Pressing charges on a psych patient?

ImThatGuy, BSN, RN · Dec 30, 2010

Thank you for the last two posts and bringing it back to the topic at hand regarding my initial post as well as answering my questions.
The psych pt that attacked my co worker (non-nurse) and "gave" him a broken nose was totally out of touch with reality (paranoid schizophrenic). The pt spoke some english, but even when we did have an interpreter the pt's speech and thought process was very disorganized. He was highly unpredictable--smiling one minute and literally the next would attack you.
No police report was filed (as far as I'm aware of), but my question was a general one--I wanted to know if it was possible or possible but "silly" to file a report on an assaultive psych pt since this topic was never brought up in nursing school and even working a year in a psych unit, I've never heard of anyone talk about it. All I know is that my DON told me that they had a nurse quit because of a pt (due to a similar issue) and she didn't want to see that happen to me....although not much was done to improve the situation. The pt was 1:1, but we hardly ever had an extra CNA to be a sitter...and of course they would be afraid to even get near the pt, plus we don't always have a male staff during our shift--it's usually just a bunch of petite women as staff.
Ever since the broken-nose incident, the pt didn't show any other aggressive signs, but then again we all made sure to keep a good distance away from the pt so he couldn't attack us. Since many of our pts are frequent-flyers, I would not be surprised to see this pt again and I would like to bet that the pt will be back within the next 4 months (it only took about 3 months before the pt was re-admitted to our facility because of the same **** issue).

If this happened to you then yes you could in fact contact the police for a report or fill out an affidavit. Like I said in my above post that doesn't mean anything will necessarily be done about it, but the documentation is there. Again, for whoever reads this, refer to my above post. In all honesty, the chances are slim to none that the prosecutor would refer charges.

I dated a cute, petite girl...(reflective pause)...for a while who worked in a mental health clinic, and all of the employees there had been trained in some self-defense tactics that could be utilized to fend someone off without doing serious harm to them. They practiced them as a group every few months as well, and she could in fact use them. I experienced them firsthand, lol.

For all readers, if you want to know the true answer to this then contact your local prosecutor's office. Many of you will call that the DA or district attorney. Even calling the police is unlikely to result in a satisfactory answer to your question. If you're that interested call the prosecutor, ask to speak to someone about an issue, and then say for the protection of yourself and your colleagues what avenues could you and they take after being assaulted (here battered) by patients be they competent or incompetent. I'd have no reservations about doing that if I were in your shoes. Just do it one day when you're off. Don't mention it to your supervisor, risk manager, or general counsel. It's nothing secretive, but to protect the organization you may get a shovel full of **** answers to assuage your concerns that don't in fact amount to any truth.

Quark09 · Dec 30, 2010

I wanted to know if it was possible or possible but "silly" to file a report on an assaultive psych pt since this topic was never brought up in nursing school and even working a year in a psych unit, I've never heard of anyone talk about it.

I would never think this was silly. As previous posters have written, you can make the report and then leave it in the hands of the court system as to whether it's pursued. Now, if (as another poster had written) it was a 79-year old dementia patient who attacked - I would likely think twice; there would not be a lesson to learn, or really any precedent set regarding a pattern of behavior that could be established for the purpose of moving them to another, more security-conscious facility. However, if this were a 24-year old patient with, say manic-depressive disorder, or borderline personality disorder, etc. etc. then yes, I'd say there needs to be a legal trail set so that should the behavior escalate, it's not only medically documented but in the legal system as well.

limestone · Jan 5, 2011

On our unit it is a team decision.

Team takes into account the pt's mental status, behaviour patterns, and the usefulness of pressing a charge in the context of the patient's management and treatment.

On our acute care psychiatric unit, staff know the risks of the job and acccept that assaults cannnot be taken personally. We expect empathy from our team, support from administration, and appropriate debriefing/ care of the injury if warranted; but we do not react personally to an assault.

The goal is management of the assault that will result in the healing of the victim, improvement of approaches to safety, and appropriate management of the patient.

MHSA LPN · Jan 5, 2011

From a legal perspective, you assume certain risks when you become a psych nurse, so it would be futile to press charges, unless the patient has been proven to be faking his/her condition.

Dawn Gloves · Jan 5, 2011

I hear you loud and clear! I am looking at a bite mark on my forearm with a huge bruise around it from a geriatric psych patient. It is my understanding that because they are on a mental health unit, charges cannot be laid. (This is from a police officer). I feel that if it is behavioural, that there should be some consequences. On the other hand, if it is not behavioural, and the patient is having a psychotic break, etc., that charges would not be appropriate. I always feel differently when I know it's not intentional. It sucks being assaulted by any patient, on any type of unit....I never get why people hurt the people who are trying to help them!!

nanadeb · Jan 5, 2011

Looking back to my ER days, I was assaulted more than once in 18 yrs. WIsh I would have reported them. I would report it now if I had it to do all over again. No matter what, you have a right to a safe work environment. I would also fill out an employee incident form and been seen by my PCP or in the ER. You can't protect yourself enough. If it's not reported, you can't claim workers comp in the event an injury shows up later as a result of the assault.

mstutz0201 · Jan 5, 2011

I agree that all assaults should be reported to the police to establish a pattern of violence. My daughter works with developmentally delayed and/or mentally ill adults who get in trouble with the criminal justice system. The first thing they look for is an established pattern of violence in order to determine how to proceed with the case. This is also taken into consideration when determining appropriate placement. Just because someone is "being evaluated" on a psych unit does not mean that the person is, in fact, mentally ill. And just because someone is mentally ill does not mean that they cannot understand the potential effect of their actions. The criminal justice system exists for a reason; let them do their part of the job!

vikki03,RN · Jan 10, 2011

:nurse:my question is- what do you do when you work in long term care and an elderly man slaps you in the face for backing his wheelchair away from a doorway, and when you report it to your don, she says nothing?!?! how do you handle this further? he was not confused, disoriented, or in any other state of mind that would have indicated that he was agitated in any way.

this is not the first situation with this man and, before he was hospitalized and subsequently passed away, he hit an stna so hard he broke her nose. that situation was not addressed either, and she is currently attempting to get her medical bills covered by bwc, but the facilty is doing its best to block that. (and yes, i am actively seeking other employment!!) :confused:

BabyLady, BSN, RN · Jan 13, 2011

I was just wondering if it is possible (or silly/ right/wrong) to press assault charges on a psych patient on a psych unit?
I work on a gero-psych unit and have been assaulted some time ago and not too long ago a coworker got a broken nose from getting punched by that same pt...
I am just curious if it's possible to press charges on the pt or because the pt is being evaluated and treated in a psych unit that it would be pointless or deemed silly since that's the reason the pt was admitted in the first place...?
And btw, although my unit is technically "psych" we are not stricly psych-- we allow IV poles and call lights w/wires (which has been used as potential weapons several times), although we don't allow knives, we do allow forks and don't count utensils post meal, etc.

I would wager you would have some issues centered around the patient being mentally competent to understand his/her actions.

It would give the patient one heck of a case in court, considering they have an admission to a psych ward to back up their claim.

I do not advocate nurses pressing charges against patients in psych facilities...ever. To me, that is the risk of working with the patient population...if they were in control of themselves, then they wouldn't be admitted.

Little_Mouse · Jan 14, 2011

I do not advocate nurses pressing charges against patients in psych facilities...ever. To me, that is the risk of working with the patient population...if they were in control of themselves, then they wouldn't be admitted.

Those were my thoughts exactly.

sambani · Jul 14, 2011

Wow, you sure do trust attorneys justa little too much. Ever sit on a big trial or do grand jury? If/when you do, you might change your mind a little bit.

I dont think he would change his mind too soon!

caregiver1977 · Jul 14, 2011

What if a person isn't really aware of what they are doing (having a seizure, reaction to prescription meds)? Should you press charges then? Is it fair for a person to end up with a criminal record when they are truly sick?

I am not talking about people who are mentally competent who are just mean, frustrated, etc.