Threatened by patient

Here.I.Stand, BSN, RN · Jun 1, 2015

Elvish--I was thinking along those same lines...that maybe OP had to do a meconium tox screen or something like that.

To be honest, I'm a bit disturbed that "what was the precipitating event?" is being asked. Based on her posts here, she seems like a nice person and a caring RN. I have a hard time believing that she was picking a fight, or threatening to withhold pain meds, or something that would make any reasonable person go nuclear.

If the setting was anything but a nurse-pt interaction, would it matter what she "did" to cause the threats and chasing her down the hall? I can't think of any. And I don't believe for a second that it matters in a professional nurse-pt relationship.

suanna · Jun 1, 2015

If you are threatened with physical harm it is no longer a workplace issue, it is a public safety issue.
If you were at the grocery store and someone was chasing you and threatening you would you call your mother in the hopes of your mother calling the police or would you call them yourself?

This has been an issue in nursing forever. If a cashier at Walmart is called every name in the book in front of the customers and co-workers, I'm betting the manager isn't long in that job, but if a doctor dresses down a nurse at the bedside/in the nurses station, at most he/she is encouraged to please tone it back by his department head. More often than not, the facility takes the doctors side. As for patients, they can spit on us, punch us, bite us, threaten us, and (at least at me facility) we are instructed to call security- not a law enforcement agency- and the patient is transferred to a different floor, new nurse, and given the kid gloves treatment so as not to "re-escalate" the situation. Assaults that would result in an arrest if directed against a gas-station attendant, when directed at a nurse will get you a private room and a new caregiver (more to your taste), at most hospitals I've worked for. In theory, pressing criminal charges could be a violation of HIPPA and a nurses broken nose is an infringement on the patients rights. ANA has been working on this issue for years, but in my 30yrs in nursing, the only answer I've seen is we need to learn to duck.

seconddegreebsn · Jun 1, 2015

So let's say I did call the police, against the advice of security and nursing management. The patient hasn't actually touched me yet, he's just threatening to do so (both in the present and in the future "I will find you and make you sorry" variety)- mostly likely they'd come and tell him to stop and that'd be the end of it until he actually did hurt me. And now I've put myself in a position to be dressed down by management for going against their advice, and I prefer to stay away from management whenever possible... Somewhat of a lose-lose scenario here.

Red Kryptonite · Jun 1, 2015

So let's say I did call the police, against the advice of security and nursing management. The patient hasn't actually touched me yet, he's just threatening to do so (both in the present and in the future "I will find you and make you sorry" variety)- mostly likely they'd come and tell him to stop and that'd be the end of it until he actually did hurt me.

No, he can be charged with making terrorist threats. It's your right to press charges. Based on that threat you might even be able to get a restraining order.

MrChicagoRN, RN · Jun 1, 2015

So let's say I did call the police, against the advice of security and nursing management. The patient hasn't actually touched me yet, he's just threatening to do so (both in the present and in the future "I will find you and make you sorry" variety)- mostly likely they'd come and tell him to stop and that'd be the end of it until he actually did hurt me. And now I've put myself in a position to be dressed down by management for going against their advice, and I prefer to stay away from management whenever possible... Somewhat of a lose-lose scenario here.

State laws vary, but generally, threatening to harm someone is assault. If you aren't getting what you need from security & management, you are free to call the police if you genuinely feel that is the best route. That is your legal right.

Assault and Battery Overview - FindLaw

the CDC has an excellent online program r/t occupational violence towards nurses. https://allnurses.com/health-stress-management/workplace-violence-education-979975.html

lindarn · Jun 1, 2015

Did you REALLY sign up to be assaulted at work, through no fault of your own? Is this what nursing has come to? I thought that you signed up to work in a particular unit.

You are assaulted at work, and believe that it is, "just part of the job that you signed up for"? Are you kidding me?

I don't care what excuse someone has, there is NO excuse that would allow assaulting someone.

The fact that you have made that ridiculous statement, tells me that you have been brainwashed into thinking that you have NO rights to be safe at work, from anyone, patient or visitor.

Has your employer made it clear, that it IS part of the job, and nurses and staff, should just bend over and take it?

If that is the case, I would be filing a complaint to the law firm that represents the hospital, with any proof that you have, incident reports, memos sent to the boss concerning the above issues, and let them sort it out. And don't forget the Labor Board.

My guess, is that the senior partner would have a cow, about the above, unofficial policy, and that new policies would be forthcoming.

JMHO and my NY $0.02

Lindarn, RN, BSN, CCRN (ret)

Somewhere in the Pacnw

Here.I.Stand, BSN, RN · Jun 1, 2015

Why would pressing criminal charges be a violation of HIPAA? "My name is Jane Smith and I was assaulted at Mercy Hospital. Yes I can identify the assailant." I'm reporting information as it relates to my assault; I'm not giving protected health information such as patient's diagnosis, lab values, etc. Besides, HIPAA allows for the disclosure of PHI for the purposes of criminal investigations. If a driver in an MVC causes fatalities, the police can follow them on to my unit and I collect a blood sample for the legal drug screen and give the blood to the police officer without the patient's consent--complete with full legal name, date of birth and the like. The hospital is not a sanctuary for escaping legal accountability.

NicuGal, MSN, RN · Jun 1, 2015

OB/Peds aren't all sunshine and rainbows. We get threats here and there and we have had to call security to deal with patients and families. We aren't there to be assaulted verbally or physically. Many times security comes up, has a word with them, and it usually settles it. Our security is actually a police department and can make arrests and take them out of the facility. And we have had it done.

You need to fill out an incident report and go to security yourself and fill out a report. Or call risk management and make an appointment to speak to someone about this.

gcupid · Jun 1, 2015

Since I don't have any details of why the patient was there (and don't need any either), I'll play devil's advocate.
Maybe the thought process of the charge nurse was that the patient was de-escalating and having anyone come to address her behavior at that moment would re-escalate her to the point of attempting to harm more people (or her unborn child if she was still pregnant).
People who are escalated are not rational. If she was still pregnant or breast feeding, you can't necessarily go drugging her to chill her out.
I am in no way condoning her behavior or minimizing the incident or your safety. I'm just saying that at that particular moment, it sounds like the priority was to de-escalate the patient for everyone's safety.
Now what should happen is that your supervision needs to discuss the incident with her (with security present) and make it clear that there will be no next time at your facility. Patient should be reminded that charges will be pressed for misconduct or threats against staff members. She should also be given the option to transfer her care to another facility immediately if she chooses.
OP under no circumstance should you be required to care for or be anywhere near this patient. Management should consider giving you the day off, with pay, until they deal with the patient and assure your safety is prioriy.
OP, I'm sorry this happened to you. It must have been very frightening.

I totally had the same thought process behind the cause of the charge not wanting to escalate the patient again but if i was charge security would have come before that shift ended just to make sure that the patient realizes that there is some type of boundaries that we provide in order to protect workers.

icuRNmaggie, BSN, RN · Jun 1, 2015

In January of 2012, Douglas Kennedy assaulted two nurses at Mt Kisco Hospital after he removed the infants security bracelet and took the newborn outside.

The nurses followed hospital policy and the hospital backed them for do so. No one can fault you if you know the policies for your unit and follow them to the letter.

Douglas Kennedy: Scuffle with nurses ruined career

The OP should not post further details on social media as it could be construed as violating patient confidentiality.

canigraduate · Jun 2, 2015

Did you REALLY sign up to be assaulted at work, through no fault of your own? Is this what nursing has come to? I thought that you signed up to work in a particular unit.
You are assaulted at work, and believe that it is, "just part of the job that you signed up for"? Are you kidding me?
I don't care what excuse someone has, there is NO excuse that would allow assaulting someone.
The fact that you have made that ridiculous statement, tells me that you have been brainwashed into thinking that you have NO rights to be safe at work, from anyone, patient or visitor.
Has your employer made it clear, that it IS part of the job, and nurses and staff, should just bend over and take it?
If that is the case, I would be filing a complaint to the law firm that represents the hospital, with any proof that you have, incident reports, memos sent to the boss concerning the above issues, and let them sort it out. And don't forget the Labor Board.
My guess, is that the senior partner would have a cow, about the above, unofficial policy, and that new policies would be forthcoming.
JMHO and my NY $0.02
Lindarn, RN, BSN, CCRN (ret)
Somewhere in the Pacnw

Totally agree. My first thought was, "That's not in MY job description."

Martyr syndrome is still alive and well in some areas, I see.

suanna · Jun 2, 2015

Did you REALLY sign up to be assaulted at work, through no fault of your own? Is this what nursing has come to? I thought that you signed up to work in a particular unit.
You are assaulted at work, and believe that it is, "just part of the job that you signed up for"? Are you kidding me?
Sounds great but unless you are living in a part of the country where a nursing licence is a guarenteed job without reguard to references- you have to take your employers policys into account. If I call the police in violation of my employers policy( we are not forbidden to file a ploice report, just we have to follow the "chain of command" - they will make out the required reports that in thier opinion need to be filed. Going outside that command structure is going to get me outside of the employment of a hosptal that I feel allows me to practice professional nursing with a greater degree of freedom than any others in the area. I may not be fired for filing a police report- but there are hundreds of things they can dicipline you for that happen every day. I for one am not willing to give up a job with a hospital I respect, and a pay scale for 30+years seniority to start over as a "new hire" assuming I can find a job with a "would not rehire" reference on my record. Like I said- I don't see anyone offering better solutions. I've been assulted 4-5 times in 30 years. I've been verbaly abused by staff and physicians more times than I can count. I've sought solutions for both through the chain of command, but the answer is,"if you want to work here,it is just the way it is. If you don't like the way things are done here, we are in agreement with your decision to leave our employment"
I haven't seen things done any differently at other local hospitals. Since on this issue, everyone is about equal, and on many other fronts, where I work is superior to my other options, I stand by my first recommendation- grow a thich skin and learn to duck.