Is it okay to tell a patient to not disrespect you

Nurses Relations

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I had a patient who was questioning me and even though I attempted to answer her questions, she wasn't happy with my answers. She told me that I am a terrible nurse and to get out of her room. I said ok I will just don't disrespect me. She flipped out when I said that. Was I out of line to say that? Where I work they stress that pt satisfaction is most important so pts come back to us again

That's the thing I like about healthcare in Canada, it's not about customer service. Either you want to be there to get better and you respect the staff or you simply leave no questions asked. In theory, everyone from a MP to a highschool student gets the same level of care and no one is going to treat you better because you have more money. I would not take verbal/physical abuse lighly I would call code white immediately. I think if nurses band together and have a zero-tolerance policy on verbal/physical abuse in the hospital we'd all improve our working conditions.

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Specializes in Acute Care, Rehab, Palliative.
OhioRn11 said:
What exactly is a code white and what system do you work for that doesn't do customer satisfaction scores?? Customer satisfaction is currently being rammed down our throats and I think is actually more important than patient care right now. I'd love to work for a company that doesn't do satisfaction scores!!

Code white is a violent or aggressive patient.

We are in Canada and our customers aren't always right.Actually we don't have "customers", we have patients.We recently had a patient that decided to make a scene and a code white was called. He backed down after a couple of large security guards showed up as well the ER doc and a couple of dozen other staff.

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Specializes in Pediatric Cardiology.

You could have said it differently but I do think it was important to say. There is no reason a nurse should take verbal abuse, in that case the patient/customer is NOT always right.

I had a patient like this a week or so back. I found fighting with her did nothing, giving her what she wanted (within reason) and keeping my mouth shut kept her out of my hair. I also involved my charge nurse. Some people are just rude and you can't let them get to you.

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I think that the pt telling you you are a terrible nurse then telling you to get out of her room probably felt humiliating and made you feel like you were 3 inches tall, and I think that it was disrespectful and who cares about pt satisfaction scores at that point. If you felt like asking her to not disrespect you at that moment then you were right. I have had to tell people who were demanding things like I was their servant to say please and thank you to me as an expectation and they did not say a word and were polite after that. I would also document any behavior that is out of line under the psychosocial part of the head to toe assessment or make a note in case she makes a complaint. If there are notes from several nurses about a pt's behavior then I think it makes any of their possible complaints less credible.

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Specializes in Critical Care.

One of the best tricks I learned in my psych rotation (that I often use with my husband shhhh lol ) is that when someone is yelling, despite every instinct in your body to yell back and louder that they are a blankety freakin' blank, say what you need to say damn near a whisper. People almost instantly get quiet to hear what you have to say,

And to my experience, nothing is more annoying than trying to argue with someone who won't argue back ?

My personal fave it try to kill them with kindness. (not spineless, natch...) being very quiet, soft spoken and polite is disarming to an aggressive and agitated person. And then once the situation has diffused enough that I can walk away, I curse at them under my breath, my back turned. Because I can't keep my sanity if I don't say what I really think out loud sooner or later.

Just the other day I had a pt with Parkinson and dementia who was stronger than any mere human I'd ever met. He tried to "Put up his dukes", let me know he *knew* I was robbing him, bent my thumb backwards and other various things because he was scared, I suppose. No approach, direct, cutesey, sneaky or silent worked on this man. He wouldn't even let me get close enough to medicate him in a medical emergency, never mind a behavioral emergency. He would scream for "Help, someone let me out of here!", prompting other concerned families to poke their head into the hallways, wondering why no nurse tended to this poor man, urgh

So, I let my charge nurse know, I fully documented in the nurses notes, and I had a tech come in with me every time from that point on. I also called the family and simply let them know I was having some "Aggression" issues today and I think it would be helpful if a grandson or something came and sat with him.

Didn't make anything perfect, but it sure did help

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wanderlustgirl said:
Well that is a rude assumption...

Besides, there is nothing wrong with setting limits. I agree with another poster that verbal abuse doesn't fly at any other job, so it shouldn't in a hospital either.

You're right about setting limits. And I did make an assumption that I have no evidence to back up. My apologies.

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Specializes in Pediatric Critical Care.

I generally (if the patient is safe and stable) will offer to have the charge nurse or manager speak to them. I'm not confrontational enough to say "hey don't disrespect me!"

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Specializes in Cardiology.

I don't think I would ever say, "Don't disrespect me," but you can get that point across by setting limits. It sounds like this woman just didn't trust you for some reason and no amount of limit setting is going to fix that. Sometimes it is best to bring in someone else (charge RN or MD) to see if they have a better rapport and can help the pt feel reassured.

I once had a pt I was so nice to but she just didn't care for me. I had the charge RN speak with her and had someone else pass her meds later that shift. She was being unreasonable, but she was in a vulnerable position and maybe the only control she had all day was firing me. Nothing I took personally.

The only time I have ever really needed to set limits is with some aggressive drug-seekers and dementia patients. I don't take it personally and I don't say it to them in a nasty way, but I will tell confused patients that it is not. okay. for them to touch/hit/yell at/pinch me. They don't always remember that and sometimes just telling them in an even, unemotional tone is enough to stop them.

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Specializes in Psych.

When a pt is that upset its really difficult for them to hear what you're saying. Remaining calm despite the ranting and raving, dropping your voice level down are very important. Set limits and give choices (I need you to stop screaming and cursing. If you can't do that x will happen). Now in my case I work inpt psych, so the "x" in my case would be a trip to the quiet room, which I am sure many of you floor nurses could probably use on a day to day LOL.

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Specializes in ER, progressive care.

I wouldn't have said anything in your situation or would have told them, "I'm sorry you feel that way" and walked out.

I have dealt with a lot of difficult patients in the past. I remember one who was extremely rude to everyone. The patient wanted a bath (and desperately needed one) but again, they were being extremely rude. I finally had enough of it and told them, "I'm willing to help you but I won't until you stop acting that way and start being nice" (the patient was grossly obese and definitely needed help with bathing). I left the towels with them and walked out. Maybe I shouldn't have done that, but the patient's attitude changed after that!

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I think what you said is perfectly ok! Very rarely but occasionally I get a patient who will just lay there cussing up a storm. I quickly remind them that this is a hospital, not a bar and that there behavior will not be tolerated and to cut it out immediately or I WILL call security to deal with there nonsense. I don't care about customer satisfaction scores! My job is to care for their health not be a pinching bag. Not that I don't care about their feelings. I do understand that they are not at their best, but I'm not putting up with that crap.

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I wouldn't get into a "back and forth" with a patient. Especially one who is not going to be happy with any answer you give them. I am fond of the "I am not sure how to answer that question, however, be sure to write it down and ask the doctor when he comes in". There are some patients who like to "fire" their nurse, until they find one who will give them the answers they are seeking. And don't ever hesitate to tell a patient that you answered their questions to the best of your ability, and that you will get your charge nurse who could perhaps explain it more in depth.

Some patients due to condition, stress, lots of things--behave in a way that is less than ideal. So I do tend to give them the benefit of the doubt, and if their mental status warrants it, make the doctor aware of the agitation. It could be the patient is a jerk (and then ask your charge to see if she can handle the questioning) or that the patient has a change in mental status that warrants further investigation (and inform the MD).

It is a reaction when one says "don't disrespect me". Try not to react in that manner. It can just escalate an already tense situation in an A&O patient. If you are dealing with a patient who needs firm limits, that is a story for another thread, but I am talking about a regularly A&O patient.

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