nurse's rights when patients are verbally abusive...do we have any?

  1. A few weekends ago I had a patient and her family that was so incredibly rude to me. Lied on me, threatened to sue me and the hospital, told her mother to call the TV news station, and was screaming at the very top of her lungs...all for dilaudid. It was frustrating, embarassing and humiliating. I just stood there and took it, because if I really said what I wanted I would've been sent home, or worse fired. I was in deep, family coming at me from every angle all in my face. I held it together. I have a great job, and I need to stay employed. I did get apologies from the patient and her family eventually for the way they acted, which meant absolutely nothing to me.

    I decided right then and there that I would have some self respect and stand up for myself. If this patient is assigned to me again, I will refuse to be her nurse. I will not take that kind of abuse again, I don't give a rat's butt about the flimsy apology, or the drama queen fake tears. I'm not a person who really holds grudges, but I'll be damned if you treat me like that twice.
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    About proud nurse, BSN, RN

    Joined: Jun '12; Posts: 561; Likes: 1,192

    19 Comments

  3. by   Altra
    It's tough - you're only human.

    But when things escalate to that point, you need to just get out of the room and not stand there and let the behavior continue to escalate. Get your charge nurse involved. DO NOT engage them verbally - you are the professional in this situation. Sometimes people are pushed way beyond their normal limits by the stress of the situation ... and sometimes the behavior is pretty much their par for the course. Some people are manipulative addicts. Some people are just jerks, every day of the week.

    I'd recommend trying to let this go -- it's an unnecessary emotional burden on you to carry around the weight of feeling victimized. Hope you can talk this out with a trusted charge nurse or mentor.

    {{hugs}}
  4. by   AJJKRN
    Does your facility have a reporting system for adverse events like when someone codes or has a med error? If it does and when you feel the conflict is warranted then write it up and tell your side factually and professionally within 24 hours of the event. I have not done this often but I do think this helps CYA when patient relations gets involved because the family is complaining. For the record, I have not ever been followed up with on any report I have ever made but I think reporting your side of the story may help "fill-in" the blanks for your facility just as you would for a code event. ((HUGS
  5. by   jadelpn
    The first time a patient or family starts threatening lawsuits and the like, is when I go and get the house supervisor to speak with them. (or the charge nurse). Sometimes with over the top patients, team nursing is the best approach.

    I would most definately note all of the interactions with this patient--chart it. I would also see about an order for behavioral health, case management, and even pain clinic. And not knowing all of the details, I would also see about a weaning program with the MD, as well as a narcotic withdrawal scale if appropriate.

    That this behavior is inappropriate is an issue. That it is due to the demanding of pain meds inappropriately is another. You have to remember this is not a personal affront. This is not an emabarrasment and humiliation of YOU, but really for the patient and family!! And the enabling family, at that. If family is "in your face" then the house supervisor needs to intervene to ask them to leave, one person in at a time--because if they can not have respect for the other patients, then they need to not be on the floor.
    DO NOT INTERNALIZE THIS! To decline the assignment based on how you are treated by them is a thought, however, that leaves a team-mate to deal. Why not tag team this patient? (And hopefully, because it was a few weeks ago, the patient is gone now).

    However, this doesn't excuse yelling and screaming. If pain continues to be an issue, then I would certainly be sure there's other pain meds on board. (Right now, I can offer you Ibuprofen....) and if a fit entails, again, get your charge and/or house supervisor involved.

    As a nurse, you can only make suggestions to the MD on where to go from here, get someone higher on the totem pole to go in and intervene, get the MD directly involved if needed. Apparently, the current plan of care is not working. So it needs to be amended and added to with multiple disciplines.
    Last edit by jadelpn on Sep 10, '13
  6. by   loriangel14
    Where I work you would call security and the manager.There is no need to put up with abuse from anyone.
  7. by   NicuGal
    Get your charge nurse, do not engage them when they are shouting. If she/ he can't stop it then you go up to supervisor and then security to escort the family out. Inhave found, over many years as a charge nurse, that patients (parents) tend to escalate faster when family is egging it on. Remove that factor and many times it calms down.
  8. by   proud nurse
    Thanks everyone.
  9. by   redhead_NURSE98!
    I don't get paid enough to be put in fear by a patient or anyone, and my license is too valuable to put it in jeopardy by trying to work while being screamed at. Visitors are invitees on the premises, have no "right" to be there and can be asked to leave if they cannot calm themselves. They are a distraction and a safety issue - I cannot ensure proper assessment, treatment, med administration when there are people screaming and making butts of themselves while I'm trying to work. I will tell them that I'm not here to get yelled and screamed at and tell them I'll come back when they can make their needs known in a calm manner. I call security whenever I ask someone to lower their voice and they don't. I call security when I feel threatened. I have never had management so much as blink at me for the decisions I've made in these situations over three years of working a med surg floor. If management won't back you up on these things start looking for other work!
  10. by   xoemmylouox
    I had a family member threaten me once. He was a police officer and implied he could figure out who I was and where I lived if he wanted to. I didn't tolerate that nonsense a minute longer. Involve your charge manager or whoever is your support person on the unit.
  11. by   LadyFree28
    I agree with everyone's posts


    I have been threatened numerous times in my career:

    -one person told me that they would kill me because I wouldn't give him medical advice over the phone for a bee sting...after his tantrum, he showed up in the ER the next day.

    -one person threatened that he would bash my head so hard against the wall so hard he wanted to see my brains. He was mid level Alzheimer's and he walks into a female room. That was hard, but I stood my ground and he was reoriented to his room. I had to advocate for that woman...she was scared.

    I've had racial slurs spewed at me, attempts to spit on me, attempted sexual aggression...I could go on...however, whenever something was escalated, I stood my ground, and documented so well that management never had an issue for me. If I needed security, I got them...I have refused pts, and I remember a pt making an allegation against me that management knew I didn't do, I removed myself from that situation to the point that I never did anything else for her; my point was, if I harmed you, then you can't even ask for my help ; management supported me with this-they understood the point I was trying to make.

    Most of the time, standing my ground has made patients and families realize they CANNOT go THERE with me.

    You did great OP. Nurse on... (((HUGS)))
  12. by   LorenRobertson
    Just home from a terrible night...was slapped at, cursed, and the patient (who is alert and oriented and knows what she is doing) grabbed the hand that I held out to help her to stand up and transfer, grab my hand and arm and yanked it as hard as she could. It hurt my back and shoulder. This same patient has attempted to hurt me and many staff members many times. I missed work for the back injury I got when she tried to drop to the floor as we were transferring her (2 nurses). I don't find any articles outside of this site that tells me what my rights as a nurse are regarding abuse towards nurses. Now if I had intentionally injured the patient, I would be in bad trouble, possibly arrested, loss of job and put my BSN RN license in jeopardy. But we constantly get hit, pulled on and verbally abused by our patients that we take care of. I can be very understanding and patient, and am good at de-escalating aggressive patients. But my ? is, do we as nurses have any rights at all when it comes to patients abusing us? All I feel like I can do is report it and document well. Take another staff with me, but as you all know, staff keeps getting cut, and the patients we get seem to be more unstable (mentally and physically). Thanks for any suggestions or link to sites.
  13. by   Esme12
    Welcome to AN! I am so sorry.....

    Most states have some legislation these days...updated May, 2013
    50 State Survey Criminal Laws Protecting Health Professionals

    Some of these laws unfortunately apply to emergency personnel only, EMT/paramedics and not all of them include nurses in the emergency room. The problem being hospitals don't pursue them and file charges because it "looks bad".

    Workplace Violence - American Nurses Association

    I caution you however...I have witnessed the persecution of a nurse who wha assaulted in a workplace setting....Charlene Richardson....who has fought bravely and tirelessly for this cause....and she worked at a union facility.

    July 15, 2009 For hospital worker, nurse-assault bill was long time coming

    By Stacie N. Galang
    BOSTON — Life changed completely for Charlene Richardson the day she was brutally assaulted by a patient she was treating in the emergency room of Beverly Hospital.
    "I don't think I'll ever be the same," she said.
    Richardson was one of about 40 hospital nurses at the Statehouse yesterday afternoon showing support for a bill that would make assaulting a health care worker on duty a specific crime with its own set of penalties.
    Since she was assaulted in March 2003, the registered nurse has spent her time advocating for a law that would support her and other nurses while they help patients.
    Richardson hopes an existing law that protects emergency medical technicians against assault from patients would be extended to protect others, including nurses.
    "Why can't we have the same thing for nurses?" she asked. "The commonwealth needs to look at that. For six years, I've been asking them to look at that."
    Essex County District Attorney Jonathan Blodgett spoke briefly yesterday to the Joint Committee on the Judiciary, which heard testimony on behalf of the bill. He told the panel that nurses can be "spit at, punched and kicked."

    Follow the link and read all her stories....https://www.google.com/search?q=char...ient=firefox-a
  14. by   redhead_NURSE98!
    Quote from LorenRobertson
    Just home from a terrible night...was slapped at, cursed, and the patient (who is alert and oriented and knows what she is doing) grabbed the hand that I held out to help her to stand up and transfer, grab my hand and arm and yanked it as hard as she could. It hurt my back and shoulder. This same patient has attempted to hurt me and many staff members many times. I missed work for the back injury I got when she tried to drop to the floor as we were transferring her (2 nurses). I don't find any articles outside of this site that tells me what my rights as a nurse are regarding abuse towards nurses. Now if I had intentionally injured the patient, I would be in bad trouble, possibly arrested, loss of job and put my BSN RN license in jeopardy. But we constantly get hit, pulled on and verbally abused by our patients that we take care of. I can be very understanding and patient, and am good at de-escalating aggressive patients. But my ? is, do we as nurses have any rights at all when it comes to patients abusing us? All I feel like I can do is report it and document well. Take another staff with me, but as you all know, staff keeps getting cut, and the patients we get seem to be more unstable (mentally and physically). Thanks for any suggestions or link to sites.
    What kind of facility is this? Can she be sent to another facility or discharged? That is ridiculous. I hope you filed another incident report and, if she injured you, another workers' comp claim. Corporations only know loss of $$ as a risk. They don't care about you or any of their other employees' backs or health, since you are expendable and easily replaceable. And this is an assault regardless of whether you're a healthcare worker or not. Healthcare workers are still human and all humans can be assaulted. I'd consider calling the police to file a report. Maybe a friendly visit from Mr. Policeman will make the patient or your facility reconsider their actions. I wouldn't help her in that manner anymore either. If she's strong enough to jerk someone's arm she's strong enough to help herself up or find another means of getting up.

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