Miserable Patient

[hemome79]

I have been working at a facility where I see the same patients very often a week. I have one particular elderly gentleman who constantly complains about EVERYTHING. For almost a year I have listened to him and along with complaining he verbally is nasty and not appropriate. I finally told him that I was not going to listen to his griping and complaining any longer and he was no longer allowed to treat me with disrespect or i would get another nurse to take care of him. Has anyone ran into this and how did you handle it?

[CaLLaCoDe, BSN, RN]

I believe you handled his rude behavior well with a statement to tweek his sense that acting mean and inappropriate is OK and to be tolerated.

[jojotoo, RN]

Why did you wait so long to tell him?

[Ms Kylee]

Gee, I had one like this for the past 3 weeks.... last time this patient acted out with me, I said "have a nice evening, and I'll see you tomorrow." The next day, I went into the room to get a blood sugar and I got an aplogy for "being so difficult." This patient has been through a lot, including a life changing major surgery. I walked over and took a hand said very quietly that I learned a lot from her, and that I understood if she was scared. She started to cry and told me she was scared because of this surgery. I sat with her for about 15 minutes while she cried and passed out tissues. She was discharged yesterday, and on the way out, she saw me in the hall and yelled "Bye Hon". I went over to her and gave her a hug and wished her good luck, and she started to cry a bit again. With this patient I learned that being mean was a coverup for fear. I'm glad I took the time to talk with her even while I was dodging bullets and verbal beatups.

[Tweety, BSN, RN]

Sounds like you handled it appropriately.

Often we can get to the bottom of their anger, which is sometimes just fear based. But we do have to set limits on inappropriate behavior.

[VivaLasViejas, ASN, RN]

What Tweety said.

I might add that it helps to think about WHY this patient is so miserable. He may have had a hard life and is having an even harder old age. He may be in a lot of physical and emotional pain, and being nasty is his way of coping. He may also just be an SOB, and there's nothing whatsoever you can do about that. The trick is not to take any of it personally---he is lashing out at whatever is making him angry, and you happen to be standing there. That doesn't mean it's OK, or that you can't set limits; in fact, the only way to stop it (or at least reduce the number of incidences) is to be firm, but kind, in stating that you will not be treated that way.

It sounds to me like you did the right thing; now, you need to be consistent about enforcing it. Complaining is OK, but if he starts attacking you verbally, make sure his physical and safety needs are met, then tell him you're leaving the room and that he can put on his call light when he's ready to discuss things in a more respectful tone. Unless he suffers from significant dementia, he will probably get the message after only a few rounds of this treatment; I'd also involve your nurse manager and the other nurses and aides on the unit so that everyone's on the same page; this may even need to be integrated into his care plan if the behavior continues.

[jamonit]

i always say, "Mr. Smith, I am here to help you. I treat you with respect and I expect the same in return."

i REFUSE to let patients or doctors to treat me disrespectfully. in the future don't allow this to occur and stay the status quo. as nurses, we are professionals and as humans we have the right to ask for respect. if more nurses would set these boundaries with all parties involved, i think nursing would be in a much better place.