Assualted by psych patient

Specialties Emergency

Published

Hey everyone,

I currently work in the ED and was recently assaulted by a patient and was knocked out. The patient was being petitioned for suicidal ideation. I keep getting told by coworkers that I should press charges against this patient. Although the patient assaulted me, I just find it hard to do knowing that the patient is obviously going through a rough time in their life. I almost feel guilty with filing a police report. Has anyone else dealt with assualt in the workplace from a psych patient? If so, how did you deal with it? Did you just let it go?

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NRSKarenRN, BSN, RN

10 Articles; 18,299 Posts

Specializes in Vents, Telemetry, Home Care, Home infusion.

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Silent No More Foundation. We are working on elevating this conversation in meaningful ways. We hope that by being #SilentNoMore, we can build a movement that ensures violence is actively prevented, the severity of assaults are reduced, and the victims receive adequate support and protection from employers after. This is our first of hopefully many posts and articles to come. We’re looking forward to getting to know you all!

The JC has issued Sentinal Alert:

Physical and verbal violence against health care workers

The realities of workplace violence for emergency nurses

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ENA has long been a proponent for policies that strive to provide a safe work environment for all health care workers, including emergency nurses. We advocate for legislation, both at the state and federal levels, to protect our members as well as their colleagues and patients.

One example is the bill, H.R. 5223, sponsored by Rep. Khanna which will help create workplace that support health care employees who experience violence while doing their jobs by providing training for employees, encouraging the reporting of violent incidents and through the establishment of non-retaliation policies. ENA also continues its research to learn more about this problem in an effort to educate our members, legislators and the public on the significant scope of this problem.

Helping RNs to address violence in the workplace has links to:

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Workplace Violence - American Nurses Association

ANA position statement on bullying, incivility and workplace violence, video and key documents

#EndNurseAbuse pledge
APNA position paper, toolkit, and safe environments components
ENA online course, “Know Your Way Out” and other violence prevention tools
AACN Nurses Healthy Work Environment standards, assessment tool, and other resources
AAOHN position statement on preventing workplace violence

Nurses Applaud Introduction of Federal Legislation to Prevent Workplace Violence in Health Care, Social Service Settings HR5223

EDRN522

5 Posts

I was bit earlier this month by a pt in for SI, pressed charges, pt got a class d felony on release from hospital. I don't feel bad at all.

If a pt is not in psychosis/AMS they have control over their own behavior and need to be punished accordingly. I personally believe that if more nurses pressed charges, we would be assaulted less because the general public would know that it is not acceptable and you will be punished.

Definitely press charges!

Guest219794

2,453 Posts

If the same person had assaulted a member,of the general public outside the hospital, how would you feel? Would you feel they should not be held responsible? If he had bitten your mother or child in the mall, for example, what would your thoughts be?

Many who commit crimes are going through a rough time. Thet, in and of itself, does not constitute a free pass. Neither does being in a hospital.

JKL33

6,777 Posts

Generally speaking this absolutely cannot be tolerated.

I hope the proper protocols were followed with regard to your care; that you were checked in and evaluated and that all of this was documented. You should have also submitted a report through your facility's incident reporting system. Next, yes, you do make a police report about this assault.

You go to work to help care for people with a wide variety of needs. You do not go to work to be a receptacle for their violent reactions to what is going on in their lives.

You can have compassion while still understanding that tolerance of others' violent actions is not an example of compassion. It hurts many people and isn't therapeutic. It is nothing other than you saying you believe you deserve to be abused because you are a nurse. You wouldn't stand out on the street corner so that people who are having a bad day can punch you. Tolerance of this type of treatment has nothing to do with the therapeutic actions of nurses, and therefore nothing at all to do with being a nurse.

Please report this, pronto.

Hope you are recovering. Utilize your facility's resources in your recovery process if that would help you. Post here, too, if you want. I am concerned about you. It is not okay to have experienced this type of trauma, but to also believe that it is somehow part of your purpose in life is concerning.

Take care ~

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hppygr8ful, ASN, RN, EMT-I

4 Articles; 5,049 Posts

Specializes in Psych, Addictions, SOL (Student of Life).

Where I work in acute inpatient psych getting hit is a hazard of the job. For years we were not encouraged to press charges when these events occurred. There has been a recent turn of thought in our facility. If the assailant is not suffering from psychosis and knows what they are doing is wrong we are now being encouraged to press charges so that the person can be arrested and removed from the hospital. IE...taken to jail. Jails do have psych meds and safety protocols to assure the safety of suicidal patients.

We are just seeing way to many very violent patients who are using the mental health system to avoid going to jail.

Without knowing the circumstances of your assault I can't comment. however filing charges does not mean the patient will be prosecuted. That's up to the district attorney.

Hppy

Wolfbiologist

16 Posts

Specializes in None yet.

You need to understand the view of the patient. If they brought themselves in, they may still have been unaware how they would be treated. Stripped of their clothes in the presence of 2 female nurses can be very traumatic, especially if they were forced to strip or even worse, held down and stripped. Humiliating. After that, they'll be agitated from the humiliation. If you restrain them, they will feel like trapped animals. If you force meds on them or inject them against their will, they will probably lose any sense of right behavior.

Imagine all of that happening to someone who was brought in against their will? Yikes! That's a recipe for serious problems. Have you ever tried to capture a cornered and injured animal?

Trust me on this, I have the scars to prove it. Even a cute little wolf pup can and will take a bite out of you.

On the other hand, if none of those things happened to your patient and they still hit you, file charges. They have it coming.

File a report.

I work inpt psych. I was punched by a pt. I'm fine. But was encouraged to follow thru for paper trail. At first it bit me in the *** as I was moved off my unit. It resolved but still is a hassle.

The thing is, the pt is not at all responsible for their actions, being mentally ill, the only thing it will do is, later on, after many reports of violence to staff, is get them in a higher level of care. So if they require long term inpt care they will most likely make it to a phorensic unit.

Susie2310

2,121 Posts

I don't think this situation has a simple answer.

Some people have made the point that psychosis or otherwise altered mental status at the time the assault is committed against the staff member should not merit criminal charges. I think this is a complicated subject. A number of medical problems and psychological problems can cause altered mental status and result in the patient's disorientation, confusion, misperception of events, lack of impulse control, anger, etc. Fight and/or flight are primal responses to a perceived threat to one's safety and/or autonomy.

Going/being taken to the ED VOLUNTARILY or being hospitalized VOLUNTARILY even when one is relatively healthy with a good support system is not a stress free experience under the best of circumstances as many of us know.

The point was also made that some patients are very violent and are using the mental health system to avoid going to jail. Staff need to be protected from being assaulted by these patients. It seems that improved nurse to patient ratios would help and also having more security personnel available close by. Facilities need to have plans in place for the assessment and management of patients who are violent or who demonstrate the potential for violence from the initial patient encounter.

Specializes in Prior military RN/current ICU RN..

I am a psych RN and I would press charges. PERIOD.

allnurses Guide

hppygr8ful, ASN, RN, EMT-I

4 Articles; 5,049 Posts

Specializes in Psych, Addictions, SOL (Student of Life).
2 hours ago, windsurfer8 said:

I am a psych RN and I would press charges. PERIOD.

You can press charges but it's the district attorney who decides to move forward or not. I suppose you could file a civil suit but most of our psych patients don't have a pot to tinkle in so it would be mostly fruitless.

Hppy

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