Dealing with abusive behavior

I was in burns unit as my elective placement and I was treating a guy with bilateral leg burns due to explosion of the oven. Upon subjective and objective assessment, he has normal knees and ankles range and pain at the burn site has been well managed by pain medication. During the first week of his admission, he has been doing daily phyiso treatment with me or the other physio staff there in order to maintain normal ROM and muscle length and he has been cooperative, compliant and keen to the exercise program being given.

The weekend passed, and upon my return on Monday, and I saw this patient again. When I walked in his room (single bed room with air lock) and asked him to go to the gym for exercise, initially the patient refused the treatment because he said he has extreme pain, at that time I thought he just didn’t want to go because all burns patients will compliant of pain. Then I explained to him the importance of keep doing exercise and asked him go to the gym. Then he became angry and abusive and started swearing at me. I initially felt really shocked and frightened because I never deal with this kind of situation before, but I stay calmed and listened and did not take it personally. He started crying afterward so I comforted him and calmed him down and let him to express his frustration. At the end I reported this incident to my supervising physio and she agreed my reaction to this incident.

On my self reflection, I think I will handle this kind of situation better if it happens again. Firstly, I think I should liaise with the nursing staff to gather information about patients so that I will know how well they are before I see them. If I know the patient becomes abusive I will not see him alone but with another physio staff to ensure personal safety. Also active listening to the patient and notice the non-verbal language, I think that will give me an idea of the emotional status of the patient and prevent the patient from going into abusive stage. More importantly, this incident gave me a lesson that I should explain things more detail and discuss the goal with the patient so the patient will know the expectations as well as increasing their motivation for treatment.