Combative patient and supervisor took his side!

zenman · Jul 19, 2004

Well, this is timely! I just came down from a M/S unit after the nurses called about an irate family member. To make this short, after I listen to the family member, I told him, in the presence of security, that if he did not behave, that he would be removed from the hospital without any hesitation. We don't have time for abuse. I've also had several patients banned from the hospital.

circa68 · Jul 19, 2004

Our supervisors need to back us! So many nurses and other health care workers are injured on the job that a supervisor should do all she can to protect us. There are so few of us anyway!! I am sorry that you were treated like this.

RN4NICU, LPN, LVN · Jul 19, 2004

Hello friends,
I'm writing for two reasons, 1) to vent to fellow nurses and 2) to ask for advice regarding my recent situation.
At work I carried the same patient load as the previous shift. The first night had gone splendidly and I gave my pain meds as ordered Q2 hours (you know the type: they'd call us otherwise).
Well, my second shift I walked into a irrate patient and it only got worse. After 1 hour and 15 minutes post medication, the patient rings me to say he needs his pain meds. I politely informed that he wasn't due for 45 more minutes and would bring it in when it was due. Long story short, I walked in to cancel the light and the patient began cursing me and calling me nasty names telling me I wasn't doing my job. As professionally as I could, I showed him the order that stated he receives the meds I have been giving him and he slapped my clipboard from my hands. Now believe you me, if the clipboard had not been there, it would have been my face!
Without giving too much info here, this man is not an elderly demented patient and truly knows better! I called security and the nursing supervisor had her two cents worth and the situation was resolved with a few apologies and a promise for no further abuse.
Whew! Did I cry my eyes out after this all came crashing down. I felt nothing was resolved. The nurse supervisor really took the patient's side and did nothing regarding the abuse I had endured at my own professional expense. :angryfire I've heard of hospitals banning abusive patients...is this ever going to be nationwide?
Thanks for the virtual ear, just had to talk this out.
JacelRN

In the words of Bill Engvall: "Stupid people should have to wear signs." Maybe that would slow administration down from putting them in supervisory positions (because and only because it would be a Public Relations issue.) There is no excuse for supervisors not backing up their staff for protecting themselves.

You did exactly the right thing by calling security - this guy is lucky you didn't call the local police. You had grounds to file assault charges. I agree, abusive patients/visitors/doctors should be banned. If they can't behave - they should stay at home or go to jail! :angryfire

Hugs to you - I'm glad you weren't injured, but sorry you had to go through this.

zacsmimi · Jul 19, 2004

I'm so sorry you felt abandoned. Even if you hadn't handled things well, or hadn't been polite... she should have backed you. I might well consider going above her - you can be sure the higher-ups will hear her side of it...

I have not endured this kind of treatment from a patient - but once the swearing began, my supervisor would have been in on it from the get go. Is it common to be called names and sworn at by patients that are not compromised mentally??

**canoehead, BSN, RN** · Jul 19, 2004

From your post I thought the patient apologized, was teary, and promised not to do it again? What did you want done besides that?

dekatn · Jul 19, 2004

Why was the pt. requesting pain med early? Sounds like more going on with the pt. than we know. Please don't flame, supervisor still should have backed you up, I am not condoning abuse from pt. or anyone else.

heart queen · Jul 19, 2004

This sounds very upsetting to you!!! First you've made it clear that this person was in their right mind, lashed out at you, possibly harming you and then quickly repented once an authority figure appeared.

With almost 10 yrs. exp. I have come across this type of folk. If this incident stopped here, the patient required a VERY firm reminder that the threat of physical assult on his part in any way, in the future would warrent a call the the police, where a report would be filed and followed through on your part until a conviction was obtained upon his release...... PERIOD.

You do not require a house supervisor to initiate this process. there are harassment laws in place to protect you and the charge, then supevisor must be kept infomed. You NEVER require their permission to initiate poliece involvement. An officer will be dispatched, the patient placed under "house" arrest until their discharge, when at this point the poliece will be called to escort them to jail, be processed and face a judge.

Now if the patient lashed out in pain, med seeking withdrawl or whatever, and stopped the behavior at the point you stated, you are unfortunately left with a unsettling incident that will leave you stronger and better prepared for the next time that it may happen.

Never, never be fearful to threaten and call for protetection for ASSULTIVE behavior in an A&O patient. Never listen to a charge that tells you different. If you don't like a supervisors response, follow the chain of command until you are satisfied at all hours of the night, and don't forget risk management!

NiteShiftNut · Jul 19, 2004

jacelrn,

first of all (((big hug))), second of all- i know how it feels when a supervisor doesn't back you up on a situation like this and it sucks. no matter what else might have been "going on" with the patient concerning pain meds, pain management, etc.... there is no excuse for hitting !!!!! obviously some people missed that day of kindergarten when we all learned that you can't hit other people out of anger, frustration, etc. and of course the patient was tearful and appologetic after he was confronted about it, but that still doesn't make it ok. your super should have made it very clear to him that no from of abuse is ok, physical or verbal, and there should have been an explanation as to what action would be taken if he acted out again. i can't tell you the number of times i have been attacked, both physically and verbally, by patients who are not elderly and demented, i'm talking about alert patients who are old enough to know better. if you don't feel like your concerns were handled by your supervisor- go above. this is one issue i would say go higher up the ladder until you find someone who will address your issue and resolve it to your satisfaction. if your employer won't take actions to protect their staff, there are plenty of other facilities that i'm sure would love to have you. last time i checked the nursing shortage was not an isolated problem. take care :balloons:

Angela Mac · Jul 19, 2004

My heart goes out to you. Nothing irritates me more, than supervisors not backing their nurses. Your supervisor would not have given the pain med any sooner, I am sure. I have had patients demand pain meds way before they were due. I must say though, that I assess them with a pulse and B/P first, of course if they are elevated- pain is evident. I have found, however, that some patients are bored and have no concept of time, or are angry and want the extra attention. I had an elderly patient who was failing, but was not in any imminent distress- the MD ordered PRN IM MS q30 minutes to 1h for pain. The social worker got in my face & became nasty, because I was not giving it every 30 minutes. I had given it at 7:30, 9:00, 10:00 & at 11:30- I had to remind her that this patient was not restless, was not moaning, and had stable vital signs. He was not terminal & had no injuries, but like I said, was dying of natural causes. Its a sticky situation, because we all know that every nurse is afraid to give a fatal dose. But in all honesty, I could not see any reason why this man needed IM MS q 30 minutes, especially since the MD had not been in to assess this patient. When the social worker continued with her complaints- I reminded her that I was trained to assess pain, and she was not, and if she had any further issues she would have to take them up with my supervisor or the nursing board. Hang in there.... I understand your frutstration.

JacelRN, BSN, RN · Jul 20, 2004

Thank you all so much,

Just to clarify my post, I was the one crying. I did it privately, away from the patient. I hate doing so at work but the tears just wouldn't stop. I cried after the supervisor took his side by saying "we'll start fresh right now and she'll give you your pain meds." She made very little mention of the fact that abuse, of any kind, is not tolerable. She requested his apology to me and he did give it, and thereafter throughout the night continued to apologize. I accepted his apology but with a guarded attitude of forgiveness. I would not forget.

Anywho, the situation was resolved FOR MY SHIFT. This patient has not been physically abusive to any staff until I, the lucky compassionate nurse who tried everything to make him comfortable and feel he was being treated with kindness and respect, took him on as a patient. He has had an ungrateful attitude and some continuing verbal abusiveness since he was admitted. To be completely honest, this was bound to happen and it happened to me. Growing thick skin is getting tough! What more do I need to endure to prove my worth here? Rhetorical question and all but seriously, nurses need to be respected as much as patients.

I again thank you for your support and if this situation occurs again, EVER, I won't be so timid to allow a supervisor to back off of the abuse.

JacelRN

Rapheal · Jul 20, 2004

JacelRN I am sorry this happened to you. Last time we had an abusive patient the supervisor lectured us on being compassionate because the abusive patient had unresolved grief issues. :angryfire

The hospital I did clinicals at as a student had a really great policy. When an A&O patient became verbally or physically abusive they called EVERYONE in to the patients room. Security, extra nurses, doctors. They called it a show of force. The patient was politely informed the behavior was not acceptable and they would be discharged if it happened again. Very effective.