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:
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.
Good night all. I'm up way past my bedtime!
Great thread!
I'm not talking about security, that's their job. I'm not talking about an out of control psych patient on a 72 hour hold. I'm talking about the topic of this thread, the PITA patient. Not a psych patient, just plain mean and verbally abusive.
Anyone remember the thread where we all compared ER stories? Stories of why people would show up at the ER? One guy didn't wipe well enough after poohing and his butt was sore. Another... a hangnail. Remember that thread? Don't you think policemen have their own list of stupid reasons they are called?
I'm not backing down on this one, police departments are abused as much as ERs are. ERs are for serious situations, policemen are for serious situations. Not because a patient is a PITA.
I have a lot of friends that are policemen and they complain about the SAME thing nurses do. People abusing the system in place.
I'm not talking about security, that's their job. I'm not talking about an out of control psych patient on a 72 hour hold. I'm talking about the topic of this thread, the PITA patient. Not a psych patient, just plain mean and verbally abusive.
Anyone remember the thread where we all compared ER stories? Stories of why people would show up at the ER? One guy didn't wipe well enough after poohing and his butt was sore. Another... a hangnail. Remember that thread? Don't you think policemen have their own list of stupid reasons they are called?
I'm not backing down on this one, police departments are abused as much as ERs are. ERs are for serious situations, policemen are for serious situations. Not because a patient is a PITA.
I have a lot of friends that are policemen and they complain about the SAME thing nurses do. People abusing the system in place.
Well I see your point. And I agree; nonsense reasons for calling the police are deplorable. I'm not arguing with that -- in fact I agree with you.
No we're not going to report the patient that swears at us to the police. It's much easier and clincially better to punt to the guy in the corner office and let them deal with life on the unit. I even had one confused elderly lady grab my breast hard enough to bruise it -- she was a confused mean old lady PITA. She probably didn't mean to hurt me -- although I was out for a day to rest my back because she pulled and twisted so hard, and to let the bruising subside some. I told my unit manager. She got haldol. No cops involved.
My point is: In any busy ER, you don't know what you're dealing with, and you can deal with a lot of bad stuff in a hurry. Pts high, drunk, etc, you know the drill. People in ER's are different; they aren't prepared, they aren't ready to hear "Your 16 year old daughter is high on meth and she's six months pregnant". We have quiet rooms and security to deal with this stuff. The cops who see what we do day in day out will also volunteer to intervene -- they're already there, so they also work with the community hospital to keep staff safe.
That was my point. Not to make it sound as if every hissy fit gets 911 straight to the psych hold.
we had a woman admitted to our floor tonight that wasn't confused, wasn't a psych patient, she was just plain mean. ....is being abusive to my staff and i will not tolerate it. ......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. ......i then informed the patient that the swearing at my staff and the punches she was throwing and abusive behavior would stop now...... 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. ................
sounds like a typical night on my unit....however you did a good job, great :nurse:ing
Well I see your point. And I agree; nonsense reasons for calling the police are deplorable. I'm not arguing with that -- in fact I agree with you. ...
My point is: In any busy ER, you don't know what you're dealing with, ...
That was my point. Not to make it sound as if every hissy fit gets 911 straight to the psych hold.
In an ER setting I totally agree with you. I wasn't responding to an ER situation but instead the nasty lady on the floor calling people names and screaming at them. THAT is just not a police situation yet someone suggested calling security and the authorities due to breaking laws. Security I fully agree with, not police officers.
Once or twice I've been known to get a patient's attention who's like that by making really good eye contact and saying something like, "Do you LIKE being this way to other people?"
I say it as if I'm really feeling sorry for them. After all, I can walk out of the room, and I'm done. That type of patient is stuck there, inside all that unpleasantness.
I think you handled the situation very well. One thing I always have to remind myself is that the way the person is acting may be because they are scared of what is going on and may not know how to deal with it...BUT that does not make it right and I think you have to be firm in situations like that. How did things go after you set your limits with her?
Well, there is one thing you can say about this job...it's always "interesting"!
Sounds like you did a great job. It's just so frustrating when the behavior of one difficult patient takes up so much time that you can't properly work with your other patients who need your care!
I work in long term care in NEw Orleans. We have some indigent patients that leave out of the building during the day and return in the evening cracked up and drunk, They wake up in the a.m. demanding pain pills at 5 a.m. One of these guys went off on me with racial slurs such as "white b__, Red neck B___, and on and on. Then, he WROTE ME up for not servicing him in a timely manner, and he wasn't even my patient. I had to take it. We are miserable with these type of patients in our nursing home, but we have to tolerate it because the Katrina situation, there is no where elase for these guys to be placed.
I also assigned three nurses to her care, two RN's and and LPN, that way one person didn't get burned out with her or hung up in the room all night not getting anything else done. I told them they could tag team each other, lol.
Good idea! One I will remember for future difficult patients on our unit. :) I've learned a lot about how to handle these difficult patients, from reading everyone's posts, so a Thank You goes out to all of you. I strive to learn something about nursing every day.
I've learned a lot about how to handle these difficult patients, from reading everyone's posts, so a Thank You goes out to all of you. I strive to learn something about nursing every day.
Bipley
845 Posts
I'm not talking about security, that's their job. I'm not talking about an out of control psych patient on a 72 hour hold. I'm talking about the topic of this thread, the PITA patient. Not a psych patient, just plain mean and verbally abusive.
Anyone remember the thread where we all compared ER stories? Stories of why people would show up at the ER? One guy didn't wipe well enough after poohing and his butt was sore. Another... a hangnail. Remember that thread? Don't you think policemen have their own list of stupid reasons they are called?
I'm not backing down on this one, police departments are abused as much as ERs are. ERs are for serious situations, policemen are for serious situations. Not because a patient is a PITA.
I have a lot of friends that are policemen and they complain about the SAME thing nurses do. People abusing the system in place.