Inappropriate patient

I had an interesting experience with a patient who was verbally behaving inappropriately. Patient was admitted with exacerbation of asthma and I was seeing him for the first time. Things first felt a little awkward when I was doing subjective assessment on him. In response to my question about his smoking history, he turned the question on me and asked if I did. When I said that I did not he asked why and continued to say that I have to try to know and compared it to sex.

I was extremely disturbed because he said it with a straight face and was staring straight into my eyes waiting for an answer. I looked at him with a dead pan faced and ignored his comment, going on to ask him the next question without a smile on my face, clearly showing my displeasure.

Later into the assessment though, I managed to put aside that awkward situation and build quite a good rapport with him without putting up with any other crude jokes that he made. It also helped that i did not quite understand some of the other inappropriate comments he made although I had an idea that it was inappropriate as the nurses in the room did not look very happy when all the other male patients were laughing.

I spoke to my supervisor about this patient and he offered taking over this patient. However I decided to continue seeing this patient as it was a good learning experience having to deal with such patient. Subsequent sessions with the patient were surprisingly smooth going and he stopped his rude jokes with me and was even very complaint with treatment.

I was caught by surprise as it was the first time I’ve experienced such as situation and did not know how to react. In future I would tell the patient straight that it is an inappropriate comment and that it makes me feel uncomfortable. I struggled with figuring how much I should shrug it off as a joke and allow him to make such comments. I feel that I cannot restrict what he wants to say but at the same time, I did not feel that I had to put up with such comments. Even though i shrugged off his later remarks and that probably contributed to my rapport with him and the cut out of future inappropriate comments, I am not too sure that is the best way to go.