Feeling threatened by your patients

[rachel h]

I am a new nurse who started working in a large teaching hospital on a med/surg floor almost a year ago. It's been hard enough adjusting to being a "real" nurse, but we get a lot of patients that are not exactly, for lack of a better term, "nice."

I am constantly stressed at work because it is very frequent that I feel threatened by one (or more) of my patients. Today I had a woman literally scream at me and lurch toward me while screaming "Ask me that question again, go ahead, ask me that question again!" Luckily I was by the door and able to make a quick escape.

This just got me thinking how often this happens. I have to deal with so many innapropriate people it is just making me sick. And there is no reasoning with these people because they have no morals/values/conscience. I just don't think I deal with it much longer without going nuts.

Does anyone else have any similar experiences? I could never imagine that as a NURSE I would have to fear for my own safety... that is one reason I chose not to work on psych.

Thanks for letting me vent- this is wearing me out!

[rachel h, BSN, RN]

Thanks for all the feedback. I think part of it does have to do with the fact that I am young. And I just want to clarify that these patients who have threatened me have all their faculties- they are A&O- I would never let it get to me if the patient was confused or had legitimate psych issues.

I don't know if it's my personality or what, but I can never seem to diffuse a situation. Everything I say or try to explain seems to make the person angrier... never was good at that therapeutic communication.

I know I can't stand it much longer- I have been checking out the employment section in the paper every week...

[sjoe]

"always document whether verbal or physicial abuse no matter how insignificant it may seem to others you document. "

Right. And if you don't know how to stand your ground without sounding apologetic about it (like ending every sentence with a question mark, for example), this is a good opportunity to learn to do so. Sometimes confrontation is the best way, sometimes not. Same thing with "understanding," etc.

Many people would experience any hesitation or "backing away" on your part as encouragement to become more aggressive--you make yourself less of a threat to them. You might be able to find an assertiveness training class, for example, if this is a problem for you.

If you have a friend who is an ER nurse in your facility, I would bet they could give you some good advice/training in dealing with this kind of patient/doctor/co-worker.

Doesn't your facility have policies to cover this kind of thing? It's hard to imagine that it would not. What does your supervisor have to say about it? What REALISTIC solutions does he/she offer?

There are a number of books out the past couple of years dealing with bullying, aggressive people. Your local librarian can probably tell you about some they have on the shelf. (This is only a start, of course, and not a solution, but it would give you some idea of the magnitude and characteristics of this kind of problem.)

These people can be found in every walk of life, and certainly in most nursing jobs, so you are better off learning how to handle it now instead of hoping to find a job where it does not occur.

[oldgirl, RN]

Medical floor-guy in DT's and a doc who doesn't medicate for that. 1 RN and 3 security guards injured in the free for all. Yeah, I feel threatened.

[altomga, ADN, BSN, MSN, DNP, RN, APRN]

I can relate to this....I deal with drug overdose, DT patients, dementia, and then the generally plain down MEAN SOB!!

I have felt threatened many times...if they are A/O I call security. I don't get paid to get beat...we can also file a police report with our hospital police. I report the behaivor to the doctor also and tell them to come evaluate the pt...most of them want to leave AMA anyway.

The OD and DT pt's...well, they get restrained! No if and or but's about it. may start with soft limb, but then go to VELCRO (gosh I miss the old time leathers) Usually takes all 7 nurses and ANA to get the pt down and security may (usually) get's called...simply b/c they can use FORCE where we can not.

I do stand my ground and tell the pt their behaivor is inappropiate and they WILL NOT BE ALLOWED to abuse me or the other staff.

Dealing with this behaivor is hard emotionally and physically!

I have taken non-violent crisis courses that has some good idea's...the best...keep near the door for a quick EXIT!!!!:)

I am sorry that this has happened to you...Just know that you are definately NOT ALONE!!

[P_RN, ADN, RN]

I received a concussion from patient's foot. LOC lasted til I got to the ER.

Call security if you need to.

[Rapheal]

You are young and relatively new. If you seem unsure of yourself some people will see you as an easy target to vent their frustrations on. Loved the earlier example of "the look." I will try that next time when I am the brunt of someone's unhappiness. Hope the good advice that you have received helps. The posters gave great advice to all new nurses. Thanks you guys.