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

Nurses Safety

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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.

HELP!!!!

We can all agree that an incompetent person must be taken care of. I, and possibly others, had the impression throughout this thread that the person was competent, just mean.

My misunderstanding. I took it that she is an elderly lady with an ongoing medical problem that has taken away her mobility and left her at the mercy of strangers who come when they can and not neccessarity when she needs them the most. An elderly woman going through the grieving proccess for the death of her own ability to care for herself.

My mistake, I thought she had emotional problems and was not healthy and able to care for her own needs.

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If you look at it from thier point of view, yes, "we did it to them" No, it doesn't make sense but they are the pt! Remember the grieving proccess?

Ignore their verbal blasts, gees words don't hurt ya.

Learn to duck so you don't become the receiving end of the physical.

Grow up. These people need your understanding not your "I'm here to help you", "you should be grateful I come here" routine.

Nurses catch people at their absolute worst. To expect pts to be gracious and thankful for your presence is to expect them to be healthy, in which case they don't need you!

:imbar i just don't understand this way of thinking dixie. no one expects patients to be gracious and i think all of us have tolerated the verbal abuses. but 'learn to duck'????? what about limit setting? what about not enabling the patient? those are just interventions for the patient but NO ONE should have to be the victim of somone's physical aggressions. it's evident that your feet are firmly planted on this issue but at the same time, you needn't tell op to 'grow up'. some of these debates should be an exercise in civility and measured words.

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:imbar i just don't understand this way of thinking dixie. no one expects patients to be gracious and i think all of us have tolerated the verbal abuses. but 'learn to duck'????? what about limit setting? what about not enabling the patient? those are just interventions for the patient but NO ONE should have to be the victim of somone's physical aggressions. it's evident that your feet are firmly planted on this issue but at the same time, you needn't tell op to 'grow up'. some of these debates should be an exercise in civility and measured words.

The post that I responded to when I said "grow up" was not in response to her objecting to being hit (and other) by a pt but by her attitude that she shouldn't have to subjected to this kind of behavior.

I don't think it's right either, but that's the way it is. That behavior is one of the symptoms that must be treated by the nurse, not something she can complain about and stop with some unknown exterior force. Yes, set limits. I do it every time I go to one kids house. (he's a good foot taller than I am and quite a good handful at 17. Had a heart attack and suffered anoxic brain injury at 14.) Anyway, he has a mouth on him, his favorite is "*****" and he bites. I remind him every visit this behavior in not tolerated. He is alert and oriented, he is "with it"; however, there are extenuating circumstances; that is anoxic brain injury. So, you learn to duck.

We all know when independant people loose their independance they retaliate any way they can. It's not right, but it is humanity. Learn to duck if you are going to last 30 or more years in nursing.

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and yes, anoxic brain injury does have its' own set of implications. but i wouldn't compare that pt. with someone who doesn't have any official dx's to warrant physical abuse. with your teenage pt. there is actual trauma to certain areas of his brain so i do not think he truly has any independent control of these outbursts. but i would never tolerate physical assault from alert and oriented without any further etiologies.

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micro--you're not an idealist, but a sentimentalist. It serves no useful purpose to permit and reward this kind of dysfunctional, physically harmful, and illegal behavior, as many battered people have ultimately discovered.

Great way to put it....

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A few days ago, I had a pt. make a rude comment to me. I IMMEDIATLY told him this would not be tolerated while looking him square in the eyes. I have also seen other nurses say things like, "I will leave the room until you can act civilized, I don't allow this behavior" etc. This is almost always effective. It is important to stop this behavior as soon as it starts so they know they cannot get away with anything. I agree with another poster when they said that the police should be called if the person is physically violent. Also, from what I've read on this board, home health agencies drop patients who either refuse care or are violent. And personally, I would refuse to see this person, my safety is paramount. I think a police report would help an agency decide to drop someone if they were boarderline before.

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the patients need to learn to remain silent when their miranda rights are being read to them. what do you think that if you dont take care of a violent patient that the patient wont get care?? the prisons all have hospitals and nurses to take care of them.:angryfire

the post that i responded to when i said "grow up" was not in response to her objecting to being hit (and other) by a pt but by her attitude that she shouldn't have to subjected to this kind of behavior.

i don't think it's right either, but that's the way it is. that behavior is one of the symptoms that must be treated by the nurse, not something she can complain about and stop with some unknown exterior force. yes, set limits. i do it every time i go to one kids house. (he's a good foot taller than i am and quite a good handful at 17. had a heart attack and suffered anoxic brain injury at 14.) anyway, he has a mouth on him, his favorite is "*****" and he bites. i remind him every visit this behavior in not tolerated. he is alert and oriented, he is "with it"; however, there are extenuating circumstances; that is anoxic brain injury. so, you learn to duck.

we all know when independant people loose their independance they retaliate any way they can. it's not right, but it is humanity. learn to duck if you are going to last 30 or more years in nursing.

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night owl, with all due respect, diagnosis is irrelevant to a situation where an employer is putting an employee at risk. Although it may be a factor in determining the patient's culpability, it is the harm to the nurse that is the problem needing speedy resolution.

With the right diagnosis a patient might not actually have any culpability. I am speaking generally of course.

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Under no circumstances should you tolerate verbal or any abuse from a patient. I guess because they may have $$$$$ doesn't give them the right. I agree with the others document and do an incident report.

I remember talking to a potential home health client and she got very rude with me and I told her right away I am not the nurse for you. The agency called me back and asked what had happened I simply told them she was very rude and nasty and I will not subject myself to that kind behavior when I do not have to. I guess they think nursing is synomonous to abuse! NOT.........

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Under no circumstances should you tolerate verbal or any abuse from a patient. I guess because they may have $$$$$ doesn't give them the right. I agree with the others document and do an incident report.

I remember talking to a potential home health client and she got very rude with me and I told her right away I am not the nurse for you. The agency called me back and asked what had happened I simply told them she was very rude and nasty and I will not subject myself to that kind behavior when I do not have to. I guess they think nursing is synomonous to abuse! NOT.........

My guess would be that I misunderstood the first post. I don't think anyone should "take it" either. but refusing to care for an individual without makeing efforts to restructure their behavior is not quite what I had in mind. I've been a nurse for over 30 years, doesn't make me smarter than anybody else just exposed to a lot more pts. Most of the disagreeable folks can be swayed to be more cooperative. Though I have run into a few that were just hateful old women. (Never ran into a man like that but I am sure they are out there!)

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Dixiedi,

I admire your attitude. While I would document every incident of abuse, speak with the supervisor, and refuse to care for this client without another caregiver present. I would hope that a frank discussion with this client by the supervisor could result in this client being able to receive the care needed.

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my answer to this is NONE u shouldnt have to take any verbal abuse ur there to help them. We have a policy on agressive and verbal abuse in our hospital. Dont u?

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