Anyone NEVER been hit/hurt working psych?

verene, MSN · Dec 25, 2019

I've worked in health care for several years. I've been "attacked" 3 times physically. Once while working in mental health -- when a person broke into our group home and shoved me out of the way as they were exiting the building. Once when floated to med-surg when a very delirious patient pushed a tray table into my leg while trying to leave "to go to the hospital" and once in hospice care where a man with end-stage dementia attempted to strangle me for "breaking into his house". Of the 3, the last was by far the scariest, and I suffered no injury from any of these incidents.

Working in psych I've been called a fair number of names and had a few verbal threats, but very few physical threats, and (so far) no physical threats which have landed one me. Working with a good team, learning to read the situation and having strong deescalation skills all go a long way to maintaining safety. I currently work on a medium/high acuity forensic unit and it is probably the safest place I've worked - the staff are well trained, usually adequate in number, and security is responsive. The team on this unit is very proactive about reading changes in behavior and about pre-planning for potentially volatile situations to reduce risk of harm to patients and staff. Sometimes lowering risk can involve a lot of patience and creativity and it is good to find an employer and team who allow for this to happen.

Orca, ADN, ASN, RN · Jan 10, 2020

I was not injured when I worked inpatient mental health, but I have experienced pretty much everything except being bitten (although one of my coworkers wasn't as lucky). I have been kicked, punched, scratched, slapped, kicked and spit on. One thing about it: I have been tested so often that it's pretty certain that I don't have HIV or any form of hepatitis.

I was once shot in the face with a chemical fire extinguisher by an out-of-control patient, which is not your run-of-the-mill psychiatric patient encounter. I was in the report room reporting off to the oncoming shift when I heard the code paged overhead for a psychiatric emergency - for my unit. I opened the report room door to see what was going on, just in time to get a face full of yellow powder.

workingot · May 15, 2020

had my arm broken 1st day on job as psych RN, in 1996. I had already worked as a psych tech prior to that, with many injuries from fighting in emergency room and psych admission unit. as an RN I HAVE HAD BROKEN TIB/FIB, ORBIATAL SOCKET, HAND. MANY BITES. MANY PUNCHES, A FEW KICKS. SPAT ON SO MANY TIMES ( YET ADMINISTRATION won't LET US USE SPIT HOODS ON THE SPITTERS) SORRY I hit caps button some where in this post. my hospital has many murderers, rapists ( well I guess I am supposed to say ALLEGED murderers and rapists since they largely are declared incompetent to stand trial, and they use nurses as security. we have police, but they patrol the parking lot and write staff tickets for parking outside the lines, they seldom, almost never deal with patients. 3 of my daughters are new ish nurses, and I forbid them to work here. they are all in ICU pursuing nurse anesthesia ( smart choice). I can retire in a year or so at age 50, so YAY! BE safe fellow nurses

Florence Frightengale, BSN, RN · Aug 7, 2020

On 1/6/2018 at 9:02 AM, guest52816 said:
I worked as a psychiatric nurse for eight months, and during that time, I was NEVER hit, threatened or spat upon.
My patients included adult psych, chemical dependency, adolescent and memory disorder patients. Many nurses on the memory disorder side had been hit by patients. And I will tell you that that population is my LEAST favorite to work with.
I will share that will working med-surge, I was spat upon and threatened by dementia patients. Personally, I have no idea why dementia patients are included among psychiatric patients. They don't have a psychiatric condition, they have dementia!
Just keep your eyes and ears open, and keep yourself safe because management isn't concerned about YOUR safety.

“Personally, I have no idea why dementia patients are included among psychiatric patients. They don't have a psychiatric condition, they have dementia!”

THANK YOU! I’ve been wondering for years why people bring their dementia family members to our ED—we CANNOT do anything for them. I think it’s just family members who are sick of dealing with violent, wandering grandparents, so they dump them with us so they can go home and have a night of sleep.

I get it, really I do. It must be exhausting to deal with dementia relatives on a 24/7 basis at home. But the ED (I work in the Psych Stabilisation unit of our ED) is for just that: emergencies. What these families need to do is to start looking at long-term facilities and stop clogging up our patient boards.

Florence Frightengale, BSN, RN · Aug 7, 2020

Being that I work in the Psych Stabilisation unit of our ED, I can say I have been assaulted many, many times. Understand that most of these pts are not in their right minds, so I can’t really blame them.

What will never cease to shock me is the strength these elderly pts can have! I’ve been thrown backwards over a chair by a “frail” 92 year old lady, amongst other things. Once a patient grabbed my wrist so hard that I had purple, finger-shaped bruises on my wrist the next day. It’s rather an occupational hazard in this field, I’m afraid. I wouldn’t trade it for anything, though. It certainly makes for some interesting experiences. ?

allnurses Guide · Aug 8, 2020

9 hours ago, Florence Frightengale said:
“Personally, I have no idea why dementia patients are included among psychiatric patients. They don't have a psychiatric condition, they have dementia!”
THANK YOU! I’ve been wondering for years why people bring their dementia family members to our ED—we CANNOT do anything for them. I think it’s just family members who are sick of dealing with violent, wandering grandparents, so they dump them with us so they can go home and have a night of sleep.
I get it, really I do. It must be exhausting to deal with dementia relatives on a 24/7 basis at home. But the ED (I work in the Psych Stabilisation unit of our ED) is for just that: emergencies. What these families need to do is to start looking at long-term facilities and stop clogging up our patient boards.

The problem for many is the extreme cost of care in a good facility for dementia patients. Most people don't know this but Medicare does not cover custodial care (And dementia care is custodial) I never brought my violent, dementia riddled mother to the ER but she ended up there a number of times before we moved her literally kicking and screaming from her home. She was having falls, wandering (She called them long walks) verbally abusinf people and police officers etc.....

We had her in two different places before we found a secure locked memory care facilty that truely gave top notch care. My dad who had passed years ago set up a significant trust to pay for her medical costs. The per month cost for her care (Again not covered by medicare) was $9,500.00 a month and IMHO worth every penny but many people simply don't have those resources. Going to ER and getting a three day stay due to a UTI constitues much needed respite to beleagered family members who have few other options. Especially when that 3 day acute hospital stay will get medicare to kick in for 30 days of skilled nursing.

Hppy

Nimrodel, BSN, RN · Aug 8, 2020

I've been in psych for a year now. So far I've dodged everything ;) but yes, I've been spat at, patients tried to bite me, kick, hit, etc. Not sure when my dodging luck will run out though.

JimRN, BSN, RN · Aug 14, 2020

I worked strictly psych for 7 years, both inpatient and Psych ED. In that time, I can't count the number of times I was hit, kicked, or otherwise assaulted. There's a caveat to all of this, though.

Of those times I was "injured" only twice was it serious enough that I needed aid, and I've lost a total of 30ish days of work and probably 30 days on modified assignment due to these injuries. BOTH of those times, the injuries were completely volitional and, frankly, the result of weak management allowing the admission people that were not appropriate for our facility. They were in no way thought disordered or psychotic. Both times, after staff had to be sent to the ED, the Chief of Psychiatry saw fit to have the patients arrested and further, testified against them. I believe he referred to them both as sociopaths.

With that out of the way, many time's I've gone hands on with really sick people. I've certainly been scratched, managed to avoid being bitten a few times, kicked once or twice, and definitely pushed. None of those times was I seriously hurt, nor can I remember anyone else being hurt and requiring medical treatment. Sick folks are usually scared or overwhelmed. They don't want to hurt anyone, thus, they're not trying to. They just want to get away from whatever stimulus is setting them off.

The key to managing these patients is having a good team and a good plan.

Grande_latte04 · Dec 9, 2020

The memory care/ dementia patients do hit during sundown. Luckily, many of them (not all) are very slow and not strong. There will be an occassional elderly lady with strong fingers for pinching and jaws for bitting. What I have found to be the most scary is working with adolescent and child psychiatry. Before I became a nurse I was a teacher in an inpatient psych unit for behaviorally disturbed youth. I was kicked, punched, spit on. I had a kid bite my finger so hard he damaged tendons. I only worked there for a year, before I became angry and bitter- realized it and quit.

allnurses Guide · Dec 9, 2020

2 hours ago, Grande_latte04 said:

2 hours ago, Grande_latte04 said:

. What I have found to be the most scary is working with adolescent and child psychiatry. Before I became a nurse I was a teacher in an inpatient psych unit for behaviorally disturbed youth. I was kicked, punched, spit on.

I would like to say that in 20 years of working adolescent psych, I have not found these patients to be any more violent or aggresive than other segments of the psych population.

Hppy

Grande_latte04 · Dec 9, 2020

14 hours ago, hppygr8ful said:

That's great. That was not my experience. I think because many of our patients in inpatient child and adolescent psych were very traumatized, had multiple behavioral issues and were in various states of foster care/conservatorship, it really highlighted their bx issues and as a result many were more violent and aggressive... especially the younger clients. That being said, I was not a nurse in this setting, but a teacher.

Purple_Clover · Jan 3, 2021

LMAOOOO

I was hit, kicked, had poop thrown at me, was cut with a razor blade, was punched in the head several times, got a sprained neck, got a concussion, etc. working in psych. It is ***ing DANGEROUS and unless a place has staff security escorts 24/7 then you're going to be assaulted. Period.