upset pt

I've been a nurse for a long time and I've had many patients who have tried my patients. However, I've never had a pt fire me.
About 3 weeks ago, I had a pt. a/ox3, pleasant, up ad lib. The first 9 hrs of shift was great. I tended to pt, provided pain meds, assisted to RR, etc. Everything was great. Suddenly, the pt just started crying hysterically, called a friend, threatened to leave AMA, then said I was a horrible nurse the whole shift. Didn't want me back in the room. Told of staff members complete lies about the care. Thank goodness I had been charting the whole shift on everything. The staff told me to not let it bother me, but how do you not let it bother you? This person was saying things that could have got me in trouble and yet, I did nothing wrong. Plus, why couldn't the pt just have handled it better? Screaming your lungs out is not appropriate. I understand when in hospitals, pt's feel like they have no control over their health, they hurt, are scared, etc. But really? To insult and lie like that about your RN who there to help you and who is bending over backwards to keep you comfortable,safe,healthy? I've spent the last week trying to let it go ,and I should. But, if does bother me. How do you just let it go? I have now changed my whole nursing approach to being almost too nice. I feel like I am becoming a mat and letting some pt's walk over me,because of this one incident.
1. When a previously pleasant patient's head suddenly spins around like the Exorcist ... make sure there's not a medical cause. Blood sugar dropping? Agitation brought on by hypoxia? Neuro event?2. Barring any of that stuff ... you said she had just called a friend. You have no way of knowing what that conversation might have entailed. The patient could be angry about any one of 100 things unrelated to her hospital stay.I have a lot of success redirecting the patient by calmly pointing out that they have been resting comfortably for the last x hours and, "If there is something else going on that is bothering you right now I'm sorry, and I understand that may not be my business, but there is no reason for you to speak to me like that. I'll be back shortly when you've had a few minutes to pull yourself together."3. Continued intent to sign out AMA? No problem - paging the physician now ...4. Take it personally? Why?

Patients don't lie, they have false believes.I'm not trying to be smart, just looking at it a different way.

pts certainly do lie so do their families.

agree with sudden metabolic changes as a possibility. sometimes there's an underlying psych problem. i'm no psych expert but this sounds like our old friend borderline, on accelerants :d. maybe a psych pro can help me out on this. can this happen so fast and hard with borderlines, or is there something else that would?

Mean people just make real ugly sick people. No big surprise.The OP simply misread her pt. It takes awhile, but eventually you can pick the hysterical ones as soon as they get off the elevator.As far as not making it personal, that's tough. An assault is an assault. Physical? No. But verbal and psychological? Yes. I don't give anybody a pass for attacking me just because I'm a nurse. Or it's just a job.I'm trying to work on that.

Quote from nuangel1pts certainly do lie so do their families.

It is usually a mental issue, which your coworkers and manager should have no problem understanding. If I took personally all the crazy stuff I have dealt with with pts I'd be a basket case myself .

I think it depends on the setting. If something is off and a patient is making accusations or insinuating that you are neglecting when in fact you are not, at my facility I would get the social worker so she could investigate. I would stay out of the room until the social worker got back to me. You can never be too careful. Of course we try to handle what we can and try to get as much of an assessment as possible in case it is an acute medical episode. But I would have a CNA with me and then get the social worker.

I could have sworn we worked on the same floor except this was male. He called someone in my presence saying this nurse wants me to do what ive been doing since morning and I will be in here a while (meaning in the hospital). What was i trying to get him to do (ambulate). what had he been doing since morning (going to Bathroom).patients do lie and some of them have nothing wrong with them. Some like it when they are in the hospital as helpless babe and everyone gets to feel sorry for them and they can get out of a lot of stuff

Consider the source, if you've ever had someone complain before- if both point away from you, that's your "answer"

Delirium perhaps? Was it at night? Sundowner s yndrome perhaps?

I so don't miss working in a hospital. I either hated the patients or their families. Something about the hospital really makes otherwise sane people freaking whack jobs.