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:

[guest2210]

In the LTC I worked at, I was assaulted by a private duty aide. She was mad because I knocked on the patient's door and woke her up. I needed to obtain a cathed urine spec at 4am. Another aide went in with me. After the fact, she came to the nurse's station. We went into the hallway where she assaulted me by putting her fingers in the middle of my chest and pushed me hard enough for me to go across the hall into the wall. I called the supervisor, who then instructed me to call the police. Called police and filed a report. They took pictures of the reddened area where she pushed me. Management supported me all the way. Got a week off. They were afraid of a lawsuit claiming they didn't provide a safe work environment for me. The aide wastaken out in handcuffs and through a plea agreement, was forbidden to ever work as an aide again.

[ozoneranger]

Oh man,

Hit, kicked, punched, pinched, grabbed, groped, propositioned, scratched, peed on, poo flung at my head.....you name it.

While I was working in an acute in patient rehab, a young man who'd come out of a wreck paralyzed from the waist down decided he loved me & we were getting married. He never asked me for my opinion on the matter, so it came as a bit of a shock to me.

As if being stalked by a man in a wheel chair wasn't creepy enough. Someone on my ward gave him my phone number & address.

Finding him at my door one cool fall afternoon was the straw that broke the camels back. I went in the house & called the clinical mgr on duty & told her he was at my door. She called the psych for the unit, as it turned out, the psych doc lived only a few blocks away. He came over & the three of us discussed this inappropriate obsession.

Once he understood how he'd misconceived my professional care as personal caring (love). He realized he was very frightened...facing discharge to home....alone. His fantasy was a manifestation of those fears.

We finally got him to understand that my interest in him was purely professional. Once he got past it, we became friends. He lived only a few blocks from me for years. He came over for dinners & we cheered him on in his wheelchair basketball games.

He came to my wedding, sent flowers when my son was born.

Though he had many friends & a fulfilling life, he never found 'the one' to share his life with, he died from complications of a decub. ulcer in 2005.

I miss my stalker friend, we used to joke about having a restraining order....."just how far is 100 yards?'

"14 telephone poles, give or take 10 feet."

[marielina85]

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.

yea i feel the same way too i forgive them they dont know any better...

[marielina85]

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.

reminds me my aunt is a cna and she says a resident once punched her "down there" hard...lol

[Spritenurse1210, BSN, RN]

more times than I can count I have been assaulted and battered by residents and patients. One place I worked as a cna the nurses would gather around the door where I was getting my rear handed to me and laugh as I was being kicked scrached and slapped. Not one of them offered to help me. Needless. To say I left without giving notice as soon as my shif was over. The rest of the places I have worked since then have offered no support. I just got better at dodging and diffusing!

[marielina85]

more times than I can count I have been assaulted and battered by residents and patients. One place I worked as a cna the nurses would gather around the door where I was getting my rear handed to me and laugh as I was being kicked scrached and slapped. Not one of them offered to help me. Needless. To say I left without giving notice as soon as my shif was over. The rest of the places I have worked since then have offered no support. I just got better at dodging and diffusing!

wow that is just f*cked up they should have stepped in...im glad you got outta there

[TheCommuter, BSN, RN]

I've been spit on by residents, had nails dug into my skin (and the scars to prove it), grabbed, had fists swung at me, and have had male residents masturbate in front of me.

I've also had a couple of visitors and family members verbally accost me by screaming loudly over the years. Since we live in an age where "customer service" is management's priority, nothing is usually done about it. Therefore, I no longer smile and greet families who walk past me, because I have learned that visitors are less inclined to mess with a nurse that doesn't look or act like a sweet person.

[NC29mom, ASN, LPN, RN]

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

that should not be though!!!!!! your job should never consist of accepting physical abuse (just as 'part of the job')!!!

[pca_85]

I know, it's kinda messed up.

[Intern67]

"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."

Getting attacked verbally or physically is a common occurrence in LTC. I have never been attacked physically by a non-patient. Family members have made comments about how awful the care was but I never took it personally. The care at my facility was often awful.

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

I was never reprimanded for getting attacked. I never needed support from a supervisor over an incident.

"3. What was the outcome?"

If the patient had dementia, then it was just another day at the office.

"Was the patient given a psych consult?"

Patients already had psych consults and were known to have psych issues. Other non-dementia patients who were abusive were shipped via police car to the ER for psych eval. The vast majority of the time they came right back and the experience of having the police haul them away was enough to make them try to get it under control if they could.

"Any new orders written?"

Nope.

"Patient discharged or taken to ER for observation of increased altered mental status?"

Never discharged but many trips to the ER.

"Do you still take care of this patient?"

Some of them.

"Did you sustain permanent and/or severe injury (and yes, if you suffered some post-traumatic stress, please let us know)?"

Nope. Worst incident was when an elderly lady with dementia smacked me in the mommy-daddy button with the foot of her walker. She saw me look away and struck like a rattlesnake. I charted the incident and walked it off.

[BVUstudent]

I am currently doing research on this very subject. My wife is a CNA,CMA and the main shower aide in her LTC facility. This is how I have my knowledge. I am conducting a huge research project: "Certified Nursing Aides within the healthcare profession have a greater risk of physical abuse by residents in the workplace."

I have looked everywhere I can think of ( so have my instructors) to find Accredited Journals in the United States to support my research. Well I have found none and there is no word from my instructors. So if any of you CNA's, LPN's, or RN's have seen such a journal I would be ever so grateful. I will be completing my Masters in Social work/Human resources in the next 3 years. This is a primary focus.

My main goal is to bring awareness to owners and administrators that this behavior from the residents IS NOT "part of the job description". feel free to email me: [email protected].

[Alnitak7]

I decided to listen to the advice of my martial arts teachers from college. You need to be aware of what they're about to do. You can pick up on it from their eyes and their body language.