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 Critical care, trauma, anesthesia.

Know anybody that ever woke up and said I think I'll be a drunk, opiate addicted, crack prostitute today? Destroy my family, my potential. Be eaten up by guilt and shame whenever/if ever I'm not high.

I wonder about the treatment choices in your ED. If this guy was so combative, why didn't the treatment team assess him, realize he wasn't going to cooperate and tube him, paralyze him for the CT? Too much trouble? I agree you have to protect yourself and others. That's the job. In the field tazer is an appropriate response at times. In the ED, it's not. Lots of other options.

Most of us got in to nursing because of our calling to be caring, compassionate and nurturing. I know it is hard for me to treat everyone that comes through the door with those qualities. I am human. I get tired. I have opinions on things. I see people with severe COPD or lung ca that continue to smoke and it's hard for me. The unwed young mother with no prenatal care having baby#x. The morbidly obese. The child suffering from abuse or neglect. IMHO, it's not mine to judge them. I have to look at what they are touching inside of me to cause the feelings I have.

I chose to be a nurse. Not everyone can do what we do. It's a calling and a privilege. It also has responsibilities to be a caring patient advocate for all who enter our care. Sometimes to put ourselves aside to care for the patient. I'm not saying I'm perfect at it nor that it's easy, but it's there. You mention that he didn't have a head injury. If he had, would you have treated him differently? How about if he had been a decompensating schizophrenic?

Sorry you had a bad night.

msgas

I care about a worthless piece of crap as much as the next nurse, but, as a father of four, the well-being of violent ED patients is not my first priority.

My going home safely is.

If it truly comes down to a choice about whether a violent patient or I am going to be hurt, there's no choice about it. I'm not talking about hurting somebody just because they're a turd and you can. I'm talking about exercising all necessary measures. Here's a personal policy I strictly enforce:

"Violent patient, if anybody here is getting hurt, it's not gonna be my children's daddy."

As long as nurses and the law continue to accept assault as part of nursing, we will continue to be victims.

Defend yourself. It's a basic human right.

Specializes in Critical care, trauma, anesthesia.

Interesting. And you are a NURSE? Lots of anger and rage in your post. I don't know I would be glad to see you coming in to the ED.

Interesting. And you are a NURSE? Lots of anger and rage in your post. I don't know I would be glad to see you coming in to the ED.

Yes, and a damned good one.

No anger. No rage. Just zero tolerance for violence against healthcare workers. If you were getting beaten up by some violent patient you're coddling, I'll bet you'd love to see me coming. :welcome:

btw, every drunk, drug addict or prostitute i've ever seen or heard of has decided to drink, drug and/or whore.

"nurse" does not equal "enabler."

Specializes in Day Surgery/Infusion/ED.
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.

Get serious! GOK what might have happened had the OP waited for security to get there. Just because she's a nurse doesn't mean she doesn't have the right to defend herself. Now, if she'd grabbed an IV pole and started whacking him over the head with it, maybe...

I don't get these nurses who think we have to sacrifice ourselves to our patients. If someone is assaulting me, you'd better believe I will fight that pt. off to get free.

Specializes in Day Surgery/Infusion/ED.
I thank God that I have never been assaulted. Having worked in Corrections, though, things often got threatening. I would simply raise my voice and say to the inmate, "Don't make me yell for a Deputy!" Before I knew it, several deps were at my side and the inmate had either come to his senses and started behaving safely or was escorted off, his med care to resume at a later time.

The key here is that I raised my voice and yelled for help. If other staff had been around the OP (and I think they were, based on him saying that they were gathered outside the scanner room), he could pretty easily have raised his voice and conveyed to them that they needed to stat get him Security backup.

Or, he should require that the doctor order the pt to be controlled with anesthesia/intubation for the scan or take whatever other steps were necessary to keep everyone safe.

Are you advocating that nurses allow themselves to enter dangerous situations? Are you saying nurses should stay in them if they find themselves in them? What exactly are you trying to say?

If you haven't been on the receiving end of being assaulted by a pt., then you really don't know what you would do. To put it more bluntly, you don't know diddly. Your post makes absolutely no sense, and actually, it frightens me. I hope newbies and students out there aren't getting the idea that they can't defend themselves.

Part of being a nurse is getting into dangerous situations, be they exposure to diseases, acting out patients or providing home care in a crime infested area.

andhow, you can work with me in the ED any day of the week!

Seriously? SERIOUSLY??????????

If I am GETTING PUNCHED IN THE FACE by a patient, I am not going to take time out to say "yoohoo - security! Help me please!" Ain't gonna happen. Even if they are 10 steps away. I'm going to fight back.

I'm going to get out of that situation as quickly and anyway as possible. If that entails hitting the patient, then YES I WILL!

No, I am not a rage filled nurse (except reading some of these replies)..... but I believe staff safety comes first.

The question about would we do this to a schizophrenic too? Absolutely - if they were punching me in the face. I don't care what your background is - if you are punching me, I am responding. My facility supports that. They support staff safety, period.

Also - I see you (TrudyRn) say you haven't been assaulted. I have. I was choked by a patient and there was other staff in the room about 5 feet away. Did I wait for them to help me? Nope - I hit the patient until he let go. I was blacking out and couldn't breathe. You bet your bippy that I was fighting for my life. I was not going to wait for someone else to come to my aid.

So maybe you can see why I'm so passionate about this. If you haven't been in that situation, I don't think it's right for you to tell the OP they are wrong for how they reacted. I've been there - I know what it's like.

OK - over and out.

a most interesting thread

too bad the OP didn't have the tazer available in the CT scanner..although it sounds like this guy was so blitzed he probably didn't care or had so much "anesthesia" already on board he couldn't feel it....hope the OP is working thru this..best wishes

topkat

I believe she says he was Tazed several times in CT.

Also - I see you (TrudyRn) say you haven't been assaulted. I have. I was choked by a patient and there was other staff in the room about 5 feet away. Did I wait for them to help me? Nope - I hit the patient until he let go. I was blacking out and couldn't breathe. You bet your bippy that I was fighting for my life. I was not going to wait for someone else to come to my aid.

So maybe you can see why I'm so passionate about this. If you haven't been in that situation, I don't think it's right for you to tell the OP they are wrong for how they reacted. I've been there - I know what it's like.

OK - over and out.

If you're fighting for your life, it becomes another story. Although that would not hold up in psychiatric nursing where, no matter what, staff are not allowed to lose their cool.

Juries daily make decisions about things they have never experienced. I guess if we, on this board, are limited to responding to events we have experienced, only a very few will respond.

BTW, I have been the victim of crime, just not on the job.

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