How much Verbal Abuse should a nurse take from a PATIENT?

  1. I have just started a new home health care case. My client is a well to do person and treats the other nurses and myself like DIRT... Constant verbal abuse is a norm from this client.

    We have been called the "w" word for prostitute, the "s" word for loose woman, the "B" word for female dog and worse.

    the last shift I worked this client pulled my hair, slapped at me, sniped, spit and was totally "with it" during every episode.

    This client's tounge is like a two sided razor and I'm needing advice on how to Doctument the abuse with out being personal, catty or unprofessional.

    HELP!!!!
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  2. 88 Comments

  3. by   debbyed
    Document exactally what he says in quotes. Fill out an incident report for any physical abuse.

    Personally I would either refuse to work with the patient or demand a second staff member accompany me when seeing the patient.
  4. by   deespoohbear
    I would absolutely refuse to take care of this person. I would immediately go to my supervisor and report the nonsense. I doubt if any other professional would be expected to tolerate such abuse, so why should nurses be any different? My thinking is: If the pt is A&O x3, then I should be treated with some diginity and respect. We use to have an old man who would slap our bottoms (and he knew better!). I flat out told him that I would not tolerate such behavoir. Our DON reported him to the administrator at the hospital, and our adm. actually defended the nurses and CNA's for once!! I will tell a pt very firmly that I am not going to take such behavoir and will not allow it to continue. I figure I have the same rights as anyone else!! Good luck and keep us posted!!
  5. by   donmurray
    I'll make it unanimous then. Nobody should have to tolerate physical or verbal violence while undertaking their employment...from anyone. Inform your supervisor of the situation, perhaps offer to go back one more time, but spellout to the patient what the ground rules are. They treat you with respect, they never swear, curse, or strike you, they control their behaviour, and you provide their care. If they do not, then you will leave, and other arrangements may be made, such as their having to attend at a local clinic, for example, where caregivers such as yourself may do so in safety, with support at hand.
    Good Luck! but don't, please, put up with this any longer!
  6. by   Zee_RN
    As the others have stated, simply document exactly what he said. Do not document your feelings, just exactly what he did and said. And then refuse to care for him again. If he is alert and oriented, then this is assault and battery if he has struck you. This is illegal. Just because you're a nurse doesn't give an alert & oriented person the right to strike you. Your employer has the duty to provide you with a safe workplace. This is not it.
  7. by   night owl
    just curious, what is his diagnosis?
    Last edit by night owl on Jan 3, '02
  8. by   donmurray
    night owl, with all due respect, diagnosis is irrelevant to a situation where an employer is putting an employee at risk. Although it may be a factor in determining the patient's culpability, it is the harm to the nurse that is the problem needing speedy resolution.
  9. by   RNKitty
    Hurt me once, shame on you. Hurt me twice, shame on me.
  10. by   Burden of Proof
    In this day and age, hospitals are more concerned with providing "patient service and customer satisfaction" than a safe workplace for direct patient care-providers. I had a physician curse at me when he became enraged and the physician used the "f" word with several witnesses (+ the patient I was caring for) present. I documented my @ss off! Ultimately, nothing was done - I left the hospital.

    This hospital has a duty to provide a safe environment for you to practice in; it appears they have breached that duty. If you fail to document the abuse in nursing notes and letters to the hospital administration, they will most likely cop out completely in the event you are injured by this nutball patient. If you document the abuse in nursing notes and letters to the hospital administration and they do nothing about it, THE HOSPITAL IS NEGLIGENT in protecting you from a documented problem and potentially dangerous situation. Most likely, an attorney would state "it is foreseeable" this patient could harm you or other care providers.
    Last edit by Burden of Proof on Jan 3, '02
  11. by   NRSKarenRN
    See you are doing shift work in home care.

    A. Documment in notes factual statement: eg "While performing wound care, Jon B Patient reached over and yanked my hair while shouting B..ch."

    B. Immediately, or ASAP report situation to supervisor. Write up an incident report. Notify patient's physician.

    C. Refuse assignment to patient unless immediate conference is held with nursing supervisor, patient and nursing staff assigned to case and client warned this behavior constitutes assault battery under the law and will not be tolerated.

    I've been in this situation before. We reminded the client of our consent form they signed stating they will abide by the rules of the agency. ANd that this behavior wouldn't be tolerated. One client appologized, had been drinking. Another time, no change after conference.......patient was discharged from agency.

    It can be difficult for some agency's to discharge a client, especially if no other agency in town or due to money brought in by client's "business." Better to discharge than to have staff leave agency. If no backing from management, time to leave.
  12. by   Uptoherern
    There are laws in place to protect people like us, from people like them... this is called battery. This is against the law....next time you are in this person's home, call the police!!! This is not something that you should be tolerating.
  13. by   night owl
    Hey Don, Thanks for the respect, I appreciate it and I'm not being sarcastic. I was just curious about the diagnosis...That's it. Of course we should not have to tolerate this kind of behavior from anyone. Obviously, the employer did know the pt had such a "lovely" disposition just from complaints from other nurses. billssisbeth,I personally would have excused myself, went to my car, called the police went back in with them and had them set him straight and made them stay until I was finished doing what I had to do. Then I would have immediately called my supervisor explained to her what happened, filled out the "point of contact" report, incident report and whatever else reports I had to fill out then politely told the super-v that I would not return to this case at all due to "conflict of interest???" And would he/she please assign myself to another case. If the answer was "no can do," then I'd say, please get rid of him. If answer was still no, then I'd leave altogether. You certainly aren't making a big difference in his life, he's only making yours miserable. There are plenty of other agencies that will hire you in a minute...and you're WORTH IT! By the way, I'm still curious about the Dx... Now don- me- boy, wait a minute don't jump yet! Burden of Proof is correct in that the Agency DID NOT provide billssisbeth with a safe work environment. This pt is a "nutball" and surely must have displayed some assaultive behavior in the hospital which should have been documented in the hospitals' nurses notes which the Agency should have been aware of prior to taking this case. If OTHER nurses of this same agency had a conflict with this pt, then billssisbeth should have been warned about his assaultive behavior. In LTC when a pt is assaultive, we work with a partner when we have to do "hands on" care. billssisbeth had no partner and therefore was not provided with a safe work environment. Maybe one of his problems was Hx of assaultive (verbal/physical) behavior then the agency could be held liable for not protecting this nurse and other nurses especially if prior documentation was made pertaining to his abusive behavior.
  14. by   donmurray
    Hands up! I did come over a bit strongly! Sorry! The UK health service has been running a "Zero Tolerance" campaign for some time now, and managers are slowly waking up to the idea that they need to do something to protect their staff. Most are barely aware of their legal responsibilities, possibly because their staff (us) dont insist on their rights, or even know them. It is now taking central directives from the management executive to remind everyone.
    Lots of info at www.nhs.uk/zerotolerance/intro/htm

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How much Verbal Abuse should a nurse take from a PATIENT?