How do you respond??

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My patient in clinical yesterday was all over the place. One minutes she's sweet as can be, next minute she's mean and hateful. I was in doing my assessment and she's chatting and what not. Next minute she looks at me and let's me know just how fat I am :crying2: Going on and on about how unhealthy it is, blah blah. It did hurt my feelings but I didn't let it show, I hope. I was speechless and didn't know what to say! I brought it up to my instructor and he was shocked. She was also rude and mean to him when he went in a few minutes later. Anyways, what do I do in that type of situation?

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Specializes in Med-Surg/urology.

I had a patient like this too.And like you, I was really upset too. My clinical instructor told me basically to get over it..sometimes the patients will be like this, unfortunately :( Sorry you had to go through this.

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Hi SunshineDaisy,

Recognize that many your patients' negative reactions are out of fear, pain and perhaps their disease processes' effect on their mind. 99.999% of the time, it has nothing to do with you.

I don't like the saying "get over it." Sometimes things are not easy to brush off. Do not dismiss your hurt feelings but also find a way to deal with them without affecting patient care. Hash it out with a trusted colleague, journal, seek therapy, find a hobby... whatever you want! Don't just tamp it down. Acknowledge the way you feel and find an outlet. Knowing what gets under your skin is a valuable lesson. It will allow you to brace yourself for situations you know where you will be upset, or avoid them altogether if it is possible.

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Sorry you had to experience that.:heartbeat but I have learned through my experience as an cna that some people will be rude and mean for a number of different reason and you just have to try to not take it personal.

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Specializes in Emergency Nursing.

Sounds like dementia.

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Specializes in Med-Surg/urology.

Or maybe she is bipolar?

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i think you do have to not take it personally. it is so not about you. if you're babysitting an infant and it makes a mess or screams, you cut it some slack because it doesn't know how to do anything different. same with someone like this. just because she's an adult doesn't mean that she knows how to do anything different at this time, for whatever reason. you may also be looking at someone with an undiagnosed major psych disorder, like multiple/dissociative personality, bipolar, or schizophrenia.

it is perfectly acceptable to remember that a soft answer turneth away wrath, as my sweet old grandmother used to say, and say something mildly like, "i'm here to help you with your hospitalization. it's hard to think about some things, isn't it?" and see what happens next.

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Thanks for the responses. My clinical instructor and I both thought schizophrenia too. He spoke with her RN and suggested a psych consult, just based on what we both experienced. I hope they take it seriously. We are at sub acute so I doubt she will be there when we go back next week, but would be interesting to find out if the consult panned out and if anything was found.

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Just try to let it roll off your back. I have had some patients that weren't very friendly but not downright rude. I'm not sure what I would say or do, actually...

Sorry that happened, try not to let it bother you.

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You have just described a practice question for mental health. The answer was do you work and leave the room. Return in 10-15 minutes and check on the patient to make sure the patient did not feel you deserted him/her. We cannot choose our patients and they come with all kinds of baggage, trauma, dementia/Alzheimer's disease, and additional medical diagnoses.

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Specializes in LDRP.

i know its not an easy thing to do, but you should set boundaries with them and let them know they are being inappropriate. if they continue to bully you, you could try saying something like "i am a professional and i prefer you talk to me like one." or "I dont appreciate the way you are talking to me right now."

this is coming from someone who, if a patient called me fat, i would probably cry or come close to it. i am pretty sensitive, but ive seen nurses set patients straight and let them know its not okay to talk to someone like that.

i have gotten pretty good at work (i work in an assisted living facility) when some of the older men say sexual comments to me. i say things like "Would you like if someone said that to your daughter/grand daughter?" or simply "that was inappropriate, i expect more of you mr. ___". but it has come with time, and I know these people on a more personal level than the acute patients in the hospital whom ive just met.

my point is, i dont think everyone is right in saying "just ignore it and let it roll off your back". you need to stand up for yourself and earn respect from these people if you are going to be a professional. no one deserves to be talked to like that.

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Specializes in Public Health.

^^^you hit the nail on the head.

I have had patients grab my breasts, call me a *****, ****, ****, *****, i've been told to go **** myself, go to hell, punched, slapped, groped, scratched, sometimes you just have to roll with the punches (no pun intended lol) other times (if i am very familiar with the pt) I will very sternly remind the patient that I do not yell, hit, curse out them and that there is no need for them to treat me that way. If they refuse then I leave the pt in a safe situation and get someone else to help them until they gain control of themselves.

After all that is said...I LOVE my pts at the LTC I work at. They all have a warm place in my heart and I miss them all when they leave.

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