"I'm going to smash your face in"

[jannjul76]

My unit is a open unit with 10 hospital beds in the ER separated only by curtains (think an old fashioned hospital ward) and is staffed by two nurses and a paramedic. We provide patient care to admitted patients while they wait for an inpatient bed to become available. We are a Level 1 trauma center and have about 120,000 ER visits a year even though the physical space was meant to accommodate about 45,000 ER visits a year. There are plans for expansion but for the meantime there is major overcrowding. The hospital has been so busy lately that some patients have to wait days instead of hours to get a room depending on the floor they are assigned. Our unit is small, only has one communal bathroom, and has no television for the patients. Simply put, it is a chaotic, stressful environment.

One night, the two nurses on duty, were both stressed from the work environment and started getting more and more irritated with each other. It escalated to the point that one nurse was yelling insults at the other nurse in front of all the patients and family members. Then that same nurse threatened the other nurse saying , "I'm going to smash your face in" in front of all the patients and family members. After a few more words were exchanged with each other the nurse making the threat called the assistant nurse manager (who was charge nurse that night) and told the manager "You better get over here before I knock the other nurse out." Even in front of the nurse manager, the nurse was yelling at the other nurse and repeated that she would "smash her face in." After being told to stop fighting and threatening by the manager, the two nurses were sent back to the unit to finish out the shift (there was about an hour left in the shift.)

A few days after the incident, I worked with the nurse who had made the threats and she happily repeated to me how she threatened the other nurse twice with one time being in front of the assistant nurse manager and that management hasn't talked to her any further about the incident. She went on to say that she "has a bad temper" and if she worked with that nurse again she would "knock her out" if she got angry enough. From the first day the nurse has started, she has repeated several times that she has a bad temper and has the attitude that aggressive behavior is justified because of the fact that she has a bad temper.

I felt obligated to tell my managers about the conversation I had with the nurse who made the threats especially since the two nurses were scheduled to work together in a few days. The managers listened to my concerns and indicated that they would schedule a meeting with both nurses. However, the day before they were scheduled to work together, the meeting still hadn't occurred so the nurse who had been threatened expressed her concerns about working with the nurse again because nothing had been resolved. In fact, the nurse who made the threats was telling other nurses about the threat she made (almost in a bragging way) and that she hadn't been reprimanded by management since the incident happened. In response to the nurse's concerns (the nurse who was threatened) the manager told the nurse "just don't start anything and try to ignore her".

The nurse who was threatened ended up calling in sick the nights they were scheduled to work together and the situation still hasn't been resolved. On the new schedule that just came out management still has the two nurses scheduled together on various shifts.

I feel management's lack of response appears like they are condoning violence and intimidation in the workplace and their "let's hope nothing bad happens attitude" isn't

providing a safe work environment for the staff and patients.

[Altra, BSN, RN]

It is possible that management is indeed in the process of dealing with this - gathering accounts from those who may have witnessed the verbal exchange, getting legal & HR depts. to sign off on planned discipline/termination, etc.

But on the surface, based on what you have written here ... it appears that your management is incredibly stupid.

[jannjul76]

Thanks for your feedback. Even if they are in the process isn't it irresponsible to have them work together when they have been told that the nurse is still talking about violence

[imintrouble, BSN, RN]

Workplace violence is a big thing where I work. It's unimaginable to me that management would ignore a nurse who threatened violence.

I'll agree with the "incredibly stupid" answer.

[monkeybug]

I worked for years with a dear, sweet nurse who, well, just wasn't right, as we say here in the South. If the unit was peaceful and all the planets aligned correctly, she was a joy to be around. If something went wrong (and often whatever was wrong wasn't apparent to the rest of us), then she would simply lose it. She also had it out for a coworker. She was convinced that Suzy Coworker hated her and was out to get her. Suzy actually only started to dislike her after years of weird behavior by the nurse in question, let's call her Baby Jane. In the years I was there, I personally heard Baby Jane threaten to bring a gun to the unit more than once. She would begin screaming at the least provocation. If the unit got stressful, and it often did, then we were in for an even worse day because we had to tiptoe around her. Management was repeatedly made aware of her comments and behaviors. After one paranoid outburst that included a suicide threat and a threat to get a gun, Coworker Suzy left our unit. We lost an awesome nurse. I was appalled at how little was done. She stormed out of a mandatory class after screaming looney bird stuff and threatened to get a gun, and she was sent to Employee Assistance. Not long after that, she said on the unit that she should just bring a gun. I promptly went to the manager. She was sent to Employee Assistance again, once, and then was back on the unit. In all seriousness, many of us had plans for what to do if she did bring a gun--hiding places, escape routes, etc. We were told, "You can't force someone to get help." I became even more upset when I learned that none of this was new. Years before most of us arrived on the unit, she acted out part of a suicide threat on the unit. She was supposedly taken straight from the unit to the psych ward, and a week later was back caring for patients.

I'm not saying that someone who is suicidal should not be allowed to work, not at all! It was the threats to bring firearms (that we knew she owned) and the vendetta against Suzy that had us all concerned. We all breathed a sigh of relief when she retired. And while most of the recent retirees came back to work float, she was not offered that option. So I guess management finally did something. We all wanted the best for her, we all liked her, some of us probably even loved her, but she made work very unpleasant and unsettled. I wouldn't hold my breath on management doing much, unless the threatened nurse makes a big stink, and the one being threatened is seen as more valuable.

[Esme12, ASN, BSN, RN]

Your management is spineless or desperate for nurses. I would NEVER tolerate that kind of exchange...EVER. I would tell management that you are not comfortable with this....I would ask to speak with HR....or make a report to corporate compliance.

[Here.I.Stand, BSN, RN]

Oh, no. No, no, no. In WHAT other situation would making threats like that be acceptable? In a bar, between a couple? WHY, in whose reality, would that be even CLOSE to being ok in the workplace??

Rant over. Seriously that is way beyond strong personalities in a pressure cooker. I would be seriously concerned about safety.

If it was me getting threatened and that woman wasn't gone YESTERDAY, I would be involving law enforcement. (That is, if HR is involved and also not doing anything. If not, I'd start there. HR is likely less concerned about retaining her warm body than the unit manager is.) I would also notify the BON that I'm concerned about this person's competence to practice. Actually you could make the latter report if you're inclined, I think...in my state anyway, you can report impaired professionals anonymously. It sounds like she had plenty of witnesses during the initial fight; I'm sure the concerned party could be any one of many... wink, wink...

[Emergent, RN]

The joint commission is coming down on this sort of hostile work environment, and rightfully so. Legally, I think the threat to do bodily harm is a crime, isn't it? I was taught in nursing school that threatening violence is considered assault.

I think the object of these threats needs to contact the police. It sounds like the hospital is sweeping this under the rug.

[KRVRN, BSN, RN]

It is possible that management is indeed in the process of dealing with this - gathering accounts from those who may have witnessed the verbal exchange, getting legal & HR depts. to sign off on planned discipline/termination, etc.

But on the surface, based on what you have written here ... it appears that your management is incredibly stupid.

I agree that this may be what management is doing. But there are certain offenses that are way up the naughtiness scale. Specific verbal threats are usually right up there with actual physical attacks and sexual harrassment with contact. I also agree that management is incredibly stupid. This was even witnessed by management, this indivudual should have been terminated on the spot. Escorted out by security and police called if not cooperative.

[martymoose, BSN, RN]

my thought is they are desperate for nurses.

As op stated-the area is being utilized way over capacity, the nurses are more stressed out than not, etc.

I'm sure they have a high turnover rate.

And weak mgmt.

[elkpark]

Wow, anyplace I've ever worked, that kind of behavior would be grounds for termination, without a lot of questions being asked.

[HappyWife77, BSN, RN]

She blantantly assaulted her co-worker in front of patients, families other co-workers....and continues to run her mouth with threats?

Call the police. Something needs addressed asap.