Verbal assault by a pt.

[imintrouble]

I am still reeling over a verbal attack by a geriatric pt last week. Without getting into details, it was probably the worst I've been treated in years. None of it was warranted. His anger was not my fault, I was simply the object available when he blew his stack. I honestly tried to rationalize his behavior, he's scared, he's worried, the bills are piling up, case management talked to him, ........... The one excuse I couldn't give him was confusion. Completely alert person. I tried to defuse the situation, but opening my mouth to speak simply enraged him further. He was old and very sick. That didn't make his attack any less violent or any less painful. What is allowed where you work? How far can you go when a pt is completely out of control, and what they say is every bit as violent as a fist?

[Colorado1]

Wow, there is a lot of anger and bitterness flying around here. Let me see if I can help by adding my two cents worth.

First of all, our profession is exactly that... a profession. With this comes an expectation of a particular demeanor... professionalism. Present yourself in a caring, genuine way that conveys confidence and competence. Make it a personal rule to greet every patient with a handshake and a smile. It will start your shift off on a good foot and you'll be surprised at how much of a difference it makes. And take five minutes to pull up a chair and sit down to talk to your patient about how the day is going. Be an active listener and you can probably diffuse problems before they get out of hand. This can really help both of you. You will learn a lot and your patient will know you are invested. Threatening a patient, doesn't solve or improve anything. Communicate in a way that preserves your dignity, as well as that of your patient.

When you do have a difficult situation, take some slow deep breaths and for heaven's sake don't say or do anything that will make things worse. Contact your shift manager, a patient rep, your department manager, charge nurse, or anyone else who may be able to offer some assistance and insight. If your facility has an on-site social worker that's another great person to utilize.

Keep in mind we don't see patients at their best. Many patients are scared. Their health is declining day-by-day. They have no means to pay for meds and bills. Their doctor isn't giving them enough information in their two minute morning fly by. They may not have the family support they wish they had. They're in an unfamiliar setting with unfamiliar information. They have pain. They are sick.

As nurses, we are here to treat the whole patient- mind, body, and spirit. What we do is important.

[redhead_NURSE98!, ADN, BSN]

You or someone on your floor likely knew she'd be coming to you post-op and likely had a fair idea of when. You kept her waiting FOUR HOURS. You said the hsuband was "bedside", then you said you had to find her a bed. I take it the issue was lack of a PRIVATE room, a preference she had probably made known in advance.

And you think she was not justified to be upset?

Where do you work? You have a lot of empty private rooms lying around, and a department that assigns rooms hours in advance? Personally I don't.

[Ayeloflo]

For me, that kind of thing is my bread and butter, my moment to shine, use my skills.

I get a LOT of that, actually steer it from others to myself.

quote]

[beth66335, BSN, RN]

I've had patients treat me badly both "with it" and not, and I make sure they are safe and tell them I'm leaving until they cool down, but I will be back to check on them soon. Usually works, they cool off and apologize, or if they are altered in some way they have forgotten the whole thing by the time I return. I would do the same thing in any profession, leave so the person can "check" themselves and get their control back...I also tend to get angry back so it helps me keep control as well! Sorry it happened to you and I hope it doesn't happen again for a long time!

[aquaphone]

The interesting part is that they take it out on who they perceive to be weak and unable to retaliate or on who they don't respect - the female nurse. Rarely, by comparison, do they dump on male nurses or on a doctor of either gender.

Korky,

I find your comments about males offensive and sexist, and your comments about doctors are not much better. As a male nurse who was grabbed, pinched, groped, punched in the face and even bitten by a patient during my six years tenure as a nurse, it's clear you don't know what you're talking about. I've also seen doctors threatened and mistreated by patients, especially in the ER. We even had one doctor threatened at gunpoint at my hospital. This is a problem that all healthcare practitioners face, both male and female. Comments like yours only serve to divide us, the practitioners, against an indifferent administration. We all need to come together to fight against workplace assault and violence, not splinter apart on some imaginary fault lines created through gender or class.

At least if you could produce some evidence demonstrating that female nurses are subject to more abuse than males, which of course you cannot, you might have something to go on. Can you show me one study or journal article validating your opinion? Perhaps you should refrain from making baseless sexist and derisive comments about your co-workers.

I stand behind my female co-workers and fellow healthcare practitioners 100 percent.

[Mulan]

This is why it ticks me off when female nurses are on here saying things such as, "well the patient has been through a lot. Surgery is physically and emotionally taxing, they have been waiting for hours for a private room so of course they are going to be upset .... yada yada yada." Well duh! Unfortunately that is not the point. As long as nurses continue to allow themselves to be viewed as weak then these people are going to continue to treat us like crap when we are trying to HELP them recover usually due to some type of chronic condition that they may have been able to avoid if they had practiced a healthy lifestyle.

If a patient gets out of line with me and I feel remotely threatened and they are not suffering from pyschosis, dementia, and some sort of bizarre confusion then I'm not putting up with it. I'd document and call security and the manager because my ability to do my job effectively could be reduced if I am scared for my safety. If I wanted to go to work and knowingly risk getting hurt I would have joined the military ... at least there is hazard pay! Ladies grow a backbone, be firm, and expose these abusers for who and what they are before one of them sends you to your maker.

Exactly, they need to be held accountable.

[TheChair1]

Korky,

I find your comments about males offensive and sexist, and your comments about doctors are not much better. As a male nurse who was grabbed, pinched, groped, punched in the face and even bitten by a patient during my six years tenure as a nurse, it's clear you don't know what you're talking about. I've also seen doctors threatened and mistreated by patients, especially in the ER. We even had one doctor threatened at gunpoint at my hospital. This is a problem that all healthcare practitioners face, both male and female. Comments like yours only serve to divide us, the practitioners, against an indifferent administration. We all need to come together to fight against workplace assault and violence, not splinter apart on some imaginary fault lines created through gender or class.

At least if you could produce some evidence demonstrating that female nurses are subject to more abuse than males, which of course you cannot, you might have something to go on. Can you show me one study or journal article validating your opinion? Perhaps you should refrain from making baseless sexist and derisive comments about your co-workers.

I stand behind my female co-workers and fellow healthcare practitioners 100 percent.

While I understand the point you are trying to make, I am pretty sure the OP was generalizing and one does not need evidence based research to do that but I'm actually interested to know if there is evidence out there because I wouldnt be surprised if women are attacked more often than men in the healthcare arena so I'll be posting if I find anything interesting and peer reviewed.

[wooh, BSN, RN]

I had a patient go off on me once, completely unwarranted and not related to me or my care, but like you I was bearing the brunt of his rage.

I simply said, "You seem very upset, so I'm going to give you a few minutes to calm down. Please use your call light if you need anything in the meantime."

When I returned, the patient apologized and was back to "normal".

Some people apparently see nurses as fodder to take their anger out on. As long as your patient is safe and doesn't warrant your immediate care, I suggest giving them time to calm the eff down.

Best advice. Also the advice to document. Although, I prefer to chart EXACTLY what they say, not just stuff like, "Verbally abusive." Because "verbally abusive" has lots of meanings. The EXACT words, not so much. Besides, once I'm finished charting word for word what they said, I feel better, and it does create entertaining notes for others that get stuck caring for them, so they can better tolerate the rectums when it's their turn.

[aquaphone]

While I understand the point you are trying to make, I am pretty sure the OP was generalizing and one does not need evidence based research to do that but I'm actually interested to know if there is evidence out there because I wouldnt be surprised if women are attacked more often than men in the healthcare arena so I'll be posting if I find anything interesting and peer reviewed.

As far as women being attacked more often than men, there is no way to know unless you're looking at studies. It wouldn't surprise me either. However, just because it wouldn't surprise me doesn't mean it's true. And if it is true, men and physicians being assaulted and verbally abused at work is still a serious problem. Personally I've lost count of the number of times I've been verbally abused. And as for assault, that has happened to me many times as well, so the whole generalization that these things don't happen to men is ridiculous.

Most importantly, like I said, we need to come together as women and men, from all healthcare disciplines, to confront this problem. Making generalizations based about gender without evidence is not helping anything, it's just driving us apart. It's not fair, it's not nice, and it's insensitive.

[SoundofMusic]

OP, it's never "nice" when we, as the closest targets available, are attacked in any way by our patients. Attempting to "talk them down" rarely works. Just let them vent-it's not personal.

Remember your psychology lectures. People admitted to hospital are no longer in charge of their own lives, and the uncertainties that they are experiencing find expression in numerous ways which would normally be unacceptable to them. Regression, aggression, dependence, you will come across all of these coping mechanisms.

My heart goes out to this old gentleman. Please convey my sincere wishes for his recovery.

***********

No, no, no -- MY heart does NOT go out for this gentleman.

He willingly admitted himself to a hospital, or at least agreed w/ the docs or whomever picked his old self up and brought him in. He and all the others who take their crazy CRAP out on nurses do NOT have the right to abuse nurses.

I agree that everyday nurses are told we have to take this bad behavior off of people. It is rationalized, justified, and excused by everyone. NO other profession has to deal with this ...it NEEDS to end.

I am of the opinion that lashing out and treating caregivers like hell for a repeated number of times should earn one a boot out into the street.

Boo hoo, you've lost control. Boo hoo you have to put on a silly hospital gown ...boo hoo you have to eat the hospital food. Boo hoo you don't understand all the treatments, all the meds. If people don't understand and feel afraid, or just need answers, they should be adults and SAY so --not lash out and pitch tantrums like 3 year olds.

I don't do it. Why is this behavior not only excused -- it's REWARDED in our hospitals, and face it, in our society in general!

I had a lady who threw a fit on me recently. I just told her that I didn't find her tone appropriate and got very firm with her. She apologized later. She was really embarrassed, and it turned out she WAS just frightened and overwhelmed ...but at least we were able to talk about it. It was a mild incident ...but I understand the MAJOR incidents, and the abuse. It's frightening, it's nerve wracking .... and it's really undeserved.

But we allow it. We just allow it. If we disallowed it in this society by reasonable means, it WOULD stop. I believe it has a lot to do with the litigeousness of our society. People know they can throw fits and tantrums, and threaten lawsuits ... and we'll all cowtow to it.

Someday, I feel, we will in the end, see an end to this ..but it will be accompanied by a lot more pain and gnashing of teeth than we're seeing now. Just wait until ALL the resources run out ...the resources to pay these ridiculous lawsuits etc. One day it's ALL gonna run out ...and then that's it.

[pedicurn, LPN, RN]

Korky,

I find your comments about males offensive and sexist, and your comments about doctors are not much better. As a male nurse who was grabbed, pinched, groped, punched in the face and even bitten by a patient during my six years tenure as a nurse, it's clear you don't know what you're talking about. I've also seen doctors threatened and mistreated by patients, especially in the ER. We even had one doctor threatened at gunpoint at my hospital. This is a problem that all healthcare practitioners face, both male and female. Comments like yours only serve to divide us, the practitioners, against an indifferent administration. We all need to come together to fight against workplace assault and violence, not splinter apart on some imaginary fault lines created through gender or class.

At least if you could produce some evidence demonstrating that female nurses are subject to more abuse than males, which of course you cannot, you might have something to go on. Can you show me one study or journal article validating your opinion? Perhaps you should refrain from making baseless sexist and derisive comments about your co-workers.

I stand behind my female co-workers and fellow healthcare practitioners 100 percent.

Now if you exclude the demented/insane/delerious/outright criminal ......

- Who gets yelled at by the 30 something alert and oriented 'loss of control' professional females?

- Who is less likely to receive a civil response from the particularly snobby 60 yr old upper income couple who have found themselves in a public hospital ER waiting and waiting ...with a relatively minor issue

- Which gender is referred to as 'the girl' ? I have lost count of the number of snooty p'ts and relatives who have referred to me as

'the girl' ....eg when 'the girl' comes in again we will ask her? or have 'the girl' get you a drink.

- Which gender receives worse verbal abuse from doctors ? Which gender is perceived as weaker and thus easier to unload on???

Non-recognising this issue is offensive to me; as a female.

Females do experience this more than males. It is easily observed. Formal studies would be nice but we can gather enough information via simple observation. I have worked an entire 12 hr shift with a male coworker and have observed him receiving none of the above....whilst I have experienced all of the above in one shift.

Please don't say this issue doesn't exist. That's a disservice to the women who continue to endure this garbage.

Sexism still exists

[aquaphone]

Now if you exclude the demented/insane/delerious/outright criminal ......

- Who gets yelled at by the 30 something alert and oriented 'loss of control' professional females?

- Who is less likely to receive a civil response from the particularly snobby 60 yr old upper income couple who have found themselves in a public hospital ER waiting and waiting ...with a relatively minor issue

- Which gender is referred to as 'the girl' ? I have lost count of the number of snooty p'ts and relatives who have referred to me as

'the girl' ....eg when 'the girl' comes in again we will ask her? or have 'the girl' get you a drink.

- Which gender receives worse verbal abuse from doctors ? Which gender is perceived as weaker and thus easier to unload on???

Non-recognising this issue is offensive to me; as a female.

Females do experience this more than males. It is easily observed. Formal studies would be nice but we can gather enough information via simple observation. I have worked an entire 12 hr shift with a male coworker and have observed him receiving none of the above....whilst I have experienced all of the above in one shift.

Please don't say this issue doesn't exist. That's a disservice to the women who continue to endure this garbage.

Sexism still exists

Pedicurn,

What exactly is a 30 something "loss of control" professional female? Perhaps you can clarify that one.

A "particularly snobby" couple isn't going to give a civil response to anyone, because they are, as you put it "particularly snobby." Particularly snobby people are not nice. If they were, we would call them "particularly polite".

You are correct, men are not usually referred to as "the girl". No, I have not had a patient ask "Can the girl get me something to drink?" in reference to me. I have been called "young man" on several occasions.

Both men and women can be verbally abused by doctors. Residents learn very quickly that female nurses are NOT weaker. Anyone who believes that female nurses are "easier to unload on" is in for a rude awakening and abrupt attitude adjustment. I've seen arrogant doctors cower after getting on the wrong side of certain female nurses. I love it. I've also seen female and male nurses verbally abuse doctors, especially residents, so it goes both ways. There have been times when I've been ashamed of my fellow nurses for the way they talk to doctors and patients.

Suggesting that we don't need evidence or studies to validate behavior is dubious. There is a whole movement towards evidence based practice. Your personal observation was that you worked ONE ENTIRE twelve hour shift with a male nurse and that he didn't receive bad treatment while you did. So based on that ONE shift, you have concluded that it was because he was male and you were female? Is it possible there are some other reasons why he gets along with the doctors and patients better than you? Your personal observation and opinion is not a substitute evidence.

As I said, I stand behind my female co-workers 100 percent. I proudly support the female surgeons, anesthesiologists, nurse practitioners, physician's assistants, charge nurses, nurse managers and staff RN's, and CNAs I work with every day. There are many women who I am glad to say are my role models in the workplace.

Of course sexism still exists. My own mother wanted to be an attorney, but was told by her high school guidance counselor that women didn't do that. She was marching for civil rights before I was born. And now you are labeling me as sexist and offensive to females, and you say that I'm doing a disservice to women? I say workplace abuse and violence is an issue that BOTH male and female nurses frequently face and that we must remain united.