Has anyone ever been assaulted by a patient?

Demonsthenes · Sep 25, 2005

I,personally, have never been physically assaulted by a patient.

I know of two female nurses who were unjustly physically assaulted by family members while working in hospice. On one occassion, a male family member physically chased a nurse from the room of a hospice patient in a nursing home.She was quietly and politely attempting to do continuous care on this hospice patient. A female family member began insulting and demeaning her. Then, the son of the hospice patient began insulting and demeaning her. Then, he physically chased her from the room into the parking lot of the nursing home. This very polite nurse was and is a very competent nurse.

As you might think, the hospice agency in question instead of comforting and supporting this nurse, terminated her after the family members stated to the hospice agency that they would sue them, if she wasn't terminated.

I was told by another nurse that something very similar happened to another nurse working for this same hospice agency. She, was, also, terminated after being verbally humiliated and assaulted by a family member of the hospice patient.

It is clear to me that this particular hospice agency condones and supports this very barbaric treatment towards nurses who are attempting to alleviate the suffering of dying patients.

Patients and patients families were aware of the same with the result that they had no compunction about instituting the aforementioned barbaric behavior. :angryfire

OUBobcat94 · Sep 26, 2005

Thank you for all of your kind words everyone. I am not pressing charges against this patient. Like I said, he is functioning at the cognitive level of a 3 year old right now, albiet a very STRONG 3 year old. :uhoh3: I don't blame the patient. I am going in to work tomorrow to file the incident report and talk to my NM about the concerns I already mentioned here. Not sure what can be done about it short of redesigning the whole unit, but maybe they have some ideas.

-Bobcat

MadisonsMomRN, BSN, RN · Sep 26, 2005

I used to work with traumatic brain injured patients. They dont know any better unfortunately so I dont really think you can press charges on them. I have been hit by a patient that was one on one care too. I had to fill out a variance and the in house physician had to check it out. This facility put us through a class on how to deal with these patients...what to do and what not to do.

We could call a code "green" and security would come to help along with other staff.

jkaee · Sep 26, 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

Excellent post! I also work in acute rehab that is currently expanding their Brain Injury unit, and I am amazed at the recovery that some of these patient's make. While I wouldn't say it's my favorite population to work with, it's nevertheless very interesting.

Back to the original topic, like Jen stated above, you can't hold people with any type of brain injury to the same standards you would a normal functioning person. It's like expecting a toddler to understand, process and assimilate normal social expectations and act appropriately. It's not going to happen, folks, and when you work with this population, that's the risk you take.

That being said, just because it's a risk, that does not mean that safety measures should not be in place. Absolutely no one should be in a closed room with a patient requiring 1:1 care. The door should always be open, so that we can at least hear you scream for help. We are trained in release and take down moves, and we have a Code Green if extra help is needed. If you do bring someone with you, it's best if you don't both walk right up to the patient....otherwise he may feel threatened and that may make his aggression worse. This can be such a challenging field to work in, and I'm still fairly new to this area, so I'm continuing to learn.

Bobcat, hopefully new measures will be put into place so you don't find yourself in that situation again. Good luck, and let us know what happens!

hipab4hands · Sep 26, 2005

So I was wondering, has this ever happened to you?
-------------
I was assaulted by an elderly pt., who slugged me in my upper back and neck and then hit another nurse, who came into help me. The patient slugged her in the abd., as we tried to put him into restraints.
I ended up with permanent damage to my neck and back, and is part of the reason I no longer do bedside care.
The patient had to surgery and later died from an infection, so there was no action taken against them.

stidget99 · Sep 26, 2005

I used to work in a state institution for the developmentally disabled. Most residents were profoundly MR. I have been assaulted more times than I can remember. Everyone who worked there had scratches, scrapes, scars on their hands/arms/legs because of residents attacking (scratching, biting, slapping). Before being hired, and annually after that, we all took a self-defense course on how to deal w/ these types of residents. However, the training that we rec'd was focused on resident safety and not necessarily our safety.

It's a shame that we have to deal w/ these situations in nursing but we do. It's all part of it. The best thing that we can do is to buy and use our own personal emergency alarm. But that is JMO.

adrienurse, LPN · Dec 30, 2006

People are lucky I don't get injured easily (prolly because of my accident prone nature and the fact that I'm always hurting myself). I have little hands and I always seem to be getting into situations here in the PCH where big strong confused people have got them in a death grip and are twisting the heck out of them. I've had many wrist injuries because of that. One of the last times I worked on the behavioral unit I was kicked in the jaw. There are some brutally violent people here. That's a really bad combination when you put them on a unit with an attending who refuses to use Benzos on them and is extremely sparing with the antipsychotocs. But I guess only spending 30 min a week on the unit behind a partition keeps her from getting the snot beaten out of her so she doesn't need to care. Another time I was there I was taking care of a head injury patient who was basically stalking and attacking everything that moved. We had to spend all his waking hours running interference between him and the other clients because unlike us it is unacceptable for them to be hurt.

Antikigirl, ASN, RN · Dec 30, 2006

Oh Lordie..I am fortunate enough to have not gone through that..but just last night...oh sorry I have to giggle, and maybe you will see why!

So I had this pt..mentally disabled since birth...all extremities contracted well..but not all the way (good for him!)...speaks in mostly Uhgsssssssss..or GRRRRRAS....when I know he is in pain..he bites the holy heck out of his nuckels..in fact..never seen so much calus on a nuckle before..and it was chewn through!!!!!!!! Poor guy!

Anyway...he had a J-tube put in...infection set in...G-tube time..but the J-tube site went bad big time....and was back to have that fixed.

Okay so he was very contractured and his movements were rather spasmic! So he hit my breasts once....I thought nothing of it (I have B cup on a good day...LOL!)..then he did it again..okay now I am thinking...he isn't even looking at me...so I was like...."oh no prob..."...

Then all the sudden I noticed he brushed a bit longer and was LOOKING!

SO I was cool and said "okay I am a lady sir...and this zone "pointed to my breasts' is a no zone for anyone except my hubby and only if HE asks for permission! So lets not try to hit there okay?".

The poor man had said nothing for three days except GRRRRRRRRRR or Uhggggggggggg...I didn't even think he could say anything...and all the sudden as clear as day...

"Oh Ohhhhhhhhhhhh!!!!!!!!!!!" With the biggest Sh88 eating grin I have ever seen!!!!!!!!!!!!!!

okay..time to put the rules down..but my total laughter on it screwed it up after hearing the 0oh ohhhhhhhh....I was worthless..it was too cute and funny! Darn it...guess that is his thing...but it was soooooo funny!!!!!!

Anyway....after talking to other nurses and his docs..I guess I was the only one he did that to..LOL! Guess I should feel honored? LOL!

Oh man..I wished I could have kept a straight face...but it was to funny hearing that Ohhhhhh ohhhhhhhhh....I mean it was like he was caught and funny as heck!

Oh btw..he didn't do it again! Not to anyone afterwards!

Sheri257 · Dec 30, 2006

Yeah ... I've been assaulted. And I'm fed up with the nursing profession's belief that I'm supposed to put up with that kind of abuse just because someone is sick.

In my opinion, the nursing profession is wrong for making RN's put up with this crap.

I really don't care what disease or condition they have ... when someone hurts me, they are no longer a patient.

They should not and do not have more rights that I do. I am not subhuman.

:typing

fetch33 · Dec 30, 2006

I had a confused total hip patient. He actually had a sitter at the bedside because of his confusion. Anyway the patient threw a cup of ice water in my face and hauled back to hit me. I had to grab his hand and yell for help from my coworker because the sitter (who was male) was NO help at all. I had security called because he was trying to kick the stuffing out of all of us also. So in walks the wife while security was holding his legs down and I was trying to medicate him. She flipped out. She was yelling for administration to be called, that this was the most horrific sight she had ever seen and she'll never forget that big security men were holding her husband down and IF THOSE SECURITY MEN HURT HIS HIP THE'LL BE A LAWSUIT... it went on and on. I had to write my account of the situation and be interviewed by administration but nothing else became of it. I really thought she'd be more understanding and realize that we were trying to keep her husband from hurting himself and the staff.

tatgirl · Dec 30, 2006

I work in LTC and have been hit, scratched, kicked, and attempts to bite me. We dont have security guards so when stuff like this happens we just pull the call light and holler for help. Most of these people have dementia or Alzheimers so I dont blame them for their behavior. They honestly dont know what they are doing. However, we do have a pt who is HIV + and spit in the face of one our nurses, she called the police to file charges against him,the police came, found out he was hiv + and refused to arrest him (this was the decision of the captain) I never could understand why they didnt file charges against this man. He knew what he was doing, and he knew his diagnosis. Anyhow the nurse had to go to the hospital and have tests done, and this guy got away with it. Plus the DON (who no longer works there) fired her for calling the cops.

Wendy

LPN

Dalzac, LPN, LVN, RN · Dec 30, 2006

I wish I had a nickel for every time I had been hit. I have filed charges 1 time. and it was on a guy who was NOT confused or had any kind of dementia. He was a mean diabetic who came in once a month cuz his sugar was screwed up. He just hauled his fist back and hit me in the middle of the chest and knocked all the air out of me. I yelled for help befor he connected. Thank God I worked in a facility that loved their nurses and when he was discharged the cops were waiting for him. He still kept coming in but he never hit another nurse as far as I know.

When I was a tech many,many moons ago I had a very confused lady who yanked her foley out, bulb inflated, and whipped me without end. I was just screaming for help. and I can tell ya that being beaten with a rubber hose , hurts like ..well you can put your on expletative. Also had a little bitty old guy that kicked me right behind the ear and I had to have 3 stitches, so The ones that are demented and confused I feel just can't help it. The ones that aren't confused need to have charges filed