Ever have a patient that "turns" on you?

carolmaccas66, BSN, RN · Aug 27, 2011

Yes have had this happen, but most peope are either in pain or having a bad day. Some psych patients can turn VERY quickly with no provocation - the wiring in their brain just SEES you, you're there at the time and they lash out. Have seen a few dragged away after trying to assault or verbally abuse nurses.

It's happened to friends of mine, who were totally caught out. I don't think there is an explanation sometimes - I think it's just human nature. You happened to be there, they had been stewing re something all day (usually it's over something simple and stupid, or an argument with a relative/friend on the phone which you didn't see or hear), but cos you're there, guess what? You cop it!

I would not tolerate any abuse in any shape or form though from patients. In Oz we have a 100% zero tolerance in all our facilities. That is why in psych I do not work in locked wards with violent/psychotic patients, after being half strangled and punched in the side of the head when I was younger.

Were you working in psych Dudette & if not, did the patient have any psych history at all?

dudette10, MSN, RN · Aug 27, 2011

Yes have had this happen, but most peope are either in pain or having a bad day. Some psych patients can turn VERY quickly with no provocation - the wiring in their brain just SEES you, you're there at the time and they lash out. Have seen a few dragged away after trying to assault or verbally abuse nurses.
It's happened to friends of mine, who were totally caught out. I don't think there is an explanation sometimes - I think it's just human nature. You happened to be there, they had been stewing re something all day (usually it's over something simple and stupid, or an argument with a relative/friend on the phone which you didn't see or hear), but cos you're there, guess what? You cop it!
I would not tolerate any abuse in any shape or form though from patients. In Oz we have a 100% zero tolerance in all our facilities. That is why in psych I do not work in locked wards with violent/psychotic patients, after being half strangled and punched in the side of the head when I was younger.
Were you working in psych Dudette & if not, did the patient have any psych history at all?

No, I'm not in psych. Psych history? One "psych" diagnosis, but not to the extent that this would have happened.

I keep going over in my head how I might have handled it differently. How I might have made it better. It all happened literally in the space of 10 seconds.

Am I that dense that I can't read the signs? I didn't even see any signs, FFS!

dudette10, MSN, RN · Aug 27, 2011

Am I that dense that I can't read the signs?

No one answer that question. It was rhetorical.

I would not tolerate any abuse in any shape or form though from patients.

I wasn't verbally abused at all. It just went from talking to him about a nursing task I had to do to, the reasons why, etc.... to detonation.

TheCommuter, BSN, RN · Aug 27, 2011

This happened to me about 8 months ago. I was doing an admission on a little old lady who started off as sweet as pie at the beginning of the shift, but within 6 hours she had turned into a witch on wheels.

The major problem is that my workplace is a very old hospital with an out-of-date heating and cooling system. The patient was complaining that she was hot, but we had no way to adjust the temperature in her room, so we moved her to another room where the temperature could be changed with a window unit control. She still was not happy with the new room, so we brought her an oscillating fan. She still was not happy, and had become verbally abusive to staff. She remained verbally abusive and condescending throughout her stay.

~Mi Vida Loca~RN, ASN, RN · Aug 27, 2011

This happened to me, I had a patient that I had a great rapport with, I had her smiling and laughing and everything. Then I had to draw her blood and she nearly hit me and went crazy. Then when she would ride the tricycle in the hall she would give me the stink eye and peddle super fast when she got close to me. Our relationship was never the same after that and I had to draw her blood two more times. But she gave me the stink eye less and less after that and even smiled to me as she left.

Ok granted the patient was 3.

PS. I don't know what FFS is :|

carolmaccas66, BSN, RN · Aug 27, 2011

Yeh, it's $hit when this happens isn't it.

But you can't see everything coming. People are people, they have good and bad days, and funny moods.

I don't think there are signs sometimes. Maybe, must maybe, they are developing some sort of mental problem? I myself would do a mini mental exam to test them and MAYBE get a psych consult, just in case they are becoming unbalanced. I've known some patients with early dementia to act like this.

I'd just say OK whatever, after it happened (usually for me in a psych setting), and go back later and say something like, now do u wanna talk about what is bothering you at all? and be non-threatening. Most people say no, then they will just open up, and you know what? It's usually cos something DID get misinterpreted, or it's about something pathetic (but not pathetic to the patient). I just listen, and listen and be sympathetic - we all have bad days, what happened is a bummer , etc and ask a few questions (reflective listening techniques). It works for me.

Can I ask if the procedure was maybe a scary one?

dudette10, MSN, RN · Aug 27, 2011

Thanks for sharing, guys. It's nice to know that others have the same experience. Hope others might chime in. I've been up for hours thinking about it.

I can deal with the hectic pace; I can deal with being told four different ways to do something (and adopting/adapting my own way); I can deal with feeling like an idiot (and knowing it will eventually get better)...what I can't deal with is being blind-sided.

I guess it's better that I experienced this early on. I will learn from it, and I will try to become more aware of the subtlest of signs and make necessary changes to avoid detonation.

I hope. :nurse:

dudette10, MSN, RN · Aug 27, 2011

PS. I don't know what FFS is :|

For eff's sake.

~Mi Vida Loca~RN, ASN, RN · Aug 27, 2011

For eff's sake.

ohhhhh lol

dudette10, MSN, RN · Aug 27, 2011

Yeh, it's $hit when this happens isn't it.
But you can't see everything coming. People are people, they have good and bad days, and funny moods.
I don't think there are signs sometimes. Maybe, must maybe, they are developing some sort of mental problem? I myself would do a mini mental exam to test them and MAYBE get a psych consult, just in case they are becoming unbalanced. I've known some patients with early dementia to act like this.
I'd just say OK whatever, after it happened (usually for me in a psych setting), and go back later and say something like, now do u wanna talk about what is bothering you at all? and be non-threatening. Most people say no, then they will just open up, and you know what? It's usually cos something DID get misinterpreted, or it's about something pathetic (but not pathetic to the patient). I just listen, and listen and be sympathetic - we all have bad days, what happened is a bummer , etc and ask a few questions (reflective listening techniques). It works for me.
Can I ask if the procedure was maybe a scary one?

No, the nursing task wasn't a scary or painful one.

I wish I had had time to react therapeutically to the issue. It just happened so FAST!

morecoffeepls, BSN, RN · Aug 27, 2011

Nevermind ... I thought it said "turns you on".

My guess is you probably deserved it. (Just kidding).

& I have gotten the stink eye from a 3-year-old before. Still recovering.