How do you stay nonjudgmental?

Kymmi · Dec 31, 2007

I dont think you are having a hard time being empathic to this person because of his lifestyle choices because you stated you have taken care of other patients that have chosen to do things which resulted in illness.

I think you are having a hard time because this patient is abusive, rude etc and I think you'd have the same difficulty with them if they had DM, HTN, CHR, CHF (you get the idea). Unless this patient is confused and doesnt know what they are doing there is no reason that you should have to put up with his behaviour without letting him know how you feel about how he is acting.

I know this has been said on this forum many times before but nurses are the only profession that tolerates this type of behavior from anyone. If this man did any of this to the police he'd be laying on the ground in handcuffs faster than you could blink, in any public place he'd be kicked out. I know we cant handcuff or kick our patients out but why is it we tolerate such behavior. If they are confused then its a totally different story however being sick doesnt mean you get a free pass to abuse other people.

We did have one man that wasnt confused but kept throwing things at staff, would attempt to bite, hit staff. He also was very demanding but when he didnt get his way he became abusive. The doctors spoke with him and told him if he continued to be this way something would be done about it.....it continued and I know no one will believe me but adminstration came and spoke with this man and informed him that he knew what he was doing and it was abusive to the staff and if it continued they would call the police and press charges.......the man then became a changed man...still not nice but he did stop attempting to hit, bite, spit, and throw things.

TigerGalLE, BSN, RN · Dec 31, 2007

Thank you Kymmi... You are absolutely correct. For some reason I was feeling guilty for being aggravated by this person. But it isn't the person's disease that is aggravating me it is their behavior. I don't know why i felt guilty. I guess I felt I should tolerate the behavior because they were dying from AIDS.. But you are exactly right. The behavior should not be tolerated. I did tell the patient that I would not tolerate that behavior, and not to talk nasty or cuss while I am in the room. They would say sorry and stop.. But next time I came in they would start back up again...

Thank you for that post.. you really helped me

Tiger

leslie :-D · Dec 31, 2007

does this pt have the aids dementia?

leslie

Kymmi · Dec 31, 2007

Im glad I could help :yeah: . Seriously, I am a very caring nurse and I treat my patients well. I feel badly for their conditions no matter what caused their illness however I do not accept being abused by totally oriented patients and I do not find myself thinking I need to accept that so and so is just a jerk.

Its ironic that we ask our patients about any abuse they have at home and if it does exist we counsel them on not putting up with being abused by their partners and we give them the abuse hotline phone number to call and yet we as nurses feel we must tolerate abuse. Once again its teaching our patients what we dont practice ourselves.

NurseNature · Dec 31, 2007

There are 3 different issues mixed in the original post.
3. My pts can cuss all they want at me, 'cause I'm so busy trying to figure out what they might be trying to communicate that I don't really hear it, but they can't cuss out other pts or my aide. That I'll hear right away and resolve.

How do you resolve this? I would not know what one could say to make them stop cursing and verbally abusing caregivers.

nyapa, RN · Dec 31, 2007

How do you try to care when you know that the patient's lifestyle has caused their disease. Whether it be sex, drugs, alcohol? I had a patient today that was very sick due to their lifestyle choices. They were very rude, hateful, particular, and flat out annoying.. I found it very difficult to be empathetic for this patient. It got to the point where I couldn't stand to be in the room anymore.. This patient was flat out disgusting.. They would try to wipe their stool on me purposely, talk very nasty and cuss. I don't even know if i can stand to take care of this person tomorrow. I'm not even going to tell you the nasty things they did today. It just makes me sick.... How do you stay empathetic???
Tiger

There is a difference between being nonjudgmental about their disease and their behaviour. If this person was doing this to you in the street, then you would have the right to call the police. You should be able to put in a formal complaint, presuming this patient is orientated. Tell them that you will not attend to them if they continue to behave like this. And tell your supervisor. Perhaps two staff members could attend to him/her at the same time.

(((hugs)))

Jay

Kymmi · Dec 31, 2007

I will initally attempt to find out why they are so upset. If they are upset about something in particular I will attempt to resolve it. Had a man last week who got very upset and was swearing like crazy about something but it had nothing to do with me. It had to do with his perception of something else and I happen to be the one in the room that he could vent to...so I listened and we resolved the issue and he became his normal pleasant self again.

If its a patient that is constantly swearing/yelling just because he feels like it then I will also attempt to find out why he/she is so upset but if there is no reason and he just wants to be nasty I have told more than one patient that I will be back to address his concerns/wants when he/she can speak to me nicely. So far there has only been one time that I've been told by management that so and so didnt like me and I told the manager what happened and she said thats what he told her also. She then told me he requested I not take care of him any longer which was fine by me. Eventually my co-workers ended up saying the same thing to this man and the list of those not allowed to take care of him got longer and at that point management figured out it wasnt the nurses but the patient that was the problem.

rph3664 · Dec 31, 2007

does this pt have the aids dementia?
leslie

I had wondered the same thing. If that's the case, he has no more control over his behavior than an Alzheimer's patient.

NurseCherlove · Dec 31, 2007

Agreed. There's nothing 'judgmental' about refusing to allow someone to assault you.

Assault was exactly the word I had in mind (when thinking about the crap-smearing attempt). I think I might have told that patient right then and there..."Sir/Maam, I hope you realize that if you soil me, I will have you arrested. You will be charged with assault and taken to jail upon your discharge from the hospital."

longhornfan1 · Dec 31, 2007

Have quick ethical question

Midwest4me · Dec 31, 2007

I AM judgemental though morally and professionally I'm not supposed to be. There have been many times I'd like to say something smart but have to realize these are ill people. Ill people sometimes do and say things which normally they would not. Just continue smiling and giving support.

In my work environment with the mentally ill we HAVE to put up with the crap-smearing(though that's at a minimum) and verbal and physical abuse; there is no option of having them arrested.

Katie82, RN · Dec 31, 2007

There are 3 different issues mixed in the original post.
1. A pt's lifestyle, while it may summarize a long list of risk factors, being no more than risk factors, can't cause disease. That's unscientific, so it doesn't even cross my mind to pass judgment on pts' lifestyles.
Respectfully disagree.As a nurse with many years in Public Health and Case Management, I can tell you that lifestyle and risk factors have as great an impact on the disease process as anything. We all know that smokers are at higher risk for cardio disease and lung cancer, obesity carries risk for diabetes. In my current job, I deal with many patients who are chroniclly ill because of lifestyle choices. Some, like mental illness or addiction, are unavoidable. But many are choices, such as obesity and smoking. THese are the folks I have a problem with - the people who are ill because of behaviors they could change.