Verbally Abused

[Bubbles72]

This is the situation, I work at a place where you look after residents, I was put down to do this one resident who was very verbally abusive towards me. She called me all names under the sun and started shouting verbal abuse at me the whole time I was there for no reason. At one point she even got in my face, I tried to stay calm by telling her if she could lead the way to the bathroom I will help her to get ready if that's okay, I helped her to sit on the toilet. I told her I will be right back as I need to tidy up her room. I tried to tidy it, thinking me sorting her bed out would give her some time on the toilet and a chance to do a bowel movement. But before I had even had the chance she suddenly start's shouting for me to hurry up, repeatedly saying, " come on, f***ing come on" over and over and over again. At this point, I am stressed out beyond belief and I forget to check the bed probably. I give it a quick glance (thinking it looks okay) and go to her as quickly as possible as she starts to get angrier by the second. So I go to the bathroom where she is, shower her, dry her and dress her. I make her a drink and breakfast before dashing out as I start to feel my anxiety going through the roof.

I got so anxious I had even forgotten to write down anything for the daily logs and now I am under investigation because it turns out the bed I hadn't checked probably was wet and I would have known that If I hadn't been so verbally abused for half an hour. I got told after that I should have gotten the manager but she had just completely overwhelmed me with anxiety. I couldn't think straight. All I was thinking about is if I quicken up she won't hit me. What was I meant to do?

[JKL33]

Bubbles, I am sorry for the disciplinary situation as you described it.

I believe, genuinely, that you need to gain some perspective and judgment. We need to stay calm and not become hysterical in our processing of a situation - not let our emotions wreak havoc and prevent us from making sound decisions. When caring for patients we can't allow these types of behaviors to cause us to become emotionally unglued.

Some things to ask yourself when in situations like this:

- As far as you can tell, what is the reason for the behavior? This is important because your actions and responses will differ based on the reason.

- Have I done anything wrong or am I in any way helping to provoke the situation?

- What resources do I have that could help me achieve a calm/therapeutic outcome?

I can't tell you one specific thing I would've done because I wasn't there and I don't know the situation nor the job expectation nor the resources provided. But I encourage you to think about these things.

One last thing (broken record....) - Don't take someone's words so personally. Does this resident have an actual reason to hate and despise you? Probably not; therefore there is no veracity/truth that is specific to you in her words. They really shouldn't cause you any particular personal offense.

[NightNerd, MSN, RN]

You cannot let your patients' words dictate the way you respond to them. Sometimes they provoke anger; sometimes they provoke fear; sometimes they just ruin your shift.

After figuring out if there's something I'm doing (or not doing) to aggravate the situation, I try to redirect the alert and oriented patient (delirious or demented patients will just not get it most of the time). I'll say that I am doing the best I can, but I need patience to finish my work and get him or her what s/he wants.

Some people check themselves, some people don't At that point, for your own mental health, just tune it out as much as possible. Don't respond to rude statements, offer simple and short directives, and finish your work safely so the patient will have no logical reason to complain about it afterward.

It sucks getting yelled at by people! I spent most if my night last night being repeatedly berated by a patient in delirium, and he had no idea what he was saying, but he was MAD. Believe me, I understand how demoralizing it is, and I'm sorry this vagueness to you. This piece only gets a little easier from what I've seen so far, but you do develop a thicker skin and learn to not take things personally. 9 out of 10 times, a patient's demeanor is not a verdict on the care you give.

[suzil]

You always have to remember they are the patient. That is probably part of their illness. They can very well be lashing out due to so many issues going on within them. This type of behavior is not new in this field. Learning to let it roll off your back is hard to do. However, it has to be done to get the job done. Because you still have to look after their physical and emotional needs. I know it really sucks to be yelled at by a resident. I would recommend to keep the manager or charge nurse in the loop on what is going on with the resident's behavior. For the future I would highly suggest to read up on dementia, sundown syndrome and the psychological changes that go on with the aging. I think it will help to give you some perspective and help you see that it wasn't you they were actually lashing out at.

[dishes, BSN, RN]

Are residents who are routinely verbally aggressive at higher risk to become physically aggressive? If so, the employer should have a policy in place that aggressive residents be assigned two staff members for all of their patient care.

[aflahe00]

Lesson to learn here is next time cover your butt and let your manager know what's going on. Just say hey this patient is giving me a really hard time and she's very angry I just thought you should know.

[GeminiNurse29]

Don't take things personally and always do your job no matter what. I work in psych and if I had a dollar for every time a patient yelled at me or got verbally aggressive, I wouldn't have to work. ;p

It's much easier to have pleasant patients but then we'd all be out of jobs. Just make sure you're safe and they're safe.

[iluvivt, BSN, RN]

Just remember the investigation is just an attempt to gather facts. Calmly explain what happened. A decent manager will clearly see this was not intentional and you became distracted by her abusive behavior. More importantly, you will need to read up on how to deal with abusive patients. You need to learn some techniques to diffuse these types of behavior and how to not take it personally and give up your power.

[Nurse Beth, MSN]

I got so anxious I had even forgotten to write down anything for the daily logs and now I am under investigation because it turns out the bed I hadn't checked probably was wet and I would have known that If I hadn't been so verbally abused for half an hour. I got told after that I should have gotten the manager but she had just completely overwhelmed me with anxiety. I couldn't think straight. All I was thinking about is if I quicken up she won't hit me. What was I meant to do?

You were rattled and it affected your ability to do your job.

But...you are held to your performance (change soiled linen, documentation) whether or not residents are well behaved.

If this is an isolated incident, it probably won't affect your job. Be sure and let the manager know what you will do differently in the future.

Best wishes :)

[JKL33]

Be sure and let the manager know what you will do differently in the future.

Excellent advice.

What has happened is done. They will be interested to know that you have the ability to handle such a situation differently in the future.

[Irish_Mist, BSN, RN]

So because you didn't mark a check off next to "bed" on the list, that means you in fact left the patient in wet sheets? What kind of investigation is this? Is it a facility investigation or state? You yourself said you at least looked at the bed and said it looked okay. Tell them that!

Just remember, you cannot allow a resident/patient to dictate your feelings/response to situations.

[Bubbles72]

Thank you for all of your advice, I suffer from anxiety anyway which doesn't help, probably need to look at going on medication to ease my nerves.