Do you arrest abusive patients?

Specialties Emergency

Published

We are having a debate on and off about whether or not to arrest someone who is abusive in the ED.

Not someone who has assaulted a staff memeber...that's a "no brainer"...bye bye my friend...enjoy your new wardrobe of orange!

I'm talking about those who threaten you or are verbally abusive.

I realize that we would be filling up the jail cells...but the PD should have plenty of room...since they bring IN all those drunks who are "Too drunk to go to jail" anyway...

I'm not sure if it's worth it or not.

Any thoughts...

Amen. I've always wondered why nurses feel they have to put up with abuse that no other profession would tolerate. I understand that we don't see folks at their best in the ER, and I'm willing to put up with more than, say, the person who works at the make-up conter at the local department store. Fear, pain and drugs (legal, illegal and alcohol) can often alter someone's normal perceptions and response.

However, I think it may be part of the whole attitude and culture of nursing which allows us to think it's okay to put up with a variety of abuse. And I'm not talking about just abuse from patients, but from our co-workers, bosses and docs....

I wonder what that is??????

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I wonder what that is??????

Sorry, I meant to say I wonder why that is...

For me it started way back in the seventies in nursing school. We were taught to always stand up when a doctor came into the nurses' station and to offer our chair to him (most docs were male back then, btw). There was a nurse assigned to push a portable chart rack while the doctor made rounds and to stand at the bedside while he examined the patient. There was also a dressing nurse who made rounds with the physician - she pushed a little cart with all kinds of supplies, handed the doc what he needed and pretty much picked up after him (back in those days a nurse was not allowed to do the first dressing change after surgery). I remember docs throwing bloody, nasty dressings on the floor expecting me to pick up after him. I certainly learned my place in a hurry.

I think this whole attitude sets the stage for an enviroment of abuse. There was a book I read a few years back called something like "The Pedagogy of Oppression" which addressed this issue. Despite that title, it was a pretty good (and eye opening) book.

What do y'all think?

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I wonder what that is??????
Sorry, I meant to say I wonder why that is...

For me it started way back in the seventies in nursing school. We were taught to always stand up when a doctor came into the nurses' station and to offer our chair to him (most docs were male back then, btw). There was a nurse assigned to push a portable chart rack while the doctor made rounds and to stand at the bedside while he examined the patient. There was also a dressing nurse who made rounds with the physician - she pushed a little cart with all kinds of supplies, handed the doc what he needed and pretty much picked up after him (back in those days a nurse was not allowed to do the first dressing change after surgery). I remember docs throwing bloody, nasty dressings on the floor expecting me to pick up after him. I certainly learned my place in a hurry.

I think this whole attitude sets the stage for an enviroment of abuse. There was a book I read a few years back called something like "The Pedagogy of Oppression" which addressed this issue. Despite that title, it was a pretty good (and eye opening) book.

What do y'all think?You were taught to to always stand up when a doctor came into the nurses' station and to offer our chair to him. Wow i cant believe thats how it used to be what make doctors so special anyway most of the doctors i met are arrogant and think they know it all.

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Specializes in ER, ICU, L&D, OR.
I'm gonna have to disagree with Dr. Gonzo on this one...but I will allow that it's situational. If the patient's psychotic or disoriented or something, OK. But if they're just an drunken orifice'ole or justa plain old orifice'ole...then yes. Arrest his orifice....with prejudice.

Imagine if you went into Starbuck's and threatend to kill the coffee guy because you had to wait too long for a latte. They'd call the police and you'd go to jail.

Suppose, Dr. Gonzo, you're at your favorite bar and your favorite waitress or bartender is being loudly berated by an angry patron for...say, pouring the wrong drink (or more likely, cutting him off...)? Mightn't you come to your barmaid's aid and twist off said patron's head for such an impoliteness? You would.

You don't shoot the cable guy because he didn't hook up the Spice channel....you just slip him 50 bucks. (imagine how'd that improve wait times in the ER ;)

In effect what you're saying is that you and your co-workers don't deserve the same respect and social courtesy afforded to all other service industry members. Hell, no. It's not like I don't have enough problems without the local Toyota dealer screaming at me because his kid has had a fever all afternoon.

Now, I'm military.....but I have no problem having our unruly non-military customers escorted out of the hospital by SP's into the custody of the local PD. You shouldn't either. My military customers who misbehave are dealt with accordingly as well.

The bottom line is that no, you don't get to be rude and disrespectful and nasty to ER nurses, be it a patient, doctor or other.

ER nurses, you work hard, you deserve respect for saving lives and relieving suffering. Anyone who whines can go to nursing school just like we did and feel free to do it better. Anyone who threatens your life needs to be reported. Lastly, a healthy knowledge of firearms, brightly lit parking lots, unlisted phone numbers, no last names, and safety in numbers needs to be part of every ER nurse's routine.

The Spice channel?????????

Is that about the Spice Girls Ive heard about

Or is it about "Old Spice"

:rotfl: :rotfl: :rotfl:

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I have worked at hospitals that have no security at all...nursing is expected to handle the role.

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Specializes in Rodeo Nursing (Neuro).

In my work as an orderly, I get used as ad hoc security a lot. I've never seen a patient arrested, but some who should have been. Our hospital isn't very proactive about protecting us, though I've been urging co-workers to write incident reports when we are struck, at least. Our Security is ambulatory, but slow. One guard showed up after several of us had wrestled a patient to bed who had been threatening other patients, as well as staff. His contribution was to advise the pt.,"Your nurse is going to give you a shot, now, to calm you down." I nearly smacked him.

My home floor is Neuro/Neurosurg, and it can get pretty physical in the Epilepsy unit, but I don't consider that abuse, since they aren't aware of what's happening in the post-ictal phase. Last such occurence was especially ugly since the patient's parents were in the room--father assisted in restraining him, mother was in tears, and now I'm sure they think we're Bedlam, but no one got hurt. The new nurse on duty didn't faint or quit, either

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See, I think that the situations like Mike was talking about with the neuro pts is just exactly the time security SHOULD get involved. It's a medical problem causing a dangerous situation and should be handled by healthcare providers with assistance from security to keep everyone safe.

The drunks that are brought in who don't have a thing wrong, except their BAL, who swear, swing and threaten...

Bye Bye...

I'm calling PD every time now when one gets abusive.

If they are able to "swear, swing and threaten" I'm guessing that they won't be stopping spontaneous respirations anytime soon...no matter WHAT the BAL!!!

:rolleyes:

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Specializes in ER, ICU, L&D, OR.
See, I think that the situations like Mike was talking about with the neuro pts is just exactly the time security SHOULD get involved. It's a medical problem causing a dangerous situation and should be handled by healthcare providers with assistance from security to keep everyone safe.

The drunks that are brought in who don't have a thing wrong, except their BAL, who swear, swing and threaten...

Bye Bye...

I'm calling PD every time now when one gets abusive.

If they are able to "swear, swing and threaten" I'm guessing that they won't be stopping spontaneous respirations anytime soon...no matter WHAT the BAL!!!

:rolleyes:

But then you get called as a witness and you lose time at work or on the golf course. It really sucks.

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Specializes in ICU, CM, Geriatrics, Management.
The Spice channel?????????... Or is it about "Old Spice"

Tom -- It's a new cable service we're now able to subscribe to here. Part of the "Smell-o-Vision" tier... only an extra $11.99 / month.

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My old facility's secutity had that hand's off approach. They were NOT allowed to TOUCH any patient, period. Well, here I am in the ICU with a 2PC (2 psyc. docs. legally commit them for 24 hours, peroid because they are a danger to self and others). Well, buddy, all 250 lbs of him tears off the tely, is in my face fist raised demanding to leave, security is called and all they can do it stand there pissing their pants??

I give the patient the official wave to the elevator while smiling. !!!!

When the hospital is serious about my safety, I'll be serious about keeping their patient where he needs to be. And I won't be lifting up the near by walker to stirr up trouble either :rotfl:

NOw, have had an impatient, A&Ox3 tell me the SO was waiting for me outside to kick my *** because I wouldn't change vistation. I called the sheriff, pressed charges against both. The sheriff, came explained to the patient, who then sincerely groveled. I held my charges, the patient was arrested at discharge, I appeared at court, and the patient convicted.

Meanwhile, hospital admin got involved, explained to me why I was over reacting, although they couldn't guarentee my safety to the car... and politely and firmly told me to drop the charges, which I didn't.

so no, hospitals don't back you up, the law does.... use it.. but know those little stinkers in administration have no memory loss when review time comes.

But it's worth it, God love those administration stinkers, they learned their lesson, when an employees purse was snatched walking to her car, she was beat to a pulp and sued. and won

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Tom -- It's a new cable service we're now able to subscribe to here. Part of the "Smell-o-Vision" tier... only an extra $11.99 / month.

It's a cooking channel featuring a variety of spicey dishes and the occasional nature program. :rotfl:

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But then you get called as a witness and you lose time at work or on the golf course. It really sucks.

Hmmmm...losing time at work...let me think...OK.

I know it sucks, but sometimes it is worth it.

Besides, since most of these guys are the drunks that PD doesn't want in their jail cell, if I call them for an arrest, they HAVE to come and sit with my "mr. happy" patient until release and take him away in cuffs. It is amazing how quickly they suddenly want a release signed.

Maybe if we do it often enough they will keep these drunks in their jails where they belong anyway.

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