Need help quick!!!

Doc · Apr 16, 2001

Sounds to me like very little can be done, but at the very least management should agree that for the time being, this aide have NO contact at all with the client in question. It is true that these scenarios do occur a fair bit in psych and in the ER, and usually staff should undergo an orientation which includes a good amount of conflict resolution skills training. I don't know if the aide received this training but I strongly recommend she gets it, or even goes on a further workshop on this topic.

Doc

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greg in mass · Apr 17, 2001

Unfortunately Doc there is no orientation for this type of problem at this facility. Soon this issue will be taken up with the "powers-to-be" and there is no guarantee that it will be resolved. This situation is presenting a definite problem for this nurse's aid. I am trying to assist her in this matter, because she is a close friend of mine. Unfortunately I need some help also, because I do not know where to go from this point. This is the reason why I posted this situation on this site.

A "no contact" treatment plan has been implemented. However, the client refuses to comply with it. So therefore, this nurse's aid feels as if she is being harrassed and fears another assault will occur again.

Any information from anyone is extremely helpful and would be greatly appreciated....even some words of encouragement.

Thank you.

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grnvillechick · Apr 17, 2001

Since I have no diagnosis of the psyche pt, it is hard to say what the best course of action may be. But the nursing aide does have to realize this is a medical field and she is dealing with sick people, be it physical or mental. I think one thing that would help would be for the aide to write out her feelings. how she feels about being attacked,how she feel about the letters. about how everyone else is treating this as a no can do situation. It sounds to me like she can possibly be a post traumatic stress disorder canidate. Though in the world of nursing, what she experienced is a fairly common thing in psych--pts who threaten verbal and physical---what has happened to her she may have internalized. Encourage her to speak out her fears and feelings and to look within...get her some help...go to the facility and see if they can provide counselling. In the end she might have to decide to leave the field. the less contact with this pt the better. tell her to avoid eye contact. watch her body posture and tone of voice..things that give away fear. that is what this pt is picking up on.And tell her to remember she is the one in control..he is the one in lock up..best of luck...she should be glad to have you in her corner!!!!

Zee_RN, BSN, RN · Apr 17, 2001

I'm not a psych nurse but of course we get all kinds of patients in the hospital )psych patients get physically sick too).

Maybe it's just a state law...but I thought your employer had to guarantee a "safe workplace" free of harassment and violence (or threat of violence). I know we have notices posted wherever it is they post those Equal Employment Opportunity, Workers' Comp and such notices. One of our nurses got written up one day when she simply stated to another nurse "Don't mess with me!" because that was a "violent threat." Surely they can move this aid to another location until it is safe again!

This sounds like a newspaper article we will see someday in the future. Headline: "Murdered Nurse's Aid petitioned for Safe Harbor but Hospital Refused"

I'm happy to learn that she went to the police. Seems like (besides you!) the only one in her corner is herself.

Mel C · Apr 17, 2001

Since I managed worker's compensation claims, lets look at this aide's situation in a different light. First of all, I don't think that management is really taking the situation in the perspective that they really should. Although this is a psych unit, there has to be some accountability here. I think that there should be some consequences for the patient and some sort of "treatment " or "debriefing" that should occur with this aide, particularly after her physical abuse situation, which I hope she reported this to her employer, who should have filed a first report of injury. As

this is work related , it is required by law to be reported, particularly if there were any injuries. If no injuries occurred, then an incident report would be appropriate as per this facilities receptive policies. There is still an ongoing "injury" which sounds more mental then physical at this time, which is continuing to occur without resolution. Her employer , who is the only one with any power here, ( aside from her resigning) should take some necessary actions to ensure, a safe work environment. It does not sound like this has occurred, and I would take it up through risk management and have her file a worker's compensation claim for her injuries. I assure you , management will take action then, because it will hit them where it hurts, in the wallet! I urge you to take action, the aide should continue to advocate for herself and her safety. If she doesn't

and decides to just take this, she will not be the last one to have this happen to. Remember , as Nurses, we are the largest group of medical professionals, together we can be heard!

greg in mass · Apr 18, 2001

So far administration will allow this nurse's aid to work away from this client in a capacity outside of a nurse's aid role, but this has not been finalized yet. I still do not understand why this has to go through so many obsticles till someone can assist this nurse's aid. It makes you wonder if staff have any rights at all. I still would like to know if anyone out there has any knowledge on what legal rights this nurse's aid has in this type of situation???

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123lisa · Apr 19, 2001

With the worker shortage, and the hassles that she is going through......she should work elsewhere......life is too short.......enjoy now......

Originally posted by greg in mass:
What is your legal right as a nurse or nurse's aid working in the psyche field when it comes to being harrassed by a client? This happened to a nurse's aid that I know. A client harrassed this nurse's aid for weeks, and the end result was that this client phyically attacked this nurse's aid. Immediately after work this nurse's aid pressed charges on this client. The next day she then alerted the client's treatment team of her actions. The treatment team decided to limit this nurse's aid's contact with this client. At first this worked, but after a few days this client continued to harrass this nurse's aid. In addition, this client stated repeatedly that if this nurse's aid does not pay attention to this client, then this client would act out and assault the nurse's aid again. This nurse's aid also received several letters from this client and continues to receive more daily. This nurse's aid could not tolerate this no longer and asked management to transfer her temporarily out of nursing until the client is transferred. Management stated to this nurse's aid that she should expect this from working with psyche clients and that she should accept it as a hazard of working in the psyche field. This nurse's aid has also discussed this issue with several people who are a committee who help staff deal with assaults from clients. They empathized with her issue, but they said that there was nothing they could do. This nurse's aid went to her union and her union also said that there was nothing they could do either.

Can anybody out there give me some type of insight so that I can assist my friend with this issue?

Stargazer · Apr 19, 2001

Originally posted by greg in mass:
Unfortunately Doc there is no orientation for this type of problem at this facility.

Why the hell not?

It seems egregiously short-sighted to expect

unlicensed assistance personnel (and I am assuming she is unlicensed as you refer to her as a nurses' aide and not as a CNA) to effectively manage pts with such complex and specific needs (i.e., psych pts) without training.

journeyy · Apr 19, 2001

Please advise her to DOCUMENT DOCUMENT DOCUMENT everything that is going on. What is your state's BON stance on abuse in the work environment? She should seek the advice of an attorney immediately.

kjmta57 · Apr 19, 2001

It sounds like stalking mental heath case or not she needs to let her employer know they are responsible for her safety and at no time shoukd she have contact with that patient. A similar thing happened in a state hospital and the employee ended up being bruitiley beaten and raped. Tell her good luck and stay strong.

greg in mass · Apr 25, 2001

Currently my friend is out of work because of stress. She is also looking for another job, because her current one obviously believes in putting staff in unsafe situations. I am outraged over this. It definitely demonstrates such a lack of respect and humaneness to people who work in the nursing field. I will take "journeyy" advice and suggest for her to seek an attorney's advice on her situation.

To all of you who have replied to my posting. Thank you for all your support and ideas. It was extremely appreciated. I will also keep you posted on the outcome.

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