nurse abuse

jessiern, BSN, RN · Mar 18, 2008

One of the first things they told us when we went in to do pysch clinicals was never to let the patient back you into a corner, or get in between you and the door. That is true with any patient that has a potential for violence. When you deal with that client, always make sure you have an exit available. Can you possibly have assignment that doesn't involve him? Or possibly if you have to care for him, have someone go with you when you are in the room.

Also, since you have been so upset by this (understandably), talk to your supervisor. She/He may have better insight then us, since they know you and the patient.

Jo Dirt · Mar 18, 2008

I was taught in nursing school that we have every right to protect ourselves, even if this means you strike and/or shove the offender as a means to get away. She told us about the time she was a young nurse and had to protect herself against a sexual assault from a patient.

I have vowed to not allow myself to take abuse, even if it means getting physical. In your situation I would have picked up something, even a chair to let him know I meant it. This business of talking yourself out of an attack and dilly daddling around with "firm verbal communication" is a joke when you are dealing with a nutjob. I don't mean to belittle people dealing with mental illness but their rights shouldn't trample others just because they may not (or may) know what they are doing. Sometimes, the threat of violence can be enough to make them back up and rethink what they are doing. A lot of times, they think there is no recourse for anything they do against medical personnel.

If he had enough of his marbles to do it I'd bet he had enough of his marbles to know not to do it, from the way you describe the situation.

I'm sorry if others don't see it this way but I believe violence has its place in the world and sometimes it takes violence to keep peace (no, I'm not advocating the War).

NurseNora, BSN, RN · Mar 18, 2008

Talk to your coworkers and supervisors about this. Look at the situation as calmly as you can. What could you have done differently to have avoided this situation? What other options did you have for getting out of it once it had begun? How will you handle yourself in the future? How have they dealt with similiar situations?

Since this struck a real nerve for you, having been in an abusive relationship in the past, it may be more upsetting to you than it would be to someone without that background. Most hospitals have some sort of Employee Assistance Program: a short term counseling program for employees. You may need this additional help to get over this experience. There's no shame in getting this kind of help. I've used it twice in my career and it's been a true life saver.

bigjim · Mar 18, 2008

In that exact situation, I would probably take the hits and try to work my way out of there, but I am a very large guy and I have a lot of martial arts experience, so I'm used to getting hit. My nose is still broken from 15 years ago getting kicked so hard my whole body left the ground. So, I don't think an old man would cause me to have to hit back.

That said, if you think you are in a position where you are going to be physically overpowered or actually hurt, do what you have to do. You have to be very careful in these situations, but you are under no obligation to let somebody hurt you. If you absolutely can't get away, and he's still coming at you, lay him out.

There are all kinds of women's self defense classes out there that can help you with picking up not only some good techniques (generally geared toward being attacked by a larger/stronger person) but also a vigilant mindset so that you can avoid attack whenever possible. Our local community colleges have pretty good classes around here. Your mileage may vary.

Above all, be safe and don't let one patient destroy your confidence. Just go get the tools you need to defend yourself, and be alert.

RN1989 · Mar 18, 2008

You need to speak with a counselor. Unfortunately this happens often in nursing today and this will not be the first time this happens to you. Nurses by nature always want to defend something like this because the patient is confused, ill, upset over the situation, blah, blah, blah. That is why this kind of thing continues every day around the world. You however have even more issues because of your past. Women who have been abused often have a more difficult time because they are accustomed to rationalizing abusive situations even though they know in their head that the situation is wrong. You really need to speak with a counselor - talking with others at work are not really going to help other than to validate your feelings. This is a long term thing you must deal with and it is best to get professional assistance. So few women triumph over abuse compared to the numbers that are abused, I would hate to see you have problems since you have worked so hard to get over the past.

bigjim · Mar 18, 2008

That is true with any patient that has a potential for violence. When you deal with that client, always make sure you have an exit available.

I have the mindset that EVERY patient has the potential for violence. Always having a way out and a plan should be automatic whenever you care for someone (obviously there are degrees of this). It is almost worse to be attacked by someone who is obviously too frail to hurt you, because it is so easy to hurt THEM, even just by blocking the blows thrown by a demented little old lady. Avoidance is key here, but sometimes you just can't see it coming. The point is to minimize those times.

aileenve, ASN, RN · Mar 18, 2008

I'm so sorry to hear of this assault; I was punched in the eye and knocked off my feet by a pt. in a wheelchair about 10yrs ago...I never forget that anyone can hurt you, especially those with sub-abuse and drug history...I was guilty of assisting him in the chair and lifting his legs on the footrests! These things sometimes happen when we are busy, not paying attention to verbal and physical cues of pt anger and resentment and their feelings of being out of control..I had a black eye and my family begged me to quit nursing; but I'm still here, just older and hopefully a lot wiser

jbp0529 · Mar 19, 2008

Im so sorry that happened to you, I hope you are physically/emotionally ok.

On a different spin to the topic of "nurse abuse," at this one place in which I worked, we had a DOCTOR back a nurse into a corner, screaming and yelling, with his hands over his head in a fist!! Didn't hit her (yet) but looked like he might. Mind you, this doc was known to be a little "crazy", we didnt know what he was/wasnt capable of. Several other nurses witnessed this happening, called security, and ganged up on this crazy doc...guess he felt it was wise to back down, since he was out-gunned 4 to 1 :wink2: Security arrived and escorted him from the unit, and the nurse filed charges. Don't know what became of that whole thing....

TRAMA1RN · Mar 19, 2008

I cannot beleive you were made to stay at work, unbeleivable!