[linda2097]

What happens if a nurse is attacked by a psych patient? Are there security guards who break it up?

[KrissyPRN]

First thing I would do is yell STAFF so that the staff I work with come to my aide immediately although I've not been attacked thus far I have seen pt's escalate to the point of being aggressive. The next thing we would do is call a Code so that security can come down and assist us.

[elkpark]

Part of the orientation/training to work on any psychiatric unit is training and certification in facility-approved defensive intervention techniques that are designed to allow you protect yourself and physically restrain the client without injuring the client. It is also the responsibility of all staff on psych units to stay alert and aware of where their colleagues are and what they're doing, so that they can respond quickly if someone calls for assistance.

In most (I would go so far as to say nearly all) cases, clients who become physically aggressive have been "telegraphing" for some time that that's where they're heading; it is also the responsibility of staff working in psych units to be aware of what's going on with the clients at all times, be alert to indications that particular clients are becoming angry or agitated, and intervene to defuse situations before they become physical confrontations.

Whether or not there are hospital security guards available to help in an emergency situation depends on the individual facility and its policies.

I would also guess (based on my experience in psych nursing over the years) that there is, in general/on average, a lot less physical violence on psych units than the people who don't work in psych units think. Of course, that depends on the specific setting and client population.

[bhensley]

I have been working in psych for a year and we have only had a few aggressive acts or attacks while I have been there. Every one on staff in the unit has to have training prior to taking the floor on how to handle various situations.

I agree that if you listen to your patients you can usually, (not always) diffuse a situation before it escalates to an attack. A way that our unit deals with it is that we always have a male staff member on each shift. While i realize this may sound sexist, it gives a stronger sense of authority and for some reason less aggression. Also, there is never one person in an area with a patient alone at anytime.

If one of the staff is attacked there is always a person to assist and call the code. Then the person with the best repore for that patient (who is hopefully working at the time) goes and helps talk the patient down out of their aggression.

The patients are informed upon admission and at various times during their time on the unit that if a code is called, those not involved are to go to their room since the unit will be flooded with every working male at that time to assist the staff member with the aggression. Never is it allowed to injure a patient, only immobilize them until they are calmed.

[bollweevil]

Originally Posted by bhensley

I have been working in psych for a year and we have only had a few aggressive acts or attacks while I have been there. Every one on staff in the unit has to have training prior to taking the floor on how to handle various situations.

I agree that if you listen to your patients you can usually, (not always) diffuse a situation before it escalates to an attack. A way that our unit deals with it is that we always have a male staff member on each shift. While i realize this may sound sexist, it gives a stronger sense of authority and for some reason less aggression. Also, there is never one person in an area with a patient alone at anytime.

If one of the staff is attacked there is always a person to assist and call the code. Then the person with the best repore for that patient (who is hopefully working at the time) goes and helps talk the patient down out of their aggression.

The patients are informed upon admission and at various times during their time on the unit that if a code is called, those not involved are to go to their room since the unit will be flooded with every working male at that time to assist the staff member with the aggression. Never is it allowed to injure a patient, only immobilize them until they are calmed.

You must work in Idealville. We almost never have any male staff on our floor. We often can't even get a good response of lots of males when we call a code. As for being alone with a client, we try hard to keep at least minimum required staffing at all times but it doesn't always happen. Often, meetings are held and staff must attend these, leaving less than the minimum required staffing level on the ward. We're told this is ok because there are sufficient staff in the building. Never mind that they are off the ward, on a different floor, behind several locked doors, down several long, long hallways, where they won't even hear the Code called.

[My2Giants]

Where I am working the majority of us are female. We have no security since this is a stand alone pysch facility, privately owned. There are a few male MHT's that work there, but depending on how they are scheduled, dictates wether we have a male on shift.

Someone asked during orientation about security or having male orderlies present to help with escalation events. The answer was that they did not want to affect the meileu with having security or orderlies present.

Of course we could always call 911 if needed.

[DontDoThat]

[A way that our unit deals with it is that we always have a male staff member on each shift.

I'm that male staff. Now I'm on modified duty because a patient slammed a cabinet on my foot, breaking my toe and causing serious trauma to my foot.

[elkpark]

It's been my experience over the many years I've worked in psych that situations with male clients are more likely to "get physical" if male staff are present than if only female staff are present (not much difference with female clients -- women will hit anyone). I've also never understood the mentality that male staff are somehow more responsible for dealing with tense, potentially dangerous situations than female staff.

[RNKittyKat]

We wear body alarms and have an imposing security staff whose job it is to respond to any threatenting or potentially threatening situation. They are present to display a show of force or actually restrain if warranted. We are trained in defensive intervention to help ourselves and fellow staff in the event it gets that far. Despite all that, sometimes it happens that a staff member gets it. Usually it's because staff failed to read the signals and intervene earlier.