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?
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.
Yep, I agree, I once told a pt "I do not tolerate this behavior with my three year old and I'm not going to tolerate it with you. You may not throw things. These things (pt was throwing call light, water pitcher, etc.) belong to the hospital and if you can't respect them, I will take them away."
It is NOT acceptable! When did abusing nurses and other professionals become acceptable because the patient is p.o.'d about their situation? Too bad. Have an adult-to-adult conversation with this person and tell them it's not unacceptable. If you were throwing a bedpan &/or urinal it would be assault, but if he does it it's okay? NO!!!!!!!!!!!! (and still...they want to sue..) Set your boundaries and document, document, document.
It technically considered assault, exspecially if someone hit you with something. I have had a fellow RN file charges with a local police department towards a patient for hitting her with a remote. From what I understand it was sent to court. What I don't understand about Nursing is that we deal with so much BS and get nothing for it in return. Other thing I have done exspecially when a patient gets out of hand is called a code gray, and in one incrident everytime that patient acted up I kept calling it until the IOC actually did something. I refuse to hurt myself for idiots. I have no tolerance any long for ppl who continually make bad choice in their lifes, and I have no sympathy for them at all.
In a very firm, non yelling voice "That behavior is beyond unacceptable, I'm walking out now to give you time to get it together, when I come back in, in 15 minutes, we can discuss what is upsetting to you".
I do go back in 15, ask if they can control their behavior now, if so, I sit down and calmly say "you are VERY upset, tell me about it...".
If I get screaming, throwing or angry responses, I give another 15 minute break. I have 12 hours, I can wait anyone out until behavior improves.
I don't tolerate it from my children and I will never tolerate it at work, but I do make every possible attempt to get to the root of the problem if the patient is willing to talk to me.
I also CHART what occurred and quote my responses as well as the patient.
That happened to me once. A patient threw a Kleenex box when he was told that he wouldnt be receiving any more narcs. I told him that since it was time for him to ambulate, he could pick that up himself if he ever wanted to use them. He never did it again. People can be such dinks, I dont tolerate temper tantrums from my young children, let alone adults.
What I really wish is that we could refuse to treat patients like this.
:yeah:
LouisVRN, RN
672 Posts
Yep, I agree, I once told a pt "I do not tolerate this behavior with my three year old and I'm not going to tolerate it with you. You may not throw things. These things (pt was throwing call light, water pitcher, etc.) belong to the hospital and if you can't respect them, I will take them away."