Battery: Defending yourself against a combative patient

[rhkenji]

I was on my new work orientation today and the topic of restraint and battery was discussed at the end of the day.

I totally understand that we CANNOT touch a patient without permission and the a patient has the right to refuse to be touched or cared for or the nurse can be charged with battery.

Now, I get that.. but I didn't know that in cases that we are getting battered ourselves, we are also not allowed to "push" a patient back or hold them to stop them from hitting us. How true is this? I know this is orientation, and this is probably hospital policy. But are we really not allowed to defend ourselves?

I asked what I'm suppose to do, the instructor just said "run. call security. lock yourself somewhere.. even your co-nurses are not allowed to hold a patient to help you", "security, EMTs and MDs on the other hand, CAN by law"

California, Los Angeles area

[vintagemother, BSN, CNA, LVN, RN]

The best defense is a good offense. Especially because, as your instructor pointed out, we're not technically allowed to restrain pts without an order.

Be aware of a pts triggers.

Be aware of s/s that physical Aggression is imminent.

Try to keep yourself arms length from an assaultive pt.

Place yourself closer to the exit than the pt is.

One reason I liked working in a particular Acute hospital and liked working in dedicated psych is that we had resources available at a moments notice to help us appropriately respond to combative pts.

It's really challenging if a facility has no restraints and has no facility policy on how/when to initiate hands on restraints.

It's much more difficult when a pt is assaultive and you have a policy in place that won't allow hands on.

Thankfully, I've never been harmed by an assaultive pt. I've been kicked, spit on, swung at, but never suffered injury.

I watched an aide get assaulted yesterday. It sucked. There weren't sufficient safe guards in place to prevent or stop the attack.

I did break the "rules" to remove his arm from around her neck. I didn't chart that.