New nurse here...slapped today by patient.

[Bonny619]

So...I'm a new RN, still in orientation mode. I was starting an IV on a patient, my primary nurse was present as well as a student we had with us. The patient's husband was also present.

I started the IV, I was getting ready to place the tegaderm on and BAM.

She slapped me straight across the face...pretty hard too. No mark, but it stung. I just left the room immediately, that was my first instinct. My primary nurse was dealing with the patient.

Anyway, the patient was an older lady....77, but she was A/O x3. NOT a confused patient, she later said she thought we were just "playing with her" I'm assuming she thought this because the student was watching? I don't know. She knew we needed to start a new IV, her IV infiltrated.

So, my question is this....at what point does a nurse actually look at a situation as being assaulted. If this lady slapped me across the face in the middle of the grocery store, I would have called the police.

What is that fine line? What if she bruised my face? Is that different?

Any advice is appreciated.

[RNperdiem, RN]

But what would happen if you called the police, I wonder? Would hospital security be a good starting point?

Strange situation with the lady being alert and oriented.

When I worked with older people with dementia, I would be ready to duck out of the way; these folks are suprizingly strong. They probably thought they were defending themselves when having a foley catheter or NG tube placed.

Did you demand an apology?

Make it clear you were offended?

[TRAMA1RN]

file charges immediately, patients think they can do whatever they want to nurses, today. Press-Ganey has been the worst thing for all nursing staff. I bet your employer will try to talk you out of pressing charges.

I am very sorry for you.

[vivibonita]

I'm sorry for what happened to you, however before filing a report IL'll make sure all my bases were covered. Did you, at the beggining of your shift, reported or charted that she was A&O x 3? What do the other people that were in the room with you think about the situation? Are they willing to back you up? Remember that you are filing charges against a 77 year old lady, who are usually considered frail and in most cases the victims.

I am also curious as to what did you do when you walked out of the room... please keep us informed of this situation.

Good luck

Vivi.

[banditrn]

I am sorry to say you will have to look out for yourself here. I was hit by a patient during a bed bath when I was in nursing school, and when I told my instructor I was uncomfortable going back in this man's room, she proceeded to assign me to him every day for the rest of my rotation to teach me a lesson. She also told me, in a later rotation, in front of other students, that she didn't understand why I "had such a problem with his personality." I didn't have a problem with his personality, I had a problem with getting hit! Moral of the story is that, as much as it sucks, you are probably the only one who will stand up for you. If she was A&Ox3, I'd do whatever you can to at least avoid taking care of her again, even if you don't press charges.

This is why I work with babies.

Yeah, but them darn babies can PEE on ya!

[miko014]

file charges immediately, patients think they can do whatever they want to nurses, today. Press-Ganey has been the worst thing for all nursing staff. I bet your employer will try to talk you out of pressing charges.

I am very sorry for you.

Amen!!!!!! Press-Ganey is the devil!!! That's probably why the OP is hesitant about what to do. Health care now has a customer service focus, instead of a patient care focus, and because of that, nurses feel like we can't defend ourselves. I mean, you can't snap back at that disrespectful family, because they might sue you, right? So how do you press charges against an old lady who hit you? It's one thing if the patient is NOT A&O, but this one was, and it's not okay for her (or anyone else) to hit anyone. I am so tired of being abused (mostly verbally, thank goodness) by patients and families who think I am there to do their bidding. OP, please don't let this go!!!

[miko014]

Yeah, but them darn babies can PEE on ya!

So can some of those darn old people, lol!!!

[Mulan]

I have not been physically assaulted by a patient, yet. But, I have seen it happen. Many patients do it on purpose, others are not in their right state of mind, but it is not easy to deal with. You feel violated, and the powers that be always want to support the rights of the patient.

You didn't mention if this was a frail old woman who was oriented X3 (not that it would make a difference in how you felt at the moment). Under those circumstances, I am not sure if I would press charges, but there would be a great deal of documentation of her behavior to warn the next nurse of this woman's capabilities; especially if she was in her right mind.

What difference would or should it make if the batterer were "frail" or not? Battery is battery.

[Mulan]

I'm sorry for what happened to you, however before filing a report IL'll make sure all my bases were covered. Did you, at the beggining of your shift, reported or charted that she was A&O x 3? What do the other people that were in the room with you think about the situation? Are they willing to back you up? Remember that you are filing charges against a 77 year old lady, who are usually considered frail and in most cases the victims.

I am also curious as to what did you do when you walked out of the room... please keep us informed of this situation.

Good luck

Vivi.

a "victim" of what?

[Fiona59]

Since the turn of the century, I have been slapped, punched, pinched, spat on and verbally assaulted. All by the elderly. The Facility always asked "what did you do to provoke them". Never are you injured, was your skin broken, are you bruised. Naively I never pressed charges.

I no longer work LTC.

A good friend who is a police officer has told me to press charges. Assault is assault. Dementia is not an excuse. Charges often make the family acknowledge there really is a problem. Sometimes "chemical restraints" are all it takes.

[greensister]

SHOCKED AND HORRIFIED

--Not a Leg to Stand on !

In 2005 Sister X , an experienced district nurse on the point of retirement, was the accused by a patient's daughter of "making a bad situation desperate" when she, and her nursing auxiliary, were called out to the complainant's "Mrs X's" mother of the at 6.30 am . The family and Mrs X, and six family members, (including three men ) were in the sitting room where their mother was asleep on the settee. Briefly the patient, who was terminally ill, was quite settled, having fallen asleep in the settee the previous night. Sister X checked her over and attempted to discuss the situation with the family. There was no means of getting the patient into a bed at that time unless the three men had brought a bed downstairs, or carried their mother upstairs. Sister X did not feel it was up to her to suggest this in the interests of health and safely, as if there was an accident she would have been blamed. The most sensible solution she felt was to contact the day staff at 8 am, 90 minutes later, and ask them to obtain a hospital bed.

Through-out the visit the family were all hostile and uncommunicative. The Nursing auxiliary had to remain standing as no chair was offered and all the seats were occupied. One family member, a daughter in law, a nurse herself , did most of the talking. Mrs X made practically no comment, despite Sister X repeatedly asking her, and the rest of the family, if they wanted to ask anything and what their concerns were . In the end Sister X and her colleague left as the patient was settled,(they ahd other patients to visit) and it was felt inappropriate to disturb her which would have necessitated calling out doctors for drugs at a difficult time, if she became agitated.Also it would have been difficult to nurse her properly on the settee. The family all agreed that they were happy with this course of action , but as soon as Sister X left they dialled 999 and got their mother into the hospice--though Sister X had offered to do this, along with all the other advice and support that had been offered, all of which had met with a negative response.

Because of the strange behaviour of this family Sister X felt very uneasy and contacted her line manager Mr A immediately on Monday morning (the visit had been Sunday am).A week later, following her mother's death in the hospice 7 days after the nurse's visit, t Mrs X wrote her letter of complaint. It was full of vindictive nonsense and defamatory comments and rude personal remarks including the fact the nurses had looked tired and untidy ( after a nine hour shift in windy weather!) Sister X was shocked and horrified by its contents. and said so in her written report which she was asked to write . Mr A, her line manager, (a younger district nurse with no night nursing experience ,) made no comment about Sister X's report though he later said he ahd advised her to change it which was quite untrue.

The gist of the letter stated:

"These two nurses should not be allowed into the home of a dying patient with their attitude and I strongly suggest they need some relevant training in basic nursing skills not to mention a crash course in in communicating and compassion for the suffering. They were unkempt and tired and incompetent and only wanted to get off their shift."

EVERYONE ELSE, ON THE OTHER HAND WAS " absolutely wonderful,hardworked and overworked." !

This was absolute nonsence. Sister X was an experienced sister who taught palliative care and was well known for her dedication and high standard of care and had been the senior night sister for five years . It was her view that the letter had been written by the daughter when she was in the bereavement process and was feeling guilty because she had not been able to keep her promise to her father to nurse her mother at home. There would not have been any problem, with the average family, in nursing the patient at home with a proper plan of care, forward planning and capable relatives. Sister X felt that this family were really not the kind who would be able to cope, but she understood that not everyone could and in these cases other plans should be

2) SHOCKED AND HORRIFIED

made in advance. It was no fault of the family that they were not of the "coping temperament" but it did not give them the right to scapegoat Sister X and her colleague.

As an immediate affect of this letter Sister X suffered an attack of supra ventricular tachycardia( which had been controlled on medication for 15 years) and had to be admitted to hospital.

More managers then got in on the act, including Matron and two office based senior managers who knew nothing about Sister X or district nursing. They said they were "shocked and horrified" by

Sister X's refutation of the complaint and comments about the family and matron said Sister X "hadn't a leg to stand on because it involved terminal care. No -one would dare to challenge Mrs X's complaint."

What followed was absolute farce. Sister X was obliged to go onto days, at the advice of her Union,for "support and mentorship." Sister X maintained she did not need supporting or mentoring as she was on the point of retirement and was quite capable of giving a patient a bed-bath ! Her Union repeatedly said it was the "Duty of care" of the Trust, though Sister X never got to know what care she was supposed to be getting. Sister X agreed to go onto days but said she would not return to nights as it was a degrading position to put her in. She then went off sick with stress.

Sister X continually asked why she was being treated differently from other night nurses who had been in trouble over other complaints, many of a specific nature, not just a catalogue of personal abuse as Sister X had been subjected to. Sister X also found out, eventually two years down the line, that the Trust had managed to dig up a report of an incident in which she had been involved, concerning another patient who had a personal grudge against the ( different) nursing auxiliary Sister X had been working with one night in 2004. Because this patient who had been involved in a grievance with Sister X's auxiliary (from days some years previously) Sister X had had to write a report, and the Trust said it "proved" the 2005 case against Sister X. This was only found at the last minute, when the Trust were desperate to make a case against Sister X. They tried to attach it to the 2005 complaint, when in fact they had known nothing about it at the time because it had never been given as part of the reason Sister X needed to go onto days for support and mentorship, as it would have been had it been known!( And in any event this complaint had been mainly directed at Sister X's auxiliary due to past problems never really resolved.)

At this point ,also, Sister X found out that that her nursing auxiliary colleague of the night of 2005 , had also written a SECOND report about the incident. Her original report which, though shorter than Sister X's, tallied in all details. Two years later, after over 30 meetings and personal investigation, including Sister X insisting on seeing the reports written about her by management, under Freedom of Information, she discovered that her colleague had changed her story in a second meeting with Matron and Mr A and to support Mrs X in her complaint, and had expressed repentance and remorse! ( no specific details over what exactly!) She was allowed to continue on nights without further ado and no supporting and mentoring for her ! In their reports the two senior managers said how shocked and horrified they were ( by SisterX's denial of the charges) and one of them, the newest and youngest, stated that Sister X should be " NIPPED IN THE BUD ! " a patronising, silly and insulting comment from an inexperienced and insenstive young woman who had never even met Sister X or knew anything about district nursing.

Sister X duly went on days for three months "support and mentorship" but no-one on the day team knew about this. They had been told a lie that Sister X had decided to come off nights of her own preference. Sister X went out unsupervised visiting patients, making a complete nonsense of the whole fiasco. She received an excellent report from the day sister of the team; however, when Sister X told this sister why she was on days she, to, was was shocked and horrified ! Matron was constantly asked by Sister X what was it all about, but matron could never give her an answer. Finally, the "support and mentorship" having some to an end, Sister X went off sick with stress again and was dismissed on health grounds in 2007.

A truly shocking and horrifyng story ! It was fortunate for Sister X that the patient did not die at the time of her visit of the world would be hearing about another Angel of Death of Nurse Shipman, and Sister X would be behind bars . not having " a leg to stand on"

[locolorenzo22, BSN, RN]

I'm going to veer over the other side from a lot of the posters...I've been in the field for 5 years....3.5 of those were spent in a Mentall ill nursing home. Folks, if you want to see residents hitting other residents, hitting other staff for cigs, having problems with each other over borrowing a dollar....those are huge issues....

now, those patients were often NOT a and O x3. However, if a staff member was hit, it became a huge deal with staff often requesting not to work with said patient.. no locked unit in facility, so can't really get away from someone...

in OP's case...there's 2 sides....was the woman A&Ox3 at the TIME? I've dealt with many patients who were really with it at 9PM, only to have same paients screaming that I'm breaking into their house at midnight. Was she on any medications that may have influenced her behavior (pain meds, behavior meds, etc)? Has she expressed remorse once told of what she did? Has husband asked her about the incident?

If all of those questions are answered, and she WAS a&O, and she has NOT expressed regret.....then charges should be filed. This woman may not have ever been called on that behavior, and should be made to realize that when a patient respects us, we respect them.

[MA Nurse]

Yeah, but them darn babies can PEE on ya!

I have never been peed on in the face...just on my shoe.

This is why I work with babies too.