How prevalent is violence in the workplace for nurses?

Nurse Ratched, RN · Feb 4, 2004

I think of abuse as being both verbal and physical, altho verbal has certainly been the more common in my experience.

I give the benefit of the doubt to the patient who isn't in his/her right mind. I think of it like in law - there has to be an intent to commit the crime and the person must be able to distinguish between right and wrong. If a demented LOL calls me a foul name, no sweat.

In the case of the abusive person who is in his/her right mind, we establish that I am a nurse, not a servant. As I have said in other posts, behavior that would not be appropriate toward a stranger on the street certainly isn't going to be tolerated by me on the job. Nowhere in my job description does it say I must take abuse (the whole "please the customer at any cost" modern theory of health care management notwithstanding.)

ArcticNurse · Feb 4, 2004

That's interesting your take on violence. I have to agree with you that nurses are not a verbal punching bag for our patients. But what about nurses being verbally abused by doctors or co-workers?

I have to admit I believe verbal abuse must be the most common. According to a newspaper article most nurse don't even report abuse. Why do think this is so??

AN:o

Nurse Ratched, RN · Feb 4, 2004

Most of the abuse nurses take is from fellow nurses, in my experience. I haven't taken too much nonsense from doctors - just haven't seen too many really obnoxious ones. (Only one, really, who could be termed abusive, and he never gave me crap directly.)

As far as lateral abuse (from co-workers) - that may be the hardest to stand up to. There are a few threads on bullies and bullying - you may want to do a search for some interesting reading. As for myself, the bully is generally best confronted. Most people who are aggressive are passively so, and can't stand to be confronted in their actions. They will generally back down when they realize you won't tolerate being abused.

I've never seen a fist fight among co-workers. I do know that the first hospital I worked in had a personality test you took when intially interviewing and one of the questions was something like, "How many physical fights have you gotten into in the past year?" Options for answering ranged from 0 to 10+. I often wonder if HR actually thought they were weeding out potentially violent workers with those questions :chuckle.

Nurse Ratched, RN · Feb 4, 2004

Forgot to add: abuse is probably not reported because of the aforementioned "customer is always right" thing and that no one wants to report a doctor for inappropriate behavior. Abuse from co-workers is often so common it is just considered part of the environment in some units.

Ruby Vee, BSN · Feb 4, 2004

In my 25 years of nursing, I've been hit, kicked, punched, scratched and threatened by both patients and their families. A friend of mine got shot in the a** as he was running away from a disgruntled former patient, and I had a family member threaten to solve "all of her problems" with a 9mm and a mugful of Jack Daniels. And I got tackled by a prison guard one time. (The patient and his son were both serving life sentences -- the son smuggled a machete into the hospital with which to "shorten Dad's life sentence." One guard tackled me as I had my back to Sonny and the machete while the other disarmed Sonny.) I've witnessed a doctor smacking a nurse in the face with a chart, another chasing my preceptor down the hall trying to dump the contents of a bedpan on her, a doctor throwing a used sharp at a nurse, hitting him in the chest and another doctor striking a nurse in the face. (He says it was an accident -- "his face just got in the way.") I've been verbally abused by patients, family members, house staff, attending physicians, one co-worker and a nurse manager but the only case of nurse'-to-nurse violence I've ever seen was when a co-worker shoved me halfway across the room during a code because I wasn't moving fast enough for her. (She saw the rhythm and ran in, not realizing that the patches were on the chest, the doc was charging and that I "wasn't doing anything" because I was "clear". The shock did the trick and my relationship with that nurse improved in a few years . . . . I hesitate to even include that last incident, except that I think there may have been some underlying personal reasons for it . . . she dated my husband before I met him. WAY before.

I've seen a lot of violence in the workplace, but in my experience, nurse-to-nurse violence is the least of it.

laughingfairy · Feb 4, 2004

I see alot of patient to staff abuse.

In long term care we have to be so careful not to violate a resident's rights that many began to feel that they have the right to do what ever they want.

And I do believe that there can be abuse with out intent. Someone who doesn't know right from wrong and spits in your face and has a known infection (spelled abt resistent) in his sputum. Well in my book thats abuse.

I've been called stupid by doctors. While working at a hospital had a physcian knock me down by shoving an empty stretcher into me.

He says it was an accident. I've been screamed at by physcians.

But I got to say...

Nothing tops nurse to nurse...the cat fights can be truly magnificent!

laughingfairy · Feb 4, 2004

When I reread this thread I started to think.

Maybe the definition of abuse vs. violance needs to be cleared up.

Nurse to nurse physical violance has been rare in my experiance. But the nasty malicious abusive mind games are all too common.

trustmee · Feb 4, 2004

Some of these responses are very amusing, yet scary!

As for the nurse v nurse abuse, yes I have witnessed and been the butt of many types of 'verbal' abuse and harrassment. Confrontation has been the best approach.

But, it's always worth trying supportive confrontation, rather than an aggressive judgemental front. Often the out bursts or 'niggles' are the result of ongoing probs and once touched upon it allows staff to reflect and resolves issues.

It's not just our clients we have to build trusting relationships with!

ArcticNurse · Feb 5, 2004

wow, Ruby Vee you've opened my eyes!! I mean I know it's possible for this kind of violence to happen but I didn't know it could happen this many times around or with the same person. What came of those patients who abused you? Was there any repercussions? I have to wonder if most nurses do not report abuse between nurse and patient because they feel nothing will come of it.

AN:eek:

Ruby Vee, BSN · Feb 5, 2004

Originally posted by ArcticNurse
wow, Ruby Vee you've opened my eyes!! I mean I know it's possible for this kind of violence to happen but I didn't know it could happen this many times around or with the same person. What came of those patients who abused you? Was there any repercussions? I have to wonder if most nurses do not report abuse between nurse and patient because they feel nothing will come of it.

AN:eek:

All this stuff happened over 25 years worth of nursing in tertiary institutions. The machete incident happened at an institution that was near a major prison. I know people who have a lot more stories to tell than I do! (And I was across town from Bob when he got shot in the a**!)

As for repercussions -- what repercussions? The surgeon who threw the sharps at Sam may have gotten "a stern talking to," but then again he may not have. He was a surgeon -- he generated money for the institution. The one who hit the nurse had to take anger management classes, or so the story goes. The nursing staff -- including the nurse who got hit -- got nothing more than rumors as follow-up. The attitude of the physician who smacked the nurse in the face with a chart was "I wasn't trying to hit her. I was trying to hit HIM (the cardiologist) and she just got in the way." Years later, when he actually DID hit another physician, he went to jail. But merely hitting a nurse isn't sufficient reason.

For years and years there's been a culture, especially in private hospitals where some of these incidents happened, that the physician has more value than a nurse. Therefore, in a confrontration between the two, the physician's side has more weight. If you report physician abuse, YOU get counselled or lose your job.

Fifteen years ago, I was charge nurse in the CCU of a tertiatry institution that was also a private hospital. We didn't use many agency folks, but there was one nurse in particular that kept coming round. One day I asked her why she didn't come on staff -- she was smart, hard working and everyone liked her.

She said that she was surprised she was even allowed inside the institution as agency. She had once been head nurse in the NICU, and one day a physician decked one of her nurses. She called the police to have him arrested. In the end, no one stood up except the head nurse and the nurse who got hit. Everyone else who witnessed the event somehow developed amnesia. Those two nurses were told to back down or go looking for work. They went looking for work. The doctor never even went to court.

These kinds of things have been happening for as long as I can remember.

As for patient abuse of nurses -- why even bother to report somethng that's going to be excused as "He was frightened," or "he didn't know what was going on." ? A patient hits you, and everyone assumes it was somehow your fault. We don't back each other up, we don't stand behind one another. And not much is going to change until we do.

LPNtoBSNstudent, BSN, RN · Feb 5, 2004

I have been kicked and hit and pinched by patients but usually they have some sort of dementia. Most of the time I just brush it off but one time when I was pregnant I got kicked HARD in the stomach, when I was trying to protect a helpless patient from a BIG farmer man who had Alzheimers. He was super strong too. It was me and two CNA's in the whole building, (NOC shift) and we could barely get him away from this other patient. He kept going in her room and trying to move stuff around. One time I walked past and he was trying to set her 19 inch television set on top of her! She was bedridden. I was horrified. We had to be very careful with how we approached him. We couldn't get him to let go of the TV for the longest time and then we couldn't get him to get out of her room! He was huge and very agile. We were not pulling and tugging on him, but rather trying to be very nice and persuade him to come to the hallway and sort of steering him toward the hall. He was mad as could be at us and was very suspicious, as many Alzheimer's patients can be. I was standing in front of him and his leg came up and kicked me right in the abdomen.

Later on that night after I thought he was calmed down (and asleep), I came around the corner and he was STANDING on the nurses station! There was a half wall sort of area that enclosed the nurses station and he was standing up there trying to change an imaginary light bulb. And this was AFTER the IM Ativan was given.

Anyway,

Even if they have dementia, it still "feels" like you've been abused.

I would like some ideas of how people cope with things like this? I ended up quiting my job over this because I felt I had no support in dealing with this from management. What are some things that management can do to help nurses in these types situations?