Management needs to step in

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I work on a very busy telemetry unit. Most of our patients are hospitalized for a few days or they are made GMF. For the last 10 days we have had an extremely demanding and rude patient on out unit. He has been very inappropriate with our staff. He has made comments about nurses hair and breast. He is refusing male nurses and requested that we wash his testicles. Not an entire bed bath, but specifically his testicles. Today he called me a fat ass and remunded me he was the patient after I would not give him more Klonipin than the MD ordered. He is a 48 year old bed bound nursing home patient who the docs have started on Ritalin due to his manipulative behavior.

So here is my question: is it okay that I suggested that my manager should discuss with him that his actions toward the staff have been inappropriate and that his lack of respect are intolerable.

The staff is starting to avoid him now. As wrong as it is; it is human nature. So he calls the nurses station from his bedside phone.

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I wouldn't just get management to talk to him, I'd get someone from security to talk to him. :)

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And ask for a psych consult :eek:

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I've dealt with an jackwagon like him in the past. My solution? I took another CNA, who is an ex Drill Sargeant, in with me to do care on him. J basically 'splained to the patient what would and would NOT fly on his shift. The patient was a complete saint after J "talked" to him.

I can send J your way to help out.

If your management team is anything like mine, nada will be done. I would hope they would do something.

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Like above, I've found that if there's a man around to do the "special" care, it cuts off the requests. He can refuse, but there's "Sorry then, nobody else is available."

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Specializes in APRN, FNP-C, Newborn nursery.
I work on a very busy telemetry unit. Most of our patients are hospitalized for a few days or they are made GMF. For the last 10 days we have had an extremely demanding and rude patient on out unit. He has been very inappropriate with our staff. He has made comments about nurses hair and breast. He is refusing male nurses and requested that we wash his testicles. Not an entire bed bath, but specifically his testicles. Today he called me a fat ass and remunded me he was the patient after I would not give him more Klonipin than the MD ordered. He is a 48 year old bed bound nursing home patient who the docs have started on Ritalin due to his manipulative behavior.

So here is my question: is it okay that I suggested that my manager should discuss with him that his actions toward the staff have been inappropriate and that his lack of respect are intolerable.

The staff is starting to avoid him now. As wrong as it is; it is human nature. So he calls the nurses station from his bedside phone.

yes totally appropriate for you to ask your manager for support. esp if you have confronted the pt on his inappropriate behavior!

He is the patient, but you are the trained professional that uses the appropriate judgement on when to and when not to administer medications. safety first. If he's not satisfied with the care he is receiving then you can tell him he does not have to stay at the hospital. he can leave at any time. it might be against medical advice, but he can go.

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I think I like my mother's way of handling guys like him (back in the day). One guy was flashing all the nurses and this upset them. My mom went in to deal with him and he flashed her. She looked at it and told him that what he had was nothing to brag about and that there was a guy down the hall who happened to have an accident that paralyzed him from waist down...she then told him that THIS guy is hung like a horse when flaccid...now THAT was something to brag about.

He never flashed another nurse.

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Psych consult, definetely. And if he is in fact mentally ill, I would not take what he says personally, as it may be a manisfestation of his mental illness. And it may be that he is enjoying egging everyone on. I would set firm limits. "Absolutely inappropiate. If you are upset by my care, the most appropriate response would be ....." --it may sound weird, but in a firm and low tone....and then "when you are ready to be appropriate, ring for me, and I will return." I would set him up to wash himself, and tell him to call when he is done. The little you "feed" into this behavior, the better. If those interventions (which I am sure you will document well) and patient education (again documented) do not work (and I would go to manger and tell her that this behavior is happening and your plans to try and manage it) I would have his MD have a conversation with him on his plan of care. All in all, firm, low tone, polite, and he can do this stuff himself, and meds that he is not due for "MD ordered them this way, end of story, this is not debate-able with me".

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Yeah...I take care of these types in LTC. As a resident...they have all the rights in the world, but treating us like that isn't one of them.

We would get a behavior contract or care plan set up right fast. When he behaves in a certain way there will be consequences...nurses will leave the room and he won't get the care he needs. He knows he is inappropriate.

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Specializes in OB, Med/Surg, Ortho, ICU.
Yeah...I take care of these types in LTC. As a resident...they have all the rights in the world, but treating us like that isn't one of them.

We would get a behavior contract or care plan set up right fast. When he behaves in a certain way there will be consequences...nurses will leave the room and he won't get the care he needs. He knows he is inappropriate.

This is how I deal with them, too. I also state that there will be the only one caring for him (if possible) so there is none of the, "well, the other nurse said I could," behavior. I just love manipulating the manipulators (cue maniacal laughter).

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Specializes in geriatrics, IV, Nurse management.
Yeah...I take care of these types in LTC. As a resident...they have all the rights in the world, but treating us like that isn't one of them.

We would get a behavior contract or care plan set up right fast. When he behaves in a certain way there will be consequences...nurses will leave the room and he won't get the care he needs. He knows he is inappropriate.

Sadly my management makes us feel like that as well. All the rights in the world, mistreating staff, but oh look dollar signs in their eyes.

I also agree with Michelle that he knows he is inappropriate and if management will not help you, I would call him out on it each time he does so. As others above have said, "This is inappropriate and I will return when you are ready to behave in an appropriate manner".

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Specializes in Med/Surg.

Agree with what all the poster's have previously stated. Including have a male staff member if available provide his "bath". Also on our unit they try to assign those patients to male staff members to avoid conflict. Having security talk to him probably is not a bad idea.

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