Violence in Nursing - page 3

Violence in Nursing When Ashley became a nurse, she dreamed about helping patients and relieving suffering. She never thought she’d be hurt, much less attacked. Her second day on the job, a... Read More

  1. by   herring_RN
    Quote from maporcrn1
    Nurses need to feel safe in the work environment. Deescalating training and Security support is essential, especially in the Emergency Departments. Defense training may not be a bad idea as well.
    Our ER and mental health nurses routinely learn and practice restraining an unarmed person. It mandatory for them and available for all staff. Many of us on nights in critical care took it. More than once five of us small to average size women were able to restrain a patient safely until sedated.
    Training and practice plus luck were needed as neither staff nor patient were injured at those times. Not even the young football player on PCP who was trying to leave.
  2. by   VKALA
    I have had patients assignment being changed just because some patient's think I was rude as I didn't discharge them on time and how can I discharge them if the DR had not discharged them yet.Another assignment was changed, I was late to give them pain medications.If there are 4 or 5 patients asking for pain medications at one time I always wish I had 10 hands.As a nurse it is getting hard to survive this days as people are seeking instant cure.The management is there for managing budget and patient satisfaction mostly.I wish people will change for the better in future.
  3. by   ixchel
    There is a pretty large group on facebook actively working on this exact problem. They have one gigantic group and then small groups for each state actively working to create better legislative changes. They've been looking at recent events and they are even sponsoring a rally in Geneva that's happening on Friday. People are flying in for it, and IL legislators are attending. It's a pretty big deal. I know we're not allowed to link people to stuff on other social media sites, so I wont, but if you guys want to see things change and be part of it, that's a great place to be. Beth, if you're feeling strongly about making things better, maybe a link *could* be okay for this?

    Keywords for searching in the meantime - healthcare workers protection act. They have a page and a group. The page is there to direct people into the group. The group is where the work is being done.

    It's not just a facebook group. They are a foundation promoting education, advocacy, and aiming to have laws that *actually* help.
  4. by   luvmyc
    I'm a nurse in a federal facility and my husband is security in the same place. It can get VERY chaotic and on edge and our security absolutely canNOT touch the patient if they are coming at a nurse or have a weapon. They are basically there to observe and call the police. We have signs up saying that is illegal to threaten employees and have threatening behavior. Let me tell you how much that helps! Ha! It's ridiculous.
  5. by   Silver_Rik
    Quote from karrikon
    I worked as a psych tech in a hospital. A male and female nurse brought charges against a violent patient. Most patients have enough knowledge to know right from wrong when they are not having a psychotic episode. I also have a nurse friend whose wife is permanently disable from a patient who came in for medical reasons. He was having a delerium episode and PTSD. He attacked her and broke her back. She sued the hospital and one due to lack of support and safety issues.
    We've had staff seriously injured by patients (in pt psych) and when they tried to sue the facility the judge dismissed, said if you work in psych you know the risks.

    If you file charges internally on an assaultive pt you get moved off that floor until the pt is discharged.

    Well, at least we get CPI training with annual refreshers, safety call fobs, and response to emergency situations is rapid and overwhelming.
  6. by   ladyandthetiger
    "You are paid for me to treat you like garbage? "
    My response would be "actually I'm paid to decide if you get the good pain meds or the Advil."
  7. by   Mfs1
    Welcome to then paramedics world. Try working for a embezzling scum bag CEO that thinks paramedics are punching bags.!!!!
  8. by   ladyandthetiger
    OMG That whole thing made me want to punch those staff. The arrogant, superior, condescending attitudes of those healthcare staff were the main cause for the problem.
    How about acknowledging how stressful the situation must be for the patient? If a patient tells you they are hearing voices it really helps to establish empathy with them by responding with "that must be really stressful for you. I'm really glad you have come to get some help, it was a really good idea for you to come in today and I'm sure we can help you get through this."
    Ignoring the comment about the new nurse was more attractive- how about replying with something like "She is such a nice person, we are really lucky to work with her."
    How about NOT talking about the patient like he isn't there and all forming up as a gang openly discussing IN FRONT OF HIM how you are going to "take him down". Remember, it is you vs. the voices in his head - try and make it more appealing to talk to you than listen to them.
    If you do need to "take down" a patient try a little stealth and coordination. I've seen it done beautifully- 2 security guards and a nurse with a shot to the ass of haloperidol.
    I work in ICU, we deal with ICU psychosis regularly I've never had a patient abuse or take a swing at me.
    I always volunteer to take care of patients who have psychiatric comorbidities - usually they are stressed and unhappy when they are handed over to me and laughing and happy when I hand over to the next shift.
    1) Don't be judgemental, use some empathy and try to understand that while you may be an overworked, stressed out nurse at least you get to go home at the end of your shift. The patient is trapped in the situation, often dealing with stressed out, bad tempered, burnt out Nurses.
    2) You're pissed off that the Doctors won't listen to you? If the doctor treats you like an idiot just imagine what it must be like to his patient and be completely at the doctors mercy.
    3) it's not about you. This is the patient's experience and taking the time to explain, nicely, solves a lot of problems before they begin.
    4) Drug induced psychosis needs different management - sedate, restrain and wait.
  9. by   ladyandthetiger
    Anonymously report the CEO to the IRS. This kind of douche is inevitably cheating on his taxes. Use a public library computer so it can't be traced back to you.
  10. by   Jay966
    What is a nurse supposed to do if a patient assaults them? It sounds from some of the comments that taking action to defend yourself can result in losing your license. Are nurses supposed to allow themselves to be hit and just wait until help arrives? What are permissible defensive actions that do not jeopardize ones license?
  11. by   Ruby Vee
    Quote from ladyandthetiger
    OMG That whole thing made me want to punch those staff. The arrogant, superior, condescending attitudes of those healthcare staff were the main cause for the problem.
    How about acknowledging how stressful the situation must be for the patient? If a patient tells you they are hearing voices it really helps to establish empathy with them by responding with "that must be really stressful for you. I'm really glad you have come to get some help, it was a really good idea for you to come in today and I'm sure we can help you get through this."
    Ignoring the comment about the new nurse was more attractive- how about replying with something like "She is such a nice person, we are really lucky to work with her."
    How about NOT talking about the patient like he isn't there and all forming up as a gang openly discussing IN FRONT OF HIM how you are going to "take him down". Remember, it is you vs. the voices in his head - try and make it more appealing to talk to you than listen to them.
    If you do need to "take down" a patient try a little stealth and coordination. I've seen it done beautifully- 2 security guards and a nurse with a shot to the ass of haloperidol.
    I work in ICU, we deal with ICU psychosis regularly I've never had a patient abuse or take a swing at me.
    I always volunteer to take care of patients who have psychiatric comorbidities - usually they are stressed and unhappy when they are handed over to me and laughing and happy when I hand over to the next shift.
    1) Don't be judgemental, use some empathy and try to understand that while you may be an overworked, stressed out nurse at least you get to go home at the end of your shift. The patient is trapped in the situation, often dealing with stressed out, bad tempered, burnt out Nurses.
    2) You're pissed off that the Doctors won't listen to you? If the doctor treats you like an idiot just imagine what it must be like to his patient and be completely at the doctors mercy.
    3) it's not about you. This is the patient's experience and taking the time to explain, nicely, solves a lot of problems before they begin.
    4) Drug induced psychosis needs different management - sedate, restrain and wait.
    You must be a joy to work with if you're wanting to punch hospital staff for what you perceive as "arrogant, superior, condescending attitudes." The same attitudes that you exhibit when you preach to hospital staff.

    I'm happy for you that you've never had an ICU patient (or a visitor, I presume) take a swing at you. I'd venture to guess that it has a lot to do with where you work. I've worked in midwestern community hospitals and "out west" rural hospitals and never had anyone swing at me; but large inner city hospitals on the east coast and the west coast I had different experiences. It's probably as much about where you work as it is about your superior customer service skills.

    It's all very well to say "don't be judgemental" and "use some empathy" when you're sitting at home clicking on your keyboard. The nurse who is in the situation is the one who has to deal with it, and perhaps she's using all the empathy anyone could have and the patient or his visitor is still being abusive. Patients are stressed -- I know that all to well, having been one more than I've been a nurse in the past few years. But as stressed as I was (the day I had 27 mammograms springs to mind) I never verbally abused OR took a swing at a staff member. I think in our rush to be nonjudgemental and empathetic, we fail to hold people accountable for their actions.

    The patient who is "pissed off" because the physician talks down to them still has no right to be abusive to anyone. They do, however, have the right to change doctors. The nurse does not.

    No, it's not about the nurse. We get that. It's about the patient. That doesn't give the patient the right to be abusive to anyone.
  12. by   Ruby Vee
    Quote from Jay966
    What is a nurse supposed to do if a patient assaults them? It sounds from some of the comments that taking action to defend yourself can result in losing your license. Are nurses supposed to allow themselves to be hit and just wait until help arrives? What are permissible defensive actions that do not jeopardize ones license?
    You don't get to hit back. Try to de-escalate and if that doesn't work, dodge and run. NEVER let a patient trap you inside the room. If you know him to be capable of movement, keep an eye on the exit at all times. If family members are threatening, try to de-escalate, ask them to step out or call security to deal with them.

    The best defense is for everyone who works on your unit to enforce the rules for visiting, assuming that you have some. If not, that's a project for someone. Two visitors at a time -- then unless the patient is actively dying, he gets two visitors at a time and they can switch out. No cell phone use in the room (one we've had to adopt to prevent picture-taking of roommates, recording of rounds and other privacy issues) -- then NO ONE gets to use a cell phone in the room. No one gets to bring weapons on their visit. If only some people enforce the rules, then those people are the ones set up to be the "bad nurse" and the visitors know that if they push the "good nurses" far enough, they can do what they want.

    And a standard "no violence" policy works well. No tolerance for violence. If you take a swing at someone, you will be ousted and not allowed to come back. Again, that only works as well as it's enforced.
  13. by   Jay966
    Quote from Ruby Vee
    You don't get to hit back. Try to de-escalate and if that doesn't work, dodge and run. NEVER let a patient trap you inside the room. If you know him to be capable of movement, keep an eye on the exit at all times. If family members are threatening, try to de-escalate, ask them to step out or call security to deal with them.

    The best defense is for everyone who works on your unit to enforce the rules for visiting, assuming that you have some. If not, that's a project for someone. Two visitors at a time -- then unless the patient is actively dying, he gets two visitors at a time and they can switch out. No cell phone use in the room (one we've had to adopt to prevent picture-taking of roommates, recording of rounds and other privacy issues) -- then NO ONE gets to use a cell phone in the room. No one gets to bring weapons on their visit. If only some people enforce the rules, then those people are the ones set up to be the "bad nurse" and the visitors know that if they push the "good nurses" far enough, they can do what they want.

    And a standard "no violence" policy works well. No tolerance for violence. If you take a swing at someone, you will be ousted and not allowed to come back. Again, that only works as well as it's enforced.
    Thank you, Ruby Vee.

    A bit of clarification. I can understand not hitting back. What I am unclear about is whether blocking is or is not permissible. If someone is punching you and you can't get away must you only duck or can you put your arms up in defense? Can you attempt restraining? Several posts mention training in restraint which would seem to imply restraining is allowed given certain circumstances. I am just trying to flush out the nuisances of this a bit

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