ER violence

ohioln, RN · Sep 8, 2006

One thing might be good to put in ERs is a doctor and nurse to see people who come in for something they need on a regular basis and then can be sent out quickly. Where I used to live in PA, there were no urgent care places, so if you needed a doctor and it was after hours, frequently you had to go to the ER if you couldn't wait until the next day the doctor's office was open. Also, maybe clinics around the clock, small ones, could be open to see patients who are not actually and emergency, rather than have them sitting out in the waiting room for hrs. With staffing the way it is, I don't know where the staff would come from, but it's an idea anyway.

ohioln, RN · Sep 8, 2006

JBudd, I got hit in the face by a woman who was psych. She hit me in the face with a coffee cup! I'm thankful I wasn't hurt and my glasses weren't broken.

jojotoo, RN · Sep 9, 2006

If somebody "needs something on a regular basis" why are they coming to the ER at all? THAT is what their PMD is for!

Gussiegoose, RN · Sep 12, 2006

If only I had a nickel for every time I have heard "I'm a hard stick..." And I get it on the first try. Pts need to understand that we start IV's on sooo many pts every DAY, many of which are dialysis pts and they are the most challenging. This is our job, and most of the time the IV starts are the easiest part of it. Pts just like to bring a little attention to themselves and add drama.

Totally agree. :yeahthat:

EMSChild · Sep 17, 2006

Everyday in the ER I am verbally abused and on a slow week I’m hit at least once. I have gone out to my car at night only to find a pt. leaning on my trunk. Got a new car REAL quick! Had a hep C pt. scratch me while drawing blood. I’ve gone in to answer a call light and had my nose broke by the pt’s husband. I’ve been kicked, slapped, punched, yelled at, and whatever else. I have a vivid memory of shoving a cop aside and throwing my self over a kid while the cops had their guns pointed at the other pt in the room. That was pretty hair raising.

I have pulled gang bangers, trying to finish the job, out of the trauma room, while the police stood there. I later asked one of the cops why he didn’t do anything, he said “I’m not that stupid”. Okay, cop with gun versus woman with forceps. Yeah, I’m probably the stupid one.

I’ve had a guy three times my size, grab my shirt and attempt to throw me across the room. Thank whoever for the two medics and the doctor that tackled him before anything happened. Security showed up five minutes later. Where were they you ask? Well, the “ER only” security guard was upstairs in L&D and the other one was patrolling our phych unit, a mile away. When I first started in this hospital, we had a minimum of ten security guards in the hospital, with two extra to patrol the area. Thanks to the brilliant security director we have (on a good day) two guards for the 600 bed hospital plus the surrounding clinic, phych facility, and the parking areas. I know and trust the security guards, but, I also know that I can’t count on their assistance. It definitely scares me.

I’m soon starting at a hospital, where they recommend bullet proof vests for ER staff. If I’m wearing a vest, I want a taser!

ednurseeducator · Oct 2, 2006

We have had multiple problems with violence in our ER. We are a suburban hospital that sees approximately 65,000 patients a year. Our biggest problem is the psych patients. However, in the last two months, we have had a patient come in and take out a knife at the nurses station and threaten to kill himself and anyone who came near him. The 2nd incident occurred when a jack knife was pulled on me by an alzheimers patient. But the worst happened three weeks ago. We had a patient who died. 2 years old. The godmother wanted to go back and see the child (again: she had already been back twice). We have a strict policy for visiots. They have to have a badge on. The triage nurse told her to hand on a second while she took care of an ill patient. The women went across the triage desk, grabbed her, punched her several times in the face and tried to choke her. In front of the whole waiting room. The nurse is now on PTSD leave. I sure do not feel safe.

cinja · Oct 2, 2006

When I was still a cop I tased a guy in the ER, it was a great shot. Picture this if you will. I am waiting for the guy we nabbed to get cleaned up before county will take him when this guy across the way is throwing a fit and trying to wrestle with the nurse and MD. I raise up form the chair I am in and pull the taser out. The MD see this move and knows to get him and the nurse down. I let him have it with a shot that just about maxed out the length of wire and made him talk like a little girl. When were cuffing this guy he resisted again and received several contact shots. With the MD still in the corner I asked him to clear this fool and looked at this guys only, not his burns and said I am pressing charges and Oh, yes he's fine. With that the other guy was quickly finished up and took both out to county. I spent the rest of the night doing paper work.

jojotoo, RN · Oct 2, 2006

When I was still a cop I tased a guy in the ER, it was a great shot. Picture this if you will. I am waiting for the guy we nabbed to get cleaned up before county will take him when this guy across the way is throwing a fit and trying to wrestle with the nurse and MD. I raise up form the chair I am in and pull the taser out. The MD see this move and knows to get him and the nurse down. I let him have it with a shot that just about maxed out the length of wire and made him talk like a little girl. When were cuffing this guy he resisted again and received several contact shots. With the MD still in the corner I asked him to clear this fool and looked at this guys only, not his burns and said I am pressing charges and Oh, yes he's fine. With that the other guy was quickly finished up and took both out to county. I spent the rest of the night doing paper work.

THANK YOU!! I personally appreciate your willingness to get involved.

pkapple · Oct 2, 2006

I would like to respond from the other side..... I request someone who is known for successfully starting on hard sticks...The third time, in a very loud voice, I threatened to hit her, if she didn't stop immediately. Needless to say, she stopped and it bought a doctor and two other nurses to my room. This nurse was committing assualt and battery on me.
Grannynurse :balloons:

Granny,

You were very lucky. You could have been charged with threatening that nurse. While all patients have a right to refuse any and every procedure and treatment, no one has the right to threaten a nurse. Perhaps that ER has a policy, as many do, that another nurse is called to "stick" after 3 failed attempts. In that case she was doing her job and following policy.

If you were in many ER's you would have been given a nice standard form "Refusal of Care", you would have been treated for whatever could be done without labs, and of course that includes limited or no pain management. At my facility, you would have been escorted out the door, unless your BP was way out of whack, or you needed manual pressure on a bleeding wound. You see we would not be able to determine any other problem since you refused to allow us to treat/assess you for proper management.

Assault and Battery--you consented to medical intervention and treatment when you signed in !! Change your mind?? Go Home!!!!!

Medic/Nurse, BSN, RN · Oct 2, 2006

Violence?

Physical assault (actually make contact)

Verbal abuse - including threats

Intimidation - invading my space, following me into "secure" areas

Weapons (think out of the box here - guns, knives, shads, contents from the sharp boxes, poop, urine, chairs in the room, IV poles, the staples from the "Patient Handbook", throwing hard objects to break a mirror/glass and then using the shards as weapons, IV and oxygen tubing - and on and on

I am convinced that "we" are seeing the tip of the proverbial iceberg here - very few ER's are equipped to deal responsively with extreme situations - they just hope for the best, lock a few doors, limit visitors.

It is a matter of TIME until we have a nurse or other ER staff fatally injured. As to the verbal stuff, I usually just let it roll off. (But, for the record I have been M*****F***** to death) When patients threatened "I'll find out where you live," "I'm make you sorry", "I'm going to make you ____" In my experience the police rarely take the threats made by patients toward nurse staff all that seriously. "After all these are the psych patients, no judge is going to charge them, they were in the ED for treatment". I have been threatened personally x 4 (assaulted x1 in front of police - they did arrest and charge) and NEVER had a police office want to get involved.

Anyway, I'm on a "vacation" from nursing. It may well become permanent.

I need to care for myself and learn to feel safe again.

To all those still out there - keep yourself aware. Be proactive. Review you facility plan as it related to patients/guests and threatening behaviors. Do you have a set plan in the event of a hostage or sniper situation? Do you know how your facility goes on lockdown? Anyway as our world changes - it is vital that we change our thinking. ED/Hospitals are not immune. I can think of 10 incidents within the last 3 years in my area that involved an armed person entering the facility. Shots were fired and people died.

There has been 4 school shootings in the past 10 days - its only a matter of time until the hospitals become the targets - why would we think otherwise?

Stay Safe!

mmutk, BSN, RN, EMT-I · Oct 4, 2006

As for violence in our 40 bed ER in a suburban area...

3 months ago an er tech was stabbed in the arm by a patient (psych) in

one of our psych rooms (locked in, locked out) He had to fight them off until help could get a key and get in there with him. Now all patients going

into a lockdown room in our ER are searched by our armed security. The rooms also provide audio/video monitoring but that can only go so far...

I would agree it's not the drunks as much as it is family and psych comittals (we have about 2-4 a day)

TinyNurse, RN · Oct 4, 2006

A long time ER RN, and charge nurse recently left the ER for a clinic position after being bitten by a hep c positive patient. I'm in a level I inner city ER, and we have a metal detector at our front doors.