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Physically abused by resident

Posted

Last night a resident slapped me in my face and called me some endearing terms. Think of the "c" word that rhymes with runt and she told me to go "f" myself. She was calm and then she went bananas without any rhyme or reason. She is unpredictable and volatile and this is not the first time she has gotten physical with staff. I am sick of it. In any other arena, the police would have been called and assault charges would have been filed.

Let's be real, in any other situation, if someone had hit me, I would have swung back...hard. :smokin: I. am. no. saint. I was pretty mad and shocked. I walked out of her room, told the charge nurse, took a break, came back in and filed an event report. A lot of good that will do. She has an obnoxious amount of event reports filed...yeah, a lot of good those do.

Why the heck is this behavior acceptable as a work hazard? Why? Someone tell me. What the heck am I missing? I know there have been numerous posts addressing this issue. I did not get it either until it happened to me. I feel let down and just I don't know, I feel violated. I hate being hit.

Edited by Poi Dog

Which unit do you work in?

if this patient has a history of violence, can you guys use restraints? chemical restraints?

i dont have any exp as a nurse but as an EMT ive transported many psych patients and a few of them can get rowdy.. infact i had to wrestle one patient to the gurney because he kept on slipping out of his restraints and wanting to jump out of the back of the ambulance.. ive been called names, which i just laugh to my self.. you also have to realize some of these patients can have psych issues..

unfortunately these types of patients are part of our work.. we will have to deal with these patients occasionally.. best we can do is grin and bear it .. unless they seriously assaulted you then depending on the case you might want to talk to the higher ups directly..

KalipsoRed

Specializes in Telemetry. Has 3 years experience.

Poi Dog, I'm sorry you have been violated just to care for someone. Nursing is insane to accept such hazards as part of our field....especially for the lousy pay we get for such a s**ty work environment. I say start looking for another job. While restraints are a good idea and can work for a short term, it really isn't something that can be considered for long term care.

I'm guessing your resident is like this. You go along your day and she's doing alright, then she has a sudden outburst and slaps you or calls you a name. You call the MD get a restraint order (which is a ton of documentation for you) the resident gets the restraint and is fine in an hour when you have to reevaluate the use of the restraint. So you take the restraint off and the resident is good for an hour or two until she has another episode and verbally or physically abuses you or other staff. If you work in a LTC it's not like you have a ton of time to keep going back and calling for a new restraint order 3 or 4 times a day. Most places don't allow PRN orders of chemical restraints anymore either. I'm guessing your patient is already on some sort of psych medication and the truth of the matter is that she will be having such outbursts for the rest of her life.

I realize it is something we have to deal with in our line of work, but we sure as hell don't get enough respect or pay for dealing with this kind of crap. I say look for a different job.

shhhh

Specializes in ICU, ED, Trauma, Transplant. Has 8 years experience.

I'm really sorry about what you went through. I've been punched, kicked and slapped. It really makes you feel violated, in a way. The worst for me was when a guy hawked up a huge loogie on my scrubs (after calling me some choice awful names) only because I asked him to slide from the stretcher to his bed and he didn't want to (I found out later that he was incredibly misogynistic and would only barely tolerate the male nurses). What happened to him? Well, after he ran all around the unit in just a T-shirt, dragging his foley around on the floor, being disruptive and attempting to assault anyone within his reach, security finally showed up, tackled him and SLAMMED him down onto the floor. I don't believe security was going overboard either. They needed to slam him to get him to realize that trying to attack nurses in the hallway wasn't going to work out in his favor.

I work ED/TICU and we get lots of drunks and drug addicts, along with our demented old folks who also might be violent. We even get sober guys who are just big jerks.

Regardless of their diagnosis, anyone who swings after their first warning is restrained. Maybe some Geodon or Haldol IM if they're really flipping. Our rationale is that if they're THAT much of a b-hole to want to swing at you while they're sober, then they're dangerous and should be restrained for the safety of everyone else. If they're so altered/mentally ill that they want to hit you, then not only is that a safety risk to the staff, it could be a safety risk to themselves and we need to "first do no harm".

I work with a very "tell-it-like-it-is" trauma surgeon who's an admiral in the Navy. He's intimidating and doesn't take any guff from anyone. We had this one guy, COMPLETELY SOBER and seemed to be appropriate until he was told by me that no, he must lay down in the bed and be still, and NO, he couldn't take his collar off (unstable C1 fx). A few expletives and some mean name-calling from him, an attempt to climb out of bed and swing at my face, a tackle by me and few more nurses, then a call from security to help us put him in 4 point restraints, he's back in the bed. The doctor comes in and sees this guy and guy starts whining, "Look what they did to me! What about my civil rights!?" The surgeon just says, "If you're going to act like an animal, we're going to hog-tie you like one." The patient was pretty quiet and fairly reasonable after that. Restraining residents is probably NOT an option at your facility, but it works for us.

But to answer your question, that behavior is NOT acceptable at all where I work. I think the ED environment can be so chaotic that we have to take control any way we can. It's unfortunate that we have people in our society who force us to go to such great lengths to preserve safety for everyone.

In your situation, I agree with KalipsoRed. I think she will continue to act this way, and dealing with that every time you go to work will cause you to grow resentful. I would look for another job if I were you.

DizzyLizzyNurse

Specializes in Peds Medical Floor. Has 12 years experience.

Unfortunately shhh in a nursing home you can't do any of the above. It's so different from what I hear. Forget about physically restraining someone. You can't even usually chemically restrain them. Management tells you it's your fault, you have must have done something, if you were just more patient, etc, it wouldn't happen.

shhhh

Specializes in ICU, ED, Trauma, Transplant. Has 8 years experience.

Unfortunately shhh in a nursing home you can't do any of the above. It's so different from what I hear. Forget about physically restraining someone. You can't even usually chemically restrain them. Management tells you it's your fault, you have must have done something, if you were just more patient, etc, it wouldn't happen.

I did make it clear that I was under the assumption that the OP probably couldn't restrain the patients in the LTC where he/she works. I explained that in my particular specialty and hospital, it's generally an appropriate measure to subdue someone acting violent. I'm unsure how extensive Poi Dog's nursing experience is and if he/she worked in any other specialties apart from LTC, but I just wanted to share with the OP that not ALL facilities are like his/hers and the grass may been greener on the other side.

It's really lousy that nurses in some LTC environements not only experience a lack of support from management when this abusive behavior occurs, but they can even be blamed for it occuring. I don't see this changing any time soon. I can't fathom a "happy ending" happening any time soon for Poi Dog and stated that maybe he/she should persue another specialty or facility that's more supportive.

Does this patient have mental problems or did they just decide that you were the person to abuse that day? If this patient is fully aware, then SOMETHING needs to be done. I am all for advocating for patient's dignity, but not at the expense of the healthcare staff.

wishinguponastarLPN

Specializes in Rehab, LTC.

I can feel your pain...literally! I have a resident that I am physically abused by every night that I work. I work on a Alzheimer/Dementia all female unit and I have one particular resident who will beat the crap out of me just trying to toilet her. She is not a little ol' lady either, she is a big lady.

I have been banged up agains the wall multiple times, scratched till I bleed, punched in the stomach, smacked, kicked, spit on, you name it. What ticks me off the worst is my facility does nothing about it! They don't care as long as she isn't trying to harm another resident. And the unit manager gets really angry with you if you attempt to fill out an incident report. And I have been discouraged many of times to not fill out a report if I want to keep my job.:eek: Lovely isn't it???

P.S. I'm looking for employment elsewhere. I can handle being abused to a certain extent but I am sick to my stomach about the way the facility chooses to handle it.:devil:

tiredstudentmom

Specializes in Medical Assisting. Has 5 years experience.

I can feel your pain...literally! I have a resident that I am physically abused by every night that I work. I work on a Alzheimer/Dementia all female unit and I have one particular resident who will beat the crap out of me just trying to toilet her. She is not a little ol' lady either, she is a big lady.

I have been banged up agains the wall multiple times, scratched till I bleed, punched in the stomach, smacked, kicked, spit on, you name it. What ticks me off the worst is my facility does nothing about it! They don't care as long as she isn't trying to harm another resident. And the unit manager gets really angry with you if you attempt to fill out an incident report. And I have been discouraged many of times to not fill out a report if I want to keep my job.:eek: Lovely isn't it???

P.S. I'm looking for employment elsewhere. I can handle being abused to a certain extent but I am sick to my stomach about the way the facility chooses to handle it.:devil:

OMG! I hate using that particular vernacular, but dang! I don't blame you one bit for changing jobs at all! :crying2: In fact I will hope and pray that you get something much saner and healthier for you! :o Please let us know what happens... It can't be legal, etc for this to be occurring.

Fiona59

Has 18 years experience.

Psych consult ever been done? If not, get a referral for one.

Then keep copies of your incident reports. Report your facilities lack of concern for staff to your professional association (if you have one).

Finally, if all else fails, take your copies of the incident reports and check with the local police detachment and see if you can file assault charges. I know of a few nurses who have managed to press charges against patients from hell.

wishinguponastarLPN

Specializes in Rehab, LTC.

Psych consult ever been done? If not, get a referral for one.

Then keep copies of your incident reports. Report your facilities lack of concern for staff to your professional association (if you have one).

Finally, if all else fails, take your copies of the incident reports and check with the local police detachment and see if you can file assault charges. I know of a few nurses who have managed to press charges against patients from hell.

Psych consult has never been done. She is private pay and the family is in denial and doesn't think she needs a consult. When they are told about what their mother has done they laugh and say "no, she would never do that!" They even take her out to get her nails done to keep them nice and long and sharp! We have been strictly been told not to cut her nails. The facility is too chicken to stand up to them. I have pictures on my phone of the scratches and bruises she has put on me.

snoopy29

Specializes in A and E, Medicine, Surgery.

I believe that mental capacity is all important here.

If a patient that lashes out is assessed as lacking mental capacity through for example alzheimers or head injury then the care facility has a duty of care to the patient, other patients and staff to have a robust care plan that gives guidance on how their behaviour can be safely managed.

If a patient has capacity and chooses to hit you then this is assault and a criminal matter.

I would simply ask my managers which model your patient fitted into - if they then don't act you have evidence that they are failing to protect.

miss81, BSN, RN

Specializes in Surgery, Tele, OB, Peds,ED-True Float RN. Has 8 years experience.

We had a psych patient do this to the nurses on our Mental Health Unit for years and the Psychologist (who thinks these ppl are his children) told them that they can't do a thing about it 'cause the patient can't "learn" from any "consequences" that punishment might bring. The pt ended up moving to his own house with "workers." The first week he was there he pulled this **** with them and he ended up in jail. Just goes to show Nurses put up with a lot of crap that we really shouldn't!

KalipsoRed

Specializes in Telemetry. Has 3 years experience.

I think it's obvious...get a new job, no one at your facility sounds like they are going to help you. When you find a new job post every where you can what a horrible work enviornment your current job is for nurses so no one else has to put up with that crap. Private pay or not, if there are enough incident reports and pictures to back up your story the manager should go to the family and put down the law: "Psych consult or find her another home. We are here to care for her, not get abused."

wishinguponastarLPN

Specializes in Rehab, LTC.

I think it's obvious...get a new job, no one at your facility sounds like they are going to help you. When you find a new job post every where you can what a horrible work enviornment your current job is for nurses so no one else has to put up with that crap. Private pay or not, if there are enough incident reports and pictures to back up your story the manager should go to the family and put down the law: "Psych consult or find her another home. We are here to care for her, not get abused."

I'm hoping to hear back today about an interview then I'm getting the heck outta there!

Rob72, ASN, RN

Specializes in Infectious Disease, Neuro, Research.

Definitely a difference in perspectives here. I've given a psych pt a full-bore elbow strike between the eyes to keep from being bitten. I do not/have not worked in an LTC, though I've had many pts from them.

1) You do not have to "put up" with much of anything. Sorry, State Codes supercede facility policy, within certain limitations. Fundamentally, if the individual is aware, any level of force required to stop the assault is appropriate. Learning effective and appropriate ways to deliver that force is key.

2) "Endangerment" is your friend. If violence is a concern in the workplace, spend $50-100 for a retainer/consult, and talk with an attorney.

Your hands are your friends, as is distance. If someone is close enough to slap you, they are too close. Personally, I'm not their significant other, teddy bear or biach, if they want to be close enough to grope & cuddle, their needs will remain unfulfilled. If you must be close, learn to use your arms and hands as a shield. The Karate Kid "wax-on-wax-off" sweep works beautifully against grabs and slaps, and it is in no way assaultive.

I'm aware of the new psych paradigm of "allowing expression". It is espoused by those who self-stimulate with Brillo-pads and steel wool and those who do not directly deal with violence. Violent personalities are restrained by the threat (and appropriate application) of superior force. Period. End of story. Violence is an endorphine and catecholemine releasing state/activity. These people are getting high. When pain exceeds the pleasure, they will stop. I'm speaking in very generalized terms, here, not referencing dementia, psychotic states, or self-destructive behaviors.

I feel your pain, I truly do. I have been trying to get my facility's admin to understand that just because we are caregivers and that our residents have Dementia and/or Alzheimer's doesn't mean we don't have rights and shouldn't be abused by them. There is one resident I struggle with right now. Every time I toilet him (especially at night), he grabs my wrists, bends my fingers back and/or slaps me in the ear. I can handle quite a bit of abuse but when it comes to being physically hit NO! I understand he can't help it because that's where his mind is at but it doesn't mean I should HAVE to be subjected to it either without something put in place to help the issues. This isn't a frail man either; he is a big guy and very strong. I'm at a loss on what to do.

Edited by J3000