Scared of dealing with violent patients

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Hello everyone,

I've entered nursing school with a passion for caring for others after taking care of my dad who passed away from cancer. I've done a lot of the "dirty" work involved in nursing. I can deal with vomit, urine, fecal matter, trachs, etc. One thing that really scares me is the violent patients. I hear many stories about being bitten, strangled, etc. I fear being injured on the job & losing my career. Does anyone have any insight on this?

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Not every area of the hospital has violent patient populations. You can also work outside the hospital setting.

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Specializes in Critical Care, Education.

I agree, those stories are horrible and no sane person would ever knowingly put themselves into that type of situation. But - those events are very rare - that's exactly the reason they make the headlines.

As a clinician, you become very expert at assessing your patients. This includes emotional as well as physical factors. Nurses who work with emotionally labile patients are trained to quickly identify the signs and symptoms of potential violence and take appropriate actions.

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That bothered me too before, I'm sure you will learn to deal with them as you go along...and violent/difficult patient is not really that common...well at least in my case

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I have encountered a few violent patients in hospital settings. I've worked in many many settings, and i personally have only encountered violent patients in hospitals.

The bulk of this small group i desribe, were head-injury or neuro patients, or dementia patients, etc, not like 'normal' people who were just honked off, but people who were not in their right mind. I got slapped more on the neuro units i worked, than i ever did in the ER.

Was not often, though, at all.

A few things to comfort you:

Such patients are usually easy to spot and once it is known, that Mr Jones will grab at you if you touch him, we develop care plans and safety plans to prevent anyone being grabbed by Mr Jones, and never send in just one nurse to do anything with Mr Jones.

You are not alone. You will have experienced staffers all around, within shouting distance (IF it ever ever gets to that) or usually, directly beside you.

Every hospital has security staff, who are almost invariably most adept at securing whoever or whatever.

but most importantly, it's rare. Some areas might be way less prone to this, than others.

Like, Outpatient surgery centers, almost never ever get anyone violent, as those are usually planned, screened patients who are there voluntarily.

and sometimes, it's even funny-ish. ONce, long ago, me and my favorite sidekick, CNA Tillie, were doing rounds together, and my itty bitty, teeny tiny 90 year old demented lady, was, frankly, being ignored as Tille and I chatted while we turned her, etc. (mistake, probably)

Now, i am squatting down, on balls of my feet, emptying patients foley bag into a container to measure her urine,

and Tillie is on other side of bed, and has her back to me, as she is writing something down.

That lil sneaky patient, was watching me, and took her little tiny bony leg, and positioned it juuuuust so,

and stuck her lil bony leg out between the side rails, and kicked me.

Now, it was NOT a hard kick,

but, i was up on the balls of my feet, squatting down, so i got knocked completely over. Only thing that got hurt, was my pride, ha ha!!

Yes, that's right, an 80 lb 90 year older had me lying flat out on the floor!! :roflmao:When Tillie turned around, and saw me laying on the floor, the two of us busted out laughing so so hard, we startled the poor patient. "Jean, this is no time or place to be taking a nap! Now come on!" and on and on, teasing me whole rest of the shift.

and yes, luckily, i HAD clipped the foley bag shut again, and did not spill the urine in the container, either, whew, right?

okay, i have other stories that weren't as funny as a teeny tinY ol lady decking her nurse completely onto the floor, but, that one was funny.

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Specializes in Short Term/Skilled.

I have dealt with my fair share of combative patients, although they've always been demented. At my hospital we have a code word that we yell out and the nearest person will call it over head. When its heard, all the males (sexist, right?) including security are supposed to show up. That being said.....i've never had to call one. The CNAs (like me :)) are usually more at risk because they are doing more hands on care, if that makes you feel any better. Also, its only happened a few times.

One little lady had such severe dementia she would completely zone out. If you caught her just right she would be sweet as pie, calling you "darling" well, if you went to take off her clothes.....FORGET IT. She would try to bite you, slap you, put you in a head lock. The only saving grace was she had no use of her legs so she couldn't stand up to beat us. We found ways to get it done. One of us would hold her hands and keep her occupied while the other started on getting her undressed. We wouldn't hold them tight, just enought so we went with her and kept her from smacking us. Always, always take someone with you if you know the patient is combative. ALWAYS. To tell you the truth, I thought I'd have a hard time with this kind of thing, but as it turns out I didn't mind one bit. I know she wasn't herself. She didn't know we weren't trying to hurt her, etc. I would still give her a kiss goodnight (while keeping my hands on top of hers so I could tell if she was about to get mad) Usually at that point she would say "Goodnight darlin, I love you" So worth it.

I promise you'll get through it. As others have said, unless you work on a psych unit it really is few and far between. Most regular floors wont tolerate someone who is A&O being violent.

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Specializes in Short Term/Skilled.
I have encountered a few violent patients in hospital settings.

Yes, that's right, an 80 lb 90 year older had me lying flat out on the floor!! :roflmao:When Tillie turned around, and saw me laying on the floor, the two of us busted out laughing so so hard, we startled the poor patient. "Jean, this is no time or place to be taking a nap! Now come on!" and on and on, teasing me whole rest of the shift.

and yes, luckily, i HAD clipped the foley bag shut again, and did not spill the urine in the container, either, whew, right?

okay, i have other stories that weren't as funny as a teeny tinY ol lady decking her nurse completely onto the floor, but, that one was funny.

I love it. :-p For some reason I just freaking LOVE old demented people.

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I love it. :-p For some reason I just freaking LOVE old demented people.

THIS really was hilarious, you might have had to BE there, to see this extremely tiny old old woman, and the nurse laid out onto the floor,

but, we laffed about it all shift....

also---the cunning involved there, the precision with moving her old bony leg, kinda amazing, really, we'd been underestimating her!! rofl!

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Advice: Never, never reach over a stretcher to get to the other side when the patient is within bite-the-tit range. Do not ask me how painful it was to learn that. :mask:

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I get really stressed and scared when dealing with combative patients. When I started nursing I knew this was a risk I would have to take. However, one day a patient kicked me extremly hard on the chin, I didn't even see it coming. I was so traumatized that I had panic attacks knowing that I would have to care for him the next day at work.

This patient was smiling in my face and the next minute he kicked me. He was a demented resident at an ALF I worked at. So sometimes it is hard to tell when they are getting agitated.

When you do see that the patient is growing more and more agitated, I always make sure I'm a priority and I'm safe. I usually create space between me and the patient and call for help. I never argue with the patient or touch them. Always have someone with you. Never close the door and make sure you have a clear way to exit. This is part of the reason I couldn't do the ED. Almost every night I had to call security or for back up.

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I too worried a little bit about this at first. In nursing schoool and now 13 months working in downtown Detroit, it has yet to happen.

Also when I was sitting for almost two years, with some reallyyyy wacky pt's, it didn't happen beyond maybe some minor scratches or something from an old lady or two. I think the more you are calm, not scarred, don't take things personally, the more a situation won't escalate.

That being said you do have to keep your wits about you, bc I have heard some crazy stories. And it might help I'm a very tall, if not skinny, young male.

The good news is that it is rare, unless maybe if you work in the ER :)

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Also nothing wrong with medication, that is ordered for this reason.

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