Threatened by patient

[BSNbeauty]

I work in OB and tonight I was threatened by a patient. She actually was chasing me down the hall when a coworker intervened and stopped her. I called the nursing supervisor who was on her way up to the unit with security when the charge nurse told her not to come or bring security in order to " not get patient worked up again". Needless to say I'm disappointed. If it was the other way around and I threatened to physically harm a patient security, police and the BON would have been called. However, patients are allowed to treat staff however they want to with little to no consequences.

[PinayUSA]

If I was a nurse and a patient or visitor threatened me I would take them down to the floor and throat punch them. If they were psychotic then I wouldn't.

I guess this is one reason why I am glad I am not a nurse

[JenERally]

There's a world of difference between a confused patient who isn't capable of distinguishing between right and wrong and a patient who understands that threats of and/or physical acts of violence to intimidate others are generally frowned upon; whose inability to play nicely in the sandbox is a conscious decision. It's the latter that warrants swift and decisive action by management in order to discourage similar behavior.

If management isn't willing to stand up for their staff's safety, instead choosing the needs of that patient over its staff, nurses ought to be involving their organizations' risk management departments, employee health, employee assistance programs, compliance officers and anonymous compliance hotlines, even state and federal regulatory agencies including OSHA and Joint Commission.

[Here.I.Stand, BSN, RN]

No offense I agree with the supervisors desision. I also understand how you feel. That's why.every facility whether it be a hospital to a nursing home. They all have resources such as documentation to protect you and get the patients the proper help they need without scaring the patient and blowing the whole thing out of proportion. Starting as a C.N.A you take a oath to care for every and any person. No matter how miner or serious. I won't go further into this but just ask your self if you were that person and that facility was there to protect you. How safe would you feel with security coming after you to through you out. Or a caring nurse to report it to the supervisor on duty and try to calm the situation. Maybe with a nurse that understands that patient better. Until they get the proper treatment. I work 69 hr weekends sometimes you just need to take a deep breath walk away and take the proper procedures that most of us are trained to do.

By all means, if a nurse or other unit staff is able to deescalate the situation, that is ideal. I want to address a couple of points, though. The patient's circumstances do impact how we approach the situation; if someone is hallucinating and seems to be having a psychotic break, that is a very different situation than, say, a pt going nuclear because the OB nurse comes to collect a meconium sample to drug screen the baby.

Also, security doesn't throw a pt onto the streets who needs medical care. Their presence can intimidate the pt--which is fine if it prevents a dangerous situation (e.g. patient attacking RN with their IV pole.) Sometimes their muscle is needed to physically restrain a violent pt--again, preventing danger to staff. A violent patient or visitor should NOT feel so safe that they think that this behavior is okay. It isn't. But again, security doesn't throw the pt out onto the street, and we do still treat the pt.

I've been an RN for quite a few years, and I never took any oath to put myself at risk. Do we have to put prejudices aside? Yes. I have cared for convicted murderers who got themselves hurt; I treat them with the same level of critical thinking, proactivity, and kindness as anyone else. But our law enforcement's policy states that two guards are in the room at ALL times, and that one ankle is shackled to the side rail at ALL times. I don't ask for privacy from the guards like I would from family visitors. That is because safety trumps feelings.

We nurses/CNAs can take an important lesson from EMS providers: always assure that the scene is safe. Do not assume care if that means putting one's self into a dangerous situation.

[Janetnzrn]

Years ago, I worked OB,16 yr old in labour, yelling for pain meds/epidural. Told her I needed to check her dilation and then would give her some meds and call anaesthesia. As soon as I started the exam, and yes, I was gentle, she started swearing and tried to hit me with a metal tray. I stopped, took off my gloves and told her that I would be back to do the exam when she was calm and apologised. Took about 45 minutes of contractions and screaming before her mother came out and told me she was ready to apologise. I did the exam and was secretly pleased that she was too far advanced to get her epidural. Petty and mean, but karma can be a b...!

[RunnerNurse09, BSN, RN]

Not where I work. There is something wrong with this picture. If a patient, whether pregnant or not, threatens staff, it's policy (at my facility) for security to be called. The last time I was threatened (actually, I was assaulted by a patient) we had 5 security guards show up. Pt was having bad reaction to medication and that still didn't stop security from coming (and tell her she would be arrested). They also held her down while i medicated her.

In the ED, if a non-critical patient threatens staff, they can be escorted out of the facility and transferred to another facility.

What is your facilities policy on threats against staff?

Forget that. When I worked in the ER, if a patient got physical, the cops were called and charges were filed. We have rights too.

[RunnerNurse09, BSN, RN]

That is probably because nurses are threatened by administration if they call the police and press charges.

Lindarn, RN, BSN, CCRN (ret)

Somewhere in the PACNW

Really? NOT where I worked. A woman brought in kicked and bit several people. Cops were called and charges filed. It is terrible and dangerous to work for management that won't support /protect their staff.

[RunnerNurse09, BSN, RN]

It's funny how quickly someone would be arrested for threatening or assaulting a police officer, yet nurses deal with this daily and the perpetrators suffer zero consequences.

In some states, I am pretty sure in mine, assaulting a nurse carries the same weight as assaulting an officer.