Pt took a swing at me today!

[FroggyMama]

OK, get report, start the day by giving morning insulins as the trays come. Walk into pt's rm, knock loudly, call his name, no response. Get closer to bed, call name again, pt jumps up, cussing and screaming, and tries to backhand me in the face!!! I jump back, he keeps cussing, and all heck breaks loose. Loooong story short, he walks AMA. AAAArrrrrrgggghhhh!!!!!!

So when did nurses become punching bags for freaks? I swear he was a meth head. All the more fun. I am soooo tired of this crap! Supervisor was good, she said if he touched me she'd call the cops, but dang! Not the way I wanted to start a 12hr shift! I had enough adrenaline, it would have been a very very bad thing if he would have hit me. I'd be in jail.

And that's the thing--they can do whatever they want to us, and we have to take it. We can't even defend ourselves! WE turn into the bad guy if we practice self defense! Why oh why didn't I go to law school or something??!? Maybe been an accountant???

[deeDawntee, RN]

I am soooo sorry that happened to you. It is really shocking isn't it? And for me when those things have happened it is amazing to me just how that "fight or flight" response comes up immediately. (really more of the fight response!) Just know, that it is a normal response and those feelings are there for your survival, however, we as nurses, cannot follow our reactions, but must respond as professionals.

I hope you have coworkers with whom you can vent. I think it is important to express those feelings so that you can continue to react as a professional. Vent away!!!!

:icon_hug:

[AirforceRN, RN]

Unless I'm mistaken...

There is no law/rule that can stop you from defending yourself if you feel your life is being threatened.

[jeepgirl, LPN, NP]

maybe he was PTSD

[JustaGypsy]

My thoughts exactly... Who says we cannot defend ourselves? A couple small key moves that won't maim but will subdue are a MUST in my daily toolbox...

[flightnurse2b, LPN]

im so sorry this happened to you. i was helping a patient get OOB once and he lost it. he got me down on the floor and had his hands around my throat and started to choke me. he was neurologically impaired, but never the less my life was in danger and i couldn't breathe. another tech was walking by the room and started yelling for help. they were finally able to get him off me after the security guard punched him in the face... and HE got in deep doo for that one. but it was ok that the man almost killed me. hmph.

[Virgo_RN, BSN, RN]

This kind of stuff does happen, and it can sure take you by surprise. I remember when the sweet LOL I had cared for, who had once told me I was her favorite (she probably told that to all her caregivers, LOL), tried to gouge my eyeballs out simply for checking her undergarment. One day she recognized me, and the next, she didn't, and I was caught off guard.

People lash out physically when they feel threatened. It sounds like your patient's fight or flight reflex was activated. It's not necessarily anything you did wrong, but probably his disease process combined with the abrupt awakening gave him an adrenaline rush.

I've had patients with PTSD who practically hit the ceiling when you wake them, no matter how gently you try to do it. Once they realize it's just me, and I'm there to give them their cholesterol pill, they calm right down. But someone going through ETOH or other drug withdrawal, or perhaps too much ammonia in their blood, or with a brain tumor, or ICP from some other cause, might not be able to calm themselves down without some help.

[JBudd, MSN]

Who the heck says you can't defend yourself? I've used Hopkido or Tae Kwon Do moves several times to either avoid or turn a blow, or apply pressure to keep an arm down. No, I haven't chopped, punched or kicked anybody, the only things I've broken are boards and the doorjamb (at home). There are a lot of subtle martial art techniques to use.

Try a Hopkido course, for self defense. Handshake techniques are great, and don't leave marks or permanent harm. Not to mention its a good exercise class :heartbeat

In the meantime, there are several rules for being safe:

-Never let the patient get between you and the door.

-If someone gets aggresive, back out of the room and don't go back in without reenforcement.

-Don't wear things around your neck that can be used to choke you (like badge holders in those plastic thingies, unless there is a quick release buckle in it).

My stethescope is on a holder on my waist, not my neck (most of the time).

-If they do grab you, start screaming or yelling LET GO loudly, and get help in there fast. Sometimes the screaming is enough to make them let go. If you can't scream, poke for the eyes, don't waste time trying to pull hands off (unless you know some really good techniques of course :) )

And by the way, swinging at you in the first place is enough reason to call the cops. Gets it on record he has a history of violence toward health care pros. In my state, the threat alone is a misdemeanor, goes up to 4th degree felony if he threatens to kill you or your family. Actually connecting goes up the felony list. If he was competent enough to leave AMA, he is competent enough to know better than to swing.

[talaxandra]

I've been kicked, slapped, scratched, spat on nad punched in the jaw. A friend was hit so hard in the face that the prone patient (a malevolent expletive with a stroke) ended up on the floor and she had to have x-rays for a ?# orbit. A colleague on another ward was knocked unconscious with an IV pole by a psych patient. Another reached out after a confused post-op patient who'd thrown a chair through his window and crept out onto the balcony, five stroreys above the ground - he grabbed her wrist and pulled it down and out through a shard of glass, cutting her from wrist to elbow to the bone.

All these incidents are more than a decade old - violence against nurses is long-standing and under-reported. In response to nursing concerns my hospital initiated an aggression management program that includes: paid-time staff education sessions on aggression management; a no-tolerance attitude; increased security; an emergency code for aggression and threatened violence (including shouting and swearing) from patients, visitors or staff; and another for actual aggression or a weapon. Just hearing code greys being called has increased awareness of the frequency of violence toward (primarily) nurses hospital-wide, encouraging staff to feel comfortable calling a code grey if they are threatened.

I agree that anti-social behaviour seems to be increasing, but I hear fewer code greys now than I used to - I think this is because the public are learning that nurses here aren't soft targets anymore.

[canoehead, BSN, RN]

My thoughts exactly... Who says we cannot defend ourselves? A couple small key moves that won't maim but will subdue are a MUST in my daily toolbox...

Care to share?

[FroggyMama]

Yeah, the part that kills me is he was young, not THAT sick (no labs or anything to explain behavior--all was WNL), totally alert and KNEW what he was doing. I've been hit enough by old confused people that doesn't even phase me, but to be purposely thrown a punch at by an alert person.....:angryfire:

And when I told my hubby what happened later, his response was "What was his name and where does he live." Oh, good thing for HIPPA, or he'd be in jail now too! :trout: (Yes, just kidding, I wouldn't really tell him)

[locolorenzo22, BSN, RN]

I work on a detox floor, so I know never to argue with anyone...and I am just firm...and I knock loudly before I enter, and speak loudly when I'm trying to introduce myself to them.

But, I did get punched in the face by a LOM who did not like the fact that I didn't have "ahem" bosoms for him to grope while we were changing him....