Agitated and abusive patients

[kiggles]

I work on a brain injury rehab floor. We have a patient now that is very agitated and abusive to the staff. What do others do in there facilities to deal with these issues? Has anyone ever refused to care for an agitated patient?

[Gldngrl]

I have...my patient was supposed to be isolated since just rec. tranplant with post op infection and instead, decided to leave floor w/o telling anyone and no MD order and BP sky high. Had to have the hosp. operator page pt., patient comes sauntering back and I explain the situation and that he must remain on the floor. Patient starts giving me a hard time and attempting to justifying his actions, I have none of it and he tells me that he doesn't like my attitude and "we're not going to get along." At this point, I step back and tell him that his attitude is inappropriate and will not be tolerated, that I am withdrawing from his care and he will be assigned to another nurse. Wrote up a report, told the docs, had drug testing done (since he left floor w/o orders and many of our patients have substance issues), and the docs had some words with him and another nurse took over. I have ZERO TOLERANCE for patients who think that they can manipulate and abuse staff. Now, I must say that my patient was alert and oriented, may not be the situation that is experienced on a brain injury rehab unit, but I do not believe that nurses should tolerate abuse, even from confused patients (it just will require different measures in those situations.) MMB