Abuse of Nurses

[widi96]

So we have recently had a patient on our unit (tele unit) that has threatened to kill staff members, called them numerous obscenities and physically assaulted at least two nurses. This is an alert and oriented patient who know exactly what she is doing. We had a meeting today and discussed what the appropriate action would be (the nurses were discussing pressing assault charges). We were told that if the patient continued to assault staff they would be given the option to sign out AMA or restraints would be applied. They are basically giving this patient free reign to slug one of us each time she gets admitted (which is frequently) before restraints are discussed. We were told we can NOT press charges and everything would have to go through the hospitals attorney if we insisted on pursuing something. This seems absolutely ludicrous to me. If an A&Ox3 pt is repeatedly assaulting staff - we can't press charges, but you know, if we try to get them to do anything they don't want, it is assault charges against us. Does anyone know if this is the norm, or what would you do it a pt hit you? (Again, this is a&ox3, not a demented little person who doesn't know what they are doing)

[mo-mo]

I think every one has pretty much covered all the bases! If your hospital is unionized, make sure to contact your rep also. Unions have been very helpful in this type of situation.

[leslie :-D]

and if you don't have it already, get your own darned insurance!

as you have seen, the hospital is protecting their own interests and no one else's.

leslie

[PICNICRN, BSN, RN]

And after you make file your assault complaint with the police...... get a restraining order!

[Xbox Live Addict]

And if they pull that "well, this is private property.." Thats crap because my home is private property and I'd call the police there if I was assaulted. Pressing criminal charges can be done no matter where the assault took place.

Criminal offenses are considered to be crimes against SOCIETY... which means they can be filed regardless of where the crime took place. Otherwise, if someone invited you into your home and murdered or robbed you, they would be untouchable.

Ever notice how criminal charges are filed as "The State of XX vs. John Doe" or "The United States of America vs. John Doe" if it's being prosecuted on the federal level? That goes back to how certain offenses are considered to be against society rather than an individual.

I am not giving up my basic constitutional rights for ANYONE.

[Xbox Live Addict]

I was charge in my LTC when 3 CNA's came to me reporting an assault by a known combative, A&Ox3 resident. I called my DON and administrator, which were both unavailable, then police upon CNA request. Police responded, resident was made aware of consequences if CNA wanted to press charges, and resident checked out AMA the next day.

Admin was furious, but I firmly held my stance that CNA was within her rights, and the powers that be were unavailable, after several calls and voicemails left. They eventually got over it.

We have the right to press charges at work just as if we were at home, or on the street. Don't EVER take an assault from a resident and let it go, because Admin will NOT help staff, they're all about pt satisfaction!

I am glad that this CNA had you advocating on her behalf. Otherwise, the administration may have intimidated her into giving up legal rights.

[RN1982]

Criminal offenses are considered to be crimes against SOCIETY... which means they can be filed regardless of where the crime took place. Otherwise, if someone invited you into your home and murdered or robbed you, they would be untouchable.

Ever notice how criminal charges are filed as "The State of XX vs. John Doe" or "The United States of America vs. John Doe" if it's being prosecuted on the federal level? That goes back to how certain offenses are considered to be against society rather than an individual.

I am not giving up my basic constitutional rights for ANYONE.

Well, there was another thread about a nurse being fired for calling the police and another member tried to convince everyone that we were not allowed to call the police because the hospital is private property. Anyhow, it was a stupid point.

[JohnBearPA]

I am glad that this CNA had you advocating on her behalf. Otherwise, the administration may have intimidated her into giving up legal rights.

The facility tried to get her to retract her statement to police the next day, but it was too late. The resident had been exhibiting this behavior for several MONTHS, and admin was VERY aware. In fact there were several other assaults, such as resident throwing feces, menstrual blood, and urine, as well as resident literally running over a staff nurse with her motorized w/c. Thankfully resident figured out that charges might be pressed against her, and checked out AMA with family the next day. Now she's someone elses problem, unfortunately.

As for advocating, I'm a pt advocate AND a staff advocate. How can I expect my staff to give proper care when they're afraid to enter a room to answer a call light?

[NewbieLPN2011]

Im an STNA going to school for my LPN and last week a combative schizophrenic was admitted into our LTC facility. His first night there he tried to beat the crapt out of us. It took eight people and two shots of adavan to finally calm him down 2 hours after the incident began. Every night I walked into work scared of what this guy was going to do to us. Administration seemed to not care at all. They pretty much had the mentallity that we approached him wrong and that it was the staff's fault we were getting spit on,kicked,punched,charged at etc etc etc. Then I found out this afternoon from my friend that worked last night that he got sent out to the psych ward (where the doctor said he belonged in the first place) because he punched the DON in the face. I laughed so hard. I knew it would take him beating up on someone in administration before they would move him. I really think that it is sad that it took a week of the staff getting beat up and scared to death but the DON gets hit once and BOOM he's off to a psych facility for evaluation and medication adjustment!!

[suanna]

Pressing charges can be tough- how do you get around the HIPPA regulations. In theory you cannot even acknowledge a patient is admited to your hospital without a signed release. I doubt the patient is going to let you release information to the local cops. The ANA has been working on this problem for a few years with but I have yet to hear anything come of it besides a policy statement that says it's bad to beat up nurses. I don't have an answer myself. I do find it frustrating that if you smack the cashier at the local IGA when she double charges you for your eggs you can bet you are going to spend some time in the back of a squad car, but you can bite, punch, kick and generaly beat up a nurse and you are going to get extra attention from the hospital to help you be more satisfied with your care! And this is why we went to college for 4-5 years. All this dosen't even address doctors throwing things, or brow-beating the nurses. We wonder why there is a nursing shortage?!

[Altra, BSN, RN]

Pressing charges can be tough- how do you get around the HIPPA regulations. In theory you cannot even acknowledge a patient is admited to your hospital without a signed release. I doubt the patient is going to let you release information to the local cops. The ANA has been working on this problem for a few years with but I have yet to hear anything come of it besides a policy statement that says it's bad to beat up nurses.

I'm sorry, but you've clearly never been in this situation. Pressing charges is not "tough," at least not if there are witnesses.

1. Police are called.

2. Police arrive and are advised of what has occurred. (response time in my area is about 3-4 minutes)

3. If patient can be discharged or has already expressed desire to leave AMA, this process is completed in the presence of PD, and patient leaves in their company.

4. If patient must remain hospitalized, pt. is advised of charges to be filed by mail. PD remains at the scene for as long as it takes to get situation back under control.

This is essentially the same process if assault/battery occurs in some other setting, e.g., your local supermarket.

The sense of powerlessness expressed by some here is disturbing.

[mama_d, BSN, RN]

from www.hhs.gov re:HIPAA

"Serious Threat to Health or Safety. Covered entities may disclose protected health information that they believe is necessary to prevent or lessen a serious and imminent threat to a person or the public, when such disclosure is made to someone they believe can prevent or lessen the threat (including the target of the threat). Covered entities may also disclose to law enforcement if the information is needed to identify or apprehend an escapee or violent criminal."

Sounds like we're protected as far as HIPAA goes.

We recently had a family member who threatened to come up to the facility at shift change and kill staff...I'd have laid down money that she was on meth or crack. I told my manager that if such a threat was directed to me, I was going to call the police and apply for a restraining order. She wasn't happy about it but she didn't really argue either.

[Xbox Live Addict]

The facility tried to get her to retract her statement to police the next day, but it was too late. The resident had been exhibiting this behavior for several MONTHS, and admin was VERY aware. In fact there were several other assaults, such as resident throwing feces, menstrual blood, and urine, as well as resident literally running over a staff nurse with her motorized w/c. Thankfully resident figured out that charges might be pressed against her, and checked out AMA with family the next day. Now she's someone elses problem, unfortunately.

As for advocating, I'm a pt advocate AND a staff advocate. How can I expect my staff to give proper care when they're afraid to enter a room to answer a call light?

I've heard at least one case of an abusive patient that had felony assault charges filed for throwing urine at staff members - one count for every person that got splashed

Being a staff advocate comes down to the same as being a patient advocate, for the reasons you cited. And who would want to work at a place where the management considered staff to be the patients' chattel or even a whipping boy/girl, to be perfectly blunt? And nursing experts need multi-million dollar studies to figure out why no one wants to do bedside care?