What would you do in this situation????

caliotter3 · Jun 12, 2011

This type of behavior can happen quite often. If you let them run you off when they act like this, you will never keep at the job. Learn to let it go in one ear and out the other. You are right, it is not about you. He is mad at his situation and it is manifesting itself by yelling at you, the easy target. You will get used to this as time goes on.

kiszi, RN · Jun 12, 2011

I do intermittent visits, not shift work, but I have not been verbally abused like that in a year and a half in home care, although I've certainly experienced less severe instances. If it were me, I would let it pass, continue to care for the pt. the best I could, but if it happened again I would refuse the patient. You are under no obligation to take such abuse from a patient, no matter the reason.

arabstarRN · Jun 12, 2011

Yeah I felt really bad because it seemed like I wasn't able to help him, and I was really trying to. He was miserable, frustrated, upset, and I think it had gone on most if not all of the day as at one point, when he was complaining, a member of his family who is with him almost non stop, looked at me like "Oh please help me!". I just kept going about my work and gave him the same care I gave him the night before, because my care shouldnt change because the client cusses me out lol. He finally was able to sleep and while I won't lie, I did pray he would sleep til the end of my shift... but I knew that wasnt possible as he had therapy in the morning... so I had to make sure he was up, dressed, fed, medicated and ready to go for therapy when they came in. He was less than enthusiastic about being up, and I don't blame him. He had a total of 4 hours sleep the whole night.

I understand its his situation, which is why it didnt really upset me that he cussed me out and called me rude names, I know he was frustrated (doesnt make it right to treat those around you like crap, but at the same time, crap rolls down hill and I was his easiest target and the only one awake at 2 am with him lol). I just wondered how more experienced nurses would react or what they would say in the same situation. I never changed my tone with him, I never let on that I was slightly miserable in not being able to help him, I just kept doing what I could and doing my best. I am sure that isn't the last time I will have a patient call me a name or cuss me out... and really, can you blame them for being frustrated and upset and miserable? I cannot... no one deserves what some of the patients nurses see are going through, but all we can do is hope to ease their pain and suffering at least a little bit to try to make their life a little more enjoyable for them and help them recover.

Kyasi · Jun 13, 2011

When I have been in similar situations I usually try to diffuse the situation by saying something like, "Mr.XX I realize that you are upset and I am trying my hardest to help you. Yelling/cussing at me only makes the situation harder for both of us. Can we try this again and if I'm not doing it right, please tell me how to do it differently." In the heat of the moment this may not work. If not, I would probably address it w/him later when he has cooled off. Saying something like, "It was very frustrating for me not to be able to help you when you were having problems breathing yesterday. Is there something I could have done differently? How can I help you next time to avoid your becoming as angry? It's very difficult to assist you when you are yelling and cussing at me." If he doesn't apologize or at least admit that he lost his cool, then you can probably expect the same treatment the next time there is a problem. You will need to decide how much of that are willing to take.

No matter how terrible the patient's situation is, they only make it worse for themselves if they treat their caregivers poorly. Setting boundaries and keeping your cool it the best way to handle it.

As a Nursing Supervisor, I once went to a client home to try to solve an issue and she cussed me out and wouldn't let me get a word in edgewise. She was young and very immature and had a horrific accident that was life changing for her so I understood her anger. Since I was in her home, I let her have her say and didn't even try to argue or discuss the issue, as it would have only aggravated the situation. Several days later, she rolled herself into our office screaming again and demanding to speak to me. I calmly told her that when she was on her own turf, she could speak as she chose, but not when she was on mine. I told her if she couldn't speak to me and treat me with respect, as I treated her when I was in her home, I would call the police and have her escorted out. She continued to scream and I did just that, all the while maintaining my cool. She returned the next day, screaming again and I did the same thing, only this time I closed her case.

If you have tried to solve the problem and it continues, I would talk to your supervisor. Hopefully, she/he will intervene because if the situation isn't resolved, there will be continual staffing issues/difficulties on his case.

Kyasi

HealthyNurse · Jun 15, 2011

You have a right to be treated respectfully, even while you are in the patient's own home. Your agency should have a list of rights and responsibilities in the patient handbook and it should be included as a responsibility of the patient to treat staff respectfully. If it's not, I would make a suggestion to add that to the handbook to upper management. Regardless, you need to set a clear boundary that it is unacceptable to call you names. I would say something like, "I know that you may be very frustrated right now, but please do not ever speak to me like that again. It makes me very uncomfortable. Instead of yelling at me, could you tell me exactly what is bothering you so I can try to help?"

You should also report this incident to your manager. You do not have to put up with that kind of behavior. Your manager may be able to help in making it clear to the patient that it is unacceptable.

Nurse Barb RN · Jun 16, 2011

Actually, you did right. This was not about you and never is in almost all situations. Being treated with respect may seem more important to some than actually doing the care of a patient but I have to ask the question: Would you feel disrespected if this person was a dementia patient, if this person was a combative Alzheimer's patient, if this person was suffering delirium due to a UTI or other infection? Most likely not; you would realize it was his condition/diagnosis that powered the behavior. And truly, you seem to understand that this is the case with this gentleman.

Maybe, as suggested, to bring up his behavior once he has cooled down and discussing it, advocating for yourself (you cannot be meek or wimpy here but firm, understanding and not confrontational) could help. If he acknowledges that sometimes he gets "growly/obstinate and downright mean, maybe you can agree on a phrase that can tone the episode down. (Like, Mister Iverson, it's getting hot in here!) And while you have a set regimen to follow for this patient, and since he can communicate, ask him in the off moments if there is something he likes that you can help him with.

I have been doing home care for six years and now work with a home care agency as a RN. It is not easy to be in the middle of a tirade and not take it personally. Your understanding of what he is going through with his condition and diagnosis will help you overcome this obstacle. And you may well find that once he has gotten used to you, and you keep up the good care, remembering he is a whole person and not just a patient, these tirades will ease off.