Verbal abuse from a TBI patient

[Crumityk]

I work home health as one of my jobs and I have a client who has a brain injury from asphyxiation. He can hold conversations, he has ok memory. He's also a quad and requires everything done for him. The problem is that sometimes something small can set him off and he will call me everything in the book. "Wh***, Sl**, B****, Stupid, Suck my D***!, Cu**) These are all the colorful words he chooses. He'll then ask me to do something for him right after it I walk away. He'll ask for water, or something like scratching his head, and for a second it feels a little demeaning. I've been in health care for 8 years. A nurse for a year and a half and usually in a situation where I can walk away for a few minutes. I normally dont take these things personally, especially from patients who literally have psych issues, it doesn't get to me. But with someone who still is kinda with it and can hold conversations and a good amount of time is sweet. I notice I take it personal and get upset. I'll tell him " Its not necessary to talk to me that way, I'm just trying to help you" he then explodes even more. It's frustrating and I'm understanding why it's so difficult for this family to keep nurses. I would love advice on how you guys handle these situations. I'm wondering if I should give up this case for my own sanity. Am I being insensitive to his explosions?

[Have Nurse, ADN, RN]

They never gave me any of that info and there is nothing that shows his exact history. I'll try to find out. Thanks for the advice!

Perhaps it is time for a new assignment.

[Workitinurfava, BSN, RN]

Is no one else not seeing this? Is it just you? Does management know about this? On one hand he is "sick" and, due to that some hospitals will find it acceptable. On the other hand the hospital will not want to lose him as a patient, $. It is tricky. When I worked on a cancer floor, I dealt with many patients like him. It is tough. Do yourself a favor despite how you feel, don't confront him in a way that will cause you to lose your job? The patient is worth more than you at the end of the day. Don't take what I am saying the wrong way, please. I mean it in the way of, the hospital is making more off of the patient than you. The hospital is a business.

[meanmaryjean, DNP, RN]

Is no one else not seeing this? Is it just you? Does management know about this? On one hand he is "sick" and, due to that some hospitals will find it acceptable. On the other hand the hospital will not want to lose him as a patient, $. It is tricky. When I worked on a cancer floor, I dealt with many patients like him. It is tough. Do yourself a favor despite how you feel, don't confront him in a way that will cause you to lose your job? The patient is worth more than you at the end of the day. Don't take what I am saying the wrong way, please. I mean it in the way of, the hospital is making more off of the patient than you. The hospital is a business.

He is a home care client and not in a hospital.

[mushyrn, BSN, RN]

If the patient is still mentally with it, I don't care the diagnosis - they are not talking to me like that. I will not allow it and will leave the situation if they won't shut up with that crap. My coworkers know that about me very well.

I would suggest you do NOT allow this behavior to continue if he is "all there".

[Crumityk]

Thanks for all the responses guys! Asking him " Would you like me to walk away and come back in a few minutes when you're more calm?" He immediately takes a breath and says "No I'm calm, I'm calm" . And then we start over. I Still think there's a long way to go though.