Slapped across the face by male patient

[noyesno]

Here's what happened, I'm so upset:

I went into my patient's room to introduce myself. It looked like he needed a boost and the PCT was in the room. I smiled at him and said, "cross your arms," while demonstrating what he should do. Instead of crossing him arms, he took a full swing at me and slapped me across my face as hard as he could. It hurt really bad and even left a mark on my face. I ran out of the room in tears. I filled out an incident report with the manager and we notified the nursing supervisor. They asked if I wanted to go to the ED but I declined.

He did not speak English so it's hard to say if he's completely alert and oriented and everyone just assumes he's confused. I looked at the physician notes on admission and it did say he was alert and oriented times 3. No history of dementia was noted. We called the family and they stated, "he did this all the time at the nursing home." That makes me so angry. Abuse like this should never be tolerated.

Should I have called the police? I've read about nurses pressing charges for things like this. When I mentioned it, everyone acted like I was crazy.

What do you guys think?

[USNavyCorpsman]

A police report documents the attack. It allows action to be taken that may prevent injury to another nurse or hospital staff person. In the many years of being a psych nurse, working the Emergency Department and several state hospitals and prisons...I've been attacked only one time. At a medical hospital. And I did not report it to the police. This man kicked another nurse in her abdomen and put her off work over 6 months. Had I reported the incident to the police, there's a chance this man would have been in custody and that other nurse would not have been hurt.

Action must be taken by the hospital to protect the staff. The incident should have been reviewed by management and if there is a mental disorder, it needs to be delt with. Or another nurse will be attacked again.

So I vote for the police report.

[JZ_RN]

I would file assault and battery charges right now.

[kimsey]

This is a horrible thing to happen to anyone, but, I feel like by not going to the ED you hurt your chances of pressing charges against the patient (assuming he was in fact AOx3) for assaulting you. I personally would still make an attempt, but I would also discuss it with your superiors. I worked in a psychiatric facility (for adolescence) and 99% of the time if you tried to put in a police report against any patients they would find a way to fire you or threaten you with being fired (because we lost money if the kids got arrested and possibly future patients), so make sure you go through the proper procedures before actually filing the report!! Psych is completely different than a regular hospital, and you take the risk of being hurt by working there, but in a medical hospital with a patient who is AOx3 and does not have a hx of mental issues you should definitely press charges - not to punish the patient but simply to protect others in the future, if he's able to slap you hard enough to leave a mark and swelling, then he could be very capable of seriously injuring someone else.

Good luck, I hope you are able to at least protect future nurses/cnas/techs from this guy!

[FMF Corpsman, MSN, RN]

The family may not have a clue why the patient reacted the way that he did. I think there's a HUGE difference between an intentional violent attack, and someone acting out due to what could be many many reasons. What is known is that this person did not speak English. The doctor said he was A&O on admission, but what were the other nurses experiences? And lastly, how embarrasing for the patient if they have no control over their thought proccess or actions when they recover from their UTI, sepsis, or get medicated for a psych disorder. If they are deemed incompetent or incompetent at the time of the incident, how in the world can one expect to send a delerious patient into prison for 7 years???? Nurses always need to expect the unexpected. Assess, assess and assess again. Carefully and fully explain what they are doing and why they are doing it in the actual language that the person speaks. Imagine if you were not well, in a foriegn country in a language you did not know, and a nurse started speaking to you saying who knows what and then crossed your arms in a restraint type fashion?? Or started pulling back the bedding to do--what exactly? You wouldn't have a clue, and react to protect yourself. Actually, what the nurse did in this situation could be considered battery. Putting your hands on a patient without their consent is considered so in some states. Seems like a huge miscommunication with nasty consequences. Hence why translators and patient permission and assuring that the patient understands is so important.

All very good points Jade, also the patient could be a sun-downer, and striking out. Obviously, I'm a male, but I'm over 6 feet tall and 240 pounds, in good physical shape, and I've had patients strike out at me, both males and females. To me personally, that kind of says they aren't dealing from a full deck. I'm not saying this out of ego, I am a big ugly guy and pretty intimidating looking. But Jade is right, we go into a patient's room and rip back the covers on a patient, we pretty well should expect to get hit. Hit, kicked, scratched and anything else they have in their orificenal. If they are confused and they don't speak the language. If they have no idea what we're up to, what do you suppose they think we're up to? They might have had a clue if we still wore whites and you ladies still wore caps, but we don't. So perhaps we need to establish the boundaries before we start ripping back the covers or before we start doing bear hugs or trying to grab our patients to move them. We may just save ourselves a few bruises and punches.

[HM-8404, BSN, RN]

Noyesno, I've been really disturbed about both your hospital (for looking at you like you're crazy when you mentioned filing a police report), and his family's "he did this all the time at the nursing home" response. To me, their apparent lack of concern reflects a belief they consider healthcare workers as people who should expect to be assaulted as part of their job.

Anyway, I found something New York state has passed into law to address this issue. I hope other states will follow suit. It's called the Violence Against Nurses Law, which makes it a felony to assault a nurse. Two excerpts from an article about this that I found surprisng.

So, up until then, you would be charged if you belted one of those in the jaw, even if you are angry, drunk, on delirious, etc. I have to ask, why have nurses been excluded prior to the present time?

My opinion now is that I would make a police report. If nothing else, it can go in the statistics kitty for one of the most underreported crimes occurring most likely as we speak.

Hurt a nurse, go to prison under new law - Times Union

My state made assault on a nurse, doctor, tech, etc a Class C felony quite a while ago. It covers any employee of a hospital, County or district health dept., a long-term care facility, or a physician's office, clinic,or outpatient treatment facility. I do find it odd that it does not cover workers in home health care that are in a patient's home for some reason.

[nurse ollie]

I would have gone to the ER as suggested by superiors. I would have filed charges of assault against the patient. You did nothing wrong.

I was hit by a patient while being a patient in a hospital. I pressed and charges and that patient was able to receive appropriate the care he needed. The second time I was hit very hard in my stomach. I lost our first child. I was very young (22). They admin staff told me if I filed charges I would lose my job with references saying I wasn't a team player. I buried my child and QUIT.

Best of luck to you... :)

[Mulan]

At the very least, since this guy had a history of doing this, you should have been told about it before hand.

Another example of nurses being set up because they are not given necessary information.

[PacoUSA, BSN, RN]

Your post says you're from Jupiter, but if you're really from New York:

... I would have so pressed charges.

[BrandonLPN, LPN]

Just because he's alert and oriented doesn't mean he isn't mentally unstable. Someone can be A and O x3 and still be crazy as all get out. This seems like more than just a language barrier to me. I'm doubtful there's anything a nurse could do legally. If he was living in a nursing home, I don't think he can be held responsible for his actions.

[loriangel14, RN]

I would have called the police.

[noyesno, MSN, APRN, NP]

Your post says you're from Jupiter, but if you're really from New York:

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... I would have so pressed charges.

I forgot to update my profile, I just relocated to Mars.

[noyesno, MSN, APRN, NP]

I would have gone to the ER as suggested by superiors. I would have filed charges of assault against the patient. You did nothing wrong.

I was hit by a patient while being a patient in a hospital. I pressed and charges and that patient was able to receive appropriate the care he needed. The second time I was hit very hard in my stomach. I lost our first child. I was very young (22). They admin staff told me if I filed charges I would lose my job with references saying I wasn't a team player. I buried my child and QUIT.

Best of luck to you... :)

nurse ollie, I am so sorry for you loss. I could not even imagine. Your former employer was completely out of line.