Gutless Colleagues

[LPC2RN]

Okay...so maybe gutless is a strong word but I am having a difficult time finding another term to describe some of my colleagues after the most recent assault I was involved in. The nurses station is isolated and poorly designed to where the patient is between the door and the desk where patients come in and sit down for assessments or just to chat.

Some time into my shift a patient enters the office and is focused on some persecutory delusion. I perform some active/reflective listening. He seems okay but just flips instantaneously, screams, jumps up from his chair, slams the door, turns to me and just charges me. I am not easily frightened, but this patient outweighs me by a decent amount and you can tell by the look in his eyes that he wanted to make me pay for...whatever.

As I am slammed against the wall, I am pushing back, trying to escape using the bi-yearly, substandard escape maneuvers we are taught during orientation, I am repeatedly shouting for help only to see one or maybe two of the techs open the door, watching the patient attempting to rip my face off, only to see them close the door. I am able to work my way around the patient take two steps to the door to try a futile escape before he grabs my back and closes the door. A couple of seconds later the door opens again and I see a nurse and a tech from a different wing on my unit enter the room. He lunges at me again but I am able to side step him and guide him to the floor. As I feel the other nurse grab him, I get out of the room to collect myself and catch my breath. I was honestly glad to be alive. When something like that happens, which has never happened to me, I felt like I was going to die.

Personnel arrived seconds later from other units to assist. After the adrenaline slows down, I assess the damage. Mostly a few scratches and bruises. As a few days have now gone by, I am beginning to feel anger, not over what the patient did (obviously it comes with the job) but by the complete cowardice of the two techs on my wing who just stood by and did nothing to help, despite me shouting at the top of my lungs for help. I must have shouted it at least 15 times. Several of those times were when the techs were looking at us like a deer in headlights and several more after watching them withdraw.

Am I alone? Am I wrong to feel pissed off at them? Thanks.

[ktwlpn, LPN]

What kind of experience do they have?Sounds like time for debriefing Maybe they have never seen anything like that before...Sorry you went through that,psych nursing is not everyone's cup of tea.I hope you get the support you need to work through it.

[Davey Do]

Feelings are never right or wrong, LPC2RN, they just are.

You have every right to feel anger, fear, or whatever.

Having had a similar experience, I can strongly advise you to seek counseling through your EAP. I sought services through Psych and Art Therapists. The Art Therapy changed my life.

Do whatever you need to do for now to get your head back in a good place. You need and deserve this, LPC2RN.

The very best to you!

Dave

[LPC2RN]

What kind of experience do they have?Sounds like time for debriefing Maybe they have never seen anything like that before...

My thoughts exactly. I was half-tempted to tell them at that moment that they should consider a new line of work.

[Davey Do]

My thoughts exactly. I was half-tempted to tell them at that moment that they should consider a new line of work.

I have but a moment now, for I need to ready myself for work, but want to say that you need to focus upon your own well-being for now, LPC2RN. We are limited in what we can do with others and their behavior.

You've made your feelings and situation tangible in telling your story- you're expressing yourself and that's the beginning of your road to recovery.

[ProgressiveActivist, BSN, RN]

Those people, who are supposed to have your back, watched you get beat up.

You have every right and reason to be angry AF and write this all up as a near miss sentinel event for their failure to act in an emergency and endangering a coworker and a patient.

[imintrouble, BSN, RN]

I'd never want to work with those two people again.

For my own sanity, I'd have to ask each of them why they didn't help. How they could be willing to watch me get murdered, and not lift a finger to save me. Murder might be too strong a word, but your own post indicates you thought you were going to die.

I personally think both techs who saw an assault and turned their head, should lose their jobs. They're a danger to the staff and the patients.

Again, I'd refuse to work with either of them ever again.

[brandy1017, ASN, RN]

Sounds like you need security guards with stun guns, not techs! This is why I wouldn't do ER or psyche! Maybe the nurses need stun guns too! I would be angry at the patient regardless of mental illness. lol Won't see me working there! Although we have plenty of psyche patients with complex medical problems where I work. Sometimes confused patients hit, bite or kick but I'm able to get out of harms way as they are bedridden. If things escalate we call on security to take over. I don't understand why they wouldn't have such a system where you work when there is certainly a risk of violent behavior!

The county psyche ward with great pay and benefits is notoriously understaffed, lots of injuries and lots of vacancies I wonder why! It is a large old fashioned hospital that is out of compliance with federal rules so the federal govt doesn't pay and the county has to pay up. There is a plan in motion to eventually close the hospital and move to group homes instead which is what the federal govt wants. Either way count me out!

[brandy1017, ASN, RN]

Those people, who are supposed to have your back, watched you get beat up.

You have every right and reason to be angry AF and write this all up as a near miss sentinel event for their failure to act in an emergency and endangering a coworker and a patient.

I'm putting it out there even though I don't work psyche, how are the techs supposed to subdue this oversized person with their bare hands? Wouldn't they end up getting attacked as well? Why don't you use security guards instead like they do in prisons and seriously why not a stun gun? Because they have a mental illness and can't help themselves you guys are supposed to be put in harms way without adequate protection? I don't get it! What about a life alert device you wear that you can press a button when you're in danger to ring for security and maybe even police backup? Seriously!

[ScenicRoute]

I certainly understand your anger. These kinds of things affect professional relationships for a long, long time. My question is, though, how did the staff from other units know to respond? Is it possible that these techs had to leave you for a moment to go get help? I agree with other posters that this is a traumatic situation, you're entitled to your feelings about it, and you should talk to someone who will help you debrief. Good luck to you, and I'm so sorry this happened. It's the worst part of our job.

[ProgressiveActivist, BSN, RN]

Psych staff are required to demonstrate competence in management of aggressive behavior on a yearly basis.

A large individual can usually be subdued if the staff practice as a team and utilize these*maneuvers.

[TriciaJ, RN]

This is a multi-level problem. Not enough staff, and the staff who are there are not fit for the job. I've worked in a psychiatric facility where anyone with a pulse was eligible for hire, skeleton staff on the off-shift, management who put bandaids on everything...

You do need to debrief the whole situation with management and they need to provide you with a concrete action plan to avoid repeats of this situation. If they can't do anything toward making everyone safer, you need to start looking for the exits.

On another note: do you have involuntary patients? If they don't have the option to leave, another patient attacks them and staff don't lift a finger to help, would management consider the situation more urgent?

I'd be P.O.'d too and I'd start looking for cages to rattle. Good luck.