call security to deal with there nonsense. I don't care about customer satisfaction scores! My job is to care for their health not be a pinching bag. Not that I don't care about their feelings. I do understand that they are not at their best, but I'm not putting up with that crap.
    loriangel14 likes this.
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    I wouldn't get into a "back and forth" with a patient. Especially one who is not going to be happy with any answer you give them. I am fond of the "I am not sure how to answer that question, however, be sure to write it down and ask the doctor when he comes in". There are some patients who like to "fire" their nurse, until they find one who will give them the answers they are seeking. And don't ever hesitate to tell a patient that you answered their questions to the best of your ability, and that you will get your charge nurse who could perhaps explain it more in depth.
    Some patients due to condition, stress, lots of things--behave in a way that is less than ideal. So I do tend to give them the benefit of the doubt, and if their mental status warrants it, make the doctor aware of the agitation. It could be the patient is a jerk (and then ask your charge to see if she can handle the questioning) or that the patient has a change in mental status that warrants further investigation (and inform the MD).
    It is a reaction when one says "don't disrespect me". Try not to react in that manner. It can just escalate an already tense situation in an A&O patient. If you are dealing with a patient who needs firm limits, that is a story for another thread, but I am talking about a regularly A&O patient.
    carolinapooh and pinkiepieRN like this.
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    I have told a patient that behavior is inappropriate and disrespectful to myself or my colleagues. I have also refused to listen to being insulted or sworn at and simply left the room. Usually about 15 minutes later the patient is much calmer.
    carolinapooh and vivere like this.
  8. 2
    Quote from lolakbolak
    I had a patient who was questioning me and even though I attempted to answer her questions, she wasn't happy with my answers. She told me that I am a terrible nurse and to get out of her room. I said ok I will just don't disrespect me. She flipped out when I said that. Was I out of line to say that? Where I work they stress that pt satisfaction is most important so pts come back to us again
    Since we weren't there, we have to make a lot of assumptions about what was said, and how it was said.

    Patient wasn't happy with your answers. Why not?
    We're they good, solid responses...that she just didn't accept, or could the quality of your answers been better.
    She was dissatisfied with your answer, was dismissive and insulting. Did you say you were sorry you couldn't give her the answers she wanted to hear, or that you'd find out the answer, or get someone that could provide the information she needed?

    What did you do after leaving the room?

    Yes, you should be treated with respect, and sometimes when people are in pain, scared, exhausted, whatever, they will be short tempered. Sometimes they just have nasty pre-morbid personalities.

    "Just don't disrespect me," is likely to irritate a patient because they are trying to get their need met, even if they aren't doing it well. That statement turns the whole conversation from her needs, to being about you. What I frequently say is "I'm sorry I can't give you the answer you need (but try to offer alternatives if possible) but I would like to say that I will always treat you with respect (or never insult you, etc) and do ask that you do the same in return."

    Gently invoking the golden rule really does work a lot of the time.
    Esme12 and Hygiene Queen like this.
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    This is a difficult problem in nursing. I personally see nothing wrong with what you did. Why are nurses so eager to be martyrs, allowing patients to be rude, curse, or in other ways "disrespect" them? I have had a few instances over the years in which patients who refused to be compliant with doctor's orders would ask for another nurse, i.e. one who would let them eat take-out food, not be hooked up to a monitor, and be on the call bell continuously for attention from staff. This is in an intensive care setting, no less! When the physician himself says to "have the AMA form ready" for the patient, there are probably going to be some issues. Hospital patients are just a cross section of our society. We are supposed to take care of all types of people, without regard for what kind of person lies in the bed. It remains a constant challenge, but if a patient is sane, and not suffering from an illness that affects the brain , I am just not willing to take any verbal abuse. Patient satisfaction is important, but if the nurse suffers a blow to her self respect, then what have we gained?
    Last edit by vivere on Jun 3, '13 : Reason: correction of syntax
    carolinapooh likes this.
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    Good answer above by Isabel. Sometimes this works, when it doesn't, I will usually just change the assignment. A fresh face will often make the patient feel as though they have some control, and often temperament has been dictated by an illness or situation in which the patient feels out of control.
    Last edit by vivere on Jun 3, '13 : Reason: reference to post #36
    carolinapooh likes this.

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