Abusive patients...

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So, here it goes. Today my problem child (an incrediby abusive patient who desperately needs a psych eval) acted out once again. She hit me (just lightly), threatened to kill a resident on the floor below mine, spouted racial slurs at myself and a resident, tried to kick yet another resident, etc... She caused countless confrontations t/o the day. I'm so sick of her s*** and so are the other residents. The residents have actually contacted and met with the Department of Social & Human Services regarding getting her kicked out. The problem is that my DNS is a p**** and doesn't stand up for his nurses.

The husband is a head case as well. He's a loose cannon and he complains about how staff treats her on a consistent basis. He ignores the fact that she's a wack job who abuses staff. We have some residents with major psych issues and missy here is crusing for a bruising.

Quite frankly, I'm afraid that someone is going to hurt her one of these times. Some of our patients have terrible tempers.

I am asking myself if I work for the right DNS, though. He never sticks up for his nurses. What has he done for us lately? Hmm...

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Specializes in Oncology RN.

I always thought that if someone makes a threat against another's life, I had to be reported. This might also be grounds to have the resident moved to another facility for the safety of others.

Document everything!!

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I work agency and one of the facilities I go to had a very similar resident. He was in his fifties and weighed over 300 pounds. He required a total assist because he refused to do anything for himself, yet he struck out at all those around him. His verbal abuse had gotten so bad even his wife wouldn't speak to him. We all complained constantly and charted every little thing he did, to no avail. Then one day while he was on one to one care for earlier dangerous behavior, he grabbed the arm of a nurse and twisted it so hard she had to leave the facility and go to the ER. Turns out he tore the ligaments in her arm. That incident was what it took in order for the doctor to finally order the psych eval and we were able to ship him out to a behavioral health hospital. It's sad that it took an injury before anyone would listen to us. But it wasn't the facility, it was the doctor. The behavioral health hospital deemed him unfit for our facility and he never came back. I hope no one where you work has to go through something like this. Good luck.

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This is a little known rarely used fact..you are well within your legal rights to call police and have the patient charged. The mental illness of the patient is completely irrelevant.

Next time a patient threatens to hit or hits or verbally abuses you tell them very clearly if their behaviour continues you will happily have them arrested. Remind them that no police officer will tolerate their behaviour and you have no obligation to put up with it either.

I would also notify your boss that you will no longer accept this behaviour and you will be pressing charges for every assault.

There is no rule in nursing that says it is okay to be assaulted while doing your job and it is about time nurses started making it really clear it wont be tolerated.

If your patient was out in the world and verbally abused and hit someone at MacDonalds they would be arrested......I refuse to accept that a fastfood worker has more rights than I do.

I also refuse to listen to that certain nurse who always says the patient is ill and didn't mean it...I don't really care..I am not their punching bag.

I have been threatened,bit and punched and each one them had a visit from the police to curb their behaviour.

The most important thing to learn in these circumstances is when to back away ,give up and leave the patient alone. This may mean no bath and no meds all day and ofcourse the family complaining..I tell the family to have a try at it and good luck to them . I don't feel any guilt about not getting into a battle with a patient over a couple of pills.

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This is a little known rarely used fact..you are well within your legal rights to call police and have the patient charged. The mental illness of the patient is completely irrelevant.

I completely disagree with that approach for an untreated Psych patient. Countering the behavior with threats of jail will likely do nothing to control the behavior. I've been seriously assaulted by a patient with MH issues (Lewe Body disease). The police were not able to do anything other than take a report. As they told me: jail is not a dumping ground for the mentally ill, even less so when there are medical issues.

Staff needs to continue to document and notify the Physician, threats (as well as acts of aggression) warrant an incident report. *Personally* I would call DSHS and tip them off to the situation, daily if needed. Plant a bug in the Ombudsmans ear. Make the sitiation too darn hot for the DNS to continue to ignore it.

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Well I have no idea how your police department behaves but I can tell you police where I work take an assault on a nurse very seriously.

Jail may not be a dumping ground for psych patients but it is a dumping ground for violent criminals. If someone is willing to beat up someone who is offering help what will stop this person from killing someone who gives them a hard time?.

To ignore the violence and not enforce a code of civilized behaviour means that the patient is free to assault and abuse with impunity.

Nurses are not required to be victims. I don't accept that any patient including the mentally ill has a right to assault anyone including me. I want that standard to be lost because it is ridiculous.

If a psych patient attacked my child I certainly expect them to be arrested immediantly. It is crazy to create a double standard and accept that a mentally ill patient has the right to attack and injure a nurse and get away with it.

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:)

This is a little known rarely used fact..you are well within your legal rights to call police and have the patient charged. The mental illness of the patient is completely irrelevant.

Next time a patient threatens to hit or hits or verbally abuses you tell them very clearly if their behaviour continues you will happily have them arrested. Remind them that no police officer will tolerate their behaviour and you have no obligation to put up with it either.

I would also notify your boss that you will no longer accept this behaviour and you will be pressing charges for every assault.

There is no rule in nursing that says it is okay to be assaulted while doing your job and it is about time nurses started making it really clear it wont be tolerated.

If your patient was out in the world and verbally abused and hit someone at MacDonalds they would be arrested......I refuse to accept that a fastfood worker has more rights than I do.

I also refuse to listen to that certain nurse who always says the patient is ill and didn't mean it...I don't really care..I am not their punching bag.

I have been threatened,bit and punched and each one them had a visit from the police to curb their behaviour.

The most important thing to learn in these circumstances is when to back away ,give up and leave the patient alone. This may mean no bath and no meds all day and ofcourse the family complaining..I tell the family to have a try at it and good luck to them . I don't feel any guilt about not getting into a battle with a patient over a couple of pills.

I agree with you 100%! Nurses are not to be used as punching bags. Patients need to know that they will face the consequences if they choose to act out.

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Specializes in Nephrology, Cardiology, ER, ICU.

In Illinois - it is now a felony to assault a healthcare worker. So...of to jail they go. Mentally ill or not - they can't assault us!

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Once I had a verbally abusive patient threaten to "punch the sh%#" out of an elderly dementia patient. I had the doctor come down and the doc told the patient that if she made any more threats he would discharge her immediately. She behaved after that.

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Well I have no idea how your police department behaves but I can tell you police where I work take an assault on a nurse very seriously.

Jail may not be a dumping ground for psych patients but it is a dumping ground for violent criminals. If someone is willing to beat up someone who is offering help what will stop this person from killing someone who gives them a hard time?.

To ignore the violence and not enforce a code of civilized behaviour means that the patient is free to assault and abuse with impunity.

Nurses are not required to be victims. I don't accept that any patient including the mentally ill has a right to assault anyone including me. I want that standard to be lost because it is ridiculous.

If a psych patient attacked my child I certainly expect them to be arrested immediantly. It is crazy to create a double standard and accept that a mentally ill patient has the right to attack and injure a nurse and get away with it.

I agree with you 100% and am glad to see communities taking a stand against those who assault healthcare workers. It has been tolerated too long, IMO.

Just curious how your facility responds to calls to the police...do they give you a hard time? IME facilities like to brush assaults and verbal abuse from (patients,families AND doctors) under the rug, and try to discredit the nurse. If yours supports calls to police, I am impressed and wish I were working for such proactive management...hope others follow suit.

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