New nurse here...slapped today by patient.

kids · Sep 15, 2009

At the very least I would file an incident report, report this to her physician, and request a psych eval. Somethings not right there. I've worked w/ demented and mental patients who are a/o x3 at the time of assessment and then turn on me like Linda Blair. I hope it all works out and I'm sorry this happened to you
Jenn

I agree completely.

In my experience just because someone is oriented 'person, place and time' doesn't mean they are oriented to events, that can make a huge difference in their reaction. The lol's response (waaaay back in the OP) that she thought they were 'playing with her' makes me suspect she wasn't fully understanding what was happening.

RuRnurse? · Sep 15, 2009

"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."

What, exactly, was the "lesson" she thought she was teaching you, I wonder? That you need to become accustomed to being a "punching bag"? Garbage! Pure and simple!

Unfortunately, this attitude seems to be very common in this field. Maybe a throwback to the days when nurses were slightly higher on the totem pole than women in general, but it does need to stop!

Several years ago, I was working on the dementia unit. We had a guy who was not really dementia, more psych, and could be very abusive, especially towards women. At that time there was a male nurse on one of the sister units...this guy was BIG, with a shaved head and tattoos on his neck. Anytime Mr. Personality decided to pull a stunt, we'd run over to that unit and get him to help us. He never really had to DO anything, just kinda stand there, that was all it took...sometimes, if a situation looked iffy, we'd call him over as a sort of pre-emptive strike.

Ah well, that nurse quit and went elsewhere. Every now and then I think of him and wonder where he is today...Come back, Mr. Riker's Island-looking guy! We miss you!

Truth66 · Sep 16, 2009

I'm glad to see this thread active again.

One of the biggest reasons why nurses and other front line health care workers are abused so much is that we're viewed as nothing more than a bunch of women and therefore not valued by society as a whole.

Here in Canada the Canadian Broadcasting Corporation did research on the level of violence towards nurses and other frontline health care workers and found that based on compensation board claims, the level of violence towards us was more than three times higher than that of police officers. Think about the level of training that police officers receive in order to deal with potentially violent situations in comparrison to nurses. Nurses recieve little to no training in this area, yet were're told to deal with it. Also, in most jurisdictions it's a criminal offence to assault a police officer (male dominated profession), yet there's very few jurisdications where it's a criminal offence to assault a nurse (female dominated profession).

As for management, well the same holds true. I remember a story that I was told about a Nurse Manager who routinely blamed the staff each time they were assaulted. Her favourite question was, "What was your approach?" Well one day a group of nurses finally stuck up for themselves and confronted her with it by saying "show us how it's done then." This Nurse Manager was obviously backed into a corner and she went into a resident's room who had a long history of physical aggression. The next thing the nursing staff knew was, as the nurse manager leaned towards the resident, the resident punched the nurse manager right across the face. You guessed it, these nurses saw it happen and imediately questioned the nurse manager by asking "What was your approach?" That Nurse Manager never blamed another frontline staff member again for being a recipient of abuse.

nursenow · Sep 17, 2009

I didnt really see this thread as a discussion about nurse abuse. I saw the original post as a situation in which a nurse failed to perform a complete assesment of a situation/patient. As a result it is very possible the patient and her family did not recieve the care she/they deserved. My impression was everyone just jumped onboard the "patient is wrong" train. Most people just wanted to punish the patient when, I believe, she probably had some mental/psych/med problems and her behavior was a sign of the problems. Now, a year later and with another years experience I am even more inclined to believe it was not just nurse abuse.

Karynica, RN · Sep 17, 2009

I wish I could offer some better advice, but after spending years being hit, slapped and pinched by patients and residents, it just became something I have gotten use to in nursing. From being a CNA to being a RN I have been hit at almost every job I worked at. The worst ones were in LTC and DD residents.

I have just learned to move quickly when I see a hand coming my way and sometimes I don't always see that hand..

I know the feeling of wanting to slap back and do something, anything, but you have to compose yourself and remember YOU are the professional. There may be some reason the patient slapped you. Could have been her response to the IV, could be she is just plain mean, or she may just not like hospitals or unfamiliar people and surroundings.

Just some random thoughts. :)

guest64485 · Sep 17, 2009

Well, here it is more than a year after I first read this topic and now more than ever it bothers me that a nurse got slapped by an obviously ill patient and the the advice experienced nurses are giving has zero focus on the patient. sue, sue sue, make money in court. Teach that old lady a lesson. After all, it is all about the nurse.

Where are people talking about making money? They are talking about filing an incident report and pressing charges for the purpose of raising awareness and decreasing the chance that this will happen again. Do not forget that in the OP it was stated the patient was a&o x3 at the time and as we were not there and do not have the chart here in front of us we don't have a whole lot more to go on. Several people did ask about hx of dementia but the OP really has not expanded much on the patient's condition. Saying that "it is all about the nurse", well, I am confused at why you would say this when a nurse is the victim here, and the discussion of the thread is vastly about how to handle injuries from a&o patients as well as confused patients. Nurses have a history of being poorly supported when it comes to physical safety on the job (among other things like safe staffing). We have the right to work in a safe environment. Nurses have to support nurses, because no one else is. When nurses are properly supported, we can accomplish great things for patients. You think wrongly that this is only about the nurse, because in the end it still all goes back to the patient.

Considering how toxic and self centered some of the replies have been, it is safe to assume that some of the people at this site are going to be bitter old people slapping nurses when they get to that age. Since reading that post I have been struck by several disoriented/confused patients and it never crossed my mind to sue them. My first reaction has been to try and figure out why they did it, what I can do to help them and how to keep myself as well as the patient safe in the future.

Toxic and self centered? The posts are telling the nurse to stick up for herself for what she described as an A&O patient, to work on the large, large problem of staff abuse. You have to stop thinking of this discussion as being focused on making money. It is simply not about that. Nurses as a whole are very staunch supporters of patients, very often to the detriment of themselves (see the thread a few months ago where people were supporting each other to go to the bathroom and eat on their shift). But, by supporting nurses to care for the caregiver, we can in turn care for the patients better. We need to stop the martyr complex that it sounds like you support! Not only do we need to make things better for the patient but also for the nurses that come after us(as that will also make things better for the patient). Working towards decreasing injuries, or as other posters have suggested, increasing education for staff about how to de-escalate situations, and precipitating factors, will help caregivers spend more time focusing on what we WANT to do, which is care for the patient, instead of spending this time trying to safeguard our, and our coworkers safety.

Some of the worst patients I have had are bitter old nurses that treat staff like total crap. When I see them I am really happy I didnt have to work with them when they were young and bitter. The worst family members I have had to deal with are bitter old nurses that know how to cause problems and go out of their way to do it. I bet they would have called the police and sued that old lady also.

Some people are just jerks, one doesn't have to have a mental condition to treat others like crap.

nursenow · Sep 17, 2009

Ayvah

Alert only means you are resposive to a certain level, oriented x3 barely even scraped the surface of a mental assessment! How many A&O x3 patients have you seen that were confused, combative, unable to make decisions for themselves... Oriented x3 means they know who they are, where they are and roughly what time it is. Nothing else.

Are you suggesting that an A&O x3 person cant have mental problems? You are wrong. What school taught you that??? I see it every day at work. What happened to A&OX4. she was only x3. Hello? Doesnt that mean anything to you?

diane227, LPN, RN · Sep 17, 2009

You can call the police and make a report but a guarantee you that the DA will not bring charges against a 77 year old woman in a hospital. They just won't do it.

I and friends of mine have been assaulted multiple times and the DA would not take the charges unless it was a visitor. They would rarely take charges against a patient unless the patient had a weapon or the staff suffered a severe injury (broken nose, knocked unconscious, shot and wounded). If it was a psych patient, they would just put them on a 72 hour hold and that was about all you could hope for.

So don't count on much support from local law enforcement in something like this. I did have one nurse bring successful charges against one drunk guy who bit her breast as she was trying to restrain him. She was a bloody mess. They did bring charges against him. He got 3 days in jail and some community service.

He turned around and complained to the board about her that she had assaulted him and held him against his will. Nothing ever came of it. I wrote the board and told them what he did. We never heard from them again.

Sirapples · Sep 17, 2009

Some of these attitudes are right in line with the, its ok for nurses to be assaulted and expected... routine that I find in our field. Now I would not press charges on a 77 year old lady but I would tell her that it was completly unacceptable. The fact remains that a lot of people in this field do find it perfectly fine that nurses get assaulted, spit on, bit, and that we should accept it as our lot in life.

I find that reasoning unacceptable. I dont know if its an older style of nursing but I hope that more nurses stick up forthemselves in these cases and do press the point that its unacceptable and in the case of a/o patients, charges should be pressed. if a waitress was assaulted and sworn at, we all know what would happen.

Scrubby · Sep 17, 2009

Ayvah
Alert only means you are resposive to a certain level, oriented x3 barely even scraped the surface of a mental assessment! How many A&O x3 patients have you seen that were confused, combative, unable to make decisions for themselves... Oriented x3 means they know who they are, where they are and roughly what time it is. Nothing else.
Are you suggesting that an A&O x3 person cant have mental problems? You are wrong. What school taught you that??? I see it every day at work. What happened to A&OX4. she was only x3. Hello? Doesnt that mean anything to you?

I understand your point about forgetting about the patient. After reading this thread I don't have enough info on the patients background to form an opinion on whether the patient had underlying issues. But still, even if a patient does have a reasonable excuse for physically assaulting a nurse because they have mental issues does not excuse any nurse being injured. If I were in the OP's situation I would be alerting other staff to the possibility of being assaulted and be querying whether the patient required restraints, or another staff member present when giving care.

IMHO nurses and CNA's are always going to be at risk of some form of assault. But this should not be considered as 'ok'. I personally do not want to work with any nurse who feels it's ok for a nurse to be abused. There needs to be strict guidelines, if a patient for whatever reason (mental issues OR just an *******) hits a nurse then this needs to be taken seriously and preventative measures taken from then on to protect nurses. This may be physical or chemical restraints, extra staff present when giving care, counselling for any nurses who have been assaulted, documentation and reports made to the police when necessary.

guest64485 · Sep 17, 2009

Ayvah
Alert only means you are resposive to a certain level, oriented x3 barely even scraped the surface of a mental assessment! How many A&O x3 patients have you seen that were confused, combative, unable to make decisions for themselves... Oriented x3 means they know who they are, where they are and roughly what time it is. Nothing else.
Are you suggesting that an A&O x3 person cant have mental problems? You are wrong. What school taught you that??? I see it every day at work. What happened to A&OX4. she was only x3. Hello? Doesnt that mean anything to you?

The OP states specifically that the patient was not confused at the time she was doing the IV, see the following quote:

she was A/O x3. NOT a confused patient

I'll repeat that we don't know all the information about the patient, so we are only going by the OP's assessment.

You have been making a massive amount of assumptions about the people on this board and nurses in general. Throwing random, unsubstantiated insults at me instead of delving into an actual discussion is also not productive.

Flare, ASN, BSN · Sep 17, 2009

I once had a frail old lady who was completely with it dig her fingernail into me so hard that I had 5 crescent spaped punctures on my wrist. Her son stood by and witnessed the entire thing (if memory serves i was doing a very benign task such as straightening sheets) and all Sonny could say was "Mom was a manicurist, she like to keep her nails long." The patient didn't have a good reason for grabbing me. My response to them both was "If the shoe was on the other foot, i'm sure you'd have the police here. Ma'am I'll ask you to keep your hands to yourself." There were no further issues with that particular patient.