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?
"If you hit me, I'm calling 911. I've sent people to jail for assault before, I have no problems doing it again." (while giving them the "make my day, moron" stare)
Never had someone who's a/o throw something a second time. If the person's a psych, DT or dementia, there's a fast call to the doc, and he deals with it -- restraints, meds, discharge, whatever.
If they're just being rude and slamming things, I do like someone else said, "It's obvious you're upset and need some time to yourself. Let me know when we can calmly discuss what's bothering you." And I leave. Period. I hate feeling like I'm putting a grown up in time out, but I hate it when they act like they need it, too.
"Your behavior is unacceptable. I refuse to be in an environment which is unsafe. If you continue to throw things, security will be called."
If verbal abuse: "You behavior is inappropriate and is considered to be verbal abuse. If you continue, I will leave the room." If it happens again when I go in to provide care: "I have warned you that I will not remain in the room while you are behaving this way, therefore I am considering this a refusal of care. Additionally, security will be called." Exit nurse.
I'm sick and tired of this crap and have ceased to have tolerance for it from people who know what they're doing.
BTW, I love the idea of having a sign posted that informs everyone that assault is a felony.
I'm with nerdtonurse about giving timeouts to tanty patients who are slamming down their own belongings. If anything leaves their hand while in motion:
"This hospital has a zero tolerance approach to violence against staff. If this happens again during your stay we'll call security to escort you from the presmises or, if you're unfit for discharge, you will be tied to the bed."
I did once have a delusional patient who threw a (fortunately empty) urinal at an agency nurse and responded to my speil with "It was not me, it was The Ghost of the World!"
To which I replied, "Maybe, but if security can't find the Ghost of the World it'll be you they tie down, so let him know." And that was the end of the projectiles!
I LOVE that RESPECT STREET is a TWO WAY STREET! (genius)..... will remember that one with the entiled feeling drug seeking "chest painer" heroine addicts who run out of money or whoes connection goes dry!!!!!!!!! UGH.
What I really wish is that we could refuse to treat patients like this.
nerdtonurse?, BSN, RN
1 Article; 2,043 Posts
"If you hit me, I'm calling 911. I've sent people to jail for assault before, I have no problems doing it again." (while giving them the "make my day, moron" stare)
Never had someone who's a/o throw something a second time. If the person's a psych, DT or dementia, there's a fast call to the doc, and he deals with it -- restraints, meds, discharge, whatever.
If they're just being rude and slamming things, I do like someone else said, "It's obvious you're upset and need some time to yourself. Let me know when we can calmly discuss what's bothering you." And I leave. Period. I hate feeling like I'm putting a grown up in time out, but I hate it when they act like they need it, too.