Harassment at work, patient to staff

Long Term Care Columnist / Guide · Feb 26, 2012

There are a couple of questions I need to ask before I can help you sort all this out. Is this resident alert and oriented? That could make a huge difference in how this issue is handled. What are his behaviors---does he curse at you, call you names, spit or throw things at you? What's more, do you feel his behavior is directed toward you personally, or does he treat other staff similarly? There's more, but I'm in the Safeway parking lot right now and am typing my response on my iPhone.

nrsejohn · Feb 26, 2012

Hunny trust me after 41 years in nursing and dealing with numerous cases you describe, the thing administration will tell you is"don't take it personally after all YOU are the professional and they (the patient) are ill with dementia or whatever". But rest asured that eventually this patient will "verbally abuse" the wrong person such as a visiting corporate VIP or the administrator or (heaven forbid) a state surveyor!!..I have had it happen to me and EVENTUALLY the incredible does happen!!...in the meantime have you exhausted all of your professional interaction techniques?..there is also the option of seeking out the one staff member this patient seems to like and assign them to dealing with them! But what ever you do DONOT let the patient know he's getting to you, never snap back, walk away whenever possible, CHART,CHART,CHART, AND CHART SOMEMORE!!,..harass the M.D, nightly if you must,..slip nightly reports under the D.O.N.'s door, enlist other nurses to document as well and build your case. ASK for a intervention with the patient and the family,..remain professional thru all of this!! If all this fails confront the scheduler and ask for re-assignment,..trust me they will situp and take notice!!!

nrsejohn · Feb 26, 2012

:yeah:hang in there!!

DixieRedHead, ASN, RN · Feb 26, 2012

Fill out incident reports or staff concern forms, whatever you think will get the most attention. Keep a copy of every one of them. Ask for your fellow nurses to do the same.

nothing gets it done like putting it in writing. Then if they decide that it is you they want to get rid of you have documentation of your reporting. And whatever you do, continue to chart in the chart. It is a legal discoverable record and don't let anyone tell you that those incident reports are not discoverable. They are.

nrsejohn · Feb 26, 2012

:flamesonb

I am a nurse in LTC and have had to deal with abuse (verbal, emotional) harassment from a patient for quite awhile now. Management knows this is going on as they have been informed repeatedley and there is documentation to support it. After all this time, things have come to a head and I refuse to put up with this behaviour anymore. Supposedly psych is to come in to consult re meds. None up to this point, why would they start taking them now??

My feeling is this. Who they gonna get rid of? A patient that brings in money or a nurse complaining about abuse and harassment? What are my options? How long am I supposed to put up with this stressful hostile environment? Yeah and I could quit, but come on, we all know in this ECONOMY if you have a job you better hold on to it. I'm doing my best but this is causing BP problems (mine) chest pain (again, mine) and severe anxiety!

There are all kinds of procedures to follow when is the shoe is on the other foot, ie, staff to patient abuse, but in my situation it's put up or shut up. Put up with it or quit.

I know there are several legal steps I could take, but what? How do I start?

nrsejohn · Feb 26, 2012

I agree with "red"!! incident reports,by multiple staff is important and if the patient is alert/orientated they should be told that their behavior is being recorded and reported..in any aspect documentation is the key..hopefully it won't escalate to physical abuse on his part since that opens a whole new can of worms...

Lynx25, LPN · Feb 26, 2012

The best thing to do, is to document well, and use direct quotes- IE, "Resident stated 'B--ch give me a B--- J-- while you're down there"

Write the words out... I'm just not sure if AllNurses wants me to. I actually had to write it in someone's chart here. The only issue with this person is that I am not normally on the hall, and the other nurses would rather let it slip and let the CNA's get harrased, than actually just chart it.

On my normal hall, if we follow it closely enough they usually get a few trips out to the mental health facility. If the mental health facility refuses them, because it is behavioral, I find that parking the wheelchair next to the administrator's office will usually do the trick. Let them harrass someone higher up, things happen much quicker then.

CapeCodMermaid, RN · Feb 26, 2012

I don't think you have any legal recourse. Speak to the social worker, the DON, the doctor, and call the Ombudsman. I've often called their office to ask for help with particularly difficult residents. If the person is alert and oriented, speak directly to them. Honestly, why do we put up with this kind of crap? I don't allow my staff to be treated badly. It's one thing if you work on a dementia unit and the patient has no idea what they are saying. But if the patient is alert and oriented they had best behave.

jadelpn, LPN, EMT-B · Feb 26, 2012

One thing that struck me was that you said the patient had never been on any meds. Dementia and/or untreated mental illness sometimes will manifest itself with the most outrageous inappropriate behaviors I have ever seen. Ask for a patient care meeting with Social Work. Let your thoughts about this patient's behavior be known. Come up with a plan that when this happens, patient is put on a 1:1, pending a bed in inpatient psych. or anything else you can think of that would help this patient within your facilitys' policies. (family member call ins to 1:1 is also a thought). And no, you should not take this personally,(and I know easier said than done) as there's usually a cause for a patient to act out--dementia, mental illness, even a brain tumor or head injury. If the patient is just simply an a**, again, social work and the ombudsman can go a long way in creating some sort of treatment plan for this patient--but I would ask that they rule out any other medical cause first. I would hate to see you lose your job, or get involved in a legal mess, only to have found out that this patient was severely mentally ill and unmedicated, or s/p head injury with significant organic brain damage. Have them involve the family in this process. And if all of this is much more involved than you would like to be, I would call the ombudsman to visit with this patient to get to the root of the issue, and keep your responses to the patient unemotional and to a point--patient is "tantruming" and when patient is winding down, you say "what is it that you need from me right now?" And if they start again, leave area with saying, "when you can be appropriate and you need something, let me know". Even the a** patients lose steam when faced with the fact that you are professional and not emotionally vested in this behavior. Some patients are master manipulators, and find people's weakness' and expose and flaunt them, pushing every button you may have. With that being said, I am also of the thinking that it is doing the patient a dis-service to allow them to continue to embarrassingly act out and untreated. That could be how you approach this with social work--not on a personal level, but that the patient is at risk, and patient is acting in a way that is inappropriate to themselves and others.

Dawnelizabeth · Feb 26, 2012

So true. I have FINALLY realized that the best change I can hope for HAS to start with me. I thank God for being patient with me and loving me enough to reveal this to me.

lindarn · Feb 26, 2012

That is the reason that I recommend that your ALWAYS make a copy of all incident reports, because they have a tendency to disappear when management is called on the carpet to explain situations.

You do not have to tell anyone that you made copies of the incident reports. It will be your little secret. Your, "ace in the hole".

JMHO and my NY $0.02.

Lindarn, RN, BSN, CCRN

Somewhere in the PACNW