Maybe the past few rough nights have got me too much on edge with not enough sleep, but I hit the end of my patience last night. Detoxer sucker punched me in the face. We had a good relationship going there on our second night together, I tend to not be a line in the sand type with my detoxers. You tell me we're on a boat, I'll ask where you're driving me. We can joke around and keep things light, as long as we're all safe. We weren't even doing anything invasive, a boost in bed with me by his chest, another aide next to me and one across. I didn't see it coming, and even with the padded mitt, it was hard enough to move my glasses (not knock them off entirely), and my jaw still feels it. Not the hardest I've ever been hit and we all know you just take it, right. But when I looked over there was clear intent on his face, and that face came back many times over the night. Ended up in four points within a few hours, and by the end of my shift I'd been threatened enough times I decided to call.
The officer comes in and his first question is "Well, what were you doing to him at the time?" He clarified that he plays devil's advocate because he has to prove intent in order to get a warrant (as we all know), and in a patient detoxing, on benzos, and hallucinating, that's nearly impossible. But "I support you" he says. Then he proceeds to show me bruises on his arm from an arrest and then tells me he's been injured many times and he's never pressed charges. As if he's better than me and I'm lacking in compassion and knowledge about my job if I'm doing this. I treated that patient professionally and courteously, as I do all my patients. I know they're dealing with addiction issues and no matter what brought you to my assignment, I try not to judge because it has no place in providing competent care. But why are we expected to just take this time and time again as an appropriate behavior? And not just us. Police, teachers, EMTs, many professions, we're now expected to just take it. So, I know my complaint won't go anywhere, nothing will happen to him, but just on the principle of it I wanted to put it out there. If nothing else, as least the next time he's back I can claim a conflict of interest.
Does anyone have a workplace that takes this stuff seriously? Because I'm not the only one recently, and especially in the ED, some of these people are alert, oriented and just mean. Or maybe I'm wrong for calling because it shows a lack of understanding for my patient, whatever. But I just felt like someone has to do something, I have friends at work, and I don't want them to be in danger, either. We can't put everyone in restraints just for our safety, that would be abuse, so we have to wait, and hope it's not more serious next time.
You did the right thing. We're not doing these patients any favors by protecting them from the consequences of their actions. I figure that some charges won't stick if they are under the influence or withdrawing, but I feel like people need to know what they've done after the fact, whether that's through the police, through the hospital, etc. I'm sorry that this happened to you and that support seems to be lacking from all sides! Could the officer have been trying to make you feel better and doing a terrible job of it? I feel like sometimes people think minimizing = calming, and they're wrong!
Specializes in New Critical care NP, Critical care, Med-surg, LTC.
Thanks everyone, I appreciate the feedback, and the support. I'm sorry for so many others that have experienced violence, and especially those with lasting injury- my jaw should feel fine by tomorrow. It's so frustrating that in so many areas of society these days, people are forced to accept unacceptable behavior in the course of their jobs.
I started a position in a community hospital, thinking the bucolic nature would carry over to the clientele. I lived in the community and my neighbors are nice enough. I came from an affluent hospital where substance abuse was limited to the medically induced sort. ETOH withdrawal is an almost daily assignment. I was amazed when a similar situation occurred after my third night with this patient. He attempted to hit me and barely contacted me and then grabbed his monitor leads and attempted to put them around my neck. We called the code green and my supervisor yelled at the patient that he was not going to hurt her nurses and I was encouraged strongly to press charges. This was a huge turn around from my previous employer who would subtly reprimand any attempt to hold patients responsible. I chose not to, and enough of my coworkers did as his behavior continued, but it is nice to know you are valued and supported.
Specializes in ICU/community health/school nursing.
6 hours ago, FolksBtrippin said:
I support your decision to call the police.
I also would have supported your decision not to call the police, had you felt that it was not warranted.
It's not a once size fits all thing.
I think we need to support each others' decisions on matters like these and not create a situation where the nurse either must make a report to the police or must not make a report to the police.
Beautifully written. I hope that the people in power in your hospital see it that way. If not, know that you are supported here.
Specializes in Psych, Addictions, SOL (Student of Life).
Good for you! Stick tp your guns as I suspect you will feel pressure to drop the charges due to the patient being psychologically ill. We just recently had a staff put in the hospital by a patient and even the facility is pushing for charges to be pressed.
Specializes in Mental Health, Gerontology, Palliative.
I watched a patient king hit another patient on the acute mental health unit. When I asked if the patient would be charged. I was told "they are under the mental health act there is no point"
This patient had told another patient exactly what they had planned to do
Good for you. We need to take a stand against violence against health workers, people need to know that if they assault their healthcare professional they will face consequences
I feel like we're all talking about two different things, are we talking about a patient with at least minimal cognizance, or a delirious, hallucinating patient in DTs?
I've never heard a nurse suggest it would be appropriate to press charges against a patient for the symptoms they are receiving nursing care for. Caring for ETOH withdrawl patients is not easy by any means, but if a nurse isn't up to the task please decline to care for these patients instead of criminalizing the patient's illness.
Specializes in Psych, Corrections, Med-Surg, Ambulatory.
20 minutes ago, MunoRN said:
I feel like we're all talking about two different things, are we talking about a patient with at least minimal cognizance, or a delirious, hallucinating patient in DTs?
I've never heard a nurse suggest it would be appropriate to press charges against a patient for the symptoms they are receiving nursing care for. Caring for ETOH withdrawl patients is not easy by any means, but if a nurse isn't up to the task please decline to care for these patients instead of criminalizing the patient's illness.
Someone already said: one size doesn't fit all. I think it's up to every nurse to decide in that situation if that patient had capacity for volition. If he was thrashing and lashing in delirium, unlikely anyone would call. But carrying a diagnosis of alcohol withdrawal shouldn't give anyone an automatic free pass.
Someone already said: one size doesn't fit all. I think it's up to every nurse to decide in that situation if that patient had capacity for volition. If he was thrashing and lashing in delirium, unlikely anyone would call. But carrying a diagnosis of alcohol withdrawal shouldn't give anyone an automatic free pass.
The nurse had already determined that the patient did not have decisional capacity and that they were hallucinating and delusional, this is an objective assessment that doesn't vary from one observer to another.
I'm not sure what you mean by "thrashing and lashing", but that's not a meaningful way of differentiating acts subject to criminal action and expected symptoms of this particular medical condition.
Specializes in Psych, Addictions, SOL (Student of Life).
I concur. I have been hit kicked and spat on by people who were clearly not in their right minds. A few even apologized after all was said and done. I don't believe that all cases are the same. We are seeing a large number of patients who feign mental illness to avoid the consequences of their actions and those should be prosecuted to the full extent of the law.
NightNerd, MSN, RN
1,130 Posts
You did the right thing. We're not doing these patients any favors by protecting them from the consequences of their actions. I figure that some charges won't stick if they are under the influence or withdrawing, but I feel like people need to know what they've done after the fact, whether that's through the police, through the hospital, etc. I'm sorry that this happened to you and that support seems to be lacking from all sides! Could the officer have been trying to make you feel better and doing a terrible job of it? I feel like sometimes people think minimizing = calming, and they're wrong!