New nurse here...slapped today by patient.

I wish I could offer some better advice, but after spending years being hit, slapped and pinched by patients and residents, it just became something I have gotten use to in nursing. From being a CNA to being a RN I have been hit at almost every job I worked at. The worst ones were in LTC and DD residents.

I have just learned to move quickly when I see a hand coming my way and sometimes I don't always see that hand..

I know the feeling of wanting to slap back and do something, anything, but you have to compose yourself and remember YOU are the professional. There may be some reason the patient slapped you. Could have been her response to the IV, could be she is just plain mean, or she may just not like hospitals or unfamiliar people and surroundings.

Just some random thoughts.

Where are people talking about making money? They are talking about filing an incident report and pressing charges for the purpose of raising awareness and decreasing the chance that this will happen again. Do not forget that in the OP it was stated the patient was a&o x3 at the time and as we were not there and do not have the chart here in front of us we don't have a whole lot more to go on. Several people did ask about hx of dementia but the OP really has not expanded much on the patient's condition. Saying that "it is all about the nurse", well, I am confused at why you would say this when a nurse is the victim here, and the discussion of the thread is vastly about how to handle injuries from a&o patients as well as confused patients. Nurses have a history of being poorly supported when it comes to physical safety on the job (among other things like safe staffing). We have the right to work in a safe environment. Nurses have to support nurses, because no one else is. When nurses are properly supported, we can accomplish great things for patients. You think wrongly that this is only about the nurse, because in the end it still all goes back to the patient.


Toxic and self centered? The posts are telling the nurse to stick up for herself for what she described as an A&O patient, to work on the large, large problem of staff abuse. You have to stop thinking of this discussion as being focused on making money. It is simply not about that. Nurses as a whole are very staunch supporters of patients, very often to the detriment of themselves (see the thread a few months ago where people were supporting each other to go to the bathroom and eat on their shift). But, by supporting nurses to care for the caregiver, we can in turn care for the patients better. We need to stop the martyr complex that it sounds like you support! Not only do we need to make things better for the patient but also for the nurses that come after us(as that will also make things better for the patient). Working towards decreasing injuries, or as other posters have suggested, increasing education for staff about how to de-escalate situations, and precipitating factors, will help caregivers spend more time focusing on what we WANT to do, which is care for the patient, instead of spending this time trying to safeguard our, and our coworkers safety.

Some people are just jerks, one doesn't have to have a mental condition to treat others like crap.

Ayvah

Alert only means you are resposive to a certain level, oriented x3 barely even scraped the surface of a mental assessment! How many A&O x3 patients have you seen that were confused, combative, unable to make decisions for themselves... Oriented x3 means they know who they are, where they are and roughly what time it is. Nothing else.

Are you suggesting that an A&O x3 person cant have mental problems? You are wrong. What school taught you that??? I see it every day at work. What happened to A&OX4. she was only x3. Hello? Doesnt that mean anything to you?

You can call the police and make a report but a guarantee you that the DA will not bring charges against a 77 year old woman in a hospital. They just won't do it.

I and friends of mine have been assaulted multiple times and the DA would not take the charges unless it was a visitor. They would rarely take charges against a patient unless the patient had a weapon or the staff suffered a severe injury (broken nose, knocked unconscious, shot and wounded). If it was a psych patient, they would just put them on a 72 hour hold and that was about all you could hope for.

So don't count on much support from local law enforcement in something like this. I did have one nurse bring successful charges against one drunk guy who bit her breast as she was trying to restrain him. She was a bloody mess. They did bring charges against him. He got 3 days in jail and some community service.

He turned around and complained to the board about her that she had assaulted him and held him against his will. Nothing ever came of it. I wrote the board and told them what he did. We never heard from them again.

Some of these attitudes are right in line with the, its ok for nurses to be assaulted and expected... routine that I find in our field. Now I would not press charges on a 77 year old lady but I would tell her that it was completly unacceptable. The fact remains that a lot of people in this field do find it perfectly fine that nurses get assaulted, spit on, bit, and that we should accept it as our lot in life.

I find that reasoning unacceptable. I dont know if its an older style of nursing but I hope that more nurses stick up forthemselves in these cases and do press the point that its unacceptable and in the case of a/o patients, charges should be pressed. if a waitress was assaulted and sworn at, we all know what would happen.

I understand your point about forgetting about the patient. After reading this thread I don't have enough info on the patients background to form an opinion on whether the patient had underlying issues. But still, even if a patient does have a reasonable excuse for physically assaulting a nurse because they have mental issues does not excuse any nurse being injured. If I were in the OP's situation I would be alerting other staff to the possibility of being assaulted and be querying whether the patient required restraints, or another staff member present when giving care.

IMHO nurses and CNA's are always going to be at risk of some form of assault. But this should not be considered as 'ok'. I personally do not want to work with any nurse who feels it's ok for a nurse to be abused. There needs to be strict guidelines, if a patient for whatever reason (mental issues OR just an *******) hits a nurse then this needs to be taken seriously and preventative measures taken from then on to protect nurses. This may be physical or chemical restraints, extra staff present when giving care, counselling for any nurses who have been assaulted, documentation and reports made to the police when necessary.

The OP states specifically that the patient was not confused at the time she was doing the IV, see the following quote:
I'll repeat that we don't know all the information about the patient, so we are only going by the OP's assessment.

You have been making a massive amount of assumptions about the people on this board and nurses in general. Throwing random, unsubstantiated insults at me instead of delving into an actual discussion is also not productive.

I once had a frail old lady who was completely with it dig her fingernail into me so hard that I had 5 crescent spaped punctures on my wrist. Her son stood by and witnessed the entire thing (if memory serves i was doing a very benign task such as straightening sheets) and all Sonny could say was "Mom was a manicurist, she like to keep her nails long." The patient didn't have a good reason for grabbing me. My response to them both was "If the shoe was on the other foot, i'm sure you'd have the police here. Ma'am I'll ask you to keep your hands to yourself." There were no further issues with that particular patient.

I've had similar experiences re: fingernails.

A patient (male) on Med-Surg took the same approach to "digging his nurse". That was over 10 years ago and I still have the scars to show. Nursing supervisor just told me to go to ED for exam. No other response to patient's behavior.

BTW, he was A+O X 4, and had not been aggressive before this. No medical, metabolic or chemical problem that would have caused this. Oh, and he was looking at me square in the face as he increased the pressure.

I've been in homes where safety of staff has been compromised because of patients and families having access to guns (gang areas in Los Angeles), been told that if I was a male RN I would not be safe in neighborhoods (racial hatred), "escorted by gang members to ensure my safety so I could care for their family", and during the LA riots told that certain areas of coverage had been "red-lined" for our safety.

My husband has been punched by a patient, had his mustache pulled by an otherwise nice little old lady that the family thought had stopped breathing (good news: she is awake and breathing. Bad news: she inflicts high levels of pain on personnel), had a gun drawn on him (why would someone bring a gun to PT?), and the usual aggressive/abusive family and doctors.

What in the world kind of occupation is healthcare? They didn't tell me about this in school. Other occupations have a certain level of risk involved, and you know and train for it going in. Somehow the nursing cape isn't an adequate defense for this kind of thing (maybe they should be part of the uniform, again. Imbued with protective powers).