Verbal abuse by a patient ...

[Sassybottom]

Do you remember the first time you were verbally abused by a patient?

I am a fairly new nurse and the majority of my patients have been very sweet and cooperative. I have had the odd uncooperative or grumpy patient but that is to be expected.

Unfortunately I had a patient today who was extremely condescending towards me - insinuated that I couldn't read, questioned my education, questioned my ethnicity, told me I was not smart, would bark out his demands, pretty much yell out in frustration (with a scary angry look on his face) when I couldn't understand him - he had a trach. I brought a clipboard with some paper in his room to help him communicate his thoughts but he refused to use it - instead he would vocally spell out what he was trying to say (instead of being more efficient and just writing out his thoughts)

I hated going into his room - he would yell out - tell me what to do, etc. He referred to me as little girl.

I have never experienced such verbal abuse. Part of me wonders if I am just being too sensitive - I honestly think I have a pretty thick skin - I have dealt with insults before (I did a stint in emergency psych for my final practicum) and they didn't really affect me. I even had a patient ask if he could do sexual things to me (a sick psych patient).

Part of me wonders if I should be more sensitive to his situation - he must be feeling frustrated because of the communication barrier, he is clearly feeling sick and ill which is why he is in the hospital.

Part of me still feels kind of upset by the situation - trying to rationalize it in my mind.

Sorry for the long post ... just needed to vent.

[CJCM]

Why is it acceptable to be verbally abused by patients at work? I am not taking about dementia/Alzheimer's patient. This is a 33 yr old alert and oriented patient with medical problems. Any other profession like this or is it only nursing? Florida has a complaint hotline/site for individuals and family that has any issue with health care providers. But I cannot find a site where the health care provider can complaint. Do we have any rights at all? Employers do not care, is there anything we can do?

[eriksoln, BSN, RN]

Well, with the economy bad, yes, right now employers dont care. Cencus is low and if you have to tolerate having uncolorfull things said to you to get it up, in managements eyes...........you should.

I have learned to excuse myself when somone is being nasty to the point where care cant be performed. I'll leave, inform the pt. I will "Return when we can be more productive" and stick to my word on exactly what time it is I return. If they are due meds at the time of the incident and are not taking them cause they are too bussy telling me the Sprite is not cold enough, I mark the meds as refused. Eventually, they either stop acting out or they call for a supervisor and fire me casue they have not seen me all day. I dont mind being fired by someone of this nature. Then, the next nurse uses the same tactics when they get nasty and eventually they get the point. Works wonders when the entire unit is in on it.

[rngolfer53]

Sassybottom:

Dont take it personal....because they don't....They are lashing out due to their illness and it just happened to be you there. If I were standing there I would have taken the abuse. If you continue to work and show the patient that you will be there regardless of the abuse...then he/she will begin to respect you and you will see the change in that patient by the end of the shift or the next day. The key is to have no reaction...they are testing you to see how you will react...play it kewl....and things will be fine.

Ken:idea:

I disagree here. General abuse, perhaps, but not personal abuse or demeaning references like "little girl."

Being sick or not, this is still an adult and he needs to behave like one. Making excuses for and ignoring abuse much more often than not simply leads to more abuse.

Moreover, you are doing the Pt a disservice by allowing him to benefit from using far less than optimal coping strategies that won't work just about anywhere beyond the field of nursing. It's better to use the situation as an opportunity to introduce some better coping skills to the Pt.