Patient's "right" to abuse nurses...I need your opinion

Nurses General Nursing

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Hi, everyone. I'm a year out from graduation and have been working my job so I haven't posted or been on in a while, but a topic came up on the job and it just rubbed me the wrong way. I didn't want to ruffle feathers at the hospital so I decided to turn to my peers on allnurses for guidance.

I recently had a patient that really tried my nerves. I'm a super patient person and she made me question why I chose nursing (which I thought would never happen!). She would ask me for pain medication and as soon as I would leave her room she would be on her light again asking for the same thing. She literally rang her light 15 times in 10 minutes. I counted because I would answer her. She did this everyday for at least 3 hours every morning for the 5 straight days that I had her. She was cognitively intact. She wanted to go smoke outside, but needed staff with her and no sooner that she went outside by herself (while I was with another patient) she broke her wheelchair then demanded that I go with her. I only had 8 other patients to take care of, no big deal right? She complained about everything from the food, to the other staff, to the other patients. Her room was next to the nursing station and she would scream my name down the hall while I was charting because I was in her line of sight. I started hating my name just because of the shrill way she would scream it and she did this constantly. If I left to tend to another patient she would scream my name louder. I could hear her screaming for me while I took lunch breaks. She yelled at other patient's family members as they would passed by her room. I got so frustrated I told her we were human beings that should be treated the way she herself would want to be treated and her behavior was not acceptable. I didn't know what else to do or say to her. Eventually, she hit my tech and started smoking in the room and that's when administration said she had to go on the 5th day with me.

I made a sarcastic comment and said, "Can someone take the light and just put it somewhere, she knows I'm coming." The nurse supervisor who was getting off of work said, "it is her right to abuse you." I just looked at her back as she sauntered off to the elevator with my mouth open because I couldn't believe what she just said. I thought a better response would have been, "she needs to have her call light in case she has a need that hasn't been addressed." or something along those lines, but she was serious. I determined at that moment I would not pick up any more shifts because I was begged to come in that day and that was what I got. I felt like the "higher ups" really didn't care about me or my mental well being.

My question is do patient's have the right to abuse us? Am I just being a baby and should suck it up because this is my life/job now? I am really dreading going in tomorrow. I loved my job until I had this one crummy patient. I woke up crying in the middle of the night on my third day with her because I knew she was going to do this every time I showed up. I was fighting back tears for those 5 days at work and I cried once in my car on my lunch break. How do ya'll keep the fire that inspired you to go into nursing from going out?

Please help, I'm feeling sooooo helpless and drained :sorry:.

She has no right to abuse anyone. Learn young that no patient, doctor, family members, other staff have the right abuse you.

The tech whom she hit needs to make a police report. We are not punching bags. No one has the right to assault and batter us.

Have you been able to involve a chaplain, art therapist, activities therapist?

Keep after the medical doctor, psychiatrist, psychologist, social worker, etc. until they get on top of this mess. PRN's maybe to

calm her down, get her to sleep for a while?

Institute a points system whereby she can earn points for good behavior and can trade them for a smoke or other thing she

wants. This can help rein her in. Violations cause a loss of points.

The woman is ill and needs treatment but she does not have the right to abuse anyone. And her doctors and therapists are not

allowed to ignore her. But since you are on the front line, it's up to you to keep reporting the patient's behaviors to these other

parties.

As for your supervisor, I'd ask what she meant. Give her a chance to save face but also let her know how demoralized you feel

and that her remark didn't help and was shocking.

Meantime, cut down your extra shifts and regroup.

I'm sorry you have to deal with this mess.

Just a patient- No a patient has no right to abuse you. Your job is hard enough you don't need abuse added to it. I'm disabled due to cerebral palsy and use a wheelchair and have been in the hospital many times. I never "ordered" around or abused staff. I knew at a young age if I wanted people to help me when I needed it, I had to be respectful, and have patience, by doing so I never had a shortage of help when I needed it. (Go figure) It's a shame others don't feel/think the same way.

To be honest I think it was very nice of you to spend extra time with her after treating you like that. I don't think I could have done that. Always remember you have patients who respect and appreciate the work you do for them.

Specializes in OR.

nevermind double post

Specializes in OR.
Just a patient- No a patient has no right to abuse you. Your job is hard enough you don't need abuse added to it. I'm disabled due to cerebral palsy and use a wheelchair and have been in the hospital many times. I never "ordered" around or abused staff. I knew at a young age if I wanted people to help me when I needed it, I had to be respectful, and have patience, by doing so I never had a shortage of help when I needed it. (Go figure) It's a shame others don't feel/think the same way.

To be honest I think it was very nice of you to spend extra time with her after treating you like that. I don't think I could have done that. Always remember you have patients who respect and appreciate the work you do for them.

Thank you. It's the folks like you that make me happy i went into nursing. I didn't do it for the pats on the back and i'm okay with people being grouchy because the loss of control when one is accustomed to having control, even if just a little can be tough. Sometimes people are scared or all they want is someone to talk to for a little while and it is amazing what a little "pillow fluffing" as i like to call it will do. "Pillow fluffing" was actually one of my favorite parts of my job and I wish there was more time for it.

That being said, we do appreciate patients like you that understand that we are doing the best we can with what we've got. Some we are just never going to please no matter how fast we move and the hardest part is management that does not seem to get it. i once had a charge nurse told me (after a situation where a patient did the "grunt and point" game and then yelled and threw his water pitcher at me at me. He was able to speak clearly and was just being a jerk) that i was just going to have to learn to take it.:speechless: I most certainly do not!! Grouchy and grumpy is one thing. Even rude can be tolerated. Outright abusive?:no:

No they dont and I would never abandon my other patients to help one patient go out and smoke.

1 Votes

Argh, one of those patients. Yeah after everything described I'd generally talk to the tech answering the bells and tell them what's going on, and only to call me if the patient says something different or important. I'd document a few times per shift that the behavior is ongoing.

I would have told the supervisor right then "Ohhh youre hilarious, here's one: how about ya take this patient for me?" I'd also tell the nurse manager or assistant manager so when the patient complains it's not out of nowhere.

For patients who are asking me to let them abuse pain medication I tell them "See this board here....this is me writing the next time you can get pain medication. I will not give you more until this time so don't ask because any more would be unsafe and I WILL NOT DO IT." (then you can set your watch by the page that will come at the exact minute on the board, but at least you know to pull the drug when the time approaches).

You need to be firm but professional, let such a patient see that you will not be manipulated. Some patients find weakness and exploit it. I do not cottle them as it only promotes the behavior and it is NOT doing them or anyone else a favor.

If the patient is genuinely ill or scared, then it's different. If they are pretty far gone, then it's different. I have compassion for those situations. However more often than not the patients who are actually dying, or who really are in need, well they are some of the kindest people you'll meet.

What I want to drive home here is that even in a hospital it pays to have a bit of street smarts ready to go. You need it as a nurse.

Specializes in Rodeo Nursing (Neuro).

No one has a right to abuse you. But I think we need to be a little careful about what constitutes abuse. Being struck is battery--a criminal offense that should be prosecuted (except in the few cases in which I've been struck, when the patient was too confused to be culpable--and even then, preventive measures have been take to avoid repeat incidents). Threatening words or actions are assault, and also prosecutable. Rudeness or vulgar language need not be accepted, but may have to be tolerated. By that I mean it's fine to call them on it, but beyond that I don't think there is much you can ethically do about it. We're obligated to provide appropriate care, even to jerks. But appropriate care does not include kowtowing. Setting boundaries definitely is part of appropriate care, but I believe you have to be careful about the consequences for violating those boundaries. We shouldn't reward bad behavior, but we can't punish patients.

I'm reading all of these comments, well skimming them to be honest... what are you going to do with the patient? They're justified to be there by their need for medical treatment (I'm assuming or they wouldn't be there).... is everyone going to refuse to care for the patient? Because that's not an option. I've heard it many times before also "it's their right to abuse you". I've been in different situations when I heard it... being hit, kicked, bitten, etc. I know that some patients are a handful (too put it lightly), but I feel that some patients you have to find that way to great an awesome rapport with them, and know how to (sorry to say it this way) kiss their a** to make YOUR life better too. Some patients will ALWAYS be a pain in the a**... and that sucks, but seriously... we all signed up to take care of people... we didn't sign up to take care of the completely agreeable, pleasant, cooperative, AWESOME patients. Keep your chin up, I'm sure it's not personal :)

& if the patient is cognitive as you said... I'd never be afraid to put it out there plain & simple that you do NOT appreciate how she's acting/treating you, that you're trying your hardest to help her, and what is/is not acceptable.

"it is her right to abuse you." It is also your right to e-mail the CEO, CMO, CNO that your supervisor said those words to you and that you expect a formal apology, and to go to the news outlets if such apology is not coming. If your supervisor said those words then he/she can not be supervisor anymore because he/she has lost all respect for the nurses.

This is he attitude that most of the administration Ive worked for in my 7yrs has. They feel dealing with these behaviors comes with the territory. Patients and their families are allowed to speak to nurses and aides in any manner, expect one on one care when you have 24 or more patients to care for, they know many patients abuse their prn narcotics, they dont care if we get lunches breaks, or how much you pick up. Its never enough. I love helping people but bedside nursing has me looking for an exit just because of situations like this happening every day. I hope it gets better for you.

Yes psych saw her and the only thing they said was she has anxiety and was taking clonipin scheduled twice a day. She didn't have memory loss. She would hit the call light while other staff was in the room just to ask for the same thing because they weren't moving fast enough. I spoke with the only person who would ever come and visit her and found out her only surviving relative didn't even want to acknowledge her, but he couldn't tell me why because he was just another resident at the assisted living facility that they both lived. All I could conclude was she was lonely. I tried to spend time with her when I had down time at first, but I got worn down with all the constant complaining. It really didn't help she could see me from her bed.

You did your very best as a good and faithful nurse. Some people just are not nice people. When nasty people get sick they don't become nicer; they are just sick nasty people. I know this doesn't fix your situation, but after 25 years of nursing I can tell you it will happen again. I'm so sorry. I get it! Even now sometimes I dread going to work or have nightmares. Are your assignments made for you, or do you and your coworkers split up the patient load amongst yourselves each shift? We are allowed to split up our own patient assignments at the beginning of our shift, and sometimes you just have to say "I need a break from this patient. It's someone else's turn." I wish you well! This is one of the hardest things about nursing.

Unfortunately, the current emphasis on "patient satisfaction" leads some people to feel they DO have the "right" to be abusive to hospital staff, and management often makes us feel that we DO have an obligation to "satisfy" the abusers in the name of "customer satisfaction."

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