R.N. Q&A #5: I have a highly abusive patient

Nurse Life Coaching

Dear Robb,

I'm a home health nurse and I'm struggling. I have a highly abusive client. She is rude, calls me horrible names, and refuses to let me lift her properly. She's fully aware of what she's doing (no dementia). I'm so frustrated. No matter how nice I am she's still mean as the Dickens. Any advice on how to win her over? 

Thanks, Sarah

Dear Sarah,

This sounds like a tough situation! Of course your first task is safety, and I would go through all of your protocols to ensure the care you are providing is safe, both for your client as well as yourself. 

But from a coaching perspective, one issue I see is that your question is "how can I win her over". I'd suggest that you have no control over what she thinks of you, or how she chooses to act, so if that is what you are focusing on, you are likely to remain very frustrated and helpless. You'll be happy if she is nice, you'll be frustrated when she isn't. But you can't make her be nice, you can't make her like you. With that goal, you have empowered her instead of you over how you feel at work. You will try X, and then wait and see if that works to get her to like you. Then you will try Y, and wait to see if that works. You are the one doing all the work, and she is in control over whether you succeed or fail.

What would happen if instead you focused on you, and what you want out of this relationship? If your goal is to like your job, or to be an excellent caregiver, or to know you have tried everything possible to establish rapport - those are things that are under your control. Whether she responds or changes - or not - has no effect on how you achieve these goals. As long as you are focused on yourself you are likely to be a lot more successful. Because then it won't matter what she does, you can always respond as you need to in order to protect yourself (as well as her) as is required to get the job done in a safe and professional manner.

Remember, her choices are not about you, they are all about her. Maybe she is sick, maybe she is hurting, maybe she is just mean. Whatever the reason, don’t personalize her behavior. Kudos to you for being a person who is trying to help her, despite herself. And maybe the gift she is giving you is the realization that you are a badass who can deal with anything. Nursing is hard, BUT YOU CAN DO HARD THINGS.


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