New nurse here...slapped today by patient.

adoyo · Mar 5, 2008

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.

my advice is that u just go to a corner and pray for the patient!! why? because when a dog bites man, it is no news and when a man bites a dod it is news! when a pt hits a nurse, its no news but when a nurse hits a pt, it'll hit d headlines!! :cry:

AZRN4life · Mar 5, 2008

It's definitely assult. I worked for 4 years on a med-surg floor and got hit, kicked, slapped, etc by many confused, alzheimers patients, but this is someone who is A&Ox3 and an adult who should have known better. I once got punched by a lady who was completely alert and oriented (albeit coming down off of meth), who flipped out because I wouldn't let her smoke pot in her room. I grabbed the nearest security guard, calmly told her that the police would be notified, then called 911 and the house supervisior (I was charge that day). When the police came, the lady freaked out and tried to jump out of the 3rd story window. Ends up that there were warrents out for her arrest and her boyfriend's too, who happened to be in the room watching the whole thing. Made the papers and everything! I'll tell you what though, ever since then, whenever I'm threatened by a patient, I tell them what I did and I always get "oh, you're that nurse I heard about". Never been hit since! :nono:

SpringTXRN · Mar 5, 2008

It is assault. Pure and simple. And you have witnesses x 3, though I am sure her husband wouldn't back you up. I hope you put an incident form in. And documented everything in your notes. Does your hospital have some sort of aggression policy? Do you have a police officer on campus? I don't care if she is 77 years old. If she is A+O to TPP then she has assaulted you...
What did your primary nurse say?

It truly is assault...but wouldnt hold my breath for anything to come of it if you do press charges

Especially when you work with psych pts...I know for sure that one is a lost cause

Truth66 · Mar 5, 2008

Well, this is clearly assault. Now I'll proceed based on experience. I've worked in LTC for nearly 12 years and I've seen numerous examples of assaults against various staff members. One of the challenges about these assaults would be that for years management would always turn things around by blaming the staff by asking questions like, "What was your approach", or "What did you do to provoke the resident", etc.

Over time staff were less inclined about reporting these incidents because they didn't want to be hauled in and be blamed once again.

Eventually this becomes a health and safety issue. The facility that I work at was eventually reported to the Ministry of Labour here in Ontario Canada for failing to provide a safe workplace for staff and was issued a series of orders by the ministry to provide mandatory training for all staff on how to deal with these assaults.

When it comes to actually calling the police, well many of my fellow co-workers are reluctant because they always say, "Well Mrs. so and so is 71 years of age". My response is always the same, "Show me where in the Criminal Code that a person is exempt after age 65."

Even if the person has some form of Dementia. Once the incident is documented and possible charges filed then it assists in getting the appropriate psychiatric evaluation done and possible changes in the person's medications if needed. As we all know, if it ain't documented, it didn't happen.

ak127 · Mar 5, 2008

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.

I had a middle aged, completely lucid patient throw garbage at me and threaten to hit me with his fist. No reason, I'd been very nice to him. But he was upset that I kept coming in his room but he was a pre-op with a lot of meds and frequent vitals- I HAD to be in his room a lot. He wanted to sleep- its 9am! He FORBID me from coming back in. When I told my instructor that she told me to ignore everything he said and do my job- hello, now you're asking me to touch a pt without his permission, that's assault on my part! Luckily he soon went to cath lab- but then came back, needed frequent checks to make sure he wasn't bleeding to death. He cursed me and looked for something else to throw. Eventually, he called the hospital's VP and had him come up to personally take his complaint. Only when the VP told the charge nurse not to assign this pt to a student was I moved off his case... after about eight hours of constant abuse. Its not good for me, but more importantly, leaving me on that case was bad for the pt- he didn't need the aggravation.

Still, it came down to my instructor thinking she was going to teach me a lesson about dealing with difficult patients. If the guy wants another nurse, give him another nurse! If he wants to sleep in, send him home! No one learned anything. That guy is probably still a jerk and -stupid me- I still haven't learned to take abuse lying down. What a terrible student I am! :rolleyes:

rhugsrn00 · Mar 5, 2008

Weather or not the patient was alert and oriented x3 does not make a true difference. I work with psychiatric patients and we are able to charge them with assault. I would not tolerate this from any patient and would file charges.

nursesherry · Mar 6, 2008

You should file charges. We have a pt at my facility who is verbally and physically abusive to the staff. What are our rights? We are constantly bombarded and educated on pts rights but what rights do we have? Can we simply walk away if we are being verbally abused by an A&O pt? Can we refuse to care for a pt who is physically abusive? I would really like to know.

BayouLPN · Mar 7, 2008

OUCH...and I am sorry that this happened to you esp since you are new. I'm not sure about charges...Since she is 77y/o, she may have appeared to be AAOx3. But, with further evaluation, it would probably be discovered that she has some sort of dementia. Having worked in a nursing home, I have seen many who were AAO x3 and would still whoop your butt. Knowing person, time, and place does not mean they are not looney. Most are. Esp. during illness. UTI's will often show up first as a change in behavior (not for the good). She probably did know that she hit you but did not really understand where the aggression came from. She just did it when she felt threatened. DOCUMENTATION and a report to social services for counselling with her and her family. Her husband needs to understand that if she is going to become violent, he has a responsibility to tell staff that on admittance so measures can be taken to minimize her aggression....A soft restaint order can be signed for invasional procedures for example. The first time I got hit, it really hurt my feelings as well as my skin, but, I came to understand that in their youth, this probably was not something they would do. Never been really injured, but a couple of my CNA's have had the stew beat out of them. We had to start using 3 shower aides instead of one for this person. 2 to distract while the other washed. QUICKLY...and her son understood and agreed to whatever SOFT measures had to be taken during shower time. It is not a fair game we are involved in, but, unfortunately, Aggession is one the effects of alzheimer's...and I have noticed that it is one of the first presenting symptoms. Again, I am sorry this happened. I hope it doesn't turn you off from nursing but it does happen.:imbar

Warpster · Mar 7, 2008

At the very least, write this incident up and get a paper trail on this old sweetheart started. Chances are you aren't the first and won't be the last.

You do have the right to charge her with assault. Whether you do so is your own judgment call. Just be aware that the husband will likely give a very different account to the cops. He doesn't want to lose his wife to the justice system.

BayouLPN · Mar 8, 2008

At the very least, write this incident up and get a paper trail on this old sweetheart started. Chances are you aren't the first and won't be the last.
You do have the right to charge her with assault. Whether you do so is your own judgment call. Just be aware that the husband will likely give a very different account to the cops. He doesn't want to lose his wife to the justice system.

Me again....This is very correct....and if she doesn't have a diagnosis of dementia now...I can guarantee that she will by the time is gets to court. The family's lawyer will see to that.

I liked what one poster stated, "It is why I work with babies" ME TOO> left the nursing home for the babies.

woody62, RN · Mar 8, 2008

I am not sure what I would do. I did threaten to slap a nurse, in the ER, once. She had attempted to start an IV on me and blew thru the vein. She then made a second attempt, something that I have always allowed any nurse or paramedic to do. She also blew thru the second attempt. I asked her to stop. She told me that she knew she could get a vein, and continued to poke around, under my skin, search for a vein. And being quite painful. I asked her to stop, twice, each time in a louder voice. The third time, I shouted, telling her if she did not stop immediately, I would slap her. I got her attention and that of the rest of the staff. The ER physicain came into my room and asked me what the problem was. I do not know if I would have really slapped her. But I do know this, when a patient asked for someone to stop doing something, you had better stop, unless it is a life or death matter. Or you can be arrested for A & B. And I have had to take my share of verbal abuse, here and on other nursing message boards, for making such a threat.

When a person acts out, be they confused or oriented times three, you should take the time to ask why they did what they did. No one generally strikes out at another person, without anger or without cause. Like I said, I do not know what happen that day. And apparently neither does the original poster. She has posted only her side of the story. We do not know what cause the patient to strike out. And to me, it is more important to find out why and attempt to avoid such situations, then to have someone arrested. No patient should ever take out any anger or feelings of pain, on a staff member. But then, no staff member should feel that they have to be obey by every patient. Nor that a patient does not have the right to say no or refuse to have a staff member take care of them or preform a procedure on them. A & B is a two way street.

And that is my :twocents:

Woody

frantic one · Mar 9, 2008

In the hospital policies and procedures, it should have procedures for your situation (whether it is verbal confrontation, threatening behavior up to and including physical assault).

In California, healthcare workers are protected by A.B. 508 which covers verbal confrontation, threatening behavior and actual assault by family or patients. There is also mandatory training on de-escalation of behavior, how to block and avoid assault, and take-downs (handy in ER and locked facility situations).

This legislation was passed (unfortunately) because of the nature of the job; we are prime candidates for attack even if we are not taking care of the patient (i.e. walking past in the hallway in your scrubs, and a family member sees you as someone to vent to. Not your patient, no idea what is happening to this particular situation, but you're a handy target).

In my facility, if the conversation becomes to aggressive towards any heathcare provider, the body language is threatening, or you get (slapped, punched, kicked, pushed etc.) it means calling Security to report the situation, fill out the Incident Report and A.B. 508 forms, and document in the chart. Security then is supposed to report the situation to the police; not necessarily to proceed with charges (unless the behavior escalated to that point) but to have a trend of behavior.

It sucks to have to know about this, but it happens all too often.

Bob and weave, bob and weave (sorry, distracted by the emoticon).