What can you do in this situation？

First off, you need to chart this kind of behavior. It goes to the patient's state of mind--emotional, psychological state.

Second, with this kind of patient, you need to set firm boundaries. If you need to get as blunt as, "You will not speak to me in this way", then do it. Stand firm on your boundaries and don't let them provoke you to respond in kind. Be the bigger person (as it sounds you probably were).

With regards to your manager, I'd be honest. Explain that there is tension historically between your country and your patient's and that you felt that you were unable to render care to the patient due to the patient's prejudices against you.

I don't take rude patients personally ...especially if they're also being rude to other nurses. I've worked with nurses who refuse to take care of "jerk" patients before, and since I don't get hysterical, they are often reassigned to me. I have to admit that I have it out for those nurses after a while. It's not fair that some of us get every difficult patient because others can't cope with hurt feelings. I also hate the fact that I may have done everything for my existing patient before being forced to switch to a patient who still needs a lot. It's double work for me.

Thanks a million, your guys teach me a lot

We need to remember that most often, the anger and fear is displaced. Many of our patients might say or do inappropriate things, but they aren't well. However, setting firm boundaries is also important. Some people just want to see how far they can go.

I have said, "If you continue to speak that way, I am leaving. I'll be back to check on you when you've cooled off." That usually works. I work LTC, so it isn't an option to ask for re-assignment. I have to find ways to deal with various behaviours.