Getting Over Assault

[River&MountainRN, ADN, RN]

How do you get over and move past being assaulted by a geri-psych resident? It took two other staff members to pull him off of me, and I just don't feel the same toward him since. I don't trust him; I don't feel comfortable around him (especially being alone around him); and, though I'll always uphold my nursing duty, I have great difficulty feeling "caring" toward him. I have to see him every shift because he gets meds on my shift, plus it's the overnight so there is less staff around if something were to happen. At the same time as I'll be passing my meds, the aides will be doing rounds, so it's not like I can always depend on one of them to be around as my second person in the room. On top of it, he has dementia, so he's unpredictable.

At the time he attacked me, punching me until I was backed up into a corner, he had been fine with me earlier in the shift. I had been able to successfully redirect him and diffuse any tensions earlier in the shift. Later on, when the attack occurred, the CNA had just reported to me that he was being "uncooperative with care". I had just entered the resident's room after knocking and all of a sudden he was on me with surprising speed. I didn't even have time to open my mouth (beyond the typical greeting) or interact any way before he was laying into me and swearing at me. Thankfully the CNA was still nearby, heard the commotion, and he called for my preceptor! I just keep ruminating on what would've happened if I was off orientation (no other nurse in the building) and the aide was helping his coworker down the other hall.

[hppygr8ful, ASN, RN, EMT-I]

Have you had a Critical Incident Stress debriefing? This should have been provided by your employer or you can get one through your employer's EAP (Employee Assistance Program) this will help you sort out your feelings about the incident. It's always good to try to understand the motive behind an attack and anything you might have done to contribute to it. It's not your fault but walking into the room of patient who was acting up already when you were alone was probably not the best move. Also was his attack motivated by his dementia? If so you will likely never understand why he attacked you. Certainly you are within your rights with regard to safety to have a staff with you while in this resident's room. Just coordinate with your floor staff and be willing to reciprocate if you can help them out as well.

Hppy

[River&MountainRN, ADN, RN]

I'm thinking this might be the first job I've ever quit without notice: the aides are totally insubordinate to the more experienced nurses, let alone a new hire, and half of them don't even speak/understand English. So having an escort is, unfortunately out of the question...they just get him more riled up anyway, which is what happened the other night. Administration has been of no help; they didn't address the attack and they refuse to address the aide situation since they are already short staffed and "don't want to scare them [the aides] away]". "Yay, for LTC" (/end sarcasm).

[BlinkyPinky]

What have you decided, Gypsy? Did you resign ? It does not sound reasonably safe, based on what you write .

And no - we don't Blame The Victim .

[River&MountainRN, ADN, RN]

There are so many reasons to resign, many of which I can't list here because I know that there is one person on here who likely operates within my small regional circle and could blow the whole anonymity aspect of posting on the forum. I'm just so afraid of confrontation, and we're so short staffed right now that the DON is already harassing me over not picking up on a date I told her twice already that I can't do. But I think I, ultimately, will resign.

[Been there,done that, ASN, RN]

This is all about YOUR safety now. You and administration are aware that the resident is volatile and dangerous As you are in orientation... where is your preceptor?

I have been assaulted by a psych patient. The PTSD never ends.

[River&MountainRN, ADN, RN]

This is all about YOUR safety now. You and administration are aware that the resident is volatile and dangerous As you are in orientation... where is your preceptor?

I have been assaulted by a psych patient. The PTSD never ends.

Preceptor has been mostly hands off at this point, and when I asked her to be my escort into that resident's room her reply was, "Well, okay, but you really need to move beyond this because you'll be on your own soon and can't count on the aides to babysit you because med pass is at the same time as their rounds. Plus, as you know, we have an aide problem [i.e. it's incredibly difficult to get them off their posteriors and/or get your point across to the ones who don't speak English]".

[peachtreednurse, RN]

Not to be overly suspicious,but considering your comments about insubordination and general disregard for the nursing staff, I'm wondering if you had fallen victim to a set-up. I've seen it happen with CNA's; they have lengthier, more intimate contact and can use that positively or otherwise.By history has the behavior gotten worse at or near the same time "sundowner affect"? REGARDLESS, you have a responsibility to protect yourself. Do not lower your guard, don't allow possibilities of any frequency to be alone with this patient. Watch body language, signs of agitation, be timely with meds, administer out of sequence if more conducive to safety and with companion if possible. Do not allow the resident to get between you and exit, alert another person to check on you. i was shocked when a patient of a fellow staff nurse without psych history, pulled his IV, Foley catheter, phone, and anchored prints from the walls in his private room before coming out and threateningly lunging at anyone who approached. Was an Incident Report done? Interventional Care Plan Meeting?

[hppygr8ful, ASN, RN, EMT-I]

Not to be overly suspicious,but considering your comments about insubordination and general disregard for the nursing staff, I'm wondering if you had fallen victim to a set-up. I've seen it happen with CNA's; they have lengthier, more intimate contact and can use that positively or otherwise.By history has the behavior gotten worse at or near the same time "sundowner affect"? REGARDLESS, you have a responsibility to protect yourself. Do not lower your guard, don't allow possibilities of any frequency to be alone with this patient. Watch body language, signs of agitation, be timely with meds, administer out of sequence if more conducive to safety and with companion if possible. Do not allow the resident to get between you and exit, alert another person to check on you. i was shocked when a patient of a fellow staff nurse without psych history, pulled his IV, Foley catheter, phone, and anchored prints from the walls in his private room before coming out and threateningly lunging at anyone who approached. Was an Incident Report done? Interventional Care Plan Meeting?

One of the things I used t ask my aids was to let me know when they were going I into so-and so's room so we could cluster the care. I would help the aid with anything that needed to be do for that resident and give my meds etc..... this had the positive effect of letting the staff member know that I was part of the team and not the boss of them.

Sometimes you do catch more flies with honey than with vinegar.

Hppy

[River&MountainRN, ADN, RN]

Not to be overly suspicious,but considering your comments about insubordination and general disregard for the nursing staff, I'm wondering if you had fallen victim to a set-up. I've seen it happen with CNA's; they have lengthier, more intimate contact and can use that positively or otherwise.By history has the behavior gotten worse at or near the same time "sundowner affect"? REGARDLESS, you have a responsibility to protect yourself. Do not lower your guard, don't allow possibilities of any frequency to be alone with this patient. Watch body language, signs of agitation, be timely with meds, administer out of sequence if more conducive to safety and with companion if possible. Do not allow the resident to get between you and exit, alert another person to check on you. i was shocked when a patient of a fellow staff nurse without psych history, pulled his IV, Foley catheter, phone, and anchored prints from the walls in his private room before coming out and threateningly lunging at anyone who approached. Was an Incident Report done? Interventional Care Plan Meeting?

I was talked out of doing at incident report at the time, and nothing---absolutely nothing---was followed up on or done as a result of what happened to me. I have since left that facility and geriatrics as a whole specialty.

[River&MountainRN, ADN, RN]

One of the things I used t ask my aids was to let me know when they were going I into so-and so's room so we could cluster the care. I would help the aid with anything that needed to be do for that resident and give my meds etc..... this had the positive effect of letting the staff member know that I was part of the team and not the boss of them.

Sometimes you do catch more flies with honey than with vinegar.

Hppy

None of the 3-11 aides had a problem with me, as a matter of fact I'd worked with several of them at a different facility and they'd promised to "put in a good word for me" with their coworkers at this one. And before I was a nurse, I started out as an aide for 35 residents by myself. So, I get it, more than most nurses. But, as a result of that experience, I also believe that everyone needs to do their jobs if they're coming to work and collecting a paycheck. It was very obviously a case of the aides on 11-7 were doing the overnight shift because they believed---as one of the other 11-7 nurses let them believe, unfortunately---they could get away with sleeping/ignoring call lights/blowing off nurse requests/doing one round the entire shift. I realized that I wasn't going to change a broken system, especially when I repeatedly went to admin and they never ONCE got back to me, so I left.