Hailed as heroes, hospital workers for years have been bitten, hit, kicked. And ignored.

[TheMoonisMyLantern, ADN, LPN, RN]

This is a good article I saw on USA Today, it was on their homepage for a few hours before it got bumped for something else (we are just nurses after all not that newsworthy). The article does well showcasing example of violence towards nurses in hot spot areas ER, ICU. However I do wish they would have interviewed a psych nurse, god knows we come across plenty of violence.

We all know though, that regardless of your specialty that nurses are victims of violence and it's an issue that really needs more attention.

Hailed as heroes, hospital workers for years have been bitten, hit, kicked. And ignored.

[DavidFR, BSN, MSN, RN]

Thanks for posting this.

Yes we're angels, heroes, people can applaud for us when something like Covid happens, but our everyday reality isn't newsworthy and our salaries don't reflect the risks we face on a daily basis.

I don't know how others feel and how it is in various different countries, but for myself as a dinosaur (qualified in 1986) I think that around the mid 90s there was a distinct shift in the way patients approach us. The respect has gone. 

I remember in the 80s compliant patients who sat up straight ready for the blood pressure as soon as they saw you approaching with the dynamap (or in those days, the sphyg!!). They listened to what you said, readily took your advice and they said please and thank you. Violence towards a nurse was extremely rare and a public outrage.

These days you can go into a patient room and the mobile phone conversation is just continued while you're ignored. There's a lot of "can't you come back later?" yet when they buzz it's "I want and I want it now" They all know their rights and they'll question every prescribed treatment even if they've been on it for years. And sadly, violence has become commonplace in all areas.

Of course I'm describing two extreme scenarios: it wasn't always rosy back then and we still get some lovely patients of course, however, do any other oldies notice this shift I wonder?

[TheMoonisMyLantern, ADN, LPN, RN]

I'm not really an oldie but, I've noticed a change just since I started nursing in the 00's. While I think incivility has increased in society as a whole, verbal abuse and violence have been tolerated by administrators and law enforcement alike. One facility I worked psych at had a patient with a personality disorder, multiple assault battery charges, no psychosis or cognitive impairments he broke into the nurse's station assaulted 3 staff members and did about 5,000 dollars worth of property damage. All three staff members pressed charges but when it went to court the judge dismissed the charges saying that as mental health workers we should "expect" to receive violence. So that makes it okay, right? 

One psychiatrist I worked with was witnessed by multiple staff members on numerous occasions telling adolescent patients during their treatment team meetings that when they get angry and want to hit something to "Hit the nurses, it's why they're here." And by golly they sure did and we had one nurse with such bad injuries she can no longer practice as a bedside nurse. When his medical advice was report to administration nothing happened, oh, well he was promoted, so I guess they did do something.

Now psych units in my area are taking down the plexiglass windows/walls of the nurses station in the name of "trauma informed care" because it may be imposing to some patients. We were told that this would curtail the rise in violent behavior in some patients. This is despite increasing acuity on the units and ever rising violent behavior. So, guess what has happened? Patients are diving over the desk at staff members, one girl had a computer monitor thrown at her, another a hole puncher, one patient nearly eloped by diving over the desk and running down the back hall. Management's response? The girl that had the computer thrown at her should have done more to prevent the damage to property. The hole puncher, should have been further way from the patient's reach.

I've taken numerous blows over the years luckily none have been serious, but usually being one of the only male staff members in this situation I usually get to be the meat shield, which is fine, I don't wish to see my co-workers injured but I would prefer not to have to be a target at all.

I know my experience isn't localized, it truly is a national problem that needs to be addressed. I don't know what it will take, or what will have to happen before it changes.

[JBMmom, MSN, NP]

While we see some of the most extreme cases I don't think that this is unique to nursing and the medical field. Over the years there has been a shift in society towards I-want-what-I-want-now mentality, and somewhere along the way our patient's medical outcomes started to matter less than what they think of our food and "customer service". Saved your life, great? But you didn't like the meatloaf- heads will roll!

Think about the Black Friday fights where people have been KILLED over a Christmas present?! That certainly wasn't going on in the 80's, and I remember the Cabbage Patch Kids craze. People working in customer service were not sworn at on a daily basis when the item on sale ran out of stock. Police officers could approach citizens and be seen as an ally, not a confrontational figure to deride and insult. Teachers didn't have to worry about being assaulted by students or parents when students didn't get the grades everyone thought they deserved.

I think it all comes down to respect over self-importance. Until people start to view the people around them will as much respect as they think they deserve, nothing's going to change. Of course in our line of work we have the added influences of drugs, alcohol, undertreated mental disorders and such that compound the problems, but it's everywhere, and it's pretty sad. 

[Emergent, RN]

This is happening more because America has been on a moral decline for many years. Permissive child rearing practices coupled with materialism and excess are destroying us. Our nation is in disarray. 

 

[MarkMyWords]

We live in cities with much more coorifice behavior. I don't know about Europe or Canada. People start fights over nothing. More profanity is tolerated and more verbal abuse but I heard that decades ago also. Psych units I expect problems because patients are not normal. I was not myself when I had 2 major surgeries and yelled at the staff in the ICU. I regret that now but I was SO angry with myself so upset that my life was in danger and scared. Maybe this is true for other patients in ICU. The nurses were great though bossy. I returned a year later to thank one and hug. 

In one doctor's office a sign reads in all caps. Be Nice or Go Away! Really. Clerk said the sign is needed. 

[TheMoonisMyLantern, ADN, LPN, RN]

17 minutes ago, Mywords1 said:

Psych units I expect problems because patients are not normal.

Trust me there are plenty of people outside of psych units that are not "normal", myself included. What a lot of people don't realize is that a lot of the people committing the violence in psych units are there due to Axis II personality disorders and there's not a dag on thing you can do about those except treat them with extensive psychotherapy which is not what psych units are for. They know what they're doing, and they know that's wrong, it's just that they don't care. Get a lot violence from substance abusers too, and I have mixed feelings about it. On one hand I empathize because addiction completely screws with your ability to make logical and safe decisions both while using and while in detox but I also don't think that someone should get a free pass because they were high off crystal meth and tweaking. Then there's the jail birds (who also usually have personality disorders) who are just trying to get a psych diagnosis in order to get less jail time or to be placed in a state hospital. The violence we see from psychotic patients and patients with dementia is unfortunate but at least one can understand WHY they were violent and that they're not in control of their behavior. 

[JBMmom, MSN, NP]

1 hour ago, Mywords1 said:

 The nurses were great though bossy.

We do tend to be a bossy bunch in the unit. ?  Glad that you're okay, we see many people in intense situations and understand that emotions can get out of hand at times. 

[Davey Do]

Thank you for sharing this article, TMIML.

In the 80's I was administering Valium to little old blue-haired ladies, and by the late 90's, I was getting stabbed in the back with a pair of scissors by a deinstitutionalized psychotic schizophrenic. In the 2000's I was administering forced meds to acting out psychotic ex-cons who were threatening to kill my coworkers. 

What changed?

A cut in resources: In the 80's, we would send our "bad" psych patients to the state hospital. The state facility stopped admitting non-criminal patients in the late 90's and the community hospitals were left holding the bag. Two area hospitals closed down their psych units and Wrongway Regional stepped up their psych program.

Wrongway became the dumping ground for the area's psych patients and, hence, the violence there has escalated.

[Daisy4RN]

14 hours ago, TheMoonisMyLantern said:

We all know though, that regardless of your specialty that nurses are victims of violence and it's an issue that really needs more attention.

While of course I agree with this I won't be holding my breath. I have witnessed the problem only getting worse over the years. (Some) people will do whatever they can get away with and our current system allows just about anything. Any problem with the pt, including the fact that the pt was violent, is the nurses/staffs fault. I have experienced it and witnessed it. Our society is in a downward spiral in which people like to claim victimhood and therefore don't feel the need for any self responsibility for their actions and of course this has led to all the negative changes in the hospital also, add to that "customer service" and surveys its no wonder what is happening and will no doubt only progressively get worse. Indeed, our country is in complete disarray.

[NurseBlaq]

Nursing started getting worse, while wages became stagnant when they started letting business people make medical decisions. They're more concerned about their bonuses than our health. Nursing is the only profession where we get spit at, poop is thrown at us, assaulted, and abused in all types of ways yet we're expected not to defend ourselves because if we do we risk losing the licenses that we worked hard to earn. We're expected to just accept being abused, of course by those who aren't in the line of fire.

[JKL33]

3 hours ago, NurseBlaq said:

Nursing started getting worse, while wages became stagnant when they started letting business people make medical decisions.

Yes.

....Same reason they they are still flying the hero flags and using that verbiage. There were more hero worship posts and articles on my employer's sites and social media very recently, unabashed, despite the fact that we are months into this and they surely know nurses' criticism of hero-talk by this point. They are not unaware. They know their hero talk looks good to the public and that is all they care about with regard to the topic.

They allow the abuse and they perpetuate the abuse.

The only thing that would be truly unusual would be if they decried it and made it stop (which they could do practically instantly if they wanted to) and actually stopped doing it themselves.