Spin Off: Nurse abuse?

[MIcrunchyRN]

Ok this is a slight spin off of the "Nurse fired for calling police" thread.

A) As a nurse have you experienced any physical or sexual abuse?

B) Was there any circumstances where you experienced or a coworker experienced abuse that was maybe at fault of the yourself or co-worker?

I ask this because us as nurses can do things to people that they don't necessarily want done (i.e. catheters, iv's etc), and can result in people lashing back. I believe Woody gave IV example. I gave example of swatting at my nurse when I asked her to not touch me during a single contraction while in labor and she wouldn't. (both in other thread) I have also seen nurses/doctors do things to patients with patient begging them to stop and they dont (again woody's IV example).

Last question:

C) if its ok for nurse to call police on patient, does patient have same rights to call police on staff? (say in situations where mentally coherent patients ask for something to be stopped like iv and staff doesn't?)

[GadgetRN71, ASN, RN]

see then isn't that abuse by doc?

I personally while in labor swatted in the general direction of my nurse, never made contact (that I'm aware of, she said I didn't when after he was born I appologized profusely). But I swung at her in her direction because she wouldn't listen when I asked her to not touch me and give me a minute. I could feel myself loosing control during my contraction. She was so focusd on her task at hand (mind you not a situation that wasn't life thretening, jsut protocol). She didn't listen to me asking her to wait a minute, after this contraction, stop. Finally I swatted in her direction and yelled "I said give me a minute!" In between contractions gave her an earful for not listening to me. I felt I had no other way to keep her away from me (because at that moment running away wasn't an option) and she didn't listen to my verbal warnings. Should she have charted that I refused EFM and called doc? No because I didn't refuse I simply asked for her to wait a minute. Should assult charges been filed and police called etc? I don't think so because I wouldn't have gotten to that point had she listened to me. (BTW Midwife and DH were also telling her to wait a minute). Were my actions appropriate? Probably not... but I felt I had used all of my options at that moment in time (I couldn't get up and run away mid contraction at 9cm.. just not posisble at that moment or I would have done that).

I also have witnessed a nurse get kicked at because she was doing a foley and pt was screming at nurse to stop it hurt .... nurse wouldn't stop.. got kicked. (Turns out 2nd foley went fine no issues because nurse #1 was inflatting balloon a little low in bladder at what they suspect was still in urethra and causing pt great pain). I still think that patient had every right to kick her nurse because the nurse didn't listen... and it wasn't until that point that the nurse got a clue.

Now i've also been on the recieving end of the abuse as well and I'm not saying all incidents are provoked by nurses (concussion from tele box, and being kicked into a wall are my highlights)... but was curious out of all of us who have been harrassed abused by patients how much of it potentially was because our actions or lack of actions. Or even someone else's actions?

I dunno lol I have a feeling the consensus will remain the same on here.

What about doing things like putting in largest IV because pt was rude etc? I've heard of that being common in some places...oh this patient is such a PITA let me get a 16g... ?

First off, we put in big IV's in the holding and OR because they just work better in the OR...I cannot tell you how many 24 g IV's we've had that have failed on us.And they fail at the worst time-pt bleeding out or crashing.

And many of the demented patients hoot and holler if you look at them the wrong way..sorry, but I'm offended that you think it would be OK for a nurse to get kicked because a procedure hurts. Sometimes, being in the hospital is painful and unpleasant. I think any mature, reasonable adult knows this. Sure, that foley may hurt a little going in, but the consequences of not putting one in could be worse.

I could be way off base..but I think you are still seeing nurses and "conventional" medicine as the bad guys here. Despite what some in the "alternative" community would have people believe, we do not set out to hurt patients or take away their autonomy. But, again, why go to the hospital if you are going to be noncompliant? Go drink some herbal tea and howl at the moon and see if that helps. (I have relatives that only believe in "natural" cures and then they complain that they are still sick-it's a sore point, LOL)

I think I'm done here, because I get the feeling that this thread is going in one direction.

[squeakykitty]

I'm sure this has already been written 100 different ways in 100 different posts, but this is really about the basic principals we all learned in kindergarten: You do not have the right to hit anyone. You do not have the right to threaten anyone.

I don't care what the excuse is; Grieving families, exhausted patients, or people angry because the procedure didn't go as planned (IV starts as a previous example). No one reserves the right to strike another human being in anger (however pained they may be)

I am, as most nurses are, sympathetic to all that familes and patients endure in the hospital. I am not so sympathetic that I won't be the first to press charges against an abusive person. Their lack of coping mechanisms does not constitute my becoming a punching bag.

:yeah:I couldn't agree more.

[J.R.theR.N2b]

First off, we put in big IV's in the holding and OR because they just work better in the OR...I cannot tell you how many 24 g IV's we've had that have failed on us.And they fail at the worst time-pt bleeding out or crashing.

And many of the demented patients hoot and holler if you look at them the wrong way..sorry, but I'm offended that you think it would be OK for a nurse to get kicked because a procedure hurts. Sometimes, being in the hospital is painful and unpleasant. I think any mature, reasonable adult knows this. Sure, that foley may hurt a little going in, but the consequences of not putting one in could be worse.

I could be way off base..but I think you are still seeing nurses and "conventional" medicine as the bad guys here. Despite what some in the "alternative" community would have people believe, we do not set out to hurt patients or take away their autonomy. But, again, why go to the hospital if you are going to be noncompliant? Go drink some herbal tea and howl at the moon and see if that helps. (I have relatives that only believe in "natural" cures and then they complain that they are still sick-it's a sore point, LOL)

I think I'm done here, because I get the feeling that this thread is going in one direction.

this thread is very interesting to me. i agree that a nurse has every right not to be hit at, kicked at, or otherwise abused. however, the patient is not in "normal mode" here. they most likely are sick, in pain, or both. they are vulnerable, in a strange and frightening place, and have lost control over their world. in these situations patients cannot be expected to tolerate painful and uncomfortable procedures as they could under normal circumstances. i also believe most of these patients really desire to be compliant and cooperative. extenuating circumstances, however, get in their way and rob them of this ability. i faced all of this during my hospital stay for cardiac testing and subsequent bypass surgery. i went to the ER with chest pain, and was confined to bed while 3 different tests were run to find the cause. the final test, a cardiac catheterization, found clogged arteries, and i was scheduled for open heart surgery. a decision was made in the ER to insert a foley catheter, which like to drove me out of mind. believe me---IT HURTS!!!!!!!!! i screamed for the nurse to stop, which she did. she alerted the physician and we talked and i informed him there is no way i could tolerate the insertion of the catheter in my present state. i was too scared and in too much pain already for me to tolerate more. since he felt the catheter was necessary he okayed as little sedation as possible to enable me to have the procedure. i feel that real discussion as to the patient's pain tolerance and any possible interventions, such as sedation be considered. although it happened in my situation i realize that pre procedure sedation may not be appropriate in these cases. this in no way makes it right to hit or kick at a nurse who is simply doing my job. it is merely a suggestion that other possible alternatives be considered.

[sharkdiver]

In preface, let me say that I do not condone assault/abuse/harassment/intimidation of anyone, including health care providers and patients.

That said, some things to think about......

As others have pointed out, once a patient says "NO" or "STOP" to a procedure they have effectively refused or withdrawn their consent for that procedure or treatment.

Doctors, Nurses and other health care providers are not above the law, and if they continue to attempt to perform a procedure after the patient has refused or withdrawn consent for that specific procedure, under most jurisdictions they are committing the criminal act of either assault or battery, depending on the specific wording of their state law.

The use of reasonable physical force to prevent an assault is self defense, and that right is recognized in every jurisdiction in this country. Reasonable force is typically recognized as the minimum force necessary to prevent the assault, and the level may escalate as needed if the attempt continues.

By extension, the use of reasonable physical force by a patient to prevent a health care worker assaulting them by attempting to force a procedure that the patient has refused or withdrawn consent for is not an act of assault against the health care worker, but an act of self defense.

The bottom line is that "NO means NO" and "STOP means STOP". A competent adult has the right to refuse any treatment or procedure, even if that refusal may be life threatening, and to do so without prejudice to any other needed treatment. As several others have already said, there's no reason to try to force the procedure on them or try to browbeat them into it. Simply explain to them the potential consequences of their refusal, document it and move on.