I got slapped by a pt. at the med window. Pretty hard too I might add. She took a dislike to me for no particular reason she can articulate and I can't fathom. Her consequences were wing restriction. While on wing restriction, I brought her a PRN for agitation. Of course she was verbally abusive and told me she wanted another nurse. I told her I was her nurse today and that wasn't going to change. She could choose to take her meds or not take her meds. The choice and the right was hers. I was professional and kept my cool with her.
What do you think happened? The charge nurse told her she would assign another nurse to administer her meds. Every nurse that went in there to give her her meds listened to a tirade of how she hated me. I felt that she was rewarded for her bad behavior, and this set up a staff splitting situation. Now she thinks she can get what she wants by misbehaving and worst, physical aggression against staff.
There are two schools of thought here that came up. 1. The goal is to get the meds in the patient and stabilize so let's get another nurse. The other is 2. The patient was successful in her staff splitting and has learned that physical aggression works to her benefit.
this is really wrong; im so sorry that you are dealing with it. I can't believe that whom ever is in charge is allowing the patients to be unsafe!! I don't know what you do when your workplace takes no one's safety into consideration, but I would not want to work there.
this patient belongs in jail, in my opinion. You don't get to assault others just because you are mentally ill.
Can a psych nurse press charges against a patient for assault?
I got slapped by a pt. at the med window. Pretty hard too I might add. She took a dislike to me for no particular reason she can articulate and I can't fathom. Her consequences were wing restriction. While on wing restriction, I brought her a PRN for agitation. Of course she was verbally abusive and told me she wanted another nurse. I told her I was her nurse today and that wasn't going to change. She could choose to take her meds or not take her meds. The choice and the right was hers. I was professional and kept my cool with her.
What do you think happened? The charge nurse told her she would assign another nurse to administer her meds. Every nurse that went in there to give her her meds listened to a tirade of how she hated me. I felt that she was rewarded for her bad behavior, and this set up a staff splitting situation. Now she thinks she can get what she wants by misbehaving and worst, physical aggression against staff.
There are two schools of thought here that came up. 1. The goal is to get the meds in the patient and stabilize so let's get another nurse. The other is 2. The patient was successful in her staff splitting and has learned that physical aggression works to her benefit.
I'd like to know what others think.
Do you work in a psych facility? You're in a position for this happening a little easier because an individual, such as this patient, is already in an agitated state. You were trying to give meds for the said agitation, perhaps someone else could have provided it, just to diffuse that particular situation. I don't see it as giving in to her behavior. What's her history, anyway? I wouldn't take it personally. If it's severe agitation, what about having help to hold her and give her an IM? I don't see it as staff splitting at all. She's just got some fixation on you and doesn't like you - oh well, move on. There will be many who come and go who love or hate you, just do your job, if she's so agitated and you can't administer the med another route or with some help, do not administer it. Don't put yourself close enough to someone in that state without someone there to either assist, protect, or distract.
Pt. in question is MR with a diagnosis of impulse control disorder. A behavior plan was drawn up for her which emphasized reward and contraindicated consequences. Of course most of us snickered at it but we complied. This is how it worked out. She would wait until she got her reward, then she would assault and threaten staff. She got her first taste of locked seclusion after she slapped the charge nurse. But it was the second locked seclusion the following night that put the behavior plan on ice. When she didn't like the reward she was being offered, her slap turned into a beating and I was the victim. I wasn't injured but quite shaken up over the attack. I want her off the unit. I would have pressed charges but because she is MR, I didnt think they would stick. Now most staff approaches her for care with a security officer. I really do not want to care for this patient at all even with security present. I'm just so done with her and get the willies getting close to her. Do I have a choice? Would it be unprofesional of me to pass her on to the other nurse?
I think it is quite reasonable for you to request to not have this patient again under the circumstances. Suggest you make sure the nurse who has this pt is warned about her behavior.
I got slapped by a pt. at the med window. Pretty hard too I might add. She took a dislike to me for no particular reason she can articulate and I can't fathom. Her consequences were wing restriction. While on wing restriction, I brought her a PRN for agitation. Of course she was verbally abusive and told me she wanted another nurse. I told her I was her nurse today and that wasn't going to change. She could choose to take her meds or not take her meds. The choice and the right was hers. I was professional and kept my cool with her.
What do you think happened? The charge nurse told her she would assign another nurse to administer her meds. Every nurse that went in there to give her her meds listened to a tirade of how she hated me. I felt that she was rewarded for her bad behavior, and this set up a staff splitting situation. Now she thinks she can get what she wants by misbehaving and worst, physical aggression against staff.
There are two schools of thought here that came up. 1. The goal is to get the meds in the patient and stabilize so let's get another nurse. The other is 2. The patient was successful in her staff splitting and has learned that physical aggression works to her benefit.
I'd like to know what others think.
Sorry, I agree with administration on this one. You took someone that was already unstable and aggitated them.
If someone told me, "I don't want you for a nurse", the last thing that I would tell them is that "I am their nurse for the day and that isn't going to change."
You lost the battle and the war as soon as you said that.
Not to be mean, but it was a very disrespectful way to treat a patient. Remember, they are there to get well, not win a popularity contest.
You dismissed her feelings as invalid...every question that I have ever taken on an exam, when something along those lines comes up, it's aways the wrong answer.
Iwould like to know how much expereince you have? When you say exam questions, I think you are a student. So am I. The problem is that what is the correct answer is not the one that is useful in real life. The folks need boundaries, being able to pick and choice nurses put the client calling the shots, whihc is not really where you want them to be.
I'm dealing with a similar situation now. I was in charge today and one of the patients on our locked sub-ward (3 bed unit within a locked unit- does anyone else have this btw?) flipped out when a certain staff was in there. She threatened assault but we avoided any actual harm. For all of the staff's safety we rearranged the schedule and kept him away from her for the shift. Manipulation and staff splitting? Maybe. Part of her enduring and inflexible pattern of perceiving and reacting to the world? Probably.
I don't mind "playing into" behavior in some cases especially when safety is involved. I don't have aspirations to improve borderline traits on an inpatient unit and would rather keep everyone unharmed until the patients can go somewhere that will actually be therapeutic for them.
It is awful to be assaulted by patients, and we don't always have the luxury to get away from them afterwards. RNKittyKat, I hope that you are taking care of yourself after this and getting support if you need it. :redbeathe
Iwould like to know how much expereince you have? When you say exam questions, I think you are a student. So am I. The problem is that what is the correct answer is not the one that is useful in real life. The folks need boundaries, being able to pick and choice nurses put the client calling the shots, whihc is not really where you want them to be.
have yoy ever had a pt like this?
So what are you saying? That a patient can't refuse treatment?
Sure they can. A patient has a right to not have a particular healthcare provider treat them. If they don't want a particular nurse, then they have the right to ask for another one. If they don't want a particular doctor, then they have the right to ask for another one.
Just because someone is a psych patient, doesn't mean that they cannot legally make ANY decisions. From the OP, this patient had issues with being impulsive...not a single word mentioned about her being mentally unable to make decisions for herself.
Someday, when you're actually a nurse (or at least have finished your Psych rotation in school) come back and reread your posts. To quote BTO " . . . .you ain't seen nothing yet. . . . . . ."
Laughter aside, you have to realize that there's NCLEX/Nursing school Nursing and Real World Nursing. At times the two can be very different. And only one is based in reality.
Sorry, I agree with administration on this one. You took someone that was already unstable and aggitated them.
If someone told me, "I don't want you for a nurse", the last thing that I would tell them is that "I am their nurse for the day and that isn't going to change."
You lost the battle and the war as soon as you said that.
Not to be mean, but it was a very disrespectful way to treat a patient. Remember, they are there to get well, not win a popularity contest.
You dismissed her feelings as invalid...every question that I have ever taken on an exam, when something along those lines comes up, it's aways the wrong answer.
in all fairness to the OP, you don't know the exact circumstances and nuances of the situation, Hopefull2009. A test question does not dictate real life, especially with psych patients where things can be a bit tricky.
Pt. in question is MR with a diagnosis of impulse control disorder. A behavior plan was drawn up for her which emphasized reward and contraindicated consequences. Of course most of us snickered at it but we complied. This is how it worked out. She would wait until she got her reward, then she would assault and threaten staff. She got her first taste of locked seclusion after she slapped the charge nurse. But it was the second locked seclusion the following night that put the behavior plan on ice. When she didn't like the reward she was being offered, her slap turned into a beating and I was the victim. I wasn't injured but quite shaken up over the attack. I want her off the unit. I would have pressed charges but because she is MR, I didnt think they would stick. Now most staff approaches her for care with a security officer. I really do not want to care for this patient at all even with security present. I'm just so done with her and get the willies getting close to her. Do I have a choice? Would it be unprofesional of me to pass her on to the other nurse?
that is a good question about not caring for her, if another nurse could. What if you all felt that way? What then? I would think that in order to care for her, she needs to be in a state that will not harm employees or herself. What about an extended plan for isolation or chemically medicating her? I'm not a psych nurse (though I get rotated to our psych rooms as often as any other nurse in the ER, but do NOT like it), but I would believe that you need to be safe first.
So what are you saying? That a patient can't refuse treatment?
Sure they can. A patient has a right to not have a particular healthcare provider treat them. If they don't want a particular nurse, then they have the right to ask for another one. If they don't want a particular doctor, then they have the right to ask for another one.
Just because someone is a psych patient, doesn't mean that they cannot legally make ANY decisions. From the OP, this patient had issues with being impulsive...not a single word mentioned about her being mentally unable to make decisions for herself.
a patient that is in a psych facility may very well be an INVOLUNTARY commitment, which means they cannot refuse treatment. If they are agitated and there is an order to medicate PRN agitation, you medicate. Period. Where I live it's called a Section 12 - they have human rights (bathroom, phone calls, etc) but cannot refuse treatment that is medically indicated for a psychiatric illness. This patient is mentally retarded, MR, which would make her mentally either unable or diminished in the capacity of decision-making.
So what are you saying? That a patient can't refuse treatment?
Sure they can. A patient has a right to not have a particular healthcare provider treat them. If they don't want a particular nurse, then they have the right to ask for another one. If they don't want a particular doctor, then they have the right to ask for another one.
Just because someone is a psych patient, doesn't mean that they cannot legally make ANY decisions. From the OP, this patient had issues with being impulsive...not a single word mentioned about her being mentally unable to make decisions for herself.
linda2097
375 Posts
Can a psych nurse press charges against a patient for assault?