How often do you deal with combative patients?

[Futureflightbsn]

So I'm a tech while I go to school and I work at one of the "rougher" hospitals in town. Long story short, this mofo hits my nurse and swings at me. I have never been legitimately afraid of a patient before, I may have been wary, but I never actually thought I would get hurt.

How common is this? I want to go into ICU, then ER and eventually fly and I know this is a lot more common in the ED than it is anywhere else.

I guess what I'm asking is: how do you get over it? I just feel really discouraged.

[HouTx, BSN, MSN, EdD]

Unfortunately, unpredictable, combative behavior is not confined to the ED - or even to healthcare environments... and it appears to be getting more common. People fly off the handle for the darndest things. LIttle League parents erupt into mass brawls over a perceived bad call by the Umpire. Bank customers threaten tellers when they don't like information that they receive. Fast food customers attack the drive-through employee for .. whatever. There's not much we can do about the behavior of others. The best thing we can do is learn to recognize when it's probably going to happen & learn how to protect ourselves when it occurs.

My organization - and pretty much all healthcare employers - provide "de-escalation" training for employees. They also ensure that there are appropriately trained resources (e.g., security) on hand to deal with physical altercations. De-escalation training includes learning to recognize and react appropriately to physical and verbal cues that indicate potential or imminent violence.

In my experience, these courses have been proven to be very beneficial. We need to know when to back down & call in the troops. One of the problems we've recognized has been the "macho" attitude of nurses (male & female) in some cases. They apparently feel that backing down is the same as admitting failure so they attempt to "control" the "out of control" person. It never ends well.

So - I just want to reassure you that nurses are not expected to serve as punching bags. Don't let that discourage or frighten you. Take advantage of training programs & use the resources available to you. It's going to be OK.

[shlay51]

You can and will come across combative patients in almost all areas. I currently work in LTC and we have a few residents that are known to be combative. I had one resident, who is now somewhere else, beat the crap out of me one morning. I was trying to keep her from hitting her arms on the bed rails and in trying to protect her I took a fist to the face twice and multiple slaps to the face. I still have no idea what set her off and was extremely happy when she was discharged. She did this frequently.

We also have/had residents that would bite. They would get near you, grab your arm and bite. Unfortunately for us not much has been done to help protect staff. The DON has said on more than one occasion that it's us that need to modify things, not the residents. I think that's a load of crap, but hey what do I know, I'm only the one getting hit, bit, and everything else while she sits in her office.

I agree with the other poster, take the training, learn from it and remember it if you are ever in a situation that isn't safe. Most employers do their best to protect their employees and make sure they don't get hurt. As with any career choice, it isn't always rainbows and sunshine. :)