How Much More Can Nurses Take?

[Erin Lee, BSN, RN]

Quote

"A nurse who survived an armed man's attack on an intensive care unit in a Pennsylvania hospital said in a Facebook post on Wednesday that she was held against him as a shield at gunpoint, arms zip-tied behind her back, as they walked through a doorway and encountered a phalanx of responding police officers.”

- Pittsburge Post-Gazette

Tosha Trostle, an ICU nurse at UPMC Memorial, begged for her life as the gunman pressed the barrel against the back of her neck. She was zip-tied, used as a human shield, and forced to lead him to a floor where he could take more hostages.

When they reached the hallway, police opened fire. Trostle collapsed under his body, feeling his cold, lifeless hand against her face as she fought to break free and run.

But this wasn't an isolated event.

More often than facing a gun, nurses are physically attacked by patients and their families.

At Jefferson Hospital, just weeks later, an 18-year-old allegedly attacked multiple nurses and a hospital officer, punching them in the face after staff caught him trying to break into a locked area. It took multiple people to restrain him before he was sedated.

If you think these are just extreme cases, think again.

A recent study from The Joint Commission Journal on Quality and Patient Safety found that nurses and nursing assistants are exposed to aggression nearly every time they step into a hospital.

📊 179 aggressive events were recorded over just 14 days in one study, with:

• 2.54 aggressive events per 20 patient-days
• Verbal aggression (2.00 per 20 patient-days) more common than physical (0.85 per 20 patient-days)
• Most common triggers: medication administration, waiting for care, and food delivery
• 50% of incidents happened during the day shift

And yet, hospitals continue to downplay or ignore workplace violence.

Nurses are assaulted, beaten, and threatened more than police officers and correctional officers—yet it feels like no one is stepping in to stop it. 

The silence is deafening.

🚨 Have you or someone you know personally experienced workplace violence?

🩺 Are hospitals actually protecting their nurses, or just offering "thoughts and prayers" after the fact?

💡 What real changes do you think need to happen to protect nurses? More security? Stronger policies? Stricter legal action?

[vlyle]

I worked in a rural hospital in the Emergency Dept. on the night shift. One night, a patient wanted an RX for Lortab and requested to see the MD. The MD would not come out and talk with the patient so he pulled a switchblade on me. The police responded and took the patient to jail. Admin reprimanded me because I had the police called. The patient was a worker at the hospital and instead of getting fired, he was in essence promoted to a different position. He was transferred to a different building/print shop but it was still on campus. Hopefully the patient received rehab but that was at least 25 years ago.

[niferbu]

I have been physcially threatened, had more hateful things than I can count posted online about me, I had my house set on fire - yes, really - and most recently I was pepper sprayed! All as a SCHOOL nurse!

[Ruby Vee, BSN]

In my 40+ years of nursing, I've been threatened with guns, knives, a machete, scissors, a "police dog," and one guy threatened to "cut off your tits" with a plastic knife.  I've been spat on, deliberately barfed on and pooped on, punched, slapped, kicked and tackled.  One HIV+ patient (back in the day when no one wanted to take care of HIV+ patients) chewed a hole in his art line tubing and stood at the nurses station, aiming the spurting blood at everyone.  (The physician said, "Don't approach him, but order up a few units of blood.  When he passes out, we'll transfuse him.")  Back when Hickmans were a new thing, an addict with a Hickman for prolonged antibiotic therapy got the bright idea to go home with the Hickman in place.  When I followed him onto the elevator, trying to explain why that was a bad idea, he grabbed me by the upper arms, lifted me a few feet and slammed me into the side of the elevator.  "You gonna stop me?" he demanded.  

Two armed agents of a federal alphabet agency (whom I mistook for drug dealers based on their obvious weapons stuffed in their pants, dress and demeanor) threatened to "mess up" the nurse practitioner, and if I didn't produce her immediately, they'd mess me up.  When the police became involved, they produced their law enforcement identification.  It didn't end there, and it didn't end pretty.  An inmate of a federal penitentiary became a long term patient with multi-system organ failure.  We wanted to withdraw care, but the penitentiary objected on the basis that we'd be "shortening his life sentence."  But they would allow his son to visit.  The son was also an inmate with a life sentence and came with his own escort of corrections officers.  I had my back to the door trying to unclog the patient's feeding tube when without any warning, one of the corrections officers tackled me.  As I lay face down on the floor with the corrections officer on top of me, I saw a machete lying on the floor where I'd been an instant before.  It seems the son had no qualms about shortening Dad's life sentence.  

While the greatest danger comes from patients, family members and rival gang members (I lived and worked in large, inner city teaching hospitals) there was that respiratory therapist who got angry and sat outside the hospital taking potshots with his 9mm at colleagues leaving the parking garage.  There was the custodian who stalked and harassed me.  There were physicians who got handsy with me, including the one who tugged so hard on my skirt that he pulled it right off me.  At the nurse's station, in full view of patients, visitors, and everyone else.  There were physicians punching physicians and other nurses, and one memorable chap who was swinging a metal patient chart at another physician who accidentally hit a nurse on the backswing.  (He said, "I wasn't trying to hit you, I was trying to hit HIM."  As if that excused it.) I once saw a surgeon (who disagreed with the anesthesiologist's method of shooting a cardiac output) burst out of the OR I was passing with his hands around the anesthesiologist's throat, and when I was on orientation in my second job, a neurologist chased me and my preceptor down the hall drying to throw a (full) bedpan at us.  Fortunately, he wasn't as young or agile as we were.  He was evidently a "world famous neurologist," and was upset because I didn't know who he was.

It used to be that physicians were the biggest hazard to our safety, but they've been required to attend anger management classes in the last few decades.  Now the danger is from patients and visitors.  They've gotten much worse.

[DallasRN]

Ruby Vee said:

 

It used to be that physicians were the biggest hazard to our safety, but they've been required to attend anger management classes in the last few decades.  Now the danger is from patients and visitors.  They've gotten much worse.

🤣😁  Oh, my, goodness!  I've got a 40+ year hx, too, and can really appreciate your comments.  Your experiences outdo most of mine, but I know exactly what you're talking about.  Talk about a "survivors club"?!?  We are charter members.

Edit: came back to say I do think it is absolutely horrendous what nurses and other staff have to deal with in today's world.  Way back when, as RubyVee mentioned, it was the irate physician that would be nasty.  Today things commonly escalate to life-threatening situations.  This newer generation of nurses have way too much on their plates.