Aggressive family member

Published

So I was placing an IV in a pediatric pt about 6mo and she was of course not happy. She was crying and the mother was comforting her the best she could. As I was placing the IV though, the dad reached across the bed while I had the needle in the child's arm and literally pushed my hands away and told me to stop & get another nurse. I was shocked that someone would do that and was taken completely off guard. The wife had jumped when he did it too and almost intervened but stopped herself. Anyways, I became angry and flustered over the whole ordeal as the doctor had explained in great detail what to expect and gave them the option of PO fluids & meds vs IV. I pulled the needle out and wrapped the child's arm, apologized, and told them I would send in another RN. I spoke to my charge RN about the situation and decided to transfer the child's care to another RN because I felt very uncomfortable at this point. I couldn't help but ask myself over and over what I did to set this man off but at the same time don't think any pt or family member has a right to lay their hands on any staff especially during a procedure. A simple "stop" would have worked just as well. Also, I do understand the frustration of having a sick child that ends up going through painful procedures in order to help them get better so I know that plays a part. I guess I just need to suck it up as part of the job. I just wonder as nurses, should we expect to be abused, whether physically or verbally? Or should I have said something about the inappropriateness of what happened right then & there? I'm not sure what was the most professional thing to do but I did not want to escalate the situation any further but at the same time I wanted to let him know that touching me or any other staff member in an aggressive manner would not be allowed.

Up Vote Up Vote ×

My only experience with the pediatric population was in nursing school and I could tell then it was not an area I could ever work in. Even though the patients are sweet, the parents who are likely overwhelmed, exhausted and worried about their child. Ultimately they call the shots. When I had to take my daughter (8 months old at the time) to the ophthalmologist with a scratched cornea and he held her down to examine and treat the eye as she was screaming I felt like I wanted to leap across the room and physically stop him from what he was doing, but I restrained myself. I can see how this is possible how your patient's father would do what he did. With that being said, their really is no excuse for him lashing out at you for just trying to do her job and you did not deserve that kind of treatment.

Up Vote Up Vote ×
...the doctor had explained in great detail what to expect and gave them the option of PO fluids & meds vs IV.

Oh boy. Problem #1 right there. ^

It's a fine line between boundary setting and possibly escalating the situation as you say, but because there are zero allowable circumstances where anyone may angrily put their hands on a nurse, I would've said, "You may not put your hands on me" or simply "Do not put your hands on me." I would document that the procedure was interrupted physically by the patient's father and describe neutrally.

People like this need therapeutic intervention. Social work consult or whatever the procedure is at your place. They need reassurance that their child's needs will be met, but they also need to respect basic boundaries.

For your own personal consideration: Do you project confidence/assertiveness?

Up Vote Up Vote ×

so when I was in nursing school, my child ended up having to have surgery at the childrens hospital. It was a stressful time as I was an intense program with two kids under two. We ended up having to go to ER after he had urinary retention for over 16 hours after having some diagnostics done the previous day. My husband is a big guy and we were not really impressed with his care by the nursing staff. But by no means did we physically act out. They wanted a urine sample but he was too dehydrated and nothing was working. Anyways, I think it is good you transferred care. However, I do think an incident report needed to be filled out as that is workplace violence and needs to be documented. I also think security or the doctor needed to come in and speak about his behavior and try to help with deescalation in the situation. Also was there any assessment for possible physical abuse?

Up Vote Up Vote ×
Specializes in Adult and Pediatric Vascular Access, Paramedic.

This is the problem with hospitals- they allow this to happen.

I would have stopped what I was doing, and made sure the child was safe by taking out the IV and putting a gauze pad etc. I would then request to speak with the dad outside of the room and let him know that that is not acceptable behavior and explain that you are only trying to do your job to the best of your ability. I would also explain that he could have injured his own child since you were in control of the needle at that time, or you, and neither of those are acceptable either. I would have given him the option to leave the room during the next attempt (even if it was by a different nurse) if he could not control his emotions or he could keep his hands to himself. IVs are painful and no one likes them, and yes his child will cry during that procedure.

Annie

Up Vote Up Vote ×
Specializes in hospice, LTC, public health, occupational health.

Call the code for combative person and have security deal with him.

You do not touch me in anger EVER. And doing it while I have a needle in your kid's arm is blindingly stupid.

Up Vote Up Vote ×

It was only you and the parents while you started the IV? We either take the child to a treatment room, away from the parents. Or have staff hold the child, never the parents.

I think you handled the situation fine by not escalating and getting another nurse. Just pushing your hands away doesn't sound so bad.

I completely understand the father's reaction to stop someone from hurting his child.

To hear the doctor explain in complete detail, then to see, to the parents eyes, a big needle being stuck in their screaming child's arm is very different. I imagine the father scared, confused, upset, feeling guilty for what he agreed to.

Up Vote Up Vote ×
Specializes in Critical Care.

Had you just inserted the needle when the dad stopped you or were you digging around for a little bit?

Up Vote Up Vote ×
Specializes in Pediatrics, Pediatric Float, PICU, NICU.

There is no situation where it is okay for a parent to place their hands on a nurse in that manner. Especially not when they have a needle in their hand and more damage could be done to their child and/or the staff member, such as a needlestick exposure. I would have hand no qualms notifying the father right then and there that I understand he is frustrated but it is not okay for him to do what he did. Then I would talk to him in more detail about why he is frustrated, why he wanted another nurse, why we needed this treatment, etc. But yea, no, not okay to even "just" push my hands away. And I've worked pediatrics my entire career. Nope.

Up Vote Up Vote ×
Specializes in Critical Care.
It was only you and the parents while you started the IV? We either take the child to a treatment room, away from the parents. Or have staff hold the child, never the parents.

" I completely understand the father's reaction to stop someone from hurting his child."

To hear the doctor explain in complete detail, then to see, to the parents eyes, a big needle being stuck in their screaming child's arm is very different. I imagine the father scared, confused, upset, feeling guilty for what he agreed to.

I have to disagree the above statement. As many other had stated, there is no situation where a patient physically touching a health care provider is OK. A simple " please stop, get someone else" would had been effective.

To the OP, not sure how long ago this happened or if the patient is still in the unit; however, an incident report should had been filed to keep everyone on the loop for future incidents.

Up Vote Up Vote ×

Nothing will happen even if she does a " report", because the blind emphasis on { Customer Service!} has resulted in things like this being allowed. The healthcare worker has NO rights: the " customer" has all. And Daddy is free to pull this cr@p again , and again. Unchecked .

Up Vote Up Vote ×
Specializes in Critical Care; Cardiac; Professional Development.
Nothing will happen even if she does a " report", because the blind emphasis on { Customer Service!} has resulted in things like this being allowed. The healthcare worker has NO rights: the " customer" has all. And Daddy is free to pull this cr@p again , and again. Unchecked .

The motivation isn't for something to be done as much as to create a legal paper trail.

Up Vote Up Vote ×
+ Join the Discussion