I am not a chew toy

[audreysmagic, RN]

Another day, another dollar...

I'm sore and annoyed. Got bit by a patient yesterday (adolescent female, not that it really matters) and BOY was she going for the gold. Trying to curse me out around a mouthful of (my) flesh, too. Plus, I'm left-handed and it's my left hand, right by the thumb joint, because of course it is. Went to our workers-comp authorized urgent care (though, as I was supervisor when it happened, finding my own coverage was REALLY fun) and got antibiotics and a Hep B booster, as she did break the skin, even through my glove. Fortunately (or unfortunately), I got scratched in the face last year during a code so I already had a current tetorifice booster! It's less red today, but deeply bruised and hurts like a very hurty thing (I have other words for it, but none the censors will allow). And I have terrible fine-motor dexterity in my right hand, so forget just switching to it to write/handle eating utensils. I'll live but I'm just so irritated over the whole thing.

We don't have security at my facility (freestanding psych) and though in theory I very much agree with the idea that "anyone who puts hands on a patient should be CPI certified and a clinical person" to avoid further trauma to the patient...sometimes I'm like WHAT ABOUT THE TRAUMA TO STAFF, THOUGH? I just get frustrated sometimes, because though our approach works very well 75% of the time, 25% of the time it doesn't and you really need some muscle. I'm 100% there to be sympathetic to the acting-out behavior if it is PTSD/psychosis related...for example, the one who scratched me in the face was psychotic out of her mind and thought I was there to harvest her organs (another fun story for another time). I let that go pretty quickly. But in child/adolescent, especially (but also adult, as I know all too well) there are some people who just want to watch the world burn. They have mental illness, but that's not why they're acting out. Sometimes criminal behavior is just that. Those are the ones I find myself stewing over.

There have been articles upon articles (I read most of them when writing a paper for my MSN on violence in nursing!) about how violence toward healthcare staff should never be tolerated. I agree. And I do acknowledge that like it or not, this will happen occasionally, especially in ED/psych. But it seems like there's just no ground of common sense in so many places, and not just my current facility. There's "that's just what we signed on for" and it's shrugged off. If healthcare is a business, what other business could you go into someone's place of employment, assault the workers, and be welcomed back (often multiple times)?

I do genuinely love this field, but...sometimes ya just gotta vent. :-D

Plus, don't get me started on the nurses who feel like just because they're usually giving the IM's in this situation, they should be exempt from learning de-escalation and proper hold techniques...half the time, I feel like those individuals are a contributing factor to a situation getting out of hand.

[Davey Do]

You're not a chew toy, audreysmagic? And you don't squeak?

Sorry this had to happen to you. Such situations can make us feel violated.

Vent at will and let us know if there' s anything else we can do.

Take care of yourself, audreysmagic.

[audreysmagic, RN]

You're not a chew toy, audreysmagic? And you don't squeak?

Sorry this had to happen to you. Such situations can make us feel violated.

Vent at will and let us know if there' s anything else we can do.

Take care of yourself, audreysmagic.

Oh, I squeak sometimes, all right, just not over that. But thank you. The support here is the absolute best.

[Juryizout]

I got attacked a few months ago and ended up in the ER. I was fortunate to have my manager advocate for me as I was having a hard time being on the floor around that patient following the incident. It was one of those attacks that you don't see coming, that patient was not agitated or irritated in any way. I know how you feel. What about staff safety? I wish their was more that they would do to protect us.

Take care of yourself!

[Meriwhen, ASN, BSN, MSN, RN]

I was assaulted by one of my patients the other day--they landed a few good blows on me, even with several security and staff in the fray as well. But said patient was delirious (UTI of course) so I didn't take it personally.

It was because of several codes and assaults--which resulted in several staff complaints--that we were able to get security present on the unit on a regular basis. Before, we'd have to call them if we needed help, and that could take a minute or five before they arrived. Now, we have at least one around who can help start damage control and also summon backup if needed.

I'm sorry you don't have security...IMO any psych facility/unit should have at least one security guard present at all times. It can actually help prevent problems before they start: a patient comes out of their room ready to act out, sees the uniform and (usually) immediately reconsiders what they were about to do. Doesn't seem like a good idea after all when there's someone there that clearly doesn't appear to be afraid of them. And it's amazing how some of the most posturing, threatening, bad-ass atttitude patients will run like a scared kitten when they see security arrive on the unit :)

[debiklages, MSN, RN]

I have worked a LOOOOONG time in mental health and have had quite a few close calls. I have been rescued by both staff as well as by consumers ( patients) on the inpatient mental health units. I have never worked on a mental health unit that had security guards on staff and I don't believe that it is necessary. I know of one instance where a 90 pound female nurse pounced on a male patient who was strangling a staff member and using the techniques we were taught in aggressive behaviour management immobilised the patient. I also worked with a male nurse who was 6 foot tall, built like a football player but had the face of a cherub. All he would have to do is walk in the room , fold his arms in front of him and ask " what seems to be the problem?" to de-escalate. We all need to be taught how to communicate with people as well as how to protect ourselves don't we ?

[Juryizout]

We have security, but they don't come to codes. They are for intake only. I have used some of my male nurse's presence to deter patients going off, and some aides.