rough night

[getoverit, BSN, RN, EMT-P]

The other night we had a man emergently transferred to our unit for hypotension and altered mental status. He got a SC triple lumen cath and started on dopamine. I was looking at the remote tele monitor when one of my co-workers started screaming. The patient had her by the hair and was kicking her in the ribs, so I run over to them and stop him. He started struggling with me, then spit dead in my face (not once but twice). Then he grabs the SC cath and starts to yank it out (with dopamine and ivf running). I grabbed the catheter right before he broke the luer lock. As I was telling him to relax, he clawed me across the left side of my face and opened it up. Long, filthy fingernails that were like talons. I thought he'd just knocked my glasses off but then a co-worker started rubbing betadine on it and I realized what had actually happened.

It was myself and 4 female nurses (who he also repeatedly tried to bite them whenever they were near) at work that night. When I got home I thought about what if he had clawed one of the girls' face? I didn't need stitches or anything and now all the guys I work with rag on me, telling me I need to wear a helmet or bringing me a hockey mask....which is great and I love kidding around. But the bottom line is that I'm glad I was the one close enough to get hurt because I can't imagine how bad it would be and how angry I would've gotten if he had done that to one of the female nurses.

I guess my point is: stay alert and safe because you never know what's going to happen next. Thanks for reading.

[jessiern, BSN, RN]

Yep, sometimes we forget how dangerous this job can be. Been assualted by patients in the past myself. Sorry you had such a terrible night, and hopefully he'll be transfered or discharged by your next shift :)

[ukstudent]

In your post there is no mention of the nursing supervisor or security being called. Hopefully both were. Also, the police should have been called and the patient charged with assault and battery.

Can you imagine that if this took place in say McDonald's, that the corporation would just expect their workers to take it. No, management would be the ones calling the police.

[Boba Fett]

I work nights on a unit where i am the only male 95% of the time. I often fear that a patient will attack one of the other nurses or staff and i will end up hurting a patient to save one of my co-workers. Im sure it will result in an almost instant termination, but the safety and lives of my co-workers comes before any patient. At 3am it can take security a few min to show up. Thats a lot of time for serious things to happen.

[DogWmn]

Glad you were there, saftey with beligerent patients is a huge problem that is often swept under the rug.

Many years ago, I was in the ED of a small hospital to help when a wreck came in, one guy was really nasty and the surgeon oredered us to duct tape him to the table because he broke out of light cloth restraints:eek:. Let me tell yah I became a real fan of duct tape after that:D. I'm sure in this day and age that would never happen but man that stuff worked grrreeaaat...LOL. That surgeon had been a combat surgeon in Vietnam and was into protecting the staff and using anything at hand that worked.

[cookienay]

So let me ask this...after he beat up the nurses, did he still require dopamine?? I know a good fistfight always raises my BP.

Anyway, glad you were there. Good to see chivalry is not dead! Glad it is not dead where I work either.

and to ukstudent- although the OP did not really specify, it is entirely possible that the patient was unaware or not in control of his behavior. The worst beating a colleague of mine received was from a 115 pound 70 year old lady with Alzheimer's. Needless to say, we did not notify the police.

[getoverit, BSN, RN, EMT-P]

Thanks everyone for your responses, I appreciate it.

I didn't mention the "after-action" report because I thought it was immaterial, but yeah I filed a report only to get him flagged as an assailant. I wanted to avoid another nurse admitting him in the future and being caught off-guard if he decided to fight again.

I didn't think it was necessary to charge him with anything. Two days after he assaulted us, he went into respiratory failure and was subsequently intubated. He had a beard that hung down to his belt buckle and we took great pleasure in meticulously shaving him and cutting his nails down to the quick.

He got a trach yesterday, they're considering a PEG. Despite what he did, I think it's too bad that he's going out like this.

[getoverit, BSN, RN, EMT-P]

I work nights on a unit where i am the only male 95% of the time. I often fear that a patient will attack one of the other nurses or staff and i will end up hurting a patient to save one of my co-workers. Im sure it will result in an almost instant termination, but the safety and lives of my co-workers comes before any patient. At 3am it can take security a few min to show up. Thats a lot of time for serious things to happen.

You're probably right about the "instant termination". In 18 years I can't count how many times a situation has flared up all of a sudden, the thing to keep in mind is that unless your life is truly in danger it's never okay to hurt someone. All a legal counsel would have to ask is "could you have avoided injuring the patient?" At least 99.99% of the time the answer is yes, and that's all management will need to know in order to make a decision about your employment.

Like you say, 3am can take awhile for security to show up and serious things can happen. You pretty much have to either isolate or physically restrain someone until they get there, but if the patient is injured in the process then you have a much worse predicament than you did before. One of my co-workers said it would be nice to have a Taser.....but that might be too much temptation sometimes.....

Take care and stay safe.