Lost Temper -- Yelled/Swore at Patient

bethin · Aug 5, 2007

Can't say whether it's a reportable offense as I'm a CNA.

The pt could deem it as abusive even though you say it wasn't. I think a few days off is a good idea. It's ok to tell the pt you demand respect but keep out the 4 letter words.

I know it's hard to bite your tongue when a pt is being a PITA.

deeDawntee, RN · Aug 5, 2007

I am sooooo sorry this happened to you. Oh my God, when I think of how easy it would be to really lose one's temper, it boggles the mind, how stressed out are we as nurses?, it is amazing we all don't lose it regularly.

I really don't know the answer to your questions, although I sincerely doubt that you will lose your license. I know someone who hit a pt and didn't lose her license. If you have a decent manager and adminstration where you work, the disciplinary action should consist of supporting you. There should not be any shame and blame instilled upon you. God knows you already feel bad enough. I could see some anger mgmt support, or something along those lines. That you already have yourself in counseling is an excellent start.

I wish you well in sorting out all of this for yourself. I hope you can forgive yourself. This too shall pass and you will undoubtedly learn a great deal from having to go through it.

:icon_hug::icon_hug::icon_hug:

Tweety, BSN, RN · Aug 5, 2007

As it really didn't compromise patient safety, I doubt it's a reportable offense.

Good luck.

Editorial Team / Admin · Aug 5, 2007

One thing to consider, and I do not want to make more of this and/or raise undue concern:

Patient care can be compromised in scenarios as this. If the patient was harmed "mentally/emotionally" by the language, it can be construed as abuse; this can be a reportable offense to not only the state BON, but to the Office of Inspector General.

Tweety, BSN, RN · Aug 5, 2007

Good point Siri, it could be considered patient abuse and thus is reportable and serious. Difficult patients such as the one described are just the type to blow it out of proporation and claim mental distress and abuse.

FireStarterRN, BSN, RN · Aug 5, 2007

This is very sad. I've never lost it with a patient, but some patients are so difficult and abusive and nurses are expected to be their whipping boy and handmaiden, catering to their every whim. One misstep like this and you are the bad one, expecially in this age of litigation and with healthcare being just another customer service job. Nevertheless, swearing at a patient is unacceptable and hopefully you'll figure out how to keep from snapping like this.

I find venting at the nurses station to be a good safety valve.

nightmare, RN · Aug 5, 2007

I hope that you have documented all that happened especially abuse from the patient.Are there any other members of staff that this patient has abused,get them to write statements as well.The fact that you lost it ,well it happened and you have to hold up your hand to it but ,if they ( the patient) claim abuse ,you can show that there were circumstances leading up to you losing it.

justavolunteer · Aug 5, 2007

I definitely can't say about specific rules for a state BON & what get's reported, etc. (I'm 'justavolunteer'). The only thing I can say for sure is that I most certainly sympathize with nurses & all the crap they have to put up with these days. What's gotten lost in all the 'customer service' push is any expectation of civility on the part of patients and visitors.

I have been upset by things directed at me by pts. I can manage to mostly dodge difficult pts because I'm 'justavolunteer'. I have often wondered how nurses & CNA's can do their jobs without totally losing it!

Madam, I wish you well in working through this. A big "THANK YOU" to nurses & CNA's everywhere, for what you have to go through sometimes.

miko014 · Aug 5, 2007

I realy hate stuff like this! I mean, they can abuse us all they want, but the minute we lose it and snap back, our jobs are in jeopardy (not saying yours is, just a generalization)...and if the pt decides to be an a** about it, they can claim "mental anguish" and all that crap. I really hope you documented everything he said to you, with quotes!!! If you did, it will probably save you, because I don't know how they can expect you to be a sweet little angel while being verbally abused by pts. Still not okay to cuss 'em out (no matter how bad we want to, lol), but I know that you didn't meant to swear at them.

I have never yelled at or swore at a pt, but I have walked out of rooms (and sworn ABOUT pts in the break room, lol!). It's really hard not to "fight back". I have had to say, "You obviously don't need me in the room right now, so I'm going to leave. I will be back when you calm down." I've only had to do that a few times, but it has always worked out so far. I have had to tell pts that they need to treat me and the rest of the staff with respect and point out that we treat them that way, so it's only fair. Sometimes it works. But if a pt is not confused, and they swear at me, I will not stay in the room with them, and I tell them that. And chart what they said to me.

It sounds like you are taking all the right steps...good luck!

hemome79 · Aug 5, 2007

I just recently had an incident with an elderly gentleman that needs attitude adjustment. I finally told him in a diplomatic way that if he did not treat me with some respect I would no longer accept his inappropriate behavior. If there is any way to get the nurse floor manager or social worker to speak with patient that is always helpful to get a third party involved. Just keep your head up and know that you are a great nurse and you are also HUMAN.

Hang in there.

Trauma Columnist · Aug 5, 2007

There is probably little to do now to remedy this situation. It seems as though getting counseling and some anger management classes would be the right direction. What your superiors and the BON (if they get involved) will be looking for is making sure that this type of incident won't be repeated.