What JBUDD said!
you've stated you've been doing this a few years, so I'm thinking, in the nicest of ways that you're missing out on some of the skills of limit setting that your peers have, ASK for ideas.
It's so situational dependent that I could give you 10 ways to handle a screaming patient, and unless I was right there with you, I couldn't read it right. does that make sense??
sometimes I'll simply stand there hands at my sides, blank look, let them finish, then let a loooong ackward silence ensue, then say, "are you ready to discuss why you're here and what I can do for you?"
-"you're obviously angry what is the first thing you'd like me to address?"
-"I can tell by the tone in your voice that you're upset, this is what we've planned, let me explain and tell me what you think"
-"When you raise your voice and shout, it's difficult to hear what you're really upset about, tell me in one calm sentence what you need FIRST"
-"when you're able to calm yourself and speak rationally, I'll be in a better position to meet your needs, use the call bell when you're ready and I'll be into assist you. (then really do walk out, even though they protest)"
-"profanity is not an acceptable way of speaking your needs or to me, are you able to say what you need and not be insulting, because I'm willing to wait until you are!"
-"yelling is only upsetting the other sick patients here and making their wait as lousy as yours, it will not speed up your wait or resolve the issue, spoken very softly, almost hard to hear.
when someone is yelling, speak softer, so they have to stop and listen.
When the patient or family calms, thank them, THEN you can be empathetic, I'm sorry you've waited, and it will be longer, how can I make you more comfortable while you wait.
there are hundreds more, just again, situational dependent. try a few out, and again, ask your peers!