How much Verbal Abuse should a nurse take from a PATIENT?

donmurray · Jan 10, 2002

Hands up! I did come over a bit strongly! Sorry! The UK health service has been running a "Zero Tolerance" campaign for some time now, and managers are slowly waking up to the idea that they need to do something to protect their staff. Most are barely aware of their legal responsibilities, possibly because their staff (us) dont insist on their rights, or even know them. It is now taking central directives from the management executive to remind everyone.

Lots of info at http://www.nhs.uk/zerotolerance/intro/htm

Whisper · Jan 11, 2002

The Zero tolernace policy is also in effect at the hospital I was just on placement at, and It was a lot better than before. I can remember being hit with walking sticks, and having cups of tea thrown at me when I was on Trident work experience in a residential care home. (I was only sixteen then) and very scared, and bruised!! But the staff just accepted it as common place, and basicaly told me to get over it.

This time as a student nurse, I was injured by a patient, but by accident, I was walking with a patient, and she gripped my hand too tight and broke my finger. It was an accident so I didn't want to make an issue of it, but the staff were all really supportive, and very apologetic that I had to be sent to A&E, to meet with the local policies:rolleyes:

I can cope really well with verbal abuse, especially insults, I just turn around and say thankyou... That usually leaves them doing an impression of a fish, and gives my ears time to relax before they spy their next target.

KARRN3 · Jan 11, 2002

WHAT WOULD MAKE YOU THINK THAT YOU HAVE TO PUT UP WITH THIS MAN'S ABUSE.DOCUMENT HIS WORDS AND ACTIONS TO JUSTIFY WHY YOU WON'T GO THERE ANY LONGER AND I WOULD CONSIDER LEGAL ACTION FOR THE BATTERY HE COMMITTED.ACTIONS AND BEHAVIORS THAT AREN'T ACCEPTED ANYWHERE ELSE, DON'T ALL OF A SUDDEN BECOME OK BECAUSE THEY ARE DIRECTED AT A NURSE. YOU DON'T HAVE TO TAKE IT.

leesonlpn · Jan 22, 2002

I know! Iknow! she said as she eagerly put her hand up in the air, frantically waving and jomping up and down in her seat, hoping the teacher would call upon her and give her permission to share her wisdom.

His diagnosis is cerebral fecal impaction with secondary penilewithering.

thisnurse · Jan 22, 2002

i would beat her unconscious and say she fell down the steps

ERNurse752, RN · Feb 12, 2002

How about a Dx of rectal-cranial inversion?

In the ER, it usually goes something like this:

Pt: "*&^%$***@#%^$$@^@#%!!!!!!!!!!!!!!!!!!!"

RN: "Why hello Mr. Security Guard...this pt is being verbally abusive and belligerant. Can you help me?"

Security: "Oh really? If you yell at this nice nurse one more time, or touch her, you're going to jail."

hehe...seriously though, I agree with what everyone else has said here. We can't tolerate that kind of behavior from anybody, no matter who they are, or how much money they have. Nobody deserves that kind of disrespect.

pebbles, BSN, RN · Feb 13, 2002

What pisses me off even worse is when we have an abusive senior citizen on the ward. He gets to sit in his wheelchair and yell things at us - and many of the staff laugh it off. "aww, dirty old man, isn't he cute!".

In that circumstance, I feel like I have no support whatsoever for percieving his comments as abusive. Getting called an asshole is abuse, no matter who says it or why. I'm not saying I'd lay blame on some demented old patient - but that still doesn't mean that *it's my job* to take that kind of crap.

Teshiee · Feb 13, 2002

thisnurse you are crazy ahahahah my words exactly. I was working with a demented patient and she socked me dead in the mouth it took everything for me not roll her a** out of that bed but I had to realize she was a nut ball and I was a nurse. I agree with most of you document as much as possible, unfortunately nothing is done. I work with a resident who was so racist, she would yell out racial slurs, the CNA'S refused to care for her. When I address the problem to the administrator he tells me that I am being unprofessional and that we are nurses. I told him I was not here to be abused, needless to say I end up quitting I was not going to be in a situation where I would end up losing my license because even though we are professional we are human too.

Tookie · Feb 27, 2002

Night Owl

that was my first thought also - we are continually dealing with residents and clients in both our residential facilites (nursing homes and Hostels)and out in the community.

(In Australia the nursing homes have higher catergories of care ie more dependent and therefore frailer and need of extensive care- our Hostels are lower care - however this is changing as there really is a bed shortage in aged care within our country - let alone a nursing shortage and crises. Hostels have increasingly higher dependency residnts)

We also have community packages and such - this delivers hostel ie lower care to the client in their own home)

Anyway l guess the point l am thinking about here with out offending anyone is that if the person to whom you are taking this service is demented or dementing then maybe we need to be addressing some interventions and stategies that may reduce his abuse and then he will get his required care and you wont be abused.

I thoughly agree with all the above about documenting his behavoiur- but l also think we need to research why -

Is it dementia or what other reason could there be? -options -

Just trying to be an alternative thought

I guess too becuse we deal continually with residents behvoiurs and 'aggression' within our dementia units at my place of work - we teach our staff and students who come on placement - we try and listen to the music and not the words. Our staff learn to recognise potential behaviours and we try to interpret 'aggressive behavoiur' as reactive behavoiur. - l wont go on because l am sure theres been many a discussion about dementia and alzhiemers on this site

As l said before not trying to provoke anything with my thoughts except thought itself

Billsisbeth - - yes document be objective at all times and tell what happened, when and why - also look for the triggers that set him off - l am not indicating blame here. Subjective reporting needs to have the emotions removed before they can become objective.

Good luck - hope this makes sense

Tookie :)

mother/babyRN, RN · Mar 2, 2002

Absolutely none. NO ONE should have to take it. If the approach of "Please address me as you wish to be addressed coupled with no other options are on the table" doesn't work, it isn't worth it.

And, it isn't right. Period.

mother/babyRN, RN · Mar 2, 2002

To clarify, I am speaking about patients or clients ( can't get comfortable calling patients, clients) who are alert and oriented.....

Tookie · Mar 2, 2002

Hi there mother/baby RN

I agree with your point about people who are alert and orientated -

the original post from billssabeth (hope l have the name right)

didnt actually give a diagnosis - so l am still wondering if there is a cognitive reason for his behaviour -

Quote

'I have just started a new home health care case. My client is a well to do person and treats the other nurses and myself like DIRT... Constant verbal abuse is a norm from this client.

We have been called the "w" word for prostitute, the "s" word for loose woman, the "B" word for female dog and worse.

the last shift I worked this client pulled my hair, slapped at me, sniped, spit and was totally "with it" during every episode.

This client's tounge is like a two sided razor and I'm needing advice on how to Doctument the abuse with out being personal, catty or unprofessional.'

I can understand her and everyone else's defensive reaction - however if the person concerned is dementing, confused or reacting to a situation out of his control then maybe as l have questioned before there maybe interventions that need to be in place before attending to him

This could include the history of the person prior to visiting him provided by your agency/employer and a list of interventions as to how to handle this abuse - as well as what possible reaction to you entering his home you may expect -

I question - is he the person who is doing the employing or is it a family member who can no longer cope or an agency or ? - not sure how your system works over there

( this leads me to a set of questions l will ask in another forum about terminolgy and abbreviations when l have time to put together a question list)

Anyway my original thought re his ability to understand who is caring for him l believe is relevant as to how we judge his verbal abuse and the subsequent reporting - is the abuse personal or general - is he abusive to all - then we get back to the documenting what we have seen heard and observedas well as experienced - not in a subjective but an objective manner.

Just some thoughts - dont mean to 'set the cat amongst the pigeons' so as to speak.

Tookie