Can a Nurse Punch a Patient in Self-Defense?

Nurses General Nursing

Published

Nurse who punched patient back breached code - HDC

A nurse in New Zealand who reacted to being punched in the head several times by a mental health patient by punching the patient back, was found guilty of breaching the Code of Health and Disability Services Consumers' Rights and ultimately suspended.

At the time, a female patient had been admitted to a medium security mental health facility "due to increasingly changeable mood, psychosis and associated aggressive behaviours." "The patient punched the nurse several times in the head leaving her ear bleeding and her earring torn out."

The nurse in this situation was a new nurse and probably without the experience and training needed to work with such volatile patients. But, even with training and experience, situations happen. Nurses and other healthcare professionals become the target of sudden violence.

While hitting patients can certainly not be condoned, what do you think about acting in such a manner in self-defense? Have you ever been in a situation where you were the victim of bodily injury inflicted by a patient?

I've been assaulted. Never saw it coming nor did the two other people in the room with me when it happened.

Believe it or not I was so taken aback, I just walked out of the room while everyone else reacted.

Off work for three months on a WCB injury claim

The patient wasn't confused, demented or still under the influence of drugs. She was just a plain old nasty piece of work who didn't get her way.

Next time, I'll strike back. I don't care anymore. I've been punched, kicked, stood on, nipped and spat on in the two decades I've been a nurse, the patient has never been penalized.

I don't care if I lose my license, you know what, I'll go out in a blaze of glory.

Specializes in Psychiatry.

27 years in psych and I've had 1 violent assault. Injuries included, having hair pulled out, black eye, broken nose and herniated disc in my neck. Resulted in 5 months off work, chronic pain and PTSD.

She was schizophrenic and out of touch with reality but had never been aggressive or violent. Yes, I've been trained in CPI and understand effective deescalation. I did everything right but the attack came out of nowhere.

She had me down so quickly and violently that I couldn't fight back. She had such strength those in the room with me had difficulty getting her off me. I see nothing wrong with fighting back in self defense. I didn't read the article but I'm guessing her reaction went beyond defending herself and escalated to her becoming the aggressor and attacking back.

Just an FYI my hospital did support me and I was given the option of pressing charges. I chose not to because she was very psychotic. However, I wouldn't have hesitated otherwise.

Over 40 years ago I was working on a med/surg unit. I had my stethoscope around my neck. The patient suddenly grabbed it and started choking me with it. I was trying to get it off my neck when another nurse came into the room. She ran up and hit the patient on the hands which broke her grip. As far as I am concerned the nurse saved my life!

Specializes in Med./Surg., Diabetes, Med. ICU, home hea.

I'm not going to take the time to read the original report. The basic fact is that CPI and other forms of "de-escalation" both verbally and physically are only marginally effective. The psychotic patient "high" on epinephrine can have AMAZING strength; I recall a time that a young "lady" was being restrained. It was all that I could do to hold one arm in place; I probably weighed 225 lbs. and she was almost lifting me off the floor!

There is an old saying in mental health: "You have the right to defend yourself, you DON'T have the right to keep your job" or license!

Can a nurse punch a patient? Sure. Can a nurse get away with punching a patient? Well that is dependent on lots of factors.

If I have a reputation as a gentle person, my patient was really out to do me harm, and I could reasonably say "self-defense", the manager and staff back me up, and the family of the patient is not demanding I be fired, and the patient suffered no visible injury, then a nurse might get away with this.

There is an old saying in mental health: "You have the right to defend yourself, you DON'T have the right to keep your job" or license!

(I've been inmental health for almost 30 years, and I've never heard​ that saying.)

(I've been inmental health for almost 30 years, and I've never heard​ that saying.)

I have, LOL. Especially working for the State.

Specializes in Leadership, Psych, HomeCare, Amb. Care.

As far as defending and self-preservation: learning some self-defense moves and using them very limited way would probably help more than a punch; not every "defense" involves a punch, just sayin'...something to think about...

That sums it up nicely.

You punch someone, and the punch may or may not be effective. Next thing you know, it's now a fistfight

Specializes in Emergency.

So there's a streetfighting concept about that 1st punch, especially to the nose. It goes something like this:

You punch him/her in nose and he/she grabs face and crumples in ball on the ground. Good choice in throwing that punch.

You punch him/her in nose and he/she shakes their head and blinks a couple of times. Bad choice in throwing that punch. Get ready for a whipping.

Specializes in Pediatrics.

I fully support the idea that a nurse should be able to defend themselves. As a victim myself, I know the consequences. Had a 52 year old grown man punch me so hard several times in the stomach I was sent to the ER and had internal bleeding. The reason? He was unsteady and I was guiding him to the chair, when he decided I was controlling him and attacked. The hospital said I "couldn't" press charges because "it would look bad for our patient care units". They also followed up with me for several weeks, pestering me about it and reminding me not to press charges and to forgive and forget. What the heck, HE punched ME!!!

Next time, I will defend myself, and get a good lawyer.

Specializes in retired from healthcare.

I remember blocking someone in self-defense and I had witnesses. My supervisor wanted to know if I took lessons in self-defense and understood that this was a built in reaction. I can't remember anyone expressing concern for the patient who tried to slap me.

Specializes in Emergency/Clinic.

Only to the extent to stop the assault or give yourself room to escape until security got there.

+ Add a Comment