Sydney Johannson, a 67-year-old man, was admitted to the medical/surgical unit 3 days ago for unresolved nausea, vomiting, and jaundice. A tumor was discovered in his bile duct, and he is scheduled for surgery tomorrow. His probable diagnosis is cancer.
You have been the primary RN caregiver for Mr. Johannson the past 3 days. He is short tempered and verbally abusive to you. He barks orders at you, ridicules almost everything you say, and is never satisfied with the care you give him. You realize that he is sick and frightened, but his behavior is frustrating and obnoxious. You find yourself avoiding going into his room just to avoid his verbal backlash. Today, when you enter his room to adjust his IV and give him his routinely scheduled medications, he makes several derogatory comments about your ethnicity and taunts you about looking like “an overstuffed pillow” and moving “slower than a snail.”
Instructions:
Read the Scenario above, and then answer the questions below:
What is the source of this conflict?
Answer the following questions concerning the scenario: Decide how you will respond. Is conflict avoidance justified since the patient is sick? Are other conflict resolution strategies more appropriate? Is bullying by a patient any more acceptable than bullying by coworkers? Role play with your peers how you might respond to this patient and what if any limits, you might set in terms of his behavior. How much control do you have over the patient’s behavior?
What is your bottom line in terms of behavior you will accept from this patient?
Write in APA format, include references
Sample Answer
Analysis of Patient Verbal Abuse and Conflict Resolution in Healthcare
Source of the Conflict
The core source of the conflict with Mr. Johannson is a complex intersection of needs-based conflict and displaced aggression stemming from his clinical and psychological state.
Fear and Loss of Control (Needs-Based Conflict): At 67, Mr. Johannson is facing an acute medical crisis (unresolved symptoms) culminating in a probable cancer diagnosis and impending surgery. Illness and hospitalization represent a massive loss of autonomy and control. His short temper and need to "bark orders" serve as a maladaptive coping mechanism to reassert control in an environment where he feels helpless and vulnerable. His underlying emotional need is for security, respect, and control, which he is expressing through demanding and aggressive behavior.
Physiological Distress and Anxiety: Jaundice, nausea, and vomiting contribute to irritability, fatigue, and pain, lowering his emotional threshold for frustration. High pre-surgical anxiety further compounds this psychological distress, manifesting as displaced anger toward his most consistent, yet non-threatening, interaction point: the primary nurse.
Value/Identity Conflict (Discrimination): The shift from general abuse (ridiculing care, slow movement) to making derogatory comments about the nurse's ethnicity and appearance constitutes a critical escalation into harassment and discrimination. This type of abuse moves the conflict beyond patient frustration and introduces an ethical violation that is fundamentally incompatible with the nurse's right to a safe workplace and professional dignity.
Response and Conflict Resolution St