New nurse here...slapped today by patient.

Truth66 · Apr 7, 2008

I had a patient pull a pair of scissors on me. The patient was w/c bound and paraplegic, A&O x 3. Not only did I call the police, I called my NM and my ADM. The patient was sent to a Psych unit for eval. The patient never returned to our LTC facility.

Bravo!!! This demonstrates that once law enforcement is involved the person is either going to be charged or sent for a Psych evaluation. There needs to be a zero tolerance for abuse period and stop using excuses.

As I respect lvnnow's recent post to this thread I would challenge it on these grounds:

1) Where does it state in any criminal code that a person is exempt after say age 65?

2) If we're going to continuosly come up with excuses as to why people abuse and assault health care workers, are going to endorse the same excuses that are always used in cases of sexual assault and domestic assault?

Assault is assault, period!!!!!!

Abishag · Apr 7, 2008

Hi
She is 77 years old and acting irrationally? Violent outbursts/irrational behavior are often indications of the onset of various mental problems. Especialy at that age. Have you questioned her husband/family members/friends/other nurses about any other unusual behavior? Is that slap a symptom of a problem that has not been diagnosed? Nothing is more frustrating than abusive behavior from someone you are trying to help(especially a patient). Hang in there!:nuke:
Lvnnow

Thank you for stating this. This was my opinion based on her age and the abnormal behavior for anyone in our culture. My grandfather had Alzheimers (passed about two years ago) and I went from seeing a wonderful caring man that never harmed a fly, played harmonica while bouncing us on his knees, to an abusive person that resorted to childlike behavior that would suck his thumb and wet himself and want to "go upstairs" in his one story house because he thought he was back home 70 years earlier. :crying2:

This lady may have been in her full capacity but we didn't realize my grandfather had AD until his last couple years of life.

I do not excuse abuse and think very ill of it. I do see this as abuse any any NORMAL person and would press charges, but given her age and circumstances it sounded a bit bizar to assume it was normal behavior for her. JMHO.

nursenow · Apr 9, 2008

Evilnightwitch, I understand what you are saying and I am sure it is based on your past experiences. Just speaking for myself, if a patient is confused, mentally ill or even just disoriented and strikes out (a very common situation, especially in the ER) I could not think of retaliating in any manner. It would be like punishing a very young child for having an "accident".(they can't help it) If you are drunk or just angry and are abusive, watch out because you are in trouble! I am sure that woman was alert and oriented, but as a nurse I have reason to suspect she may not be A&O x4 (person/time/place/reason) at all times. Her reasoning(for assulting the nurse) was bizzare. It is my job to determine that before I jump to conclusions in anger. But then again, maybe she is just an abusive person.

tk3100 · Apr 9, 2008

From day one in school, I was taught that it is not about me but about the patient. Sometimes they pee on you, sometimes they throw-up on you and sometimes they slap you. I am suprised at how many relies to her post are focused on how wrong the patient was and how the nurse should retaliate. Am I the only person to consider that the patient has some type of mental impairment? The patient is 77 years old and slapped the nurse because she thought they were "playing with her?" HELLO!!??

Serial abuse of nurses will never stop unless we stand up for ourselves. The management, the public, and the families will not do it for us. I don't care if she is 177, letting this go is just the same as saying, " It's okay honey, I am a compassionate nurse and I know you didn't mean it. Go ahead and hit me again if it makes you feel better!":madface:

bollweevil · Apr 27, 2008

If you had to do it all over again would you have pressed charges or been more adamant about not going back into the room?! Just curious as I am a NS now and it seems students are really afraid to stand up for themselves for fear of failing. It's a shame that safety doesn't always come first. Teach you a lesson?! I guess it was on how to be abused.

I think the instructor needed to clarify exactly what she wanted the student to learn.

What I would have learned was the number to the police and the route to the Dean's office.

That said, I think working with difficult patients should teach us to stand up for ourselves. I would tell such a patient that I will not help him if he is going to do anything even remotely like what he already did and I would inform him of exactly what the rules of our relationship were. No touching, no foul language, no violence, no disrespect. If he violated it, I'd get someone to trade assignments with me or otherwise distance me from him. If violence had occurred, I'd be on the phone to the police.

bollweevil · Apr 27, 2008

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.

Diagnosed dementia would certainly be a mitigating factor if the defendant had any kind of decent lawyer. Rapists, murderers, child molesters, etc. get off as Not Guilty by Reason of Insanity all the time. Why not a 77 y.o. woman?

bollweevil · Apr 27, 2008

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"

I am neither horrified nor shocked, having heard of such malarkey on more than one occasion in my many years in the world of work. I am very angry, though, and hope that Sister X got a really good attorney. :madface: :no:

bollweevil · Apr 27, 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!

I wonder if you'd have been blamed if she'd jumped but I'm glad she didn't and that you got a positive result. :uhoh3:

RobLPN · Apr 27, 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.

When they are that old not much is going to happen. you'd have to get clocked by a young man or something before someone would do something.

bluefabian · Apr 27, 2008

Oh please!!!

How long are we gonna say it's the patient factor and take all the hit? I have 80+ patients who are still rational and have the courteous attitude ever against the 30+ diva. I think the OP have stated that she was A&O.

We should quit defending the patient if our well being are at stake. I will be severely ****** of by that incident and would have snapped there and then. Happened to me a couple of times. Being sick is not the license to be rude. And every nurses who cares for any patients knew the somewhat emotional/social implications that a condition/disease inflicts. The very least we can do is be patient - with verbal abuses. I take this like air to my lungs by now. But not to physical harm, never.

RobLPN · Apr 27, 2008

Oh please!!!
How long are we gonna say it's the patient factor and take all the hit? I have 80+ patients who are still rational and have the courteous attitude ever against the 30+ diva. I think the OP have stated that she was A&O.
We should quit defending the patient if our well being are at stake. I will be severely ****** of by that incident and would have snapped there and then. Happened to me a couple of times. Being sick is not the license to be rude. And every nurses who cares for any patients knew the somewhat emotional/social implications that a condition/disease inflicts. The very least we can do is be patient - with verbal abuses. I take this like air to my lungs by now. But not to physical harm, never.

Technically it's assualt, yes. My point is that the hospital probably would never do anything if the pt is elderly verses young.

Right or wrong certain situations carry various reactions with people. For example, if a 80 year lady is hitting on me, which is assualt, and I clocked her one time in self defense I'd be fried chicken. if the pt was a 20 yr old man attcking me and I clocked him one good time it wouldn't carry the same impact verses grandma getting clocked.

Hopsitals do indeed put image high on the list even if it means not backing staff members at times. So filing charges against an old lady who slapped a nurse would not be supported by the hospital, because it would hurt the hospitals image.

bollweevil · Apr 27, 2008

From day one in school, I was taught that it is not about me but about the patient. Sometimes they pee on you, sometimes they throw-up on you and sometimes they slap you. I am suprised at how many relies to her post are focused on how wrong the patient was and how the nurse should retaliate. Am I the only person to consider that the patient has some type of mental impairment? The patient is 77 years old and slapped the nurse because she thought they were "playing with her?" HELLO!!??

I'm wondering if she might have messed up electrolytes and I want to know more about her steroid psychosis. these are real physical problems and I am kind of surprised that almost no one here has asked anything about her most recent labs, her meds, and so on. This has been focused almost totally on the nurse, who gave a shocking but incomplete picture.

Not that we shouldn't want our colleague treated better. We all should be treated like the important people we are. But we need to recall that this was a hospitalized patient and that she was there because of illness, presumably, and because we need to know (I do) if her illness adversely affected her behavior. And where was the preceptor and what did Management say and what did the OP decide to do?

I'm glad she at least felt badly - about having done it, most

e likely. The husband I would have ignored his remark, possibly, as he ws probably overwhelmed, although not necessarily.

Again - I care about the nurse but want to hear the end of the story and get the whole picture.