Violence in Nursing - page 4

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   ladyandthetiger
    Have you ever even heard of a patient being able to switch doctors once they are an inpatient? Once they are admitted they are pretty much stuck - much like you must have been the day you had 27 mammograms (I'll take you at your word about that).
    The only nurses who have a problem with me are the burnt out or lazy ones - like you sound.
    Not getting abused has more to do with my advanced situational management skills and ability to head of problem behaviours before they escalate. That combined with my exceptional reputation with doctors, shift leaders and hospital coordinators who listen to me when I suggest putting behavioural assists in place (prn orders for chemical restraint, additional staff to special patients likely to cause problems etc) means I prevent the problem rather than cleaning up after the fact.
  2. by   moremayo-RN
    'Abuse can include yelling, cursing, scratching, spitting, hitting, kicking, and verbal threats.'

    This isn't just patients - I worked in a clinic and the MD (owner of clinic) constantly yelled at me, in front of patients, peers, etc. It was shamming, degrading and I couldn't quit fast enough. When he left the room patients would say 'what an a$$h0!#', or 'you do not deserve to be treated this way'...

    At review time I always got A+! Living with this cognitive dissonance caused me depression and anxiety. I quit at a time when the clinic was extremely short staffed, gave my 2 weeks, and he couldn't understand why I did this to him. Karma!

    This experience gave me the balls to stand up for myself with MDs who speak to nurses like trash. No job is worth my mental health again.
    Last edit by moremayo-RN on Aug 6 : Reason: language
  3. by   Roz, RN
    We have no security where I work. As far as calling police, sure, we can call. We get told they're at "the north end of the county". I called about an issue in mid-June. Still waiting on them! I'm thinking about carrying a can of bear spray!
  4. by   macawake
    Excellent and much needed post, Nurse Beth

    Quote from Nurse Beth
    Culture of Acceptance

    There’s a culture of dismissing and minimizing violence towards nurses. Nurses believe in “doing no harm” and will put patient safety before their own.


    Culture of Non-Reporting

    There are barriers and attitudes towards reporting. Nurses themselves under-report violence. Nurses fail to report, believing it is just part of the job, and that managers may be non-responsive.
    This needs to stop.

    I am going to be deliberately provocative here and I'll no doubt upset some people and some will try to argue against my position, giving examples of just how unsupportive managers or whatever, have been when they or a nurse at their facility was subjected to work-related violence. I've had this discussion before, both on AN and in real life with other nurses. "Oh, you must work at a more supportive facility than I do". "You don't understand how our managers treat us".

    It doesn't matter if other people (whether those people are the patients themselves, the healthcare facility's managers or the general public) have an expectation that nurses should tolerate more violence than other professions. It really doesn't matter. What matters is if nurses think they should tolerate more violence than others. What matters is what we are willing to put up with. If we accept being beaten, then we will continue to get beaten. The ONLY ones who can change the current culture of acceptance, is US. I we sit and wait for someone else to do it, hell will freeze over before it happens.

    Quote from albert_636
    I've heard stories of patients assaulting a nurse and if another nurse stepped in to defend (such as push the patient off or physically hold the patient down) they get sued and the nurse loses their license. I think its BS considering how some of these patients can really hurt even kill a staff member. What are we supposed to do, just watch and yell for security?
    Quote from Timbal
    I have worked with mental health patients who can be very violent, at multiple facilities. The workers have always been told to run away or call for help if a patient becomes violent and attacks. That leaves us in a dilemma if we are cornered and cannot get away without putting hands on the patient. We have no legal defense. Just the very real threat of A) allow the patient to injure us or someone else, or B) defend yourself and loose your license.
    Quote from 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.
    Anecdotal stories apart, can anyone point to an actual real (BoN) example where a nurse has lost his/her license for using a reasonable amount of force to defend themself or someone else from a violent attack? (What's considered reasonable of course depends on the nature of the attack).

    Full disclosure, I don't live or work in the U.S. so our laws are different. I obviously can't offer legal advice, but I do encourage everyone to find out what their actual LEGAL rights and obligations are. If I'm to make an educated guess, it would be that it's not ILLEGAL for a nurse to defend herself or himself from a violent attack. I'm willing to bet that you have the same right to not be beaten, kicked or strangled on your on-duty Wednesday shift at work, as you have when you're grocery shopping on your off-duty Thursday (but as I said, you need to verify that).

    Whatever restrictions you feel are in place at work, are likely simply your employer's policies. The law most likely doesn't say that you aren't allowed to defend yourself against violent attacks, and while I'm not a U.S. legal expert, I highly doubt that facility policy trumps state or federal laws.

    If it actually states in the facility policy, that you or someone else can't even touch a patient who comes at someone with a weapon, then you need to approach management and make them change that policy. You might argue that it's not that easy to do. My response is, that it actually is. A single one of you can't do it, but together you can.

    Whether you will actually manage to get all nurses on the same page and demand reasonable work conditions, or not; should you be the victim of a violent attack; REPORT it to the police.

    Quote from FlyingJoey
    Someone mentioned about pressing charges and I was wondering if it's okay to call local police to a hospital unit to get a police report? Or is there any better way to handle this type of situation when I want to pursue legal action?
    Are you asking if your employer thinks it okay? I honestly have no idea. But if it were me, I wouldn't even be asking myself if it was okay or not. If I've been the victim of something that fits the criteria of a criminal offense, I will call the police.

    Quote from Laurean
    The reason, I believe that violence is condoned towards nursing is because ADMINISTRATION does not hold the patient and the individauls chain of command accountable. It is directly given to the one who is attacked.
    While I agree that it would be nice to work in a facility where management is supportive of its staff, in my opinion it always falls on the victim of a crime to report it to the police. Sure, witnesses and bystanders can also dial 911, but the victim has an absolute right to file the legal complaint/press charges.

    Administration can't really hold the violent offender accountable, that falls on the criminal justice system.

    Quote from Froggybelly
    It's sad that nurses feel workplace violence comes with the job. I cannot imagine a financial advisor thinking it's okay to be punched by his client.
    Who are the nurses who think that violence is okay? I'm a nurse and while I realize that we are subjected an increased risk of violence in our jobs due to its nature, I have never nor will I ever accept violence as a part of my job that I'm not allowed to do anything about.

    Back when I worked in the ED, a patient (under the influence of several illicit drugs) came after one of the ED docs, with a knife and with clear homicidal intent. Without getting into too many details at 6'1'', my forehead is perfectly aligned with the nose on a 6'5'' violent armed attacker. And on that day, one shoulder (dexter) was forever anatomically altered and one patella was slightly offended...

    My point here isn't to illustrate how I defend myself when I or someone else is attacked, but rather to tell the story that we are in fact allowed to use force to defend ourselves. If I'd used this level of force against a patient with dementia who was scratching me or trying to bite me, then it would have been deemed an unreasonable amount of force. I would most likely have gotten a felony conviction, which in turn would have led to my license being revoked. (and justly so). But with the level of threat I was responding to and the limited options available to me or the cornered physician, I was never the least bit nervous that I'd be in trouble. (I wasn't nervous because I'm familiar with the relevant legal statutes regarding use of force in self-defense. I recommend that all healthcare professionals find out about their local laws). That didn't stop several doomsday coworkers from sharing their dire predictions about me losing my license, and one of them was shocked by my actions and said to my face that she thought it was completely out of line for a healthcare professional to use violence. I told her that I agree with her, but that in my opinion self-defense is a different matter altogether.




    We need to change the culture. We are the only ones who can do it.
    Last edit by macawake on Aug 6
  5. by   Jay966
    Quote from macawake
    Anecdotal stories apart, can anyone point to an actual real (BoN) example where a nurse has lost his/her license for using a reasonable amount of force to defend themself or someone else from a violent attack? (What's considered reasonable of course depends on the nature of the attack).
    This is precisely what I would like to know.
  6. by   herring_RN
    This was one of the incidents that led to our working for and achieving new workplace protections as posted here:
    Violence in Nursing

    I thank Nurse Beth for her article and this discussion.
    I think it does no good to blame the nurse. I do think we need to plan ahead to prevent harm to our patients and ourselves.
    Contra Costa nurse dies; El Cerrito man charged with murder in jail attack
    Aaron Nygaard, 34, was booked Monday morning into County Jail in Martinez on suspicion of residential burglary in El Cerrito. That afternoon, authorities said, he faked a seizure and then attacked Palomata. Nygaard was charged Thursday with murder...
    ... Nygaard had no criminal record and showed no signs of aggression before the surprise attack, authorities said. He continued to fight deputies after striking Palomata and was eventually subdued by use of a Taser and physical force, the Sheriff’s Office said...

    ... Palomata is the second Bay Area medical worker to die after an attack by an inmate this week. Donna Gross, 54, of Concord, was strangled Saturday by a criminally insane patient at Napa State Hospital, Napa authorities said. Jess Willard Massey, 37, has been charged with murder in Gross’ death.

    Contra Costa nurses repeatedly have called for stronger security measures to protect staff members in the jail, the county hospital psychiatric unit and emergency room, where numerous violent incidents have occurred, Jacobs said. Sheriff Warren Rupf said there were 48 incidents of jail staff members being assaulted by inmates in 2009, but none of them were medical workers...
    http://<b>http://www.mercurynews.com...il-attack/</b>
  7. by   herring_RN
    The Ventura County ER nurses did not have supportive management.
    They did succeed in getting the help they demanded.
    Years later they continue be safer.
    I posted about it here:

    Violence in Nursing
  8. by   Nurse Beth
    Quote from macawake
    Excellent and much needed post, Nurse Beth



    This needs to stop.

    I am going to be deliberately provocative here and I'll no doubt upset some people and some will try to argue against my position, giving examples of just how unsupportive managers or whatever, have been when they or a nurse at their facility was subjected to work-related violence. I've had this discussion before, both on AN and in real life with other nurses. "Oh, you must work at a more supportive facility than I do". "You don't understand how our managers treat us".

    It doesn't matter if other people (whether those people are the patients themselves, the healthcare facility's managers or the general public) have an expectation that nurses should tolerate more violence than other professions. It really doesn't matter. What matters is if nurses think they should tolerate more violence than others. What matters is what we are willing to put up with. If we accept being beaten, then we will continue to get beaten. The ONLY ones who can change the current culture of acceptance, is US. I we sit and wait for someone else to do it, hell will freeze over before it happens.







    Anecdotal stories apart, can anyone point to an actual real (BoN) example where a nurse has lost his/her license for using a reasonable amount of force to defend themself or someone else from a violent attack? (What's considered reasonable of course depends on the nature of the attack).

    Full disclosure, I don't live or work in the U.S. so our laws are different. But if I'm to make an educated guess, it's not ILLEGAL for a nurse to defend herself or himself from a violent attack. I'm willing to bet that you have the same right to not be beaten, kicked or strangled on your on-duty Wednesday shift at work, as you have when you're grocery shopping on your off-duty Thursday.

    Whatever restrictions you feel are in place at work, no doubt are simply your employer's policies. The law doesn't say that you aren't allowed to defend yourself against violent attacks, and while I'm not a U.S. legal expert, I highly doubt that facility policy trumps state or federal laws.

    If it actually states in the facility policy, that you or someone else can't even touch a patient who comes at someone with a weapon, then you need to approach management and make them change that policy. You might argue that it's not that easy to do. My response is, that it actually is. A single one of you can't do it, but together you can.

    Whether you will actually manage to get all nurses on the same page and demand reasonable work conditions, or not; should you be the victim of a violent attack; REPORT it to the police.



    Are you asking if your employer thinks it okay? I honestly have no idea. But if it were me, I wouldn't even be asking myself if it was okay or not. If I've been the victim of something that fits the criteria of a criminal offense, I will call the police.



    While I agree that it would be nice to work in a facility where management is supportive of its staff, in my opinion it always falls on the victim of a crime to report it to the police. Sure, witnesses and bystanders can also dial 911, but the victim has an absolute right to file the legal complaint/press charges.

    Administration can't really hold the violent offender accountable, that falls on the criminal justice system.



    Who are the nurses who think that violence is okay? I'm a nurse and while I realize that we are subjected an increased risk of violence in our jobs due to its nature, I have never nor will I ever accept violence as a part of my job that I'm not allowed to do anything about.

    Back when I worked in the ED, a patient (under the influence of several illicit drugs) came after one of the ED docs, with a knife and with clear homicidal intent. Without getting into too many details at 6'1'', my forehead is perfectly aligned with the nose on a 6'5'' violent armed attacker. And on that day, one shoulder (dexter) was forever anatomically altered and one patella was slightly offended...

    My point here isn't to illustrate how I defend myself when I or someone else is attacked, but rather to tell the story that we are in fact allowed to use force to defend ourselves. If I'd used this level of force against a patient with dementia who was scratching me or trying to bite me, then it would have been deemed an unreasonable amount of force. I would most likely have gotten a felony conviction, which in turn would have led to my license being revoked. (and justly so). But with the level of threat I was responding to and the limited options available to me or the cornered physician, I was never the least bit nervous that I'd be in trouble. (I wasn't nervous because I'm familiar with the relevant legal statutes regarding use of force in self-defense. I recommend that all healthcare professionals find out about their local laws). That didn't stop several doomsday coworkers from sharing their dire predictions about me losing my license, and one of them was shocked by my actions and said to my face that she thought it was completely out of line for a healthcare professional to use violence. I told her that I agree with her, but that in my opinion self-defense is a different matter altogether.




    We need to change the culture. We are the only ones who can do it.
    Amen. No one is going to do it for us.
  9. by   Jessy_RN
    Violent patient, violent family member/friend, violent physicians. At my place of employment they don't give a rats ass. They will at whatever level get creative enough to say it wasn't intended, you're too sensitive, it was a moment of oops, the aggressor was acting out of emotion due to the circumstances, there was a misunderstanding and so on. It sounds amazing in paper and theory but the REALITY of the situation is that as nurses we are treated like punching bags and are expected to tolerate it unless were stabbed or shot at, I suppose. It's like an unsung theory that it comes with the job. I don't care what anyone says because I have been chased with dirty needles, hit upside the head with an object by an irate surgeon, constantly berated in the operating room with no place to run/hide or exit and management always finds a way to say no it's not acceptable but patients and surgeon are our clients so either take it or move along. We are a dime a dozen in their eyes. Don't for a minute say it doesn't happen or I work in a unique environment because I've worked in so many places/states and it's all the same bullcrap. They all talk about it and provide wonderful literature and classes about violence in healthcare but not a damn thing is ever done about it. It's kinda like unsafe nurse to patient ratios. Lots of blah blah blah but in the end nothing is ever done. No one cares about us! Be prepared to lose your job if you get too brave, retaliated on and black listed from finding another job. I've seen it!

    Remember we don't want negative patient satisfaction scores because at the end of the day they matter more than staff safety, staff satisfaction and everything else. Ask any dedicated staff up the food chain.
    Last edit by Jessy_RN on Aug 6 : Reason: misspelling
  10. by   JKL33
    Quote from macawake
    Who are the nurses who think that violence is okay? I'm a nurse and while I realize that we are subjected an increased risk of violence in our jobs due to its nature, I have never nor will I ever accept violence as a part of my job that I'm not allowed to do anything about.
    Excellent post in its entirety, though I've only quoted a portion.

    Working @ random ED: Patient with weapon (not a gun) and violent/threatening behavior. Staff was in a safe position, I called the police. I hung up the phone and everyone told me I was in BIG TROUBLE because they aren't allowed to call the police to come to this ED. I politely said to the effect 'we'll see about that'. As soon as I encountered the supervisor (later) I told her, "Oh by the way. I had to call the cops earlier for a violent patient waving a weapon around. These guys have told me I'm going to be in trouble because they aren't allowed to call the police, but I told them they must have misunderstood because that is ridiculous and would be a major legal issue!" <make excellent eye contact>. She said "Oh....well....good work. I have no ideeeeaaa why they would say THAT??!!" <of course you don't!>

    I was prepared to be as assertive as necessary over this issue but as it turns out I never heard another word about it. And that, right there, was the end of them being "not allowed to call the police."

    We all have to put our foot (feet) down. For the best results, I suggest making no apologies and leave no room for being bullied about it.
  11. by   macawake
    Quote from Jessy_RN
    Violent patient, violent family member/friend, violent physicians. At my place of employment they don't give a rats ass.
    Quote from Jessy_RN
    the REALITY of the situation is that as nurses we are treated like punching bags and are expected to tolerate it unless were stabbed or shot at, I suppose.
    Quote from Jessy_RN
    We are a dime a dozen in their eyes.
    Quote from Jessy_RN
    No one cares about us!

    I get so frustrated when I read a post with such a defeatist attitude.

    I'm sorry that these things have happened to you at work. It's not acceptable. Of course if you had a decent employer they wouldn't tolerate that their nursing staff gets treated the way you've described, and in an ideal world the victims of a hostile/abusive workplace shouldn't be the ones responsible for fixing the problem. But you have to deal with reality and by now it's painfully clear that they won't do anything to improve your work conditions. Why? Because they lack the incentive to.

    You guys need to motivate them... MAKE THEM give a rat's ass.

    Trust me, every decision a manager makes, whether that decision is to act or to do nothing at all, comes after a cost-benefit analysis has been done of the available options. Ít's within your power to affect the variables in that mental calculation.

    Quote from Jessy_RN
    I don't care what anyone says because I have been chased with dirty needles, hit upside the head with an object by an irate surgeon, constantly berated in the operating room with no place to run/hide or exit and management always finds a way to say no it's not acceptable but patients and surgeon are our clients so either take it or move along.
    Who apart from your unmotivated managers did you report these incidents to? Union rep if you have them? Did you contact the police? (If someone chased me with a dirty needle, I definitely would have. Where did the person find the used needle anyway? Did they have it in their possession when they arrived at the hospital or did they somehow get their hands on one in the facility? That's a safety issue if it happened).

    Quote from Jessy_RN
    Be prepared to lose your job if you get too brave, retaliated on and black listed from finding another job. I've seen it!
    This is where solidarity comes into play. A single or a few individuals can seldom affect any meaningful change on their own. The power balance employer vs. one employee isn't even. The employer has the upper hand. But when people unite and speak with one voice, it's not as easy to ignore. The strategy is to make the status quo more of a pain in the *** for management, then implementing and enforcing rules that say that staff should not hit other members of staff with objects.

    The surgeon who hit you over the head with an object only did that because s/he confident s/he'll get away with it. Relieve that person of that conviction. I assume it wasn't just you and the surgeon in the OR? You and your coworkers need to band together and isolate the wrongdoer. You do have strength in numbers. Stop enabling that kind of inappropriate workplace behavior.

    Quote from Jessy_RN
    They will at whatever level get creative enough to say it wasn't intended, you're too sensitive, it was a moment of oops, the aggressor was acting out of emotion due to the circumstances, there was a misunderstanding and so on.
    If my manager had said this to me, this would have been my repsonse: "Please don't think that I'm threatening you right now because I'm not, but hypothetically speaking, if something you did displeased me like for example this conversation, would you consider me smacking you over the head with some suitable object, an oops moment?" [insert innocent looking face] They will inevitably answer no. At that point in the conversation I don't really even have to deliver the last line; it wouldn't be okay for me to do it, just as it isn't okay for the surgeon or the patients to do it. But that's me... Might not be the best strategy, but I've found that for me personally it drastically reduces the amount of future stupid comments I have to endure from the other party...

    Quote from Jessy_RN
    Don't for a minute say it doesn't happen or I work in a unique environment because I've worked in so many places/states and it's all the same bullcrap.
    OP asked the following in her original post; Why is violence towards nurses so pervasive? It happens because nurses won't say in ONE voice; enough. No more.

    Jessy, it doesn't happen where I work. It doesn't have to happen to you either. But I can't change it. I wish I could, but only you together with your coworkers can. The responsibility is in fact your employers', but since they won't do anything it falls on you all.
    Last edit by macawake on Aug 6
  12. by   herring_RN
    I clearly remember a 1978 newspaper article. A nurse at a nearby hospital sued a surgeon.
    She and other staff testified that they had been reporting via incident report and to the medical director that he was frighteningly verbally insulting and threatening to staff. He had once thrown a scalpel which lodged in a wall.

    The suit was regarding a time he opened a sterile tray that was what he had asked for, but not what he wanted.
    She told him, "Oh. That is what you asked for."
    He cursed and threw the plastic tray at her. It hit the bridge of her nose causing a small cut with a few drops of blood.
    She hired an attorney and sued him for $1.25 in civil court. She said that she needed to use a couple bandage strips and suffered moderate pain for four days. She wanted 25 cents a day for her pain and suffering.
    The judge ordered that he pay her the $1.25 plus ten thousand dollars punitive damages.
  13. by   herring_RN
    Part of how the law was passed in California.

    Florida nurses working for violence prevention

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