We had a woman admitted to our floor tonight that wasn't confused, wasn't a psych patient, she was just plain MEAN. The CT department called and said, we are sending her, be prepared, in 20 years we have never met anyone like her. Well, it didn't get any better for us. The nurse tried to do her assessment and was told "YOUR PUSHING TOO HARD WITH THAT STETHASCOPE, STOP YOUR HURTING ME!" She refused to answer any of her P&A questions because "her doctor knew everything and we didn't need to know her business." So I call the doctor and tell him, first thing in the morning, you need to talk to your patient, She is being abusive to my staff and I will not tolerate it. In the meantime, any advice you can give on how to handle her would be greatly appreciated. Ofcourse, she is on the call light every 3 minutes, the room is too hot, the dinner is too cold, can she have a second dinner tray, her stomache hurts, she is having chest pain, her hip hurts, her neck hurts, her back hurts. This went on ALL night. THEN, the nurse calls the doctor about her hip, because it seems to really hurt more than the others:uhoh21: she REFUSES to go to the X-Ray he ordered. We are in the middle of an RRT and she is screaming at the transport guy...I left the RRT room and told her that she needed to get on the cart because she told us of the hip pain and this is what her doctor wanted. Yes, ofcourse it is her right to refuse, but she was just doing it for attention....So, I go back to the RRT room where we are pushing 12mg of Adenosine:imbar and I hear this woman carrying on. I go back to the room tell the nurses to leave her alone and stop fighting with her, if she doesn't want to go to the X-Ray, she doesn't have to but to sit and fight with her about the reasons is useless. I then informed the patient that the swearing at my staff and the punches she was throwing and abusive behavior would stop NOW, I had a real emergency down the hall and needed the nurses to focus on her. I was DONE playing her games and she was not to call out anymore for nonsense issues, expecially when she would not let us do anything about i. I then called security and they came up to talk to her. After the RRT, I looked out in the hallway and she had found a wheelchair, she decided the X-Ray might not be such a bad thing and was waiting by the elevator for transport to come back up to get her. Poor doctor, I then called him back and gave him a piece of my mind, lol. He said, what do you want me to do, something for nerves? I said, yeah what do you have for me?:chuckle Luckily, I have a good relationship with him, I said, I am just giving you a hard time because I am frazzled and at my wits end with her. He told me he would try to get her home tomarrow:rotfl:
Yeah well...I am pretty sure it would be considered a crime anywhere, but considering this facility where I used to work at...I don't think they would really care..they just want money & that pt was $$$ signs in their eyes.
The crime is working for facilities that continue to work short, to save/make money..that is their slogan! They don't care if you are working your tail off, short-staffed, under-staffed, and no lunch/dinner-breaks, let alone taking a bathroom break. Sorry got off the post, but where it occured at is a friggen sweat-box for all medical staff. I feel sorry for the patients there & the staff.
I wondered though why you didn't let loose with a little German (like on your way out the door), just so she would have known you knew. I don't know if I could have resisted!
Probably not profession, but I would have done it anyway!
Oh I would have loved to, but I don't know enough to speak it, especially angrily. About all I would have been able to garble through is "My German isn't very good" and I don't know if that would have helped the situation.
She sure had her opinion of this German word for married woman, though!:balloons:
Could you call security for verbal harassment? I mean, it's illegal to verbally harass someone, right? So, if a pt. was swearing at you and saying awful things, could "the authorities" be called....or is that over the top? I'd hate to threaten that and not be able to carry it through.
I feel your pain. I worked on a psych unit specifically for borderline personalities for about a year. It was the longest year of my life. Imagine working everyday with 16 of those people. They certainly have a knack for just sucking the life out of you during a shift with all that attention seeking, manipulation, and antisocial behavior. The best advice I have for dealing with this type of patient is to act as unphased as possible by their antics. Set limits but do it with a smile on your face no matter how much you want to strangle them. What ever you do, do not ignore them. They will just keep upping the ante until they get a reaction. Give them a reaction, just not the one they want. I had a pt. one time smear feces all over her bedroom wall. When I walked in and found it I just smiled and said " Oh well now I have an excuse to use that new cleaner we just got. I just love the citrus scent." She never did it again because I acted like I was happy to clean it up, and a borderline never wants to see other people be happy. This approach always worked for me. Good luck!
Thank you all so much for the support I guess after our little talk, she was on her best behavior all night last night. She is still grumpy, but no longer abusive. Hmmmm, the security thing must have worked better than I anticipated.:rotfl:
We had a weird one last week, who thankfully wasn't mine but I did help with her. She had one nurse two nights in a row and got meaner by the minute towards this poor gal. She couldn't just mash a call light, she'd hold it down till you got there. Wanted my charge nurse to move the bedside commode while she was using it. Lots of little piddly stuff.
I started night no. 2 with telling my coworker who had this patient, to do some limit setting right off the bat, and that when I went in there I would do the same. If we agree on how to handle her and nobody coddles her, it might work. In order to not be in there all night arguing about silly stuff, I had to use this format: "I am gonna do X for you. Here you go. No, I'm not gonna do X, Y, and Z for you. It's time to sleep." And walk on out...
It worked okay. She was never really through talking or whining and I think she drove her nurse bananas. If she hadn't had a physiological reason to be loopy we would have been a lot more irritated.
Could you call security for verbal harassment? I mean, it's illegal to verbally harass someone, right? So, if a pt. was swearing at you and saying awful things, could "the authorities" be called....or is that over the top? I'd hate to threaten that and not be able to carry it through.
What's the nurse to do? Dial 911, point to the patient and exclaim, "She's being MEAN!" Maybe the nurse could stomp his/her feeties at the same time to *really* drive the point home to the police officers.
Com'on folks, the police departments have serious issues to deal with. It's time we start calling the authorties with BETTER common sense than people use to come to the ER.
Thank you all so much for the support I guess after our little talk, she was on her best behavior all night last night. She is still grumpy, but no longer abusive. Hmmmm, the security thing must have worked better than I anticipated.:rotfl:
Shay, We've all been there and I'd be willing to be that there are more stories like this. You are not alone in your feelings and your experiences.
This is a great place to vent and receive feedback from others who may have experiences to share.
Keep us posted on the cranky patient. I'm glad you and the security guards showed her that you won't be bullied -- or that you give as well as receive!
You handled you situation with admirable, memorable grace and tact, and did so while not ripping into the patient's soul. Even if Grandma is off her meds and you'd like to lose her in a cornfield somewhere, she is still your grandma, or somebody's grandma, and now she's in a situation where she has no control and familiarity with the system.
Yes we can be angry and even come here and get a good belly laugh about our PITA patients, but all of us on this board are mature enough and respectful enough, even in the toughest of situations, to remember that there's a scared, frightened soul in that room who is lashing out with aggression because it's all they've got.
Once you lay down the unbending, unflexible ground rules, I think that most people turn into decent human beings if they are able to admit they're frightened. It's hard for me to admit I'm scared in unfamiliar situations and I feel that way most of my life! I ask myself, how to make this better now?
Sometimes a short talk of support helps, sometimes they need social services. Or psych consults. Or the elephant sized dose of Xanax -- the pill that you have to bite into because its such a high dosage. I pray those days are coming!
What's the nurse to do? Dial 911, point to the patient and exclaim, "She's being MEAN!" Maybe the nurse could stomp his/her feeties at the same time to *really* drive the point home to the police officers.
Com'on folks, the police departments have serious issues to deal with. It's time we start calling the authorties with BETTER common sense than people use to come to the ER.
Verbal harassment gets reported up the food chain. In the ER, I tell the charge, doc, and any male nurses we have working. If we do any procedure that's going to be uncomfortable, etc, we tell them ahead of time that they will have a lot of support -- and they do. Out of control patients get a security guard sitting outside of their locked patient room. Patients in for criminal matters usually have a cop to sit with them. But for the basic out of control PITA, we give them one shot to staighten up, then security gets called and the appropriate measures are taken to make sure they comply. Soemtimes this behavior qualifies for a psych hold and then the patient is really pissed at that point.
In any event, at any ER, you'll have police coming and going, so if someone is out of control, when the cop has a free minute s/he'll say a few uplifting words to the patient in question and most times they snarkiness abates.
SFCardiacRN
762 Posts
Great thread, I see a lot of professional behavior going on!