verbal abuse from patient

[big bang theory]

There is a patient who has been verbally abusive, uncooperative and with lots of complaints.

(He is orientated and with no history of mental illness!)

He has so many odd requests and complaints that sometimes they disturb nursing routines.

As he is having IVABs 4 hourly, I flushed his line with 10mls of saline before the IVABs as charted. And obviously he did not like it. He started yelling, "Hey, it's 5mls!" I politely explained that I was following the order. And another nurse who was with me also told him the same thing. Later, I clarified the order and corrected it to 5mls as the patient wanted.

4 hours later, I went into the patient's room to do the IVABs again. He said, "let me tell you something. You do what I tell you to, bloody monkey. When I say stop, you stop, bloody monkey!" I left the room and another nurse took over.

Beside all of his unrespectful behavior toward nursing staff, calling me a monkey (FYI, I am asian) is personal and against race.

I would like to take this to the next level. (I already let the management know)

If anybody knows what is the procedure, please advise me.

Thanks for reading.

[Scrubby]

I would calmly tell this patient that his behaviour won't be tolerated. I would report this verbal abuse and document every incident in the patients notes.

I strongly advise that you do not enter this patients room alone, always have a witness with you. If management don't like it I would be very firm and insist that you don't feel comfortable with the racist comments and would prefer another nurse present.

[Orange Tree]

He may have no history of mental illness, but his behavior suggests that he's not quite "well". I find patients like this annoying, but easy to shrug off because their comments and demands are so ridiculous.

[tyvin, BSN, RN]

I don't understand why your facility is letting him dictate policy as far as flushing the IV; to me that sounds insane and is only feeding the megalomaniac. As far as being called monkey (LOL) I can't even print some of the stuff I've been called by these elderly please kiss my ring while you drop to your left knee types.

I think you are taking him far too seriously IMO. He's old and in a facility; he's crying for attention and you people are giving him the wrong type by allowing him to dictate policy in regards to medication.

Next time he calls you monkey thank Mr. Gorilla from me and tell him that's Ms. Monkey to you (turn it around). Sounds like he's a long term resident and you...............

[LordErrorProne-RN]

OMG, let me tell something that ull find funny but is a reality where i work. so our ... sub manger .. the person who works under the unit manger, came to our report and sat and listened when we were done she had a little vocal diarrhea and said that what most nurses do a monkey can do... everyone looked at her funny and her reply was when she first started nurseing they threw her in and gave her a book to read, and she is sick of us asking for teaching... soo being called a monkey by a pt would b a compliment but being called a monkey by ur superior thats something

[gymnut]

I would have just laughed and replied:

"So that's why they've been paying me in bananas."

or if I was feeling particularly evil:

"Well let me know if you want me to groom the lice out of your hair."

[Spritenurse1210, BSN, RN]

I had a guy like this before. He actually said that I wasn't doing what he wanted because he was black. (I'm white) I told him that I was following the doctor's orders and the facility's policy as well as the nurse state practice act. I told him that he could have been Martian green for all I cared and that his skin color had no bearing on my standard of care. If he wasn't happy with the doctor's orders that he would have to tell him in the morning (this guy was a known frequent flier who had control issues and I had been calling the hospitalist all night. At one point he said, I'm not changing any more of his orders.) Don't let patients or families push you around like that. Be professional and respectful always. I'd see if the doctor could do a psych consult for him as well. Sounds like he's got a few screws loose anyway. You don't deserve that abuse. Just keep documenting everything and make sure you have someone in the room with you at all times.

[gjwandkids]

I'm so sorry he called you that. What an obscene thing to say. Unfortunately racism still exists, especially among the elderly. Because you are Asian most people don't realize that calling you what he did is equivalent to calling a person of African descent the N-word.

I would report it immediately and let your manager know you want someone else assigned to him.

If having to take that kind of verbal abuse doesn't constitute a hostile work environment I'd like to know what does.

[NotFlo]

Aside from everything else, why on earth would you change the amount of saline you are flushing an IV with becaue the patient demanded it? We flush with 10cc normal saline, period. The patient doesn't have a say in something like that.

[CNABESS]

Well, there is a line everyone must draw and I would say you picked the right place to draw that line. Because you are a nurse does not give anyone the right to abuse you. I deal with the elderly(mostly) and there is so much room for tolerance and forgiveness when you factor in dementia, old fears and notions, but abuse is abuse. If he is mentally stable, he is just nasty and abusive.

In my nursing home we had a temporary patient who was there while his family was away for 3 months. He would throw full unrinals, hit, kick, and constantly threatened the women who cared for him with a "slug to the mouth" . He had hit several. He was completely oriented and had no mental issues, just needed help with ADLs. One morning as I brought him his breakfast he said he was cold and I better do something about it now or he would throw the tray at me. I said "I do not deal with men who threaten me in any way, so You will need to wait for one of the men to help you" (He NEVER threatened or hit a male CNA). I told the charge nurse and that was that. He was sweet as pie to me for the rest of his stay.

I think sometimes we put up with far too much because it is a "caring profession". There are times, though, when you just have to say"No abuse from people who are without excuse!".

[linearthinker, DNP, RN]

Wow. I have taken care of some ******** in my day, but I don't recall anyone that bad. I'd probably ask not to have to take care of him, but if that's not a possibility (it wouldn't be where I work) I'd just ignore it and do the minimum required. Sorry you have to put up with that.

[OldNurseEducator]

Shrug it off. You will never change his behavior and only make yourself more angry and miserable while you are trying to go up the management ladder. Don't let anyone make you feel less of a person. I am sorry he called you a foul name..don't take it so personally. You will learn after time, I hope, to just keep your confidence up and ignore the guy. He's looking to get you rilled up! In my 37 years of nursing and 58 years of living, I've been called lots of mean things. If you were my son or daughter, I'd hope you had enough confidence and self-esteem to shrug it off!