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.
And....what does management or your supervisor have to say about the way things were handled?
My management has actually been very helpful and supportive. I love my workplace. As far as what others here have said, many are correct. It is a multifaceted problem with understaffing (made worse by the holidays), lack of adequate training, poor occupational fit for those without a brave spirit, poor office design, poor placement of the office on the unit, etc.
Someone mentioned how people knew to come. We have an intercom system where anyone near a phone is able to call a code that sends out a message to the other units to send staff members to respond. Again, due to the holidays and low staffing, the response was smaller than usual but I have no problem with their response as I believed they responded as well as could be expected. The techs on my unit could have shouted or made eye contact to pass a message to start the code process and have been in the office in under 10 seconds.
What is your workplace's policy on take downs? Giving benefit of doubt, did the techs act according to policy by leaving you there to go get help? Or should they have intervened. Any psych until I've been on has an all hands on deck during an event like that and every single employee receives take down training and is expected to utilize it. I'm just wondering if they did go to get help or if they just left you there.
There is no policy, or at least none that I am aware of, that states specifically what each person's role is. It is kind of a judgement issue. If someone is calling for help and you are the closest person to help, based on their placement and the size of the unit one could easily alert someone (who could then call a code) within earshot or within sight and then respond to the call. Again, 10 seconds is plenty of time do both (alert someone then run to the other end of the wing). Even still, with two techs on the unit, one person could have called for help while the other responded. That should have taken the response time down to about 5-7 seconds.
I have a lot of respect for you psych nurses. I worked psych for about 6 months and loved everything about it except the possibility of an attack. You can really get beat up badly. I was taught various techniques of protection...something called TOVA..but I just never felt prepared enough for an attack. I worked on a unit to where everyone had each others back..I am so sad to hear about how you were left to be attacked. I can only hope those people went to get help...but I would feel bad leaving someone to be attacked. Not sure what their thinking was...they are trained to help fend off attacks. I worked for a state facility that was big on deescalation.
Id b contacting legal counsel because it sounds like they did not have good protocols in place to protect staff. Id be angry at management. Your coworkers might not be appropriately trained to deal with this but hopefully they at least called for help for you. I'd still be pissed though that they didn't try to help. Sorry this happened to you OP.
We recently had an incident at our local health psych unit. A well respected, experienced tech was killed. As he was rounding, doing bed checks, a pt was hiding behind the door. Tragic. He never had time to call for help. You say the person was big; if the techs had joined in immediately, that would be 3:1. So either they were too afraid, or didn't know what to do, both unacceptable. Definitely needs to be written up, and different arrangements for a safer office!
^ yea seriously, whether they were gutless or not...You're on a psych floor..It's hard for me to digest that a psych unit does not have take down policies and role definitions..yet they provide training 2x a year? I would surely be talking to legal.
And you yourself said it was a multifaceted problem...Why are you even working there and allowing yourself to be put in danger with "understaffing (made worse by the holidays), lack of adequate training, poor occupational fit for those without a brave spirit, poor office design, poor placement of the office on the unit, etc."
In all actuality, you could have gotten severely injured, or worse.
Substandard self-defense policies are why I don't do psych. My MMA locks and pins (even the "nice" ones) would be frowned upon in a clinical setting ...
I don't blame you for being mad. I would be as well. How dare you get hurt and they stand there. I would understand more if it was just one person who froze in the moment, but there were two of them. Scared or not you do not let another co-worker get beaten like that. Even distracting the patient would have been helpful. Simply doing nothing wasn't the right option. I did psych for a short time and enjoyed it some days. Others I felt like I was at serious risk and that was mainly due to poor staffing/terrible training for staff. Psych patients can be very dangerous and unpredictable. Management may not care since their risk is minimal, or at least they think it is. I bet if it was a manager that was attacked wheels would be in motion already. Being the Nurse we are expected to take this abuse. It's crap. Now I'm p*ssed for you. Get some help through your Employer if at all possible. Take care.
Specializes in Med-Surg, OB, ICU, Public Health Nursing.
Good luck to you, and I'm so sorry this happened. It's the worst part of our job. Nicki Laughs, BSN
Violence should never be considered "part of our job." In California nurses are working with Cal OSHA to develop standards to prevent workplace violence.
_zoubisoubisou_
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And....what does management or your supervisor have to say about the way things were handled?