Enraged (venting)

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Specializes in ED-CEN/PACU/Flight.

OK, I know y'all can relate...

Tonight I received a 23yoM, out drinking and driving, hitting parked cars. He already has 2 felony DUI's on his records.

He fought with fire department on scene (no head injury - he was just a drunk jerk), EMS on scene, police on scene; en route was kicking my medics and the police. He arrives and is still screaming and trying to swing while handcuffed to the cart.

I *tried* my very best to remain calm and therapeutic, but could only tolerate so much of the, "I refuse, you can't touch me, I'm suing you because my dad's a lawyer, and you can't let them take me to jail because I want to go home," while he attempts to swing, swears, and spits. He made mistake number one at that point by grabbing at my hand and squeezing until my hand popped (I filed charge number one at this point).

He smelled so strongly of ETOH it made the eyes water, and of course, he ended up in CT scan.

He fought and carried on over there, getting tazed several times. I ran over and medicated with Haldol and Ativan, but it was like spitting in the wind. Head blocks were gone, c-collar askew, and un-even on the LSB.

For a few minutes he chilled out and I once again explained everything. The CT tech needed his arms above his head, so I explained that I would remain at his side to care for him, and help him hold his arms. He said, "Whatever." (Meanwhile my tech and 5 policemen were on the other side of the glass watching).

I put on the lead, and was helping him hold his arms, and he screamed, "Let go of me you 'effin B*tch!" He then pulled an arm free and punched my chest (mistake number two, and charge number two filed) and face (mistake number three, and charge number three filed).

I lost my cool at that point and completely lost it. I'm ashamed to admit that without thinking, and in order to get away, I punched him very hard and quick 3 times in the chest so he would let go of my other arm (and it worked).

The police were all over him like a cheap suit. I told him that we were done playing the easy way, and he would now be going down the hard road, and told him I was taking him back to the ER to paralyze and intubate him.

He cried all the way back.

I'm just irritated that such a young man is wasting his life an potential and doesn't even care (he could have killed someone!). I'm furious that he thought he had to right to assault me. And I'm even more enraged that I lost my cool and responded the way I did.

Any tips for calming down?

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Specializes in cardiac/critical care/ informatics.

oops sorry no tips, because I don't have any tolerance for that either. I have little compassion for etoh intox, abuse. I am a dtr of etoh father.

THat is one reason I don't work ED or Gen. ICU anymore, so I don't have to deal with them anymore.

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Specializes in Emergency.

First, stop wasting your time thinking about him. He's made his choices and now he has to live with them.

Second, are you upset that you punched him? Your actions seem reasonable to me since you said that you were trying to get away to prevent him from further assaulting you. How many times do YOU think you should allow yourself to be punched before you become proactive in your safety?

And shame on your ER doc. Any patient that has to be tazered to be CT'd should have immediately been paralyzed and intubated.

You've had a huge adrenaline rush tonight. You're going to think about it a lot. Time will make it better.

When you tell this story at work, leave out the part about punching him. While your peers that have stood there on the line with you understand the dynamics of what happened, there's always going to be that ONE who will put you at fault and try to take your license if they can.

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Specializes in Emergency.

He cried all the way back.

Just one more thing to say, do you think he was crying because he was sorry for punching you or kicking the fireman? I don't think so. Try not to lose too much sleep over him. He probably won't give you another thought, at least until he has to go to court for the assault charges.

And BRAVO to you for pressing charges!!! :yelclap:

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Specializes in Nephrology, Cardiology, ER, ICU.

I worked level one trauma center for 10 years and I think you did what any human being would have done. I do agree this guy needed intubation and paralysis for staff safety. I've seen it done and it works...the CT and tests can be done easily, you give short acting paralytic and you can extubate quickly too and send him off to jail - no need for admission.

These patients literally suck the life out of us. I filed charges against a guy who spit in my face and hit me. I went to court about three months later and the guys swore he had never seen me before and he had never been in the ER. He was so wasted he blacked out. Oh well - the judge gave him 120 days in the county jail to try and remember what happened.

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Specializes in Trauma ICU, MICU/SICU.

The only thing you did wrong was put up with this guy for as long as you did. I'm sorry, but leaving a nurse as the only individual in lead while everyone else watches through the glass is unacceptable. He would have long since been intubated in our facility.

I'm sorry you had to go through that. You did NOTHING wrong.

However, I agree with the other poster that said don't admit to punching him. You pushed him off of you to protect yourself.

Tell your trauma attending to get some ba**s!

God bless,

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Specializes in LTC.

He got exactly what he deserved. Don't beat yourself up. Even the calmest people lose it under EXTREME conditions :cool:

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Specializes in Pediatrics.

However, I agree with the other poster that said don't admit to punching him. You pushed him off of you to protect yourself.

:yeahthat:

I agree. Since he was under the influence, the argument can be made that he was unable to make rational decisions. I've worked in psych and dealt with detoxers before. We were taught NEVER to hit or strike a pt (even iff they were to "lay into us" and if we did so it would result is immediate termination. I also agree that you were put in a poor situation to begin with. You shouldn't have been alone with him in that CT room, he could have completey hurt you more than he already did before anyone could have gotten in there to help. All around terrible situation. I hope eveything turns out OK for you and bad (jail time for him).

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Specializes in Emergency & Trauma/Adult ICU.

I agree w/the other posters ... just wanted to offer support.

In my facility if a handcuffed pt. who has been given the Ativan/Haldol cocktail still cannot chill out enough to allow appropriate care then intubation is the next step. It's also our practice that anyone accompanied by law enforcement remains within arms length of those officers at all times.

Have a glass/cup of whatever helps smooth out the rough edges, hug your family, cat, dog, etc. ... and know that you did the right thing. Hope there has been or will be a debriefing ... request one if there isn't.

I work in a facility that has refused to allow installation of metal detectors because it would "interfere with the mission of serving the poor." It's always been my view that I can't serve the poor if I'm injured or dead ... so my safety comes first.

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Specializes in Case Management.

When you tell this story at work, leave out the part about punching him. While your peers that have stood there on the line with you understand the dynamics of what happened, there's always going to be that ONE who will put you at fault and try to take your license if they can.

I agree with this. We recently heard a story on this board about a nurse who used "excessive force" according to a witness and he is now fighting for his license and being investigated by the Board of Nursing. Hopefully the pt will remember little of this experience. And hopefully the people in the room are all sympathetic to your actions, as they should be.

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Specializes in Developmental Disabilities, LTC.
I'm just irritated that such a young man is wasting his life an potential and doesn't even care (he could have killed someone!). I'm furious that he thought he had to right to assault me.

Just be thankful this guy isn't a part of your family, or somebody you care about. Just about the hardest thing I've ever had to do was babysit a friend of mine who couldn't handle his booze. It's still amazing to me how the nicest person in the world can turn into the biggest A**HOLE when they've had too much to drink. I eventually had to join a support group that taught me you can only do what you can do, then you have to leave the rest to God. You just have to. Easier said than done, but you've gotta stop thinking about this guy, because the truth is, he probably doesn't even remember you. When this same friend of mine got his 3rd DUI last summer, all he remembers is being at the bar, then waking up handcuffed to a hospital bed. Police said he was a complete jerk the entire time. Friends of ours said he was even yelling at them when the police turned him over to them b/c they couldn't handle him anymore. Doesn't remember any of it. You never hear a drunk say, "Yeah, the cop/nurse/doctor was being a jerk! So I refused to sit still for the CT, then I hit one of them!" What you usually hear is, "Yeah, I don't know what happened...I guess I refused to sit still & even punched somebody!" Reminds me of this episode of Scrubs where 1 Dr is getting frustrated b/c this young guy, a smoker, was admitted for pneumo & the Dr. unsuccessfully tried to get him to quit smoking. Another Dr. finally said, "So, we'll treat this guy's pneumonia today & when he comes back with lung cancer, we'll treat that, too." You can only do what you can do. You can't live people's lives for them, unfortunately.

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Specializes in cardiac med-surg.

you are a human being protecting yourself

i hope you find peace over this issue

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