How often do you encounter violence?

[studentnurse9806]

Going to be starting an internship in psych soon and am a little nervous. Just wondering how often you deal with violent patients and does it vary depending on unit? I am going to be rotating though adult and child/adolescent. Also, would appreciate any tips! Thanks

[JustKeepDriving]

I work on a lock down forensic behavioral stabilization Psych unit. Violence directed towards staff happens every day. These patients are criminally insane and the majority are guilty with exception of insanity. None of them want to be here and many will attack staff because they want to get new charges and go to prison. Some believe that if they're violent enough, the state will wash their hands of them and they'll get to go back to the community (sadly, this has happened- corrections can't handle them and they cause so much damage to the state hospital- one guy did 2 million dollars worth of damage- that the state can't afford to keep them, so they just get sent back out).

We get training in crisis management, learn safe containment (least restrictive means to stop violent behavior), and if a patient is having a behavioral crisis we always make sure to have 2x to 3x the weight and height of the patient standing off to the side (so as not to provoke the patient while still being prepared) while one person attempts to deescalate (starting by giving the most amount of choice, "It's okay to be upset but you can't do that -observed behavior- here", to the least amount of choice, "Right now, could you please return to your room or walk with me to the side room." Ect.).

sometimes patients give no indications prior to attempting assault, so we follow basic safety precautions- always work in pairs, don't turn back on a patient and basically be aware of your surroundings.

Acute psych - non- criminal was very different however and I never personally experienced physical violence.

[EatYourVeggies]

I did a nursing internship on an inpatient adolescent unit for 2 months and I never encountered any violence but there are so many factors to take into account. My advice is do not be fearful but do take precautionary steps to stay safe : )

[karlevensnemor]

I did a nursing internship on an inpatient adolescent unit for 2 months and I never encountered any violence but there are so many factors to take into account. My advice is do not be fearful but do take precautionary steps to stay safe : )

I encountered violence just last night..patient with ams 2/2 brain tumor kick the **** out of a nurse right in the chest while attempting to put restraints on this poor guy by herself..violence regularly happens depending on what arena of nursing your involved in the most violence I've seen was working in a emergency, psych and neuro tele.it definitely adds spice to any given shift

[nurse lala, BSN, RN]

patient with ams 2/2 brain tumor kick the **** out of a nurse right in the chest while attempting to put restraints on this poor guy by herself..

No nurse should ever put him or herself in a situation like that...being alone with a violent individual. Standards of care indicate three staff minimum to subdue and restrain. That nurse was asking for an injury. Being injured on the job is NOT an expectation of the field.

[MrChicagoRN, RN]

No nurse should ever put him or herself in a situation like that...being alone with a violent individual. Standards of care indicate three staff minimum to subdue and restrain. .

Couldn't agree more.

One of the basic principals of CPI is that if the patient is escalating you wait for the team. Don't be a hero.

if a patient is out of control enough to require restraints, the use of your team is essential.