Has anyone ever been assaulted by a patient?

talaxandra · Sep 25, 2005

Hi Bobcat - sorry to hear about your experience. Being assaulted is distressing enough, but having it happen at work, especially with a patient that you previously felt comfortable with, is most unsettling.

I've been pinched and grabbed hard enough to bruise, kicked and slapped, and was once punched in the jaw hard enough to loosen a tooth (but no swelling to show anyone )

One of my colleagues was punched in the face so hard that the patient (who had a dense hemi) propelled himself out of bed and on to the floor; my friend had a suspected fractured orbit.

The problem isn't so much when a patient is known to be aggressive, because you can pln for that - go in pairs, staay out of arms' reach etc. It's when the patient isn't known to be aggressive, or when their condition changes (we've had a number of incidents with hypoglycaemic and post-ictal patients) that you're at greater risk.

My hospital has a 'code grey' system to alert security, the orderlies, the psych reg and nursing admin about aggressive behaviour that can't be safely managed by the ward staff, but there isn't anything in place that allows a lone staff member to summon help is cornered. Well, except yelling for help.

DutchgirlRN, ASN, RN · Sep 25, 2005

In 30 years I've been verbally assaulted more times than I can remember by people who are supposedly in their right minds.I have had a telephone thrown at me, he too was in his right mind and wanted pain med 2 hours early, his doc said "well it looks like you feel good enough to go home" and promptly threw him out. (Pancreatitis patient who still had elevated enzymes) I've been pinched, spit at and slapped by elderly patients who honestly did not know what they were doing, or at least I don't think they did, and an occasional pinch on the butt. Nursing you gotta love it !

purplemania, BSN, RN · Sep 25, 2005

I had a two year old pinch my boob when I leaned over him. Does that count?

Seriously, I would consider filing a police report if assaulted. People should learn how to behave!

fluffwad · Sep 25, 2005

i used to work on a ortho/ neuro rehab unit that got a lot of head injuries......a lot of them druggies. most of that set were violent in the early stages and basic jerks after they'd recovered enough to talk coherently.

i decided to leave because i'm too old, and too short to spend half my time defending myself against 20 something violent men who were saved to probably only continue to be a burden on society, danger to themselves and others, and develop no redeeming qualities ever.

that said, i work now with dementia patients who are also violent at times....but i have more empathy for them since they didnt do that to themselves and they aren't nearly as dangerous. a lot of times you can figure out what is provoking them ( pain, overstimulation, being rushed, being wet) and avoid those triggers.

i think that historically nurses have been socialized to put up with the aggravation / abuse ( its part of the job) from the patients , the families, the doctors, the administration. it is time for a culture change.

papawjohn · Sep 25, 2005

Hey Bobcat

Most recent experience of this sort was the worst. Young and very husky/muscular fella surprised me with a bull-rush that woulda qualified him for the NFL. My head hit the wall so hard that I knocked the clock off the wall ON THE OTHER SIDE.

A skinny female resp therapist saved me, jumped on his back and wrapped arms and legs around him screaming 'You're not going to hurt MY JOHN'. (Fortunately my Mrs wasn't around to hear that I was 'hers'. I might have been assaulted twice!!)

Called the police on the guy when he was finally strapped down at all four extremities. (During the struggle the SOB even bit me on the butt!!!) The officer took the complaint but the guy was already "Baker-Acted" (Florida law for involuntary committment) so nothing was done.

I think days like that are why they don't let me bring my pistol to work

It happens. You just gotta be careful.

Papaw John

spirit1 · Sep 25, 2005

hello,

it is so funny i read this today. i was speaking with a male nurse today who agreed that nurses are traditionally womean and are expected to put up with abuse. i personally have been abused, and have seen a nurse cornered by a pt's family member and the nurse was yelled at by management. all of which is inferriating!! i myself have been thinking of going into nursing law and sueing the hell out of the hospitals for supporting nurse abuse due to "physician and patient satisfaction". this is a subject i fell very strongly about. and especially for our nice young gunshot victims and the families that come in with threatening and volitile behavior.

my question is, if we are not allowed to go into any place of buisiness, except of course a hospital, and hit and threaten people without having the cops called, then why as nurses do we not call the cops in fear of facing punative action by our managers? my saying is the job is needed, and in this day in age, my skills are needed nationwide. so if the hospitals are not supporting us, then leave them hanging.

sincerely,

a frustrated nurse (what's new)

i used to work on a ortho/ neuro rehab unit that got a lot of head injuries......a lot of them druggies. most of that set were violent in the early stages and basic jerks after they'd recovered enough to talk coherently.
i decided to leave because i'm too old, and too short to spend half my time defending myself against 20 something violent men who were saved to probably only continue to be a burden on society, danger to themselves and others, and develop no redeeming qualities ever.
that said, i work now with dementia patients who are also violent at times....but i have more empathy for them since they didnt do that to themselves and they aren't nearly as dangerous. a lot of times you can figure out what is provoking them ( pain, overstimulation, being rushed, being wet) and avoid those triggers.
i think that historically nurses have been socialized to put up with the aggravation / abuse ( its part of the job) from the patients , the families, the doctors, the administration. it is time for a culture change.

rambisisking · Sep 25, 2005

About 25 years ago, I worked in a mental instutition on a floor where Behavior Modification was being used, well actually experimented with at that point in time. Unfortunately, our patient load consisted of more than just persons with behavioral problems. We had some truly insane people that of course the treatment program was doing nothing for. One 29 year old woman would agress every time she heard the Stones song,"Shattered", and for some reason a couple of staff members could not stop them selves from playing it from time to time. One night, on cue, she ran to a patients room and jumped on her beating her, we had a skeleton staff that night and all 4 of us ran to her to try to pry her off, she somehow grabbed my hair and began banging my head against the floor like a punching balloon. The other 3 staff members were doing everything they could to subdue her other limbs, (these people are incredibly strong when adrenaline is pumping). There were other patients at the door watching this and one of the nurses threw her keys to one of them, told them to go into the nurses station and call for help, giving the number to the unit downstairs. This guy actually went in and called and brought the keys back to the nurse! Help came and we were able to seclude her. I seemed ok except for a headache and decided to continue with my work, I was in the Treatment room when I passed out. Aparently someone found me lying on the floor, I woke up to the house doctor taking my bp, while he was fondling my breasts. He's the one I pressed charges against.

RoadRunner · Sep 25, 2005

Spirit1, you got me thinking.... What other work environement does not press charges against violent clients? (I'm not thinking about dementia or neuro challenged patients here) Jail?

How wonderfull...

donmurray · Sep 25, 2005

Bobcat, hope you 're feeling better. It seems like you have identified many of the problem areas.. i.e. being expected to care for a potentially dangerous patient, alone, in a closed room, with an ineffective surveillance system. As there is a protocol, one presumes that the behaviour is not new, and this combined with the other aspects of your description of the event would suggest that your employer is not providing a safe workplace, or safe systems of work.

I would explore your case with a lawyer, and perhaps talk to OSHA if not a union rep. Meanwhile, make sure the incident is recorded, and don't enter that room alone, certainly not with the door closed.

MS._Jen_RN, ASN, RN · Sep 25, 2005

I too work on an acute care rehab unit that takes a lot of patients with TBI's (tramatic brain injuries). There is so much with behavior mgnmt I could write a book here. These folks are different than those with violence r/t dementia, confusion etc. The most important thing is to be able to recognize escalitory behavior sympotms ie figgiting, restlessness, crying, avoiding eye contact, being too quiet. Then you know that the person is about to be a problem. Problem is it's different for everyone. Also, try to pinpoint anything that triggers the behavior- ie overstimultation. There are several things that we do including not going into the room alone if the person is known to be overstimulated, decreasing stimulation and the use of restraints. Your staff should be instructed in release moves and take-down techniques as well. These keep you and the patient safe.

Working with these patients is tricky because as their brains heal they are almost different people from day to day. I too have had tussles with a few TBI patients, the worst result being a black eye.

People who do not understand this population are the one who will say that pressing charges is appropiate. What they don't understand is that going through an aggressive/ violant stage is quite normal for these patients. The outcome is in how it is managed.

You didn't do anything wrong and I hope that your experince will not keep you from working with this patient population. It is an amazing recovery process. They are my favorite patient population to work with.

If you have any other questions, please feel free to PM me.

~Jen

Cute_CNA, CNA · Sep 25, 2005

A skinny female resp therapist saved me, jumped on his back and wrapped arms and legs around him screaming 'You're not going to hurt MY JOHN'. (Fortunately my Mrs wasn't around to hear that I was 'hers'. I might have been assaulted twice!!)

:uhoh21:

Anyway, at my hospital (psychiatric), if a patient assaults you, they do paperwork and bring in security officers. You have the right to press charges against the patient who assaulted you. Unfortunately, many times the patient is found NCR (Not Criminally Responsible). I am not sure what happens, then.

It's commonly said where I work that the patients have more rights than we (the staff) do, btw.

Addendum: We have something called PMAB (Prevention and Management of Aggressive Behaviors). We're supposed to refresh our skills once a month on how to get out of holds, keeping a patient from escalating, etc.