Verbal Abuse...I Gave What I Got...

emtb2rn, BSN, RN, EMT-B · Jul 16, 2012

Assault on hospital staff is a felony in my state. I explain that in very simple direct terns to non-psych pts & families. Usually works, if not, I call security.

Can't fix stupid. And it sounds like that includes the charge.

caliotter3 · Jul 16, 2012

When I speak back to the client using the same or similar tone to them that they are directing toward me, it is usually not long before they call my agency and I am out of a job. I have come to just assume that this will happen at X point in time, anyway, with or without, any less than pleasant conversations. I do not find it amusing that I am dealt with for the behavior exhibited by the patient and/or the patient's family. If the employer backed up their employees once in awhile, perhaps there would be a better workplace atmosphere all the way around.

MN-Nurse, ASN, RN · Jul 16, 2012

Has anyone ever snapped while on the job? After all of the verbal abuse has anyone ever just gave back to the patient what they give to us? I did last night...all the threads I've searched no one has ever said they as the nurse responded aggressively..

Usually, responding with aggression just escalates the situation and doesn't do any good. That's why you don't hear about it too often.

In certain situations, though, it works. Quite well. I've seen the "****** off mother" tone work quite well in some cases of agitation and confusion.

ecerrn · Jul 16, 2012

Hhmmmm, not so hot, but it happens. Two wrongs don't make a right. I try (hard sometimes) to remember, they are on that side of the stretcher and alot of people think they are bleeding to death...as long as you can hear him...you know he's not! A Dr told me something I carry with me, remember not to take anything they say or do personally, they don't want to be there, they may be off their meds, or needing meds, or they do want to be there, if they weren't sick and miserable they might be nice people. But! Just the fact that he -took an ambulance, with his mother screams PYSCH! To me....for a minor nosebleed?

amygarside · Jul 16, 2012

Although I might not have reacted the way you did, I do understand why you responded that way.

lcornett007 · Jul 16, 2012

abundantjoy07-

How long have you been in the ER? Have you had any recent life changes? The reason I ask is because I have been in the ER for three years, two at a level 1 trauma center and one year at a level 4 trauma center. I entered the ER straight out of nursing school, and worked in the ER while in nursing school as well. I have a 6 month old son and he is my world. I had a situation in my ER with a patient probably about a month ago. I was already contemplating getting out of the ER, but this situation confirmed it. The patient had a low cognitive level, history of seizures, psych, etc....his mother was with him. The first thing the mother said when I walked in the room with a smile and introduction is, "Where is the doctor? This is ridiculous, we need a doctor in here NOW." I stayed calm, as she obviously was not, she was being a you know what from the get go. Her son was there for dizziness and an anxiety attack. In the meantime we had a pedi trauma come in and our doc was in there handling that. So I politely told her I would let the doctor know right away and they would be in there as soon as possible. So the doc went in, let me know he put an order in for meds for this patient, I went to pull meds out of the pyxis and I walk towards the room...this patient is on the floor wrestling with security and one of our doctors. The doctor ordered him to be emergently detained....My charge nurse was in there, took control of the situation, stood up for herself and for me, as the patient was holding his fists up to her and the mother was telling us how worthless we all were as nurses. The charge nurse explained to the mother that we cannot just give meds without a doctor's order, and the mother proceeded to tell us that it is our responsbility as nurses to get a doctor into the room. I was absolutely FUMING!!!!! I could have said so many things to her....oh man....but this situation, from the disrespect, to the verbal and physical threats, to the mother calling us WORTHLESS, I have had enough!!!! My charge nurse did stick up for me and I love her for that, because that is what a charge nurse is supposed to do. It sounds like your charge nurse may not have your back, and that is a problem.

But anyways, this situation was the straw that broke the camel's back. I updated my resume, applied for jobs, and acquired a job that is outpatient, M-F, no holidays, minimal call on weekends, etc, less than two weeks later!!! My friends work there and love it. I needed a change...it just took me a while to realize it. Maybe you need a change too and just haven't recognized it yet. I was sick of the verbal assault, the drug seekers, the stress...everything. I found a way lower stress job, and am so excited!! You don't have to put up with it. Don't let working in the ER ruin your outlook on being a nurse. I am sure you are an outstanding nurse. Hope all works out for you!!

imintrouble, BSN, RN · Jul 16, 2012

Nope. I've never yelled at a pt. I've never given back "as good as I got".

I'm not sure what management would do. I need my job too bad to find out.

However, I enjoy reading about those that say no to abuse.

Vicarious works for me.:)

Esme12, ASN, BSN, RN · Jul 16, 2012

Has anyone ever snapped while on the job? After all of the verbal abuse has anyone ever just gave back to the patient what they give to us? I did last night...all the threads I've searched no one has ever said they as the nurse responded aggressively. I'm just curious to hear the responses of others. My charge nurse was allll tooo happy to report it to the director and to tell the family to file their complaint... but when I got in to speak with the director he just said, it happens. Patients are always going to be mad and for me to just go home so I could get rest for work tonight... Really? In the age of customer service and just grin and bear it I expected more.
Just a little background, the 18 year old patient literally thought he was bleeding to death from his nose (vitals stable, no horrible frank bleeding, mainly dried blood from the pressure he was holding) and the doctor wasn't able to see him in 5 minutes of his arrival...EMS brought him in and he automatically got a room and I guess he thought he was in dire straits. He was also mad because guess what I was in another room and not in his giving him the magic pill he needed. He yelled he needed help now and I straight up told him, you're not dying, keep the pressure on it because it's working, the doctor knows you're here and he will see you soon. He cussed and started throwing stuff, his mother got angry and started getting hostile and I just told her they could either wait for the doctor or they could get up and go to another ER. She got angry and then I really went off...
How on earth can you stay sweet and kind all the time anyway? Sometimes therapeutic touch and all that mess just goes out the window and self-preservation kicks in...

Responding aggressively will not help in any situation. I have worked in hospitals in some pretty rough areas.....while my responses are not always syrupy sweet they are not aggressive.

Telling at someone that they aren't dying and to buck up will only serve to escalate the situation...which it did as he started throwing stuff and not you got his Momma in on the act. Telling them to sit down or leave isn't helpful either and of course the situation deteriorated.

You are lucky your director was understanding. I've seen nurses fired for a lot less.

It is very hard to keep your cool especially on busy nights but engaging the offender is like arguing with a 2 year old in the throws of a tantrum....you aren't going to win. engaging Momma....who obviously hasn't taught her son self control is a recipe for disaster.

When there are drama kings and queens that have learned that acting out will gain them immediate attention it is difficult to not become engaged in a battle. But the battle is futile and you will be the one losing. Here are some tips.......Don't take their behavior personal. Consider the source. Is the risk of being fired worth this situation? Is this patient really worth your time, frustration and energy? In a hundred years will any of this matter? If the answer is no to any of these questions.....keep your frustrastion to yourself. Walk away....go to your charge nurse, or co-worker, and tell them you can not deal with the jerk in room xyz.

My high school drama teacher had something painted alon the cieling of the drama room...

All the World's a Stage by William Shakespeare...

All the world's a stage,
And all the men and women merely players;
They have their exits and their entrances,
And one man in his time plays many parts,

So, for me, I play a part in the play. Act I Scene I...The jerk enters stage right. My character...the calm, serene and patient one who can't be bothered by the trivial wailing of the rabble.

It all a game. On my bucket list....I want to work for one week saying exactly what I have kept inside for 34 years. How satisfying that would be.....sigh with a smile.

Now if they get assaultive and start throwing things......I know the number to 911 and I am not afraid to use it.

"You need to calm down" in my best no nonsense Mommy/authority voice.... :madface: ..and "If you continue the police will be called and you will be escorted off the premises, Mom...you need to calm your son down immediately if he wants to be treated. This is not a bar on a Saturday night there are children and sick people here. If he doesn't want to clam down he will be asked to leave by us or the police." If he doesn't want to play....he can leave. By Police escort, or on his own power. I don't particularly care which but they will be leaving.

Now, have I ever gotten so annoyed that my response was less than therapeutic? Yes.

Have I ever told anyone that if they were so unhappy with their treatment they are welcome to seek a second opinion while holding the AMA papers for them to sign (as well as the elopement/LWBS papers in my pocket? Yes :lol2:

Have I told more than one or two obnoxious drunk/drugged/crazy

patient/person/parent/gang member to lay down, shut their mouth and knock it off? Oh heck yeah!!!! :smokin:

Have I broken up fights in the waiting room with a fire extinguisher? Um.....yes.

But the most threatened I have ever felt was when a father (who was an airline pilot for a major airline) felt his infant daughter wasn't being seen by the EDMD soon enough for a fever (100.1) after immunizations that day held me by my throat demanding the ED MD...was I nice and polite to him in my request to let me go? YOU BET I WASN'T...and he went to jail.

Pick your battles and try to choose only the one's you will win. Above all else....don't let them get under your skin...it really isn't personal. I'm sorry you had such a bad night:hug: and I know it's tempting.....but don't engage the.....malcontents.

I wish you the best.:paw:

That Guy, BSN, RN, EMT-B · Jul 16, 2012

Oh those wonderful pts in the ER that think they are the end of the world. I had a pt like that who wanted me to lance an abcess on her daughters labia with no anesthesia at all. She was mad she had to wait 3 hours for the doctor to come in and numb it up. We flat out told her we had someone dying in the trauma bay and her words "I dont care about them come fix this now". At that point I stepped out told my charge nurse what happened and she looked at me like what the heck.

When it gets to that point that, step back, bring in reinforcements. Stupid people and the ER go hand in hand.

marydc · Jul 16, 2012

After many years in psych I've seen my fair share of verbal abuse. Most of it from patients well aware of their actions and right from wrong.

Though we may be seething inside, I have never responded or witnessed a co worker respond to verbal abuse "aggressively". That doesn't mean we tolerate such behavior, just that we respond with firmness, limit setting, and accountability for actions.

However; when a patient begins threatening and throwing things, they have become a danger to us, and may require aggressive action (emergency medications, restraints, or discharge to police) on our part to ensure safety.

Bottom line, what they say shouldn't be used as an excuse for inappropriate behaviour on our part. We are ultimately responsible for our own actions. Not meaning to sound critical, just answering your original question.

Are-En-Fla · Jul 16, 2012

How on earth do I stay sweet and kind all of the time? My hospital has zero tolerance on "going off" on anyone, regardless of the situation. This includes patients, family, doctors, staff, ANYONE. I would have been fired immediately. That is enough motivation for me to smile, walk away from the situation, ask someone else to help, etc.