Have you been afriaid of a pt?

Blackcat99 · Jan 30, 2011

Yes, I have been afraid of patients. Especially the patients who are known to have injured staff members.

We had a small woman who only weighed 110 pounds. But everytime she became violent it took about 8 guys to get her into the seclusion room. No, I am not kidding. That gal was so super strong!!!! :eek:

Yosemite, RN, ASN, EMT-I · Jan 30, 2011

Of course. When I ponder it, though, I realize it's not the client I'm truly afraid of, it's the fact that the current "standards of care," staffing and budgets are less than, um, shall we say optimal to handle the variety of clients than can and do become violet for what ever reason.

I'm sure I'll get flamed for this, but I'm sick and tired of the injuries, the trips to the urgent care because I was in the position of a jailer rather than a health care professional.

opossum · Feb 1, 2011

I was just going to post a similar question in a thread...I too am a new grad about to start orientation at a psych hospital and I'm getting really anxious about it now. I've talked to an RN there who loves her job, but told me she'll give me all the tips on "how to not get hit." I feel like I can handle verbal and emotional assaults, but physical ones scare the hell out of me...mainly due to what you've mentioned about budget cuts and trying to do more with less.

I don't think it's odd to be afraid of pts in this setting and it's clear you understand their mental illness and needs. Just utilize your team and make sure you're never alone.

ok2bme · Feb 6, 2011

of course..I had something thrown at me the other day. It was my first inevitable experience of being the target of violence in psych. Although my life was not really in danger..my reaction was "fight or flight", specifically the former. Any other context, omgosh it would have been ugly. I am very professional but I am afraid at how I will react if I am truly threatened.

Davey Do · Feb 7, 2011

Ah! The sweet sound of reality!

To you, Mashira, I applaud your enquiry, concern, and perspective. Follow your intuition- it's a higher level than cognitive when realizing posibilities. However, also realize that brain chemistry differs during the circadian cycle's typical sleep stage. We can have a tendency to be hypervigil at night when awake. So your feelings of fear may be something as simple as you working the graveyard shift.

Opossum's recommendation of utilizing your team is priceless advice. There's strength and security in numbers. Even if one team member acts as nothing more than a gopher.

I have honestly been afraid of some Patients. To the point that I could feel myself shake in their presence. Oddly enough, the two times I have been injured by patients, fear was not a factor. I was stabbed by a beloved Undifferentiated Schizophrenic and sucker punched by an Alzheimer's Patent.

But I keep doing this job. Sometimes I love it. And sometimes I just deal with it.

Carl Yung advised us to embrace our fears. I think that's what you're doing, Mashira. And I believe you will grow from this embrace. The best to you.

Dave

chevyv, BSN, RN · Feb 8, 2011

Yes, I'm a newer grad who's been working in a county psych hospital since July. I'm the only rn on with an lpn and 3 cna's. I have been afraid about 3 times since I started. I especially keep my guard up when a pt fixates on me. I can see whether they want to hit on me or hit me is what they are building up to. Either one is some sort of release. I get frustrated because my safety nets have huge holes. Sure I can call a code (if I can get to a phone), or I could call security before it gets too far (and hope they can come right away), or I can hide out for a few days keeping my distance and hope it blows over until the following month or week or whatever. I keep my wits about me and listen to my staff. Praying helps and I'm not a particularly religious person. This is the reality of psych nursing. So far, I wouldn't change it. To every bad there has been 5 goods. I wish you and all of us the best :)

Guest717236 · Feb 8, 2011

Yes, when a patient revealed they had a delusional system and

one of the enemies was me. We had to shift staff assignments around

so she would not escalate. I also worked outpatient and all the staff

at one point in time not only had threats , but death threats against them.

We waded through all that stress by supporting each other as a team.

And you need a cohesive team who works together to keep the

environment safe...

Domestika · Feb 9, 2011

I've only had four shifts on the psych unit (I'm a psych nursing student) but yes, I've been afraid of a patient. I had an otherwise friendly 19 year old male suffering from schizophrenia storm across a room while we were having a normal, friendly conversation and begin yelling about 3" from my face. I'm scared of him! It's the unpredictability of it that makes it so scary, I think.

I'm learning that it's important to be relaxed but also keep your wits about you and keep mentally alert, watching people for changes in body language. I think that's why I'm so mentally exhausted at the end of each shift. I'm such a newbie that I haven't figured out how to be alert without being on edge!

I will say, though, that I'm lucky enough to work on a unit who has security quite readily available. They are not stationed in the unit, but they show up pretty darn quick when you call them. Not that that will actually stop you from being punched in the face if someone decides out of no where that they're going to do that. But interactions we have with potentially aggressive or threatening patients are almost always accompanied by security.

Retired RB · Feb 24, 2011

I'm a retired psych nurse and over the years there has been many scary situations. But I think the anxiety helps you do your job because you know anything could happen at any time. You just do the job one moment at a time.

beccajean · Mar 5, 2011

Once you get a feel for the diagnoses you will encounter, I think you will be more comfortable. I thought I would be more scared than I turned out to be. The patients (as a whole) are not violent. They might be irritable, they might yell, or cast demons out of me, but in my 5 years I've never had a patient try to hurt me. Hone your therapeutic communication and de escalation techniques. Those are priceless. You'll develop an intuition and learn how to read people better and better with time. Then when you get that feeling, trust your gut!

Popwhizbangz, LPN · Mar 6, 2011

I'm a new grad RN that will be starting orientation on Valentines.
I will be working 11p-7a shift. Something that I've been wondering... are any of you at times afraid of your patients or your job?
From time to time there will be a patient w/ Schizophrenia or DID that just scares me. I don't know why. I guess the bodily harm more than anything, but also just a 'creepy' feeling. I really hope that I don't get flamed. I understand that these patients have a disease process going on just like any other.
I guess I'm just trying to see if I'm alone in this or not. The night shift is lovely, but I do have a little bit of anxiety going into it because of this (I'm your classic afraid of the dark girl, in a place where I might have a pt that scares me). It's not uncontrollable anxiety, just an odd feeling of alarm if they get too near.
Thoughts? Opinions? Experiences? Suggestions? Anything would be lovely!
Note: I'm not afraid of them in the day time, just the night. Could this just be my fear of darkness/night projecting onto the patients themselves? ARGH... I dono...

Fear's normal and at times an excellent red flag to take seriously. At other times, a red-herring, often hard to to tell. Also normal: ambiguity, self-doubt, frustration, anger, intimidation, etc. The big deal is what you do with these feelings we all have.

For what it's worth, All the (very few over ten years) times I've been successfully attacked, I had no fear and got taken off guard. "Out of the blue" events: got punched a few times (once a little old lady got me good in the TMJ - I was as impressed as I was surprised!) , my glasses crushed once without warning. Other than the surprise and some mild discomfort, no real harm done. But maybe, just maybe, if I'd been less oblivious and over-confident, more worried, I'd have been better off.