LTC and SNF nurses and CNAs: Have you ever been attacked by a resident/patient?

[MissFlashRN]

A few questions for nurses and nursing staff in Long-Term Care settings (other fields, please see below):

1. Have you ever been attacked, physically or verbally by a patient or other non-nursing person (visitor, family member) on the job? Please describe the incident if you can.

2. Did your supervisor or DON offer you support or were you reprimanded?

3. What was the outcome? Was the patient given a psych consult? Any new orders written? Patient discharged or taken to ER for observation of increased altered mental status? Do you still take care of this patient? Did you sustain permanent and/or severe injury (and yes, if you suffered some post-traumatic stress, please let us know)?

Side note: Ok, I know there was a poll not long ago about nurses and nursing staff being assaulted or attacked at work, but can't find that thread for the life of me. If anyone knows where it is, please reply with a link. I really wanted to show a non-nursing person (which would be EVERYONE I don't work with!) how high that percentage of "yes" was. I believe it was over 90% of us that responded yes to having been assaulted in some manner at work, either by a patient or other party. As you all know, non-nurses have a very hard time understanding or believing exactly what we go through and the terrible things that we often consider "just part of the job". I have a hard time believing it myself. Maybe that shock is what keeps us there? Maybe learning that it happens (too often!) and is highly likely to happen dulls us and we forget how ridiculous it is that we nurses tolerate what would not be tolerated in any other job? Yes, we expect some of what happens, but is there not a line to be drawn stating "No more!" that we can sign? Even though we may expect certain behaviors and try our best to prevent them, it doesn't always work. When it does happen, why are we often blamed for the actions of confused, angry, demented, or under-the-influence patients? (these are musings, not the specific questions I'm asking, but feel free to comment or vent with me).

My question is directed in particular to the nurses and nursing staff at long-term care facilities, skilled nursing facilities, and those in direct patient care with confused and angry patients or residents. I am basically trying to get a picture of how high the percentage of attacks are in LTC/SNF (yes, because I work in that field, and yes, because I've been attacked and seen others attacked and have never seen management offer help or support of any kind, unfortunately). Other fields, please feel free to share your horror stories...I know psych and ER have a high percentage rate for getting smacked, spit on, kicked, punched, and so forth.:sstrs:

[cakegirl]

I work on an Alzheimer's unit and have been kicked, slapped and threatened more times tham I can count. We also have one resident that threatens to punch people almost regularly. He hasn't ever acted on these threat but will yell very loudly when having these outbursts. This can be very unnerving. As far as support goes I'm a nurse and my fellow CNA's support each other and try to to help calm residents when this happens. I've never been approached by management in regards to any instances, although it is always documented in the nursing log which I know they read daily. I think the thinking is that this is to be expected behavior for these pts. I attended a workshop specifically for dementia training and asked the so called experts for interventions to use when a 6'4 260lb. high fall risk resident begins ambulating on their own and I intervened to try and get them to sit back down. This resident became very verbally abusive and threatening to hit me. Guess what he ended up falling with me pretty much right next to him. No injury thank God, but what was I suppose to do? They never gave me a direct answer. I would love to hear some others experiences with this topic.

[NurseLoveJoy88, ASN, RN]

I also work with alzheimers residents. I have been scratched, hit, verbally attacked, patted on the behind. The worst was when i was kicked in the face while trying to help a resident put on his socks. he didnt appear agitated and the kick just took me by a surprise. for a while i was actually afraid of that one resident. Time heals and i was able to move on. My strength comes from God.

[NurseLoveJoy88, ASN, RN]

Oh ive also had residents tell me they are going to kill me, i have had hot soup and silver wear thrown on me, had bite attempts, been cursed out. I forgive them they dont any better. Management never offered support.

[canigraduate]

Let's see...

Hit

Kicked

Spit on

Pinched

Hit with a flying cup of Coke

Verbally assaulted (Where the hell have you been!? Give me a bite of that titty! Etc.)

Butt grabbed

Boobs grabbed

Head grabbed and pushed near groin when giving a shower

The list goes on, but these are the typical ones. As a CNA at an LTC/rehab, I reported it to the nurse. Sometimes, if it was serious enough, I'd fill out an incident report. The social worker will often speak with the family and they will help straighten out the resident if there are ongoing problems.

For the most part, dodging works really well.

As for being reprimanded, if anyone ever suggested that being hit, kicked, or pinched was my fault, I would have been out the door right then. That's the same BS abusers try to manipulate their victims with, and I don't put up with any of that crap. The nurses and higher-ups were very supportive.

As for new orders, I don't know. In some cases, we were told to pair up whenever we had to enter a certain resident's room, for witnessing and for back-up purposes. Also, with some residents, we were told to back away and get the supervisor if they became agitated. I think some of the residents had med changes after severe incidents, because I noticed several of them became much more mellow.

[fuzzywuzzy, CNA]

I've been:

slapped in the face

kicked in the chest

spit in the face

bitten

pinched

had handful of my hair grabbed and pulled

scratched and had nails dug in (I have scars all over my arms from these instances)

had my arms and/or clothing pulled and twisted

groped

been masturbated in front of

had sexual remarks made about me

been called names like the C word and other colorful names for women.

That was all from confused residents.

Alert residents have made sexually intrusive comments, slapped my hands, hit me with a walker, verbally insulted me, and thrown dirty washrags in my face. But it was always the same guy that made sexual comments and the same bitter, nasty woman who abuses me (and everyone else) on a daily basis.

I have also been screamed at and had false accusations made against me by a nut job family member.... actually, 2 nut job family members of different residents. And one of them actually physically assaulted another CNA.

[mikeicurn, ASN, RN]

When working as a CNA at a LTC facility that primarily housed residents with mental disorders I was attacked once. I should say I am a guy who is 6' tall and over 300lbs. A man came out of his room and charged me in the hallway swinging at me because I had asked him to turn his tv down an hour or so earlier. I put my hand in the middle of his chest (just placed it there, I didn't push him or anything like that), and held him at arms length so he couldn't hit me in my face. This was not an elderly patient, this guy was probably 30'ish, 5'10", 250 lbs or so. This lasted for a minute or so, and the medicine aid came down the hall behind him and asked what was going on, when he turned to talk to her I retreated down the hall behind me to diffuse the situation. The next morning the incident was reported and I was told they may have to report me to the board of nursing and have me placed on the abuse registry because I had placed my hands on a resident. That was the last night of work for me that week, so several days passed before I worked again, and when I came back I was told that they were not going to report me. This was a summer job that I took before I started nursing school, and I was only going to be there another week or so, so I just finished my time. I did consider quiting over this, because I was afraid management would report me to the board of nursing over something silly, and mess up my chance at becoming a nurse.

[pca_85]

Too many times to count. Nobody cared. I have faster reflexes now.

[NC29mom, ASN, LPN, RN]

I work in a SNF/LTC and YES I have been hit, bit, scratched, and spit on. We have this one particular patient who gives everybody a fit. He tenses up anytime care is given, making it hard for the caregiver. I have to do a skin assessment on him weekly, which means I have to look at him undressed. He repeatly digs his nails into my arms. I have reported this several times. He was on Ativan for this issue, but it was later discontinued because even the lowest dose made him so drowsy he wouldn't eat. Yes, he has had a psych consult, didn't matter much though. He was put on Risperdal for a bit, but it was later discontinued. Our facility does not like to use antipsychotics, antianxiety drugs or the like. If a patient has them ordered, they will give the meds for a bit, then do a gradual taper to get the patients off the meds.

I feel like nursing home residents are NO DIFFERENT THAN ANY OTHER PERSON!!!! If they cause physical harm to another resident or staff, the police should be called and a police report filled out. Most of the time, they know what they are doing. We also have a lady who continuely abuses the staff, just because she knows she will get away with it.

IT'S DEFINITELY TIME FOR A CHANGE - THERE SHOULD BE A ZERO TOLERANCE POLICY REGARDING PT/STAFF ABUSE!~

[pca_85]

A change would be nice, I was always taught that a small amount of physical abuse comes with the nursing home territory.

[imintrouble, BSN, RN]

Ditto to all of the above. There was a dangerous psychotic confused geriatric woman in one SNF where I worked. She was seriously dangerous and scary. She would routinely attack the staff and the other residents. Nothing was done about her until she tried to strangle a visitor. She was transferred within days. I think the threat of a lawsuit by the visitor finally saved the rest of us.

[Temeika, LPN]

I did work in a LTC and I was verbally and physically attack by numerous residents. It became so routine, sometimes I just brushed it off but a couple of incidents I can recall that did really hurt was once, while changing a total care patient who was a 6ft + man and before his health declined was a mechanic, and he slapped me across my face so hard, I almost forgot my obligations and duties to that resident, but I had to stop, take a breath and continue caring for him but only after calling for help.

Another incident, a resident who was refusing care, and slapped me across the lower half of my back practicallyin the area my kidneys lie, that her hand print left my back welted up. I immediately went to the ADON/DON and reported the incident because I almost lost my cool it stung so bad, I don't recall any measures being taken other than they made mental notes. But I later refused to work with her if I could help it and if I had her on my group, I would trade her for another resident with another CNA.

Besides that, I've been, punched, kicked in the stomach ( while suffering with an umbilica hernia and endometrioma that i was unaware of besides the excruciating pain I was in), scratched, bitten, food spit into my face, called every name but the child of GOD, and no matter what, Administration did little, except want you to write an incident report which required me to drive 20-30 minutes to their head facility to take a drug test. I dont do drugs but when u are riding on fumes, that could be an issue.

What kills me the most is to see all these law office commercials about suing for nursing home abuse, but they don't expect us to sue in return. I feel there is more abuse done towards the staff/nurses/CNA from residents than there is abuse towards residents, if these law offices really want to get to the bottom of it, but we are expected to deal with it. But, I am adapted to the verbal part, but the physical abuse from residents I cant adapt to, I try to stay out of harms way.