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Discussion

Enraged (venting)

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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Could pepper spray use be considered assault/battery? Just curious ... Or is it just more palatable in your mind than taking physical action? (quote)

It is more doable for me than having to fight off a young drunk male. Ready, aim, fire and done with it. I am not a pro boxer or a 7th degree black belt.

Don't sweat it. He won't, and you were defending yourself. Our facility won't handle patients like that until they have come down enough to be docile.

What do you do with them while waiting for them to chill?

"If you're fighting for your life, it becomes another story. Although that would not hold up in psychiatric nursing where, no matter what, staff are not allowed to lose their cool."

THE ER IS NOT A PSYCH WARD!!!!! Our goal is not to establish a therapeutic setting so Mr Alkie can figure out why he drinks. The OP was working to make sure he did not have a possibly life threatening injury. And I really don't feel that telling this pt to "calm yourself or we will paralyze you and put a tube in your throat" was battery/threatening. (quote)

I'm not sure if it is or not. The problem I have with it is that I am wondering what the pt thought she meant when she said "We'll paralyze you." Even as a nurse, my first thought was not using a resp m. paralying agent. I envisioned that the pt thought she meant she'd break his neck. And if she didn't mean it as a threat, why state it so it could possibly be interpreted as such? That's the problem I have with it.

I'd also like to know who was remiss in not doing tubing him in the first place. OP? Doc? Other? This whole mess indicates perhaps some improper assessment?

Where is the OP, whom we have not heard from for a long time now for some feedback?

Could pepper spray use be considered assault/battery? Just curious ... Or is it just more palatable in your mind than taking physical action? (quote)

It is more doable for me than having to fight off a young drunk male. Ready, aim, fire and done with it. I am not a pro boxer or a 7th degree black belt.

The trouble with pepper spray is that it affects just about everyone in the room, and depending on the ventilation in other rooms as well.

I've been exposed only once, and that was outside, about 20' from the source, on a day with a very light variable breeze. The spray was acutally aimed in the other direction. Within seconds my eyes were burning and effusively tearing, and I was experiencing difficulty breathing.

Used in a confined area, the OP would have been as incapacitated as the Pt. The ER would have been left shortstaffed in addition to the problem of treating the OP and Pt for the effects of the spray.

In that situation, I think pepper spray would have been worse than what the OP actually did.

duplicate post

The trouble with pepper spray is that it affects just about everyone in the room, and depending on the ventilation in other rooms as well.

...

Used in a confined area, the OP would have been as incapacitated as the Pt. The ER would have been left shortstaffed in addition to the problem of treating the OP and Pt for the effects of the spray.

In that situation, I think pepper spray would have been worse than what the OP actually did.

Totally agree -- that's why I pointed out that the entire dept. would need to be decontaminated. Every other patient, staff member & visitor would also be exposed.

Oh, and you'd have to manage to fish that out of your pocket while being punched ...

You physically defended yourself after first giving this bum several warnings and chances to ease off. You acted with compassion and grace, and he returned your kindness with physical abuse. You have every god-given right to do hit back. You honor yourself, and all nurses, with your actions. Don't beat yourself up (pardon the horrible pun) for this.

What do you do with them while waiting for them to chill?

They go into the monitored seclusion room, with the cops stationed outside, and if we need to go in, we don't go alone.

The trouble with pepper spray is that it affects just about everyone in the room, and depending on the ventilation in other rooms as well.

I've been exposed only once, and that was outside, about 20' from the source, on a day with a very light variable breeze. The spray was acutally aimed in the other direction. Within seconds my eyes were burning and effusively tearing, and I was experiencing difficulty breathing.

Used in a confined area, the OP would have been as incapacitated as the Pt. The ER would have been left shortstaffed in addition to the problem of treating the OP and Pt for the effects of the spray.

In that situation, I think pepper spray would have been worse than what the OP actually did.

Tazer

in our ER if the pt. is abusive and violent and slugging nurses and if there is no apparent injury, the doc will refuse treatment and give him to the cops and that's it.

but if the doc is truly concerned then he is paralyzed and intubated.

I think the OP did the best they could. If any one of us had been punched we may well have acted instinctively. This man was violent and out of control. I think those of us who don't do ED should remember the conditions under which our collegues who have to work.

You lost your cool w/ a drunk selfish jerk who has no regard for anyone's life, even those who are trying to take care of his sorry @#%. You put up w/ way more than I would have. The doc should have tubed him a long time before it got to that. Why is it that we have to put up with this abuse and assault just because we are nurses? Don't admit to punching him; you pushed him away in self-defense. Try not to beat yourself up; there is only so much anyone can take. The fact that you feel bad about it speaks volumes about the type of caring person you are.

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