How far can a patient go?

Nurses General Nursing

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So after dealing with an extremely demanding, non-compliant patient on our telemetry unit for a combined couple of weeks now, I am curious: How far does a patient have to go in abusing staff to be removed from the unit? This patient has managed to verbally and emotionally abuse every member of the staff, and demands a huge amount of our time, usually to the detriment of other more needy patients. (this patient is completely ambulatory and is not a fall risk, and does not receive psych treatment) They have threatened to report almost every caregiver assigned to her and leaves every single staff member at their breaking point by the end of the shift, including tears.

So what does it take? Attempted murder? Rape? I'd be interested in hearing any stories you all might want to share of any actual patients being removed from a unit for bad behavior.

Specializes in Nursing Home, Dementia units, & Hospital.

I don't have any stories of having a patient removed, but have also have the same sort of experience....I was told by my unit director that "All patients need care, we don't have to like the patient, but we still have to give them the care they deserve." Most of the time they make these patients "share the wealthers" and they are passed from nurse to nurse everyday so that no one nurse has the patient for more than a day, hopefully. I too feel that there should come a time when the patient is told "NO MORE!" But with the economy the way it is, a patient is a patient and is also money so I don't see it getting better any time soon.

Specializes in cardiothoracic surgery.

In my experience, patients (and families for that matter) can get away with just about anything. They can verbally abuse anyone and it doesn't seem to matter because they are still the patient. Nurses apparently are people that can be abused without any consequences. We have never had a patient kicked off the unit for bad behavior, but we have had patients that should have been! Now, if I talked to and treated a patient like some of our patients treated us, I would be sued for millions! Shouldn't respect go both ways? Dealing with patients and familiies like this is what is going to drive me out of the nursing profession.

Specializes in Rehab, Infection, LTC.

sometimes i think they could even get away with attempted murder and management would STILL find someway we needed to apologize for "making" them try to kill us.

Specializes in LTC, hospitals and correctional settings.

Thank you, Press-Ganey scores! :flmngmd:

Administrators are so afraid of getting even one bad survey, they give this type of patient anything they want, usually to the detriment of the facility, staff and other patients. Positive reinforcement for negative behavior is why society is in the nasty shape it's in now.

In my experience, patients (and families for that matter) can get away with just about anything. They can verbally abuse anyone and it doesn't seem to matter because they are still the patient. Nurses apparently are people that can be abused without any consequences.

This is definitely true.... I have been cussed at, poked in the face, screamed at and a multitude of other sins by a woman and when I reported it to ADmin... know what I was told?

"You haven't taken your Customer Service class yet this year, have you?"

Yea... let's stand behind our nurses, shall we? (What a joke!)

I've never heard of anyone removing a patient from the unit. They would/ could be discharged to home or a nursing home for care when stable. (yep...Those are the admits we love in LTC....NOT)

When we get "those type of patients", we try to rotate staff. Once we get them, it is almost impossible to get rid of these people since they have the right to the best care they can get. What we do is care plan out the butt, document out the butt, get family involved as much as we can, psych if appropriate and we will call the state/ ombudsman for guidance on those issues.

As far as in the hospital..can you get managment involved to kinda head them off at the pass?

Nurses are human and should not have to take crap like this...but as long as management veiw nursing as a customer service industry and not a care industry (and nurses do not stand up for each other and make excuses for this type of behavior), this abuse will continue. the only way out of this situation where I work is to have the patient fire you. some people dread this, but at times, I pray for it because that ends the relationship with that patient.

Specializes in Nursing Home, Dementia units, & Hospital.

Who the heck is Press Ganey and what makes him/her or them such an expert? Do they have any experience in caring for patients? Or is this just another company that thought up a way to make some money from hospitals???

I hate this kind of behavior. My biggest pet peeve is when the patient pulls the "race card". I just want to strangle them.

I also don't think I have ever seen a patient removed from a unit for bad behavior. Once, we had a patient/family that was extremely awful to take care of, so we started a list, as some have mentioned. We NEVER had to take care of him more than one day at a time, so we rotated, and you cuold get through the day knowing it was only 12 hours.

A long time ago, I had a teen patient who's father just didn't like me. One night, we went to change his trach and ran into a problem. The kid was fine, but when the dad came in adn was told what had happened, he actually said to me, with a smile as if he was kidding "Maybe I have to get my shotgun". At the time (this was around 1989), I was immediately removed from that patient's care and wasn't even allowed to care for patients on that side of the room (open PICU) until the patient was discharged. I would guess today something more would have been done. Scares me just as much now to remember it as it did then!

When patients act out like this, it is usually because they fear loss of control, or worse, death. In my experience, when I've spoken up and basically told the patient not to talk to me or treat me that way, they back off. Sometimes you have to tell them their behavior doesn't help nurses who are trying to help them..in these instances, patients had no idea how they were coming across. Perhaps a social worker or physician can lay it on the line for them if nursing is not able to do this.

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