How does a Nurse properly defend him/herself from a patients physical attack?

  1. this is my first thread...just registered today so.. here I go

    please read article.
    http://www.sanluisobispo.com/2010/10...-hospital.html

    ok a napa nurse died because of the criminally insane patient. the patient was unarmed but manages to choke/kill that poor nurse.

    this article makes me HTN mad/furious/enraged as F... a patient kills a nurse.

    I only have 6 months experience as a nurse and I dont know all the legal aspects (some forgoten since NCLEX preperation/nursing school)

    How do I protect myself from a physical attack from a patient?
    Can a nurse use his/her martial art skill if (he/she knows any) to defend herself?
    Or are nurses legally defenseless.
    I just want to know how can I legally protect myself without losing my license/getting fired from my job.

    (offensive type of martial art as in punching or kicking to inflict damage, I KNOW THAT THIS IS A BIG NO NO)
    (defensive martial art as in grappling to break free from a patient's choke hold or blocking an attack, But what if I caused a skin tear or a bruise trying to break free from a patient's choke hold? Am I still liable for that skin tear, or bruising? )
    Last edit by MMA-N-Nursing on Oct 29, '10 : Reason: added info
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  2. 126 Comments

  3. by   AgentBeast
    I'm not a lawyer nor did I stay at a Holiday Inn Express last night, but the law probably says something along the lines of use the least amount of force necessary to defend oneself. Me, personally I'm using any and all means necessary to defend myself. Pretty much anything is better than being dead right?
  4. by   thinkertdm
    The exact legal issue varies widely on such factors of the situation, the quality of the lawyer they hire, the quality of the lawyer you hire.

    Here's what I learned in my martial arts training: avoid the situation if you can. Don't let the patient get between you and the door. Run away. Scream.

    The other item common sense tells me is to decide which matters more, your license or your life. It's better to be judged by 12 than carried by 6, my sensei always said. Do what it takes to remove yourself from the situation, no more, no less. Incidentally, you can be successfully sued if you used more force than necessary, as you have the training, as well as how to use it properly.
  5. by   rn4ever?
    There is always a gray area in this. Having worked in Psych, I believe that you should be preventive about this. Know when to back off-----especially when handling a paranoid/delusional patient. Be extra-careful when going into patients' rooms. If they are agitated and combative, call for help ALWAYS and never underestimate the strength of a patient-----NEVER! I haven't seen a documentation of this yet personally but an experienced co-worker who is also RN informed me that in the state of NJ, if you are caught in a combative position, particularly if you raise your fists in a ready-to-punch position, that would be grounds for dismissal automatically.
  6. by   SharonH, RN
    If you are being attacked, you have a right to defend your life. What is the point of being legally right if you are dead? The best policy is always prevention, de-escalation and taking proper precautions but if it gets past that and someone has their hands around your throat, then do your level best to gouge their freakin' eyes out.
  7. by   SlightlyMental_RN
    Personally, I wouldn't care if I caused a bruise or skin tear in the course of defending myself. I'll sort out the details after I'm safe and sound.

    Now, I work with psych patients and addicts, and I've only felt really threatened a few times. When that happened, I used humor to defuse the situation and had my co-workers go into the room with me. Prevent the situation whenever possible.
  8. by   Lovely_RN
    I work with addicts and MICA patients and our security is a joke. It's provided by a contracted company that uses a lot of young people who look like they couldn't hurt a fruit fly much less handle an irate patient. They also have had zero training in verbally de-escalating tense situations and most are too immature to have figured out how to speak to people. I don't feel like i'm in danger on a daily basis but I always stay focused and aware of my surroundings. I speak respectfully to the patients and I never use sarcasm. When I started my job some of the patients tried to test me but now that they know me for being consistent the majority don't bother. My biggest concern are new admissions because you just don't know who you're dealing with but luckily I haven't been cursed out or physically threatened by any patients (yet).

    I carry "something" for my protection even though it's against company policy. I have children and a strong interest in staying alive so if it comes down to my life or my job/license...I'm going to use what I have and worry about it later.
    Last edit by Lovely_RN on Oct 29, '10
  9. by   MMA-N-Nursing
    Well I guess its better to survive and lose my nursing license than being in a casket. (now i get the phrase being carried by six) I hope I dont have to wrestle a patient if my life depends on it.

    LOLROFL+LMAO on gouge his eyes out. Deadliest martial art of all. kudos
  10. by   OttawaRPN
    Count me as among those that will not go down without a fight. I guess along with everything else we're expected to be superheros with magical powers and nine lives. It's funny how many facilities have a explicit "no abuse policy" but for some odd reason that doesn't apply to staff, where being the punching bag of the day is to be expected. When I worked in LTC it was unforgivable to leave a soiled patient in bed, even if he was kicking, punching and biting, you were required to grab an extra pair of hands and keep trying further escalating the behaviours. It didn't matter if you came out bruised and scratched, as long as you got him dry and clean, filled out an incident report to make you feel better and go do it again the next day.

    I won't forget the night one of my HCAs got beaten to a pulp from a frontal lobe dementia patient who was hallucinating and had been threatening to pound someone from the day he was admitted. Well he held true to his promise and all the HCA was doing was providing care to a female patient so it was entirely unprovoked and unavoidable. Backed into a corner, she came out of it with two black eyes, a broken mandible and clavicle and a missing tooth. She also suffered PTSD and couldn't work for 6 months. Later she admitting that other than screaming, she couldn't lift a hand on him for fear of being disciplined. Management's response? You did the right thing. Yeah, right. Had that been me, I would have been like a tom cat caught in a wet paper bag and done everything my survival instincts taught me to get the he!l out of there, including fighting back. Sorry, but being assaulted is not in my job description.
  11. by   AgentBeast
    Quote from MMA-N-Nursing
    Well I guess its better to survive and lose my nursing license than being in a casket. (now i get the phrase being carried by six) I hope I dont have to wrestle a patient if my life depends on it.

    LOLROFL+LMAO on gouge his eyes out. Deadliest martial art of all. kudos

    Being a dude like me you should be aware of another.
  12. by   NurseFrustrated
    I have been a nurse for just over 5 years and fortunately have not been physically attacked. I have had elderly dementia patients or some confused patients swat and kick at me, but not enough to cause harm. If a patient is known to be confused or has the potential to be violent, it is told to us in report and no one will go in the patient's room alone. In one job I had, we had a patient that had such erratic behavior, we always had to take a security guard in with us. Just the sight of the security guard behind the nurse kept the patient's behavior in check. Always have backup with you if there is any doubt about your safety, no matter how nice the patient may appear. This way if a violent patient could get a hold of one person, the other person can call for help or call a violent patient code and help will arrive fast. Also, as others on here have also mentioned, never let the patient come between you and the door.
  13. by   MMA-N-Nursing
    Quote from ScottE
    Being a dude like me you should be aware of another.
    THE DEADLIEST FORBIDEN FRONTAL KICK causing blunt testicular trauma
  14. by   MMA-N-Nursing
    Quote from NurseFrustrated
    Also, as others on here have also mentioned, never let the patient come between you and the door.
    I am new to nursing profession. (only 6 months) care to elaborate why? Is the patient gonna attack me from my back?

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