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What do you do with verbal abuse

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In my facility, there is one particular long term pt who is verbally abusive to me. By the way, Im new to dialysis. He has said some very abusive things to me and I know it started when I requested he leave his access exposed and he told me why he had to do that now that I started. Well to make a long story short, since then he has said some pretty nasty things to me. Management does nothing to say the least because he is a long term pt there 10 years plus. I have gone as far as written in his chart word for word what he has said under cooperation. He will not take a deep breath when assessing him nor be even the least bit polite. I have now gone as far as just asking the required questions and listening to his lungs, heart and assessing for edema as quick as possible. Any suggestions would be appreciated. FYI, I have been a nurse for 10 yrs in a acute care step down unit and changed to this. In acute care, I didnt have to deal with this on an ongoing occurance.

jnette, ASN, EMT-I

Specializes in Hemodialysis, Home Health. Has 10 years experience.

I'm sorry to hear this.

You should expect your clinic mgr./ NM/DON ... whoever... to back you. I'm appalled that he/she is not. :confused:

The patient has responsibilities for his care as well, and compliance in these above mentioned areas are his responsibility.

I would speak directly once again with your NM and ask that he/she sit down with this patient and discuss his responsibilities with him. Explain why it is so important to leave the access exposed and that it is for his OWN safety.

Or , perhaps better yet...you could take a deep breath, and during tx., pull up a stool, sit next to said pt., and have a calm, one on one discussion...

let him know that his behavior has not gone unnoticed and that the two of you need to clear the air. Be polite, kind, yet firm in explaining the importance of HIS OWN SAFETY regarding this issue. Explain that patients have bled to death while having their access covered by a blanket. Explain also that unless he inhales deeply for you, you are not able to assess his lungs, and he is endangering his own self, leaving himself open to a condition you may not be able to pick up on. Explain that you CARE about his well being... that there are very sound reasons for what you ask of him.

These patients have very little left in their lives which they can control........ this may be difficult for him to give up what little control he has left... might seem a trivial thing to him, but when you help him to understand that your concern is his safety and well being, he may end up respecting you more than you think.

If nothing else, he will respect you for the direct communication with him on a personal level.

Give it a shot... what have you got to lose? You have far more to gain. ;)

jnette, ASN, EMT-I

Specializes in Hemodialysis, Home Health. Has 10 years experience.

PS.

As far as any actual verbal abuse, as in personal verbal attacks or cursing, swearing, etc......... I would clearly tell him that this type of behavior will NOT be tolerated... and I would make it clear to your DON as well. If he runs you off, he will do this with every other nurse he decides he doesn't like...

In our clinic that would be referred to the social worker and a contract would be written and they would be required to sign it and it would be discussed with the dr also. If it continued and no one was willing to care this pt they would be forced to find another clinic. Rarely does that happen.

jnette, ASN, EMT-I

Specializes in Hemodialysis, Home Health. Has 10 years experience.

Originally posted by nursefiggy

In our clinic that would be referred to the social worker and a contract would be written and they would be required to sign it and it would be discussed with the dr also. If it continued and no one was willing to care this pt they would be forced to find another clinic. Rarely does that happen.

Same here.

teeituptom, BSN, RN

Specializes in ER, ICU, L&D, OR.

Must be nice, it never happens that way in the ER...

However You can start their saline locks with a 14 or 16 guage cath

However You can start their saline locks with a 14 or 16 guage cath

Sometimes in the back of the hand, I know a 16 will go in a lot of peoples hands!

bob

ktwlpn, LPN, RN

Specializes in Med Surg, Homecare, Hospice.

Originally posted by 2ndCareerRN

Sometimes in the back of the hand, I know a 16 will go in a lot of peoples hands!>quote

Oh, bother!" said Pooh, as he chambered another round!

Build a man a fire and he will be warm for the night...........................Set a man on fire and he will be warm for the rest of his life.

I have always loved the "Pooh" quote but the newer addition to your siggy lines just made me pee my pants.I love it!!!!:roll :kiss :chuckle
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