I tell my unruly patients from the get go-- I will fight for you, I will bend over backwards for you, I will do everything in my power to help you. What I expect is respect back when I give it to you. I don't want deference, that's not what this is about. Nursing is a partnership entered into by the nurse and patient.
Respect needs to flow both ways. But when my patients mistreat me or other staff members, I remind them of this partnership. Often in the ED we get overdoses, drunks, psychs, or patients who are non compliant with treatments and get sicker as a result.
I am nice as pie at work. I'm a multiple award winning nurse because of this. But I will not tolerate rudeness and disrespect to any team member trying to help.
I will break out the serious nurse voice when the patient becomes agitated and belligerent and inform them I am there to help them. I am not there to hurt them. I am not there to cater to them. I am there to help them heal and recover.
I don't know where this idea that it is ok to treat healthcare workers so badly comes from. But anymore I stopped tolerating it. I won't raise my voice or degrade a patient. But they will get the riot act read to them. "If you want my help, which you obviously do if you came in to the ED today, I strongly advise you reconsider your tone and choice of language with me. I will not tolerate being cursed at, threatened, or insulted. I will not hesitate to contact security. Now, if you want to stop this now, take a second to recollect yourself, I'd be very happy to move forward with caring for you"
Do no harm, but take no sh**. Seriously.