Is this really the norm?

[WittySarcasm, BSN]

Alright I'm gonna keep this as anonymous as I can. I just am wondering if this is really the norm or should I be as upset as I feel...

But lately we've had residents on our unit that have become worse. Verbal abuse is common on our unit, however it is starting to get to all of us. But with it being 5 days a week, 8 hours a day it would get to anyone. And I mean we get the f*** you, motherf***ing b*****, a**h*** and so many other curses. And it's not just one, it's several people. I chart everytime someone on my unit is cussed out and report it. However nothing is ever done.

Some of our residents are physical (not super often though, thank god), or if not they are threatening and all I hear is "What did you do to cause the situation?" When it's explained that we haven't done anything it's like they just go- oh ok and that's it.

But I know where I work it's more of a 'last resort' place. But what can we...heck I do to keep the morale up? Because we all are feeling the strain now...

[Woodenpug, BSN]

I'll make the arrogant/naive/ignorant presumption that you sincerely wish to address this issue.

I don't deal with "residents" that's an issue for landlords.

When I encounter an abusive patient I find it helpful to say "I know you are better than that. You will respect me as much as I respect you." Then I explain the options and empathize with whatever excuse the patient had for being abusive. Sometimes it's valid. They feel that they have no control, that they are being forced to accept treatment. Most of the time it's just manipulative bx fostered by the workplace culture. Still, empowering the patient and giving them some other option instead of abuse seems to help. Then again, I have options, including refusing an assignment or an employer. So your situation could be different and what I think irrelevant.

[littlewingrn]

OP, I am pretty new (to nursing and this forum) so I may not have much to offer. I am sure others will that might benefit you. In my very short experience with this type of behavior from residents (yes, they are residents in environments other than hospital / clinical / landlord settings), you must provide a safe environment for your other residents first and foremost. If this type of behavior is directed toward other residents it becomes an abuse situation that must be addressed immediately. Immediate interventions to calm the abusive residents and provide safety for the others. No, this abusive behavior should not be the norm directed towards staff either. I would think that a psych consult would be in order if there are no physical / medical issues causing the outbursts that need to be addressed. If your DON or facility administrators allow this type of behavior to continue without intervening, I would seriously look for another position. Good luck to you.

[nurse2it]

I worked in LTC for almost 4 yrs where this type of behavior is common. I was called every name in the book, slapped, kicked, spit on and more by pts with dementia. If this is coming from pts who are "normal" and management does not intervene, then it will continue. It is so difficult to work in this type of environment, I chose to leave and took a large pay cut.

[KalipsoRed]

If these patients are mentally challenged in someway or demented then the best thing you can do is get a psych consult. If they aren't and are just being rude then I would just say, "Please don't talk to me that way, I'm doing what I can to help you." (Really what should be legal for us to do is turn around and leave them to their own device....I do not feel, as some older nurses seem to, that I should have to continually put up with being abused because of my profession. Yes, we are a caring profession, and for the most part I'm willing to give people a few out bursts, but you are talking about long term patients that continually do not change. No nurse should have to put up with continual abuse just because we chose to care about people.) However, back in reality the best you can do is stick up for yourself and your co-workers by asking the patient not to talk to you in that manner. More importantly, for the sanity of your co-workers and yourself, you all need to be more verbally kind to each other. It really helps if your aid just got told she was a f***ing c**t by a resident that later you compliment her for doing something well. You help each other stay out of the grips of depression by being supportive of each other. Frankly though I'd be looking for a better job because you don't deserve to be treated like that at work and your stupid employer should be doing something to support you, but like so many stupid employer's they won't. You owe your employer no loyalty or support, get the heck out of there.

[NurseLoveJoy88, ASN, RN]

OP, I am pretty new (to nursing and this forum) so I may not have much to offer. I am sure others will that might benefit you. In my very short experience with this type of behavior from residents (yes, they are residents in environments other than hospital / clinical / landlord settings), you must provide a safe environment for your other residents first and foremost. If this type of behavior is directed toward other residents it becomes an abuse situation that must be addressed immediately. Immediate interventions to calm the abusive residents and provide safety for the others. No, this abusive behavior should not be the norm directed towards staff either. I would think that a psych consult would be in order if there are no physical / medical issues causing the outbursts that need to be addressed. If your DON or facility administrators allow this type of behavior to continue without intervening, I would seriously look for another position. Good luck to you.

You have the perfect text book answer, but even with psych consults and providing a safe environment some residents still are verbally abusive. I have the patience of an Angel but it can wear on you to be verbally abused daily by residents. What I did to get through my day was to take frequent 3-5 minutes breaks in a corner somewhere and just breath and remind myself that I can go home and they can't.

[imintrouble, BSN, RN]

I would move on. Sometimes you come across a single pt/res who will abuse you. Most of us can handle single attacks. It sounds to me like there is an entire culture of "abuse the nurse" where you work.

If will eventually affect the way you feel about yourself. Or, God forbid, you yourself could become abusive.

[classicdame, MSN, EdD]

If this is new behavior it could be related to CVA, TIA, medication ----. Ruling that out, set boundaries. Ruling that out - go work elsewhere. If you threaten someone you could be in trouble. I agree. This type behavior is abusive and you did not sign on for that.

[kalevra, BSN, RN]

Were not talking about resident physicians right? These are patients your talking about?

[WittySarcasm, BSN]

@ kalevra- Yeah these are patients that are on our unit.

To everyone else thank you. I was just half wondering if this was some crazy norm that I had missed in nursing homes. Especially since everyone above me seems so unworried about any of it.

And no none of these are new behaviours, they either have been going on for months now or the patient has a history of it.

[CT Pixie, BSN, RN]

I've worked in SNF/LTC since the early 80's. I can only speak for my own experiences but I have noticed (as have several other friends who are also nurses) that the residents/patients behavior has really gone downhill. I have had more screaming, cursing, yelling, threatening and physical abuse occur with A&O pts than my dementia/alzheimers etc pts. Its sad really that this behavior is allowed.

Oh and families?! They REALLY have gotten worse right along with the residents/patients!

[WittySarcasm, BSN]

What's sad is that our dementia patients are angels compared to the ones that have no actual reason to act this way.

And families...erg not even gonna comment on them...*shudders*