Verbal abuse ... what are my rights?

[KHT]

So, I work in a facility where it's not uncommon to have patients who are confused and aggressive - out of psych issues or other diagnoses where aggression is an expected stage of their disease process. Sometimes, they're cranky or aggressive because they're seekers and you're not getting them their much needed "pain" med.

However, this latest patient is a whole new ballgame for many of us on the unit. Quadriplegic - so completely dependent for all activities of daily care. BUT, he is verbally abusive ... you F'n nurse, hurry your F'n ass in here when I call, F you! (racial slur here and there), and he goes on for 45 minutes that he eats up of your time "fixing" his position because he dictates every minute detail. I'm at a loss as to how to deal with this .. if it's coming from a confused patient, that's one thing but this is draining when it is coming from someone who is completely oriented and knows exactly what he is doing! 45 minutes each time repositioning is required is also a problem because it takes me away from my other patients who can go downhill very quickly but I wouldn't know it.

The charges, nurse manager, supervisors, head nursing office, all know about this patient because he calls them incessantly when things don't go his way. BUT he is allowed to continue this behavior. I'm dreading the next time I go in and find that I'm assigned to him!

[Kaylight, MSN]

On the psyche ward this type of behavior earns a removal of grounds privileges. It does him no good to cater to his foul behavior. Remember your Skinner, folks. He don't do what you want he either gets no reward or a "punishment". He does what you want, he gets a reward. Not saying he's a pigeon or anything, but this type of thing work wonders on the psyche ward along with loads of Ativan and Haldol.

[nursesunny, ASN, BSN, MSN, LPN, RN]

That was what I loved about the hospital I worked at. The surgeons on our floor backed their nurses and would shut down verbal abuse of any kind quick. They would let the patient know that it was unacceptable and if it continued they would be discharged.

I feel for this guy, he has no control over anything. BUT you can be frustrated without being degrading. Racial slurs. Nope. I would refuse the patient. You shouldn't have to endure that.

Document.

Administrative discharge...

[FullGlass, BSN, MSN, NP]

Request a psych consult. This patient may have an underlying psych issue and he may do better in a psychiatric facility. It's worth a shot.

[Kooky Korky, BSN, RN]

I'm not a nurse yet but maybe you should put on some dance music and dance in front of him show him moves he will never be capable of.

(don't do this :))

stay in school

[Kooky Korky, BSN, RN]

Is the pt getting much in the way of therapy? Is whatever physical strength he might have being utilized? It is absolute hell being dependent when you are used to being self-reliant or if you were born with limitations of your independence and haven't reconciled yourself to the facts. It is easier for some people

to do this than others, I imagine. And it is something that has to be done often, not just OK, I'm reconciled and it's done.

Still, you must make clear to this patient that you will not tolerate being called names or cursed or anything other than courteous behavior.

Psych consult, talk to his doctor, get him to move to a state with legal euthanasia/assisted suicide, get him some legal grass, have him taught how to use a

mouth stick to paint, turn on the ball game, talk to him about his interests (do you know what they are?), do as others have suggested about walking out if

he is rude. Maybe a visit from clergy would help?

Your managers and Admin are jerks for not helping the staff by setting some limits for this guy. He will be happier, too, once he's reined in somewhat.

Remember Lieutenant Dan from "Forrest Gump"?

Good luck and God bless.

[AlwaysLearning247, BSN]

If he called me a "f'n nurse" I think I would have been inclined to say to him "I'm sorry, my name isn't F'n Nurse. I'll go find F'n Nurse for you." I'd leave for a short period of time and ignore his yelling/call light. Then I'd go back in all apologetic about not being able to find "F'n Nurse" and that he would have to settle for me. Rinse and repeat.

Hahaha yes!

[missmollie, ADN, BSN, RN]

This person has lost his ability to do anything for himself. If that were me, I'd be pissed. This isn't an issue of him lashing out at you, this is an issue of him coming to terms with his grief at his loss and inability to care for himself, and attempting to have some control.

he tells you to hurry up, that's what he would've done when he could use his legs

He tells you he needs it now, he'd get it if he could

He has an itch he literally can't scratch, it might be gone by the time you get in the room, but it was there, he can feel, and this is hell for him.

Every single quad I've had has asked me to kill them, and I work in neurosurgery so I see more than I'd like. Think about being so helpless that you can't even wipe yourself, pee on your own, bathe or scratch an itch. Imagine the hell of being poked, not able to move, but able to feel it.

Get over yourself. You have it so good, your patient does not. This is a stage of grief he has to work through. In my opinion, be glad he's not a clicker, and try to talk to him. Tell him how much time you have, and draw that line, but understand this is going to take some patience.

TLDR: Don't whine about having to use your legs and arms to help someone without that ability. ffs.

[missmollie, ADN, BSN, RN]

Also, if he gets verbally abusive, tell him that is not appropriate and leave the room. He'll learn, and he will behave better. But let him vent when he needs to.

Other great things to do:

1. bring in your ipad/iphone/android. If you have an audible book, a podcast, music, something he can mentally engage with, that will help. He's bored out of his mind. Give him something to look forward to. I often bring in my 2nd amazon echo for these patients with the ability to speak. Suddenly they can play what THEY like by voice. It makes all the difference. It's about control, which they have none and see an opportunity with nursing staff. Give him another option.

2. Music when you are bathing. I always ask any patient what kind of music they like, and I play it for them. Takes the stress and embarrassment out of being bathed by nurses. Makes the mood light. Give him some options.

[linda darveau]

Send this to ZDOGMD

[CapeCodMermaid, RN]

Not to minimize this but at least it's an acute care setting so you know eventually he'll be leaving. Imagine working in a SNF where people like this are there for years. I'd get the doctor involved as well as social services.

[GeminiNurse29]

Sounds like the type of patients that would get sent to our Geri psych ward...at least there, we could medicate them, seclude if they were an immediate danger to self or others, and could send them to a more secure unit if behavioral and safety issues persisted.

People have given some great ideas. Just remember not to take anything personally or let him push your buttons.

[Ruas61, BSN, RN]

Get over yourself. You have it so good, your patient does not. This is a stage of grief he has to work through. In my opinion, be glad he's not a clicker, and try to talk to him. Tell him how much time you have, and draw that line, but understand this is going to take some patience.

TLDR: Don't whine about having to use your legs and arms to help someone without that ability. ffs.

Wow, I think you should heed your own words.

The text speak as your last words for profanity is a really classy touch to support your point.,

Yes, he has a lot to be pissed about and is entitled to be angry , I get that but that doesn't give him carte blanche.

Does he have the right to spit, bite along with his verbal outbursts?

He needs help and you have offered some advice but belittling the original poster accomplishes what?