Ever feel abandoned in hostile situations?

nightingale, RN · Sep 24, 2004

Oh Man, Mattsmom... that is terrible. I am sorry that happened to you.

The only incident I had with physical Nurse Abuse was a couple of years ago. I have to admit, I was very steamed at the facility for the lax attitude. At the time of the incident, the CNA's were helping me to get this guy off of me who had me cornered and was kicking me with his brace; it was ugly. The next day, we reviewed what happened and I felt better about it. The one thing I learned was to not (but you probably know this) confront most residents (let management or their Guardian do this).

A couple of weeks ago, at the facility I do Agency at, a Nurse was attacked by a resident. She did not get bruised but she ran like the dickens along with the other Nurse. The next day, this resident was discharged back to the VA (good riddens). The police were called, their office was literally next door. The police took 20 minutes to respond and an incident was filed with their Chief of Police (they were smirking, so I was told, and picked fun at the Nurses who had ran away. The attacker was a big guy too! Thank God no one was hurt.

Again, I am so sorry this happened to you. It is not right and something must be done. I am not big on involving outside sources but this does not seem right. At the minimum, you should not go back there.

I hope my story helps...

A couple of weeks,

jad2 · Sep 24, 2004

I had a strange situation as agency. An older woman w dementia became literally like a prize fighter...kicking, scratching, slugging us...it was like super human strength and she surprised us.
I had a similar "when little old lady's attack" experience. We didn't take it personally, the lady was just hostile to everyone. I recall her saying, "D@@ YOU " over and over ... she scare me because she said it with such hate, for a minute I thought she was possesed and we had a "Linda Blair" situation in our hands. Fortunately, her doc walked in and had mercy on us.... he Rx some anti-psychotics prn or whatever and we were able to give her some care. We also, had a hospital sitter come in and watch her.
It was a tough couple of days.
Then, a fellow nurse was attacked by a ETOH detox patient. He had been verbally abusive since day one to everyone. (You guys should of heard the obcenities this guy said when calling nurses over the call light. ) Anyway, he pushed the nurse assigned to him ( the charge nurse for that shift) pinned her to the floor and kicked her. She ended up with a hurt back.
What is surprising was that she did not call security or police!!!
If that would of been me, I would of called them both.
Yikes!!!

mattsmom81 · Sep 24, 2004

Thanks for both your stories...these are hard situations for sure.The public and the management team just expects we can manage these things I guess...its our job.

This lady was trying to leave, but had no idea where she was, etc (incompetent to make decisions, no family available) These 'little old ladies who go postal' can sure do some damage...ouch....this wasn't a small woman and I'm sure she was as strong as many men. Seems aggressive men are taken more seriously.. .

I guess what bothered me most was the lack of support. I wanted the supervisor to get us some help so we could physically put her into bed and posey her (to protect her as well as us) and she looked at me like I was crazy...she thought it was OK to leave her up kicking and slugging us I guess. . Patient had IV Nitro going for MI, had pulled it out, wouldn't leave her O2 on, etc so she was injuring herself as well as us.....yeesh. Hard to manage these situations...as we are supposed to protect these people from themselves....aren't we?

Thanks for letting me vent. guess its one of those situations where we do the best we can. This was an isolated unit away from everybody else, as mentioned. Its a better situation when more people are around, like ICU where I usually work.

I have seen nurses allow patients like this to leave AMA but it seems risky IMO and negligent when the patient is not competent.

nightingale, RN · Sep 24, 2004

Well, for me, next time, I will let the pt. go AMA if they seem agressive. I usually carry my cell telephone and I will call 911.

jad2 · Sep 24, 2004

Well, for me, next time, I will let the pt. go AMA if they seem agressive. I usually carry my cell telephone and I will call 911.

You know, this hospital had this "the patient is always right" motto. Which is fine, I am all for great service and I strive to give my patients 110%.

But, where do you draw the line?.

Many patients in this medical unit got away with ALOT of bad behavior from yelling and being verbally abusive to making allegations that were totally false against nurses to physical assault. And wouldn't you know? It was mostly directed at the top notch, nicest nurses. Never the bad ones... Murphy's law????

The unit manager would always side with the patient and not give us any support or the benefit of the doubt.

It got to the point were we were asking the doctors to talk to these patients from hell and intervene. Most of the docs were very understanding and defended us.

mattsmom81 · Sep 25, 2004

I agree with you guys 100% about letting aggressive patients leave AMA whenever possible. By all means I show them the door , IF they're with it and understand the ramifications of leaving AMA ..but when they're NOT competent and don't have someone to assume responsibility for them it sure throws a wrench in.

A physically abusive patient was allowed to leave by herself altho she was not competent to make the decision...she walks outside and gets hit by a car...the nurse could be responsible. Guess I worry about that kind of scenario.

I've wanted to let mean aggressive wild patients leave and call 911 simultaneously...but my supervisors have not agreed. Their feeling is the cops will just bring them back to the ER anyway.

Glad I work ICU normally where we are given a bit more leeway in managing situations.

boulergirl, CNA · Sep 25, 2004

Several months ago one of the dementia residents in our ALF attacked one of the nurses' aides. He thought she was an intruder and had her pinned in a corner, screaming for help and sobbing while he tried to break her wrists with his big hands. I had to speak to him in Spanish (he doesn't speak English) and pull him off her to calm him down. He kept chasing her, so I called 911. The police and paramedics came, looking at us like "Well, geez, what do you want US to do?" (Resident had calmed down by then.) A bilingual police officer talked to him and the family came. Turns out the resident had not gotten his anti-psychotic med that evening (the nurse wanted to verify it first) and he had just moved from another country. Oyyy.

The nurse called us later that night and told us we should handled the situation more calmly. She also told the nurse's aide that was attacked that she should have hidden in a room when that resident chased her. Umm, how is she supposed to care for her other residents, pray tell?? He could be out on the hall all night.

Thank God he's on his anti-psychotic, but what if he wasn't? This is one reason I avoid working on the dementia ward anymore. And yes, I know how you feel about the lack of sympathy from others at times.

mattsmom81 · Sep 26, 2004

Wow thats a scary story Boulergirl...LTC and nurses on geropsych units really have their work cut out for them. These people are hard enough to deal with in the hospital,(and we usually have a few on each unit ) I can't imagine working with them on a daily basis. The staff that does should be up for sainthood.

Supportive management makes or breaks it for the staff, doesn't it. When we are wrong no matter what we do, it gets to be very hard to motivate ourselves to back to the job everyday.

MandyInMS · Sep 26, 2004

Oh boy....picture this one.....

Sitting at the desk and hear a strange noise..like a shower going but different..go down the hall and water is in the hall..go into the room where the pt has stuffed linens in the commode and water is pouring everywhereeeeeee...pt admitted with abd pain...with history of MAJOR mental problems...btw a week before he had burned down his gf's house as well as his mothers...grab blankets to absorb the mess as best as we could...he becomes more and more agitated..starts trying to rip the tv out of the wall..page security STAT..who arive and stand there with their hands in their pockets..I can just immagine this man ripping out the tv and hurling it at one of us..I run to the desk and call the POLICE..in the mean time I ask the man if he wants a smoke.. trying to distract him..he seems to like the idea...lead him outside into the courtyard and light him one up..standing inside with the glass door between us until the police arrive..I hear the guards telling the cops it's alright now..he's calmed down and they can leave!...I'm like HELLLLL NOOOOOO....is he not a danger to himself? a danger to staff? a danger to the other pts? well duhhhhh...they take him away...during all this the super/md have been notified and acted like WE over reacted...go figger.....people never stop amazing me :/

mattsmom81 · Sep 27, 2004

Oh boy....picture this one.....
Sitting at the desk and hear a strange noise..like a shower going but different..go down the hall and water is in the hall..go into the room where the pt has stuffed linens in the commode and water is pouring everywhereeeeeee...pt admitted with abd pain...with history of MAJOR mental problems...btw a week before he had burned down his gf's house as well as his mothers...starts trying to rip the tv out of the wall..page security STAT....during all this the super/md have been notified and acted like WE over reacted...go figger.....people never stop amazing me :/

Their main concern seems to be underplaying all this stuff and avoid doing anything 'rash' like calling cops doesn't it. Glad he didn't hurt you. Wish more facilities would have 'code strongs' or 'code whites' to manage these type things better. There is some safety in numbers and some aggressive folks will quiet down when they see a crowd. I've also seen successful group tackles to get aggressive folks down to give parenteral sedation...works pretty good.

GLORIAmunchkin72 · Sep 27, 2004

We've always been taught that if we get hit it's our fault for "invading" their space. When they are agitated we have to back off and reapproach.