A/O patients throwing things

[vashtee, RN]

How do you handle those extremely nasty, alert and oriented patients?

It's not the little old dementia patients flailing at me that irritate me (though one even gave me a black eye). Even the detox patients can be excused to some extent, but the ones that are verbally abusive, disrespectful, and throwing things around - though alert and oriented - infuriate me! Especially when they are frequent flyers.

I feel like saying "listen buddy, I didn't drag you in here against your will, and if you want me to help take care of you, you'd better be nice", but of course, I don't. It wouldn't be good for patient satisfaction scores. What I really wish is that we could refuse to treat patients like this.

How do you handle this kind of outrageous behavior?

[CapeCodMermaid, RN]

I explain to them that Respect Street goes both ways and I won't tolerate any one treating me with disrespect. I say it quietly making eye contact the entire time. Usually they start behaving .

[LouisVRN, RN]

I had a pt like that. Very calmly and clearly I stated that her behavior would not be tolerated and if it continued I'd be forced to call security. I told her that I'd be happy to have a discussion with her when she was ready to speak to me in a calm manner.

[VICEDRN, BSN, RN]

Call security. No discussions if you throw something at me or threaten me. Sorry to be so pessimistic but this also documents the behavior through a witness: the officer.

[vashtee, RN]

Thank you for your responses, but to clarify, they aren't necessarily throwing things at ME, just throwing things around. Like a urinal (clean). A call light. A water pitcher.

[Poi Dog]

I throw stuff back at them.

*in my dreams*

For the record I've had the following thrown at me:

walker

pancake

tv remote

cross

pillow

:icon_roll

[vashtee, RN]

A pancake? lol

I go so long without a break most days, I might not mind that! haha

[crb613, BSN, RN]

I call the police period.

[anotherone, BSN, RN]

I don't know how to deal with these patients. i try the "kill them with kindnes." i just go in, do my job and try to get the hell out of there.

[divaRN*]

this is one of my biggest pet peeves! we work hard and do not deserve to be treated like that by someone who knows better. i will ask them why they are acting inappropriately (sometimes this is enough, sometimes there is something bothering them and they will talk to me about it), ask them if they would like it if someone was treating them this way, warn them that i will call security, tell them this behavior will not be tolerated, if they are refusing treatment/ threatening to leave if i don't do "xyz" i will tell them they are not being held against their will and offer to call the MD so they can sign out AMA (calling them on their bluff works everytime, if they let me get as far as calling MD the second MD shows up they agree to treatment). also setting boundaries works great too! just make sure you pass on to the new RN what the rules are. just be very firm, stick to what you say and they will realize the behavior is not tolerated.

[Poi Dog]

A pancake? lol

I go so long without a break most days, I might not mind that! haha

If he hadn't sunk his canines on it, I might have considered eating it.

He had a heckuva aim - the pancake got me on my cheek (face).

[canigraduate]

I look them right in the eye and talk to them like they're two year olds. "Nope. Unh-unh. Don't do anything like that again. One more tantrum like that and I'm calling security." Works like a charm. Sometimes I even get an apology. Be ready to back it up, though, and actually call security. Just because no one's taken me up on it yet doesn't mean they won't.