Patient's "right" to abuse nurses...I need your opinion

[MsNewbee]

Hi, everyone. I'm a year out from graduation and have been working my job so I haven't posted or been on in a while, but a topic came up on the job and it just rubbed me the wrong way. I didn't want to ruffle feathers at the hospital so I decided to turn to my peers on allnurses for guidance.

I recently had a patient that really tried my nerves. I'm a super patient person and she made me question why I chose nursing (which I thought would never happen!). She would ask me for pain medication and as soon as I would leave her room she would be on her light again asking for the same thing. She literally rang her light 15 times in 10 minutes. I counted because I would answer her. She did this everyday for at least 3 hours every morning for the 5 straight days that I had her. She was cognitively intact. She wanted to go smoke outside, but needed staff with her and no sooner that she went outside by herself (while I was with another patient) she broke her wheelchair then demanded that I go with her. I only had 8 other patients to take care of, no big deal right? She complained about everything from the food, to the other staff, to the other patients. Her room was next to the nursing station and she would scream my name down the hall while I was charting because I was in her line of sight. I started hating my name just because of the shrill way she would scream it and she did this constantly. If I left to tend to another patient she would scream my name louder. I could hear her screaming for me while I took lunch breaks. She yelled at other patient's family members as they would passed by her room. I got so frustrated I told her we were human beings that should be treated the way she herself would want to be treated and her behavior was not acceptable. I didn't know what else to do or say to her. Eventually, she hit my tech and started smoking in the room and that's when administration said she had to go on the 5th day with me.

I made a sarcastic comment and said, "Can someone take the light and just put it somewhere, she knows I'm coming." The nurse supervisor who was getting off of work said, "it is her right to abuse you." I just looked at her back as she sauntered off to the elevator with my mouth open because I couldn't believe what she just said. I thought a better response would have been, "she needs to have her call light in case she has a need that hasn't been addressed." or something along those lines, but she was serious. I determined at that moment I would not pick up any more shifts because I was begged to come in that day and that was what I got. I felt like the "higher ups" really didn't care about me or my mental well being.

My question is do patient's have the right to abuse us? Am I just being a baby and should suck it up because this is my life/job now? I am really dreading going in tomorrow. I loved my job until I had this one crummy patient. I woke up crying in the middle of the night on my third day with her because I knew she was going to do this every time I showed up. I was fighting back tears for those 5 days at work and I cried once in my car on my lunch break. How do ya'll keep the fire that inspired you to go into nursing from going out?

Please help, I'm feeling sooooo helpless and drained .

[Roz, RN, BSN, RN]

I've heard the phrase "It's the same no matter where you go." many times. I wonder why we, as a group of professionals, tolerate "the same". Exactly who do patients, their families, and management think will provide complete care if we all decide to quit?

[Steffy44]

No. A patient does not have the right to abuse you and it's not right that your leadership would say that even in jest. Why would they assign the abusive to the person two days in a row let alone 5. That's just inhumane. We have one of those right now. She was discharged and returned within two hours twice now. This is the third admission. The first two were for no reason. No one will take her because she's psychotic. She took great pleasure in calling the nurse every 5-10 minutes for 12 hours. It was horrible. Hospital won't see a dime for this patient either. Uninsured.

[CapeCodMermaid, RN]

No cognitively intact patient has the right to abuse their nurse. End of story.

[AlwaysLearning247, BSN]

Patients absolutely have NO right to abuse staff members. I've actually witnessed doctors kick patients out of the hospital who are rude to staff. If your hospital doesn't support nurses, I wouldn't want to work there. It is NOT your job to go outside with her so she can smoke. When my patients want to smoke I tell them I can get them a nicotine patch but they can't leave the floor. There have been times when I get a doctor's order for patients to leave the floor with a family member, but I never go. I'm sorry you're going through that, but you don't have to take her crap. She's being extremely disrespectful and it's definitely not right for management to let her treat you that way. I have told patients I will come back in the room when they stop being rude to me and other staff members. I have had a manager ask me if I wanted to press charges on a patient for verbal abuse. Good luck!

[Jennh79]

I have experienced this type of behavior at my hospital as well. It's very disheartening. Our patients can smoke but we are not allowed to assist them. Our management does not back us up with these types of patients either. We are expected to just tolerate it because we want good patient satisfaction score. We do usually alternate with the very difficult patients though so that no one has to deal with that continuously.

[logachelle]

Daaaaang, I am a Nursing Supervisor... please tell me she was joking...

[Lisalpn3829]

Patients do not have the right to abuse you. It is best to nip this behavior in the bud from the get go. The first time a patient is abusive, I tell them that "although I understand they are in pain and most likely scared, disrespecting staff is not acceptable. There are other patients on the unit with similar issues and disruptive behavior is unkind." I then become firmer each time the behavior occurs, if it happens 3-4 times I ask the patient what is going on? I doubt you behave this way in real life so tell me what has you so upset that being rude is okay with you.

In 22 years of nursing I have had more than 1 patient whose family says "that's mom/dad, they are rude to everyone. Kill those patients with kindness and don't let them make you do or say something out of character for you. You will never win this argument with management

[Medic/Nurse, BSN, RN]

Another word about the -

GO OUTSIDE TO SMOKE patients.

If they are accompanied, the nurse that takes them to this smoking place is on the bubble for their safety (100%). Be sure and check your policy manual and patient orders.

If there were issues, how would you address them? Say the patient becomes unresponsive, now what? How long will that take?

What if patient burns themselves? Is the nurse responsible? Que the incident report!!!

If the patient smoking area is accessible to traffic, is patient at risk of being hit by a vehicle or otherwise getting in an active traffic pattern. If smoking area is open to other folks, area they general public or inpatients (how do you know another person couldn't give this patient meds? -- not just IV here – easy peasy - I know it's happened).

*** And for those that work in facilities that let the smokers go outside with IV access -- given the world some live in and the prevalence of drug abusers and the number of sentinel events you want in your career is ZERO -- letting folks outside the facility with IV access to do whatever is courting disaster. *** I'm sure there are RISK MANAGERS that prolly think NO BIG DEAL and maybe it's not in some areas. Some places I've worked, leaving the ER or hospital with an IV cath will get you an EMS unit w/ 50 escort sent to you to remove it. Not even kidding.

ON SMOKING

I would NOT do it. I have reactionary asthma (cold/smoke/heavy fragrance/sometimes exercise). Tap out on medical reason if need be.

I also like my nursing license and would intend to keep it instead of risk it over nonsense for no good reason over something with no upside and all risk.

:angel:

[nursejeanette]

I am nearing the end of my career in nursing. I have been a nursing for 42 years. You meet ALL kinds of people as patients....and they WILL test the limits of your patience. You will also see ALL kinds of unacceptable behavior from other staff members, including supervisors. What YOU need to do is know what your facilities rules are, what the state rules and regs are for nursing. You need to be well informed on what is already on the books and in place to protect YOU. This patient sounds like she may have had Borderline Personality Disorder. You do need to be careful, as you don't want your fatique with a patient's poor behavior to ever cloud your judgement...so that you do miss something significant. This is why MOST hospitals trade of difficult and demanding patients to differerent staff members. Document poor behavior as if it is being read in court and you are on the witness stand. Does a patient have a "right" to "abuse" you? This depends on what you consider abuse. I have, during my career, had feces thrown in my mouth, my glasses broken, been thrown into a wall, been choked from behind and been verbally called every name you can think of....many of them quite creative. I have never been able to press charges because these were patients receiving care in the hospital and were considered "ill". Times are changing....so maybe during YOUR career things will change for the better...but right now...they probably, legally can. You can set all the limits possible....but for someone who has always gotten their way with verbal abuse and intimidation of others...your limit setting won't change them. IF your hospital will discharge them, great. Many won't, as they are afraid of lawsuits. Nurses need to demand better treatment for their own.

[Crush]

Patients have absolutely NO right to abuse us.

Exactly. No one has the right to be abusive period. People who cannot or won't behave appropriately and do not participate in their care need to be discharged back home. This is clearly where setting limits comes in and having management have your back.

[Rchr64]

Those kind of pts are HARD, but after a few days, did you speak to your floor mgr/charge nurse or DON? Another way to take it is maybe she trusted you in her messed up kind of way? Did she ever have any family that visited? I have called family members before and asked them to come sit bedside for a while. I'm sorry you had such a stressful time, like all of us would have, but those are few and far between, and think of the people that you are making a difference with. Chin up, straighten up that crown, and don't let 'em get you down!

[MPKH, BSN, RN]

Set boundaries and enforce them. We have a patient similar to yours on our unit-cognitively intact with behavioural issues. We learn to ignore her incessant screaming and name calling, and if she chooses to throw things on the floor, she doesn't get what she wants. We close the door to her room and put her in "time out".

You need to stop catering to your patient's every whim. Ignore the call bell (silent it if you can). Take it away if she's on it excessively. If she wants to go off to smoke, that's on her (at my hospital, patients are allowed to smoke on designated grounds, but it's all on their own power. We are not to assist in any way). She broke the wheelchair? Too bad. And your manager should bill her for a new one if she does it intentionally.

We don't have to be abused.