Verbally Abusing a Nurse

Flatline, BSN, RN · Nov 30, 2018

What would you like to see administration do? What would be the punishment for the patient? Were you reprimanded by the administration or was the lack of patient punishment the concern?

macawake, MSN · Nov 30, 2018

People come in totally alert and oriented demanding things we cant give , yell, scream, call you names.

I'm sorry that's happened to you. Some patients, well some people, are just plain rude and obnoxious. Being hospitalized is, as I'm sure you agree, of course stressful and sometimes people behave out of character due to that stress, but some folks are ****s 24/7. It's kind of their default position.

Then when you call security because they refuse to be transferred to another floor and are carrying on abusing the NA's have the nerve to file a complaint for having security called on them.

How come you called security? Did you feel like you or some other member of staff or patient, were in physical danger? If the patient was "merely" being rude and loud, with no risk of physical escalation that you'd identified, I don't really see what security could do that you yourself couldn't have done.

I'm assuming/hoping that security aren't allowed to forcibly transfer the patient to the other floor, so what did you think they'd bring to the table? If a person is agitated already, bringing in "the uniforms" will likely just trigger/escalate them further in my opinion. If you did fear for your or someone else's physical safety, then I do think calling security was warranted.

Of course the patient advocate is kissing thier butt like they had every right to act like a tantrum throwing child.

That kind of sounds like it's in the patient advocate's job description. Perhaps kissing their derriere is a bit above and beyond, but I wouldn't expect them to admonish or "chastise" the patients.

It drives me crazy when Administration basically tells patients it's ok to abuse your nurse.

What does "basically tells" mean? Have they actually said outright that you should tolerate abuse from alert and oriented patients, or are you interpreting their lack of support when it happens, as tacit approval or acceptance of the patient's behavior?

But my question is WHERE IS THE STAFF SUPPORT? WHY ARENT THEY LETTING THE PATIENTS KNOW ITS UNACCEPTABLE TO ACT THIS WAY IN THE HOSPITAL?! It makes me sick.

Personally, I've never felt that management finds abuse of nurses or any other hospital staff, acceptable. It's been my experience that they have my back in that regard. Granted, I'm a nurse in another country, and we don't think of patients as customers. That may be a factor, but I do think that the main reason for not being expected to tolerate abuse, is that I signal very clearly that I don't accept it.

Alert and oriented patients don't yell at me very often and almost never calls me names. On the few occasions that it has happened, I've addressed it head on. I'll just tell them that I realize that situation x, y or z is causing them stress and I'll be happy to help solve the problem if it's in my power to do so. But in order for that to happen, they need to calm down and start acting their age. (Well, I wouldn't phrase it exactly like that because calling a person a child is a surefire way to escalate things, but I usually get through to them).

I tell them that I'm there to help them, but I'm not their emotional punching bag. I must look like I mean it, because it works. If they're not on drugs or suffering from some disease process that affects their self-control, they always stop with the abusive behavior. I've never gotten in trouble despite being very direct, and perhaps even blunt in some cases.

I don't know exactly who you mean when you say "administration", but have you told them about how you perceive your job situation and that you don't feel like they support you when it comes to abusive patients, and what you'd like to see change?

Do you know for certain how they'd react, if you were to tell a patient who's clearly abusing you verbally, that they need to stop that behavior because it's an unacceptable way to address you or any member of staff? Are you clear with your patients regarding what you expect of them?

It's seldom defensible or justifiable to be rude to patients, but I don't see how anyone could fault you for standing up for yourself and asking that you be treated with basic civility.

Best wishes!

Hk30 · Nov 30, 2018

Anytime a patient is being out of line verbally abusing staff or calling staff names getting rowdy yelling and threatening you in the hospital you absolutely should call security for everyone's safety patient and staff. The fact that noone has talked to the patient about thier actions and how it wont be accepted in the hospital is BS. It's just annoying that instead of having that talk with the pt they reward the behavior with kissing thier butt. In that way I feel they leave staff open for continuous abuse by not saying hey it's not ok to act like this and it wont be accepted.

Hk30 · Nov 30, 2018

You are so lucky you are not a nurse in the US they have turned our hospitals into hotels where patients can be on thier worst behavior and do whatever they like to you with no consequence. Part of the reason I am leaving the bedside.

macawake, MSN · Nov 30, 2018

Anytime a patient is being out of line verbally abusing staff or calling staff names getting rowdy yelling and threatening you in the hospital you absolutely should call security for everyone's safety patient and staff.

I can't comment on the specific situation that you described which is why I asked for clarification regarding some of the details. Speaking generally though, we'll have to agree to disagree, that security should be called every time a patient is verbally abusive. Speaking only for myself, I know which situations I can handle myself and probably better than security staff, and which situations warrant their presence.

The fact that noone has talked to the patient about thier actions and how it wont be accepted in the hospital is BS. It's just annoying that instead of having that talk with the pt they reward the behavior with kissing thier butt. In that way I feel they leave staff open for continuous abuse by not saying hey it's not ok to act like this and it wont be accepted.

I understand that part, but what I asked you is if you ever tell patients that you don't accept being addressed that way.

I can't tell you how you should act in every situation you find yourself in because a threat assessment needs to made in each individual situation, but what I can tell you is that my ability to speak up for myself, means that my need for someone else to speak up for me, significantly decreases. You do actually have a say in how other people treat you.

Emergent, RN · Nov 30, 2018

Sometimes, calling security can escalate a situation. It's always best to give the patient a way to save face. Often, if I am calm and matter of fact, I'll get an apology next time I enter the room.

Anyone who works customer service has experienced people having a bad day. Some are always rude and others are under a lot of stress and reached a breaking point.

I'm normally pretty laid back, but there are those occasions where I've been been a cranky or irate customer. The manager of the store did a good job of smoothing things over. I usually, then, thank them and go home and take a nap or eat. If they called security, that would have probably not gone well.

Golden_RN, MSN · Nov 30, 2018

What about saying something like, "I won't allow you to talk to me that way. I am leaving the room now but I will return when you are not yelling"? Saying something along those lines allows you to set limits. A mentor of mine taught me this tactic. I know it is not quite that simple in real life, but it can be another tool in your bag to use with abusive people.

Hk30 · Nov 30, 2018

I'm obviously not talking about a run if the mill jerky person which you could as a nurse say hey that type of behavior wont be tolerated and def not saying everytime you should call them. I think it's interesting other nurses would rather try to reason with an irrational person than to protect themselves and your ancillary staff from an unruly patient. Guess that's why the numbers of nurse and hospital staff abuse are so high in this country and why it's so accepted by the people who run the hospital.

Neats, BSN · Nov 30, 2018

I am fair, firm and consistent, with staff and patient and out in my community.

If I was on the floor today I would not survive, and here is why. I do not take abuse-verbal or physical in any form.

If a patient is getting upset I pause and when they take a pause, I get my chance to say I see that this situation is upsetting you, I will come back when we are able to discuss the situation in a calm manner. I then would leave the room/area. I am not running away I am setting boundaries, my boundaries. This is why I would fail because my star rating would be in the toilet flushing down all the time. I am no ones maid. I am a professional with professional duties. I am not a peacekeeper, they have staff for that.

Hk30 · Nov 30, 2018

What would you like to see administration do? What would be the punishment for the patient? Were you reprimanded by the administration or was the lack of patient punishment the concern?

Not a punishment but at least have someone make it clear that the behavior will not be tolerated or some sort of changes in policy. I wasnt repremanded. The lack of saying hey, this isnt appropriate behavior from administration who actually have power to make a difference is what is bothering me. Because it's not just this one patient it is continuously the case.

psu_213, BSN, RN · Nov 30, 2018

Then when you call security because they refuse to be transferred to another floor

Makes me grateful that at my hospital, one of the written pt responsibilities is that the patient will "accept their room assignment." Refusing transfer is not an option.