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.

[leslie :-D]

i deal with many angry patients.

it doesn't affect me when they're yelling.

but, as soon as they make it personal, i firmly put my foot down.

i verbalize understanding of their situation:

tell them i don't blame them for being so upset;

but i will NOT tolerate your abuse-

followed with a, "do i make myself clear?"

a steady gaze with a moment's silence, and everything's fine after that.

they can tell, by my tone of voice as well as my' scary, angry face', that i mean business.

gen'l abuse i tolerate.

personal abuse, never.

leslie

[nursekristy]

Try to put yourself in his shoes. This does not excuse his behavior but everyone reacts to illness differently.

I would try not to let it bother you AT ALL. Most patients who behave like this are just upset with the situation, not you.

Whenever I had a patient like that I would go out of my way to form somewhat of a bond with them. (this only got me called upon by co-workers to deal with these difficult patients because they knew i could get it done, though)

[withasmilelpn]

Being a nurse does not mean being a saint. I respectfully tell patients that I will not tolerate disrespect and expect them to treat me as I do them. You can always resort to "'Mr. Jones' (whoever), you seem a little upset right now, I will return when you have calmed down.

Some people are just nasty, though. You wouldn't have liked them as a neighbor or at work. Just remain professional and keep in mind that after him could be someone worse! (Just kidding - sort of!)

[lovingtheunloved, ASN, RN]

I work with demented pts. I've been called everything but the nurse. That being said, an A & O pt doesn't get to talk crap to me, I don't get paid enough for that. It's one thing to understand how frustrated/scared/angry/lonely they feel, but they don't have the right to be abusive. Tell 'em. When he starts yelling, inform him that you will return when he is finished being a butthead, (not in those terms, of course) to help him however you can. That usually works for me. Mean people smell fear, remember that.

[Tweety, BSN, RN]

I handle each situation differently. Sometimes I walk out, sometimes like Leslie above, I validate their concerns saying "I would be upset too if I were you, (or it were my child/mother/whomever) let's talk about the issue and what we can do about it." Sometimes a firm "you need to settle down and not talk to me (or "my nurses") like that...." works. Depends on the circumstances and what they are angry about. Usually I can defuse the situation and get them to refocus. I think most people just want to know that someone cares and someone is listens. Others it's the way they were brought up, or are just angry people in general.

One thing is to not take it personally, especially if they are angry at you.

[Sassybottom]

Thanks for all the tips and support :)

Anyone else remember the first time they experienced verbal abuse from an alert and oriented patient?

[Altra, BSN, RN]

Anyone else remember the first time they experienced verbal abuse from an alert and oriented patient?

Vividly. Complete with racial slur and offensive slang term for female anatomy. :stone +ETOH but pt. was A & O.

[KenCCRN]

Thanks for all the tips and support :)

Anyone else remember the first time they experienced verbal abuse from an alert and oriented patient?

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:

[vivibonita]

I do remember and it was when I was still a student, doing my rotations. I didn't take it personal then, I understood the position the pt was in, but I did let him know that he had been rude and offensive without a valid reason, that I was there to help him and not to be his punching bag... i didn't say that literally but you guys get the point.

Nowadays, (still a student nurse but getting paid), I do the same... let them know that there is NO reason to treat you like that, bad languange will not be tolerated, if they want respect they also should respect others (not only you but also other pts), when you are done with your speech ask them in a nice way if there's anything you can do for them. Sometimes that will bring their guard down sometimes they just keep being...well , pts, then is when you turn your back, make your little notations in your chart, and go on with your life :)

Don't let anyone bring you down, not even those you are helping :)

Peace,

Vivi

[jojotoo, RN]

Mean people smell fear, remember that.

Truer words were never spoken!

[sharona97, BSN, RN]

Hi Sassybottom,

I agree,people can just be plain mean in their nature. I would tend to take it personally,even tho I know better.

I've had family members in my face,all the while the patient is there smiling away. When the time has come to put my foot down, I simply retort,I don't allow my children to speak to me or others as you are, so let's figure this out. I put it back on them.

Most often it results in their fear, anger, anger of the unknown, etc.

You are a good person, and that will shine through with some assetivenss. Soon they will be eating out of your hand as they figure out you do care for them.

Sheri