Disrespectful patient

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Tonight I got a 20 y.o. pt from the ED who came in saying he tried to harm himself by benzo OD. A&O drug screens neg. I went to his room to check vitals and get his admission history done. He was talking to his friend and did not stop to respond or even acknowledge that I had entered. he complained that he wanted to be released ASAP in the AM and that he didn't even have his cell phone charger with him. When I asked for his emergency contacts he sighed and rolled his eyes at me then went back to talking to friend.

Then mom came in from the hall. Pt then started playing with his cell phone and would not make eye contact. Just incredibly rude and snotty. I asked him to please put his phone down, show some respect and make eye contact so we could get this done He rolled his eyes & sighed ugh fine is that better. At that I told him it looks as though he has a lot of growing up to do and said that this is unacceptable behavior how he is acting towards me. I reminded him that he is here because of a choice he made and not to get smart with me as I'm trying to help and it's not my fault that he's here. His mom then told me that I shouldn't be talking to him that way that he just tried to kill himself (which he really didn't) and I should be more understanding. I said that's what I'm trying to do my job and no matter he still should not be so rude. It's not ok for him to be talking to me like this.

Then pt started screaming at me sayin you ***** you don't know and punching himself in the head. I stood back and watched and said this is pathetic how you are acting this is terrible behavior. Other staff heard him screaming & security was called. I then left the room and family requested another nurse and acted as though I was in the wrong. What do you all think? I just felt that his behavior was awful and inexcusable- needed to be brought to his attention that this is not the way to behave.

Specializes in Short Term/Skilled.

It worries me that you jumped to the conclusion that he didn't really try to kill himself, or that he wasn't suicidal. Maybe he took something he thought was a benzo but wasn't. I feel like it should have been pretty clear that this wasn't the time or place to try to correct bad behavior.

Sounds like you had a psych patient. I would have acted as if they were a psych patient, when you do that it helps put things in perspective for you and you wont get offended as easily.

Specializes in Psychiatry, Forensics, Addictions.
DCtooRN said:
Sounds like you had a psych patient. I would have acted as if they were a psych patient, when you do that it helps put things in perspective for you and you wont get offended as easily.

What is this supposed to mean? How does treating a person like a "psych patient" put things in perspective? As a mental health professional, I don't treat anyone in a stereotypical way, but as individual patients.

SarahMaria said:
What is this supposed to mean? How does treating a person like a "psych patient" put things in perspective? As a mental health professional, I don't treat anyone in a stereotypical way, but as individual patients.

I don't think they meant that in a derogatory way. I think they meant that when dealing with someone who has an untreated mental illness, you should keep in mind that their behavior may be a symptom of the illness and not just "rude" or "disrespectful" or "bad" behavior.

Folks, this didn't happen in the ED. The OP's specialty is Med/Surg. The OP said (bold is mine):

Quote
Tonight I got a 20 y.o. pt from the ED
Specializes in UR/PA, Hematology/Oncology, Med Surg, Psych.

There is not one scenario in nursing where telling the patient that you think they are "pathetic" is appropriate.

Specializes in Mental Health, Gerontology, Palliative.
hppygr8ful said:
I agree that some of could of been a bit nicer to the OP who BTW hasn't been back since the responses were mostly negative. ......

FYI, I dont say anything to someone online that I wouldnt say in real life.

I can honestly say had I encountered someone like the OP when I was in the middle of my self harm, and suicide attempts I would have been a hell of alot ruder than I've been on this thread.

Specializes in Mental Health, Gerontology, Palliative.
Anna Flaxis said:
Folks, this didn't happen in the ED. The OP's specialty is Med/Surg. The OP said (bold is mine):

At the risk of seeming snarky, why should that make any difference? It was not a helpful way to manage the situation regardless of where the patient was located.

Anna Flaxis said:
Folks, this didn't happen in the ED. The OP's specialty is Med/Surg. The OP said (bold is mine):

Doesn't matter; the OP's behavior would be equally inappropriate and problematic in any healthcare setting.

Since everything has already been said, I am wondering about the OP's state laws regarding suicide attempts or ideation. I know that Florida has the Baker Act and Louisiana has PEC, both of which call for 72 hours of involuntary psych care. If admitted to the hospital, they would have a sitter to watch them. They would not have their phones (definitely not a charger!) and visitors would be limited to immediate family if any.

Specializes in Pediatric.

You were wildly inappropriate.

As a manager I would have a huge problem with any of my staff saying those things to a patient. I agree that nurses are not always treated appropriately by patients and families. I remind my nurses to keep in mind that most of the time when we see people they are at their worst - they are sick, scared, and often angry with their situation. I encourage mine to make sure the patient is safe and to say I'm going to check on my other patients and then will be back. Gives everyone a chance to gather themselves.

As far as a patient with mental illness being able to just stop their behavior is like telling a patient who is physically ill to just make their symptoms stop. Not gonna happen.

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