Enraged (venting)

Specialties Emergency

Published

OK, I know y'all can relate...

Tonight I received a 23yoM, out drinking and driving, hitting parked cars. He already has 2 felony DUI's on his records.

He fought with fire department on scene (no head injury - he was just a drunk jerk), EMS on scene, police on scene; en route was kicking my medics and the police. He arrives and is still screaming and trying to swing while handcuffed to the cart.

I *tried* my very best to remain calm and therapeutic, but could only tolerate so much of the, "I refuse, you can't touch me, I'm suing you because my dad's a lawyer, and you can't let them take me to jail because I want to go home," while he attempts to swing, swears, and spits. He made mistake number one at that point by grabbing at my hand and squeezing until my hand popped (I filed charge number one at this point).

He smelled so strongly of ETOH it made the eyes water, and of course, he ended up in CT scan.

He fought and carried on over there, getting tazed several times. I ran over and medicated with Haldol and Ativan, but it was like spitting in the wind. Head blocks were gone, c-collar askew, and un-even on the LSB.

For a few minutes he chilled out and I once again explained everything. The CT tech needed his arms above his head, so I explained that I would remain at his side to care for him, and help him hold his arms. He said, "Whatever." (Meanwhile my tech and 5 policemen were on the other side of the glass watching).

I put on the lead, and was helping him hold his arms, and he screamed, "Let go of me you 'effin B*tch!" He then pulled an arm free and punched my chest (mistake number two, and charge number two filed) and face (mistake number three, and charge number three filed).

I lost my cool at that point and completely lost it. I'm ashamed to admit that without thinking, and in order to get away, I punched him very hard and quick 3 times in the chest so he would let go of my other arm (and it worked).

The police were all over him like a cheap suit. I told him that we were done playing the easy way, and he would now be going down the hard road, and told him I was taking him back to the ER to paralyze and intubate him.

He cried all the way back.

I'm just irritated that such a young man is wasting his life an potential and doesn't even care (he could have killed someone!). I'm furious that he thought he had to right to assault me. And I'm even more enraged that I lost my cool and responded the way I did.

Any tips for calming down?

Specializes in Psych, Med/Surg, LTC.

Wow. What a rough time you had. :o I agree, leave out the three punches. You "pushed" him off of you. It sucks that nurses can get into big trouble for defending ourselves. It seems like its ok for some to use self defense, but others not. Police can use tazers and other forms so they don't get injured, but nurses are supposed to get the crap beat out of them it seems like. Its great that you pressed charges. Maybe they will stick and this guy will learn something from the whole experience. Hopefully your co-workers will leave out the 3 punches when they tell their stories. Maybe they didn't "see" that. Does anyone who wittnessed the even dislike you? If your job frequently puts you in situations like this, it may be time to start looking for greener pastures. Your safety and well-being is very important. Please let us all know how this turns out for you.

Specializes in Emergency & Trauma/Adult ICU.
First, I think you need to stop working with this type of patient. You assaulted and battered a patient, which could very well be felonious. You'd better check with a lawyer ASAP, I think.

Your upset is perfectly understandable. No one should have to deal with this mess. But I am not sure that a nurse has the right to strike a patient. I suppose a case could be made for self-defense.

There's the answer:

"Dear ER manager/charge nurse, I will be unable to care for intoxicated, unruly patients as of this date."

:stone

Specializes in Emergency & Trauma/Adult ICU.
The OP really needs to know and follow policy at his workplace. Maybe he should have called Security.

Just curious ... have you ever called Security while you were being assaulted?

Specializes in Emergency Room.

I wasn't going to add my thoughts (because they're along the same lines as the first page of replies) but after reading the last few replies, I can't resist.

I take care of people with diseases every day. Just because someone's disease makes them violent, irritating, and a threat doesn't mean I shouldn't defent myself when they come at me. I'm very lucky to work in a facility where my security and doc's completely back me up; if an intoxicated person is threatening (in words or manner) then we will paralyze and intubate. I'm quite surprised your pt wasn't intubated enroute....a lot of EMT-Ps I know will not hesitate either. I wouldn't want your patient in the back of an ambulance.

And there is always the argument that the patient is intoxicated and unable to make rational decisions, as evidenced by the fact that his c-collar was off - so for his own safety he needed to be intubated until it was sure he didn't have a head injury or cspine injury.

I come to work to help people, not to be assaulted. I am #1 (along with my coworkers) and will do whatever it takes to go home in one piece. I think you did what any reasonable person would do to protect himself....you didn't walk up to him when he was mouthing off and punch him, you punched him to protect yourself as you had already been punched x2. It may not have been the 100% right option in hindsight, but it was acceptable.

Take your bath and have a glass of wine (tonight, not at 8am). Good luck!

Specializes in Pediatrics.
He is ill, let's not forget. He has an addiction to alcohol. Addiction. A person will sell his soul to satisfy a craving when addicted. It is an illness and the person deserves treatment. He might need jail, too. But he definitely needs treatment. And to be forgiven. There, but for the grace of God, go you and I.

I am well aware that this is an addiction. I've worked as an RN and Nurse Practitioner in dual diagnosis (substance abuse +dx of psychiatric disorder) residential programs for teens. I have heard stories of teenagers prostituting themselves for their preferred drug. It is still against the law, no matter what "reason" you have to do the action. His addiction or substance abuse is NOT an excuse for his actions. He assulted aother person on three occassions, and he is responsible for those actions. So I hope he does get some jail time. You will find that in treatment programs, the pts are not allowed to use their additictions as an excuse for the behaviors and actions they exibited while under the influence or even during sober attempts to acquire their preferred drug.

I imagine the OP will forgive in time, but expecting someone who has had this traumatic experience to forgive right away is unreasonable. She needs to vent first, the forgiveness will come later.

Specializes in Trauma, Teaching.

The OP did NOT "assault and batter" a patient, her arm was being held and she used her free arm to get loose. Its called self defense. Why the heck was the PD on the other side of the glass?! :angryfire When I have one like that, both officers and security are right there with me wearing their own lead aprons.

andhow5, I hear you, I get mad at myself for letting myself react that strongly too. I want to be in control of my responses all the time, not let somebody else push my buttons. This too shall pass :kiss

Let us know how what the judge does with the charges.

First, I think you need to stop working with this type of patient. You assaulted and battered a patient, which could very well be felonious. You'd better check with a lawyer ASAP, I think.

Your upset is perfectly understandable. No one should have to deal with this mess. But I am not sure that a nurse has the right to strike a patient. I suppose a case could be made for self-defense.

In a extremely concerted effort to not be disrespectful in any way, I will just say that anyone who took measures to protect themselves after having been puched twice in the chest and once in the face IS NOT an assault and batterer, but a VICTIM of assault and battery.

Where I wonder, did this idea come from, that health care individuals have no right to protect THEMSELVES from physical harm inflicted by another individual? Where do you draw the line between getting hit 2,3,4,5 times and getting dead? Several well placed hard punches can knock a person out, and then what? You are at the mercy of someone who obviously did not feel it was wrong to punch you in the first place, you really think it's not a leap that they might not feel its wrong to kill you just because they feel like it?

Not in my world people, I've got three babies to go home to.

This entire line of reasoning has me enraged.

Specializes in Utilization Management.

I too, wear the scars of being gouged by an post-anesthesia patient who got psychotic and violent. It's no fun to know that I'm forever damaged and the patient neither knows nor cares what happened after that surgery.

I have worked with demented, dangerous patients all my life, and I have so far never hit one back. I was trained not to defend myself.

However, if I was in the situation that the OP was in, I might very well have reacted in much the same way the OP did.

My professional self would have been overrridden by the need to protect myself at the point where there was no help in the room and no escape from an assault.

It might help you to go to EAP to debrief, as this kind of experience tends to come back on you at the worst moments.

Specializes in ED-CEN/PACU/Flight.
The OP did NOT "assault and batter" a patient, her arm was being held and she used her free arm to get loose. Its called self defense. Why the heck was the PD on the other side of the glass?! :angryfire When I have one like that, both officers and security are right there with me wearing their own lead aprons.

andhow5, I hear you, I get mad at myself for letting myself react that strongly too. I want to be in control of my responses all the time, not let somebody else push my buttons. This too shall pass :kiss

Let us know how what the judge does with the charges.

We think a lot alike, I think.

Since he had received the Haldol-Ativan cocktail, and had already been tazed several times, he had settled down a bit. And idiot me still wanted to help the patient while he held his arms above his head.

Since he was chilling out, the cops (and my tech) stayed on the other side of the glass, watching (security officers at this place are a joke - they tell us they are not allowed to hold anyone down).

When the patient started assaulting me, we were struggling back and forth. The CT tech (I really don't like her) was yelling at me to knock it off that we would break her table. The cops (one of them shoved her out of her chair in the process) and my tech came running in and dog-piled on him. He was tazered several more times while I was getting back up and taking off the lead.

I was just enraged...

But it all works out in the end. I transferred him to a "big" room to be paralyzed and intubated and care resumed to determine extent of injuries, if any.

As for the poster that stated I should not be around that kind of patient; good suggestion, but this is ER, and we get a LOT of drunk, disorderly, combative, psychotic patients. And in the area I am in, that is a majority of what we see (usually in the hallways as our poor CHF'rs and COPD'ers need the side rooms (and the traumas, overdoses, and codes get the front rooms). That's why I love ER, because you just never know.

This is not the first time I've been assaulted (and won't be the last). Usually pressing on a good pressure point will cause them to release, but the only ones he had in my reach wouldn't have been appropriate for suspected injuries.

Ah well...

i doubt that either assault or battery apply here....

1) assault requires "putting in fear"..i doubt this young male was feeling fear

2) battery is touching without permission, he was already an ER patient

implied permission...in fact was being touched at the time

Specializes in pure and simple psych.

Can't help but to add my :twocents: on this thread, because I have long been an advocate for laws that insure that a nurse who is assaulted at work will have the support and assistance of the institution in which s/he is employed when (not if) charges are pressed following any and all assaults. Being under the influence of a substance, legal or otherwise, is not an excuse, or no-one could be prosecuted for drunk driving. California has had a law on the books for about 8 years that insure the institution is supportive or it will be fined, and the the DA is obligated to follow through and prosecute the assault. The bill is called AB 508, for those interested in seeing a good prototype.

OP, stay strong, don't let anybody guilt trip you. Protective reflexes come into action, called fight or flight, and you acted to free yourself. That is self protection, not "assault and battery." And get the policy altered to mandate the police to remain with all arrested persons while undergoing exams and treatments. He probably was better behaved earlier because the cops were still near by. When he felt you were vulnerable, he attacked again.

Specializes in CT ,ICU,CCU,Tele,ED,Hospice.
Police/correction officers are taught to use reasonable force/proportionate

to the threat.........you followed correct procedure based on those rules.

I know we are not police/correction officers, but sometimes we have

to act to save/protect ourselves or others.

The OP really needs to know and follow policy at his workplace. Maybe he should have called Security.QUOTE

the police were in ct scan with her what good would the security officer be ?and in my place on off shift we don't have security .its the ed staff or maintenance.she had a right to protect herself.

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