Um... Can you hit before you get hit?

Specialties Emergency

Published

As a 1yr ms RN going into ED, one of the top things that concerns me is the safety. I'm sure you have seen lots of crazy things that happen at ed, and I'm not doubtful that one of them include violence against staff.

I have heard from others that people bring guns to the ed, sometimes you can get punched, kicked, put in choke holds, wrestled like in the octagon, etc.

In my state, we have a law that makes assaults on ed staff a felony, but I don't think that will stop the real crazies. I already have a bad back for which I go to the chiropractor, and I don't want to get disabled.

I understand that the best thing to happen is just avoid the violence when it's happening, but what if I have a coworker who is 5ft and will surely go to Valhalla if I run away? Or what if I'm cornered and have to fight? I be honest with you, if there's two options, one being a saint and risk being disabled for rest of my life or being badly hurt, and the other being "selfish " and knock the snap out of someone so I can support my family, I will happily put someone to sleep as best as I could with the blessings of Rocky Marciano. This is not really something you would worry too much about in MS setting, so I feel apprehensive about it.

As you all know this is my first ed position and I know I will defend myself and my coworkers in violent situations. So the question is probably this: what is the realistic approach in hitting someone before yourself can get hurt bad in ed? I'm not going to just simply start punching pts but I'm taking about real danger situations where you know it's either do something or get hurt.

Many ED nurses I talk to about this said they had to use "rough" methods to avoid having themselves or coworkers from getting badly injured... Or am I worrying about something that happens very very rarely?

Sorry guys- I am going to let the cat out of the bag.

OP- Of course it's ok to hit somebody first. The more experienced nurses are having fun at your expense.

Every ER has a list of instances in which a preemptive strike is allowed, or even encouraged. This list varies from facility to facility, and you need to become familiar with it.

But the list is not given to new nurses until orientation is over. It's kind of an open secret you would have learned about sooner or later. You will also be taught some one-punch knock out techniques after you finish your telemetry training.

really? can you give me those instances? let me get my note and pen. as I can see that you're very experienced, based on your experience, are there any facilities that allow nurses to carry weapons? I bought a poison dart and a bazooka, but I don't know which one to use. should i use the bazooka on monday, wednesday and friday and dart on the rest? or should i procure another contact weapon like claymore or morning star? please pm me I really need to know your experiences.

really? can you give me those instances? let me get my note and pen. as I can see that you're very experienced, based on your experience, are there any facilities that allow nurses to carry weapons? I bought a poison dart and a bazooka, but I don't know which one to use. should i use the bazooka on monday, wednesday and friday and dart on the rest? or should i procure another contact weapon like claymore or morning star? please pm me I really need to know your experiences.

Varies from facility to facility. Check your P&P for authorized bazooka days.

really? can you give me those instances? let me get my note and pen. as I can see that you're very experienced, based on your experience, are there any facilities that allow nurses to carry weapons? I bought a poison dart and a bazooka, but I don't know which one to use. should i use the bazooka on monday, wednesday and friday and dart on the rest? or should i procure another contact weapon like claymore or morning star? please pm me I really need to know your experiences.

11 years rn- 9 ER, 2 ICU.

Thanks to travel, a total of 9 ERs.

ACLS, PALS, TNCC, CCRN, ANDT, MOAB, EMT-B.

Weapons are a personal choice. DO NOT use pepper spray inside. Ever.

And, if by "poison dart" you mean 5 cc's vecuroonium pre-loaded with an 18g attached- I like the way you think. The deep IM takes a bit to absorb, but man, when it does.....

As far as punching somebody? This is always a bad idea in any environment, unless you happen to be good at it.

Call your Dr. Strong or A-Team for help. Duck. And I tend to agree: perhaps the ED is NOT the best place for you - which is not a fault or a shame. We all have our strengths and our weaknesses; we are human, after all. Good luck in finding your niche!

Specializes in Leadership, Psych, HomeCare, Amb. Care.
Disciplinary action?! The guy had a knife for jumping Jacks sake! This is why I hate this profession, that though must be angel, do no harm is so ingrained stupidly in the profession that the only defense you have against a guy with gun or knife trying to kill you is telling them "sir I know I might be murdered or disabled if lucky, but I'm really offended by your behavior and won't give you the soda you asked if you don't put that down!"

Thats pretty cynical for someone who hasn't even started there yet. I work in a patient setting with a high potential for violence, and patient and staff safety is our highest priority. But we never fight patients. I also believe a potentially Volitile setting is not for you.

Will let u folks know how I do! I'm sure I will do just fine with good preceptor and learning leriod

Specializes in ER.

I'm not sure in what ER a nurse would "hit first" - you could put your arm or leg up to ward off a blow - but really? to HIT FIRST? Walk away - run away - duck and zip and get outta there - but I would think there would be no defense at all for "hit first". DIFFERENT story if you have already been assaulted - in that case - do what you gotta do to get outta there and protect yourself , block / punch their eyes out / kick em in the groin / do what you have to - and get the frig outta there!

Assault and battery charges will be filed against you if you hit. Block, dodge and scream for help. Yes I have been hit before but its not something that I always fear. That's part of the adreline rush. Maybe ED isn't the best choice for you at this moment.

Assault and battery charges will be filed against you if you hit. Block, dodge and scream for help. Yes I have been hit before but its not something that I always fear. That's part of the adreline rush. Maybe ED isn't the best choice for you at this moment.

Lol NURSING is not a good choice for me, but I will tell you why I think I will do well in ED. There are people who sink or swim, and I always swam. ED is no different although it will be tough. Thanks for your opinion but you probably had other people tell you that you couldn't do this or that in your life and you probably just laughed them off. We are on the same page ☺

In my state, felony charges are filed to anyone that assaults ed staff. Trust me, I will be happy to charge criminal charges because man with knife in ED is no different than a man with a knife at the street, and if you are happy to be punched and stabbed and smile with heart full of adrenaline, maybe that's why our treatment is not improving.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Thanks for the jewels of inputs so far. To be clear on the hypothetical situation upon which my question is based on, let's say the pt/family is being very belligerent and face to face with you yelling and about to strike or crush you down the ground. Of course punching someone at this stage will only make you the instigator and therefore should not be done, but at the moment the fist swings and you duck and you are cornered so nowhere to go, and you know the punches are going to reign upon you, can you strike to make space to get out. No preemptive strike haha.

I guess the basis of my question is in what situations are strikes (implicitly) allowed for your part, or it is not at all and you should stand there and block only possibly end up getting hurt. I understand of the show of numbers, deescalation, etc but I'm talking about those rare situations that happen very quickly and no time to try other peaceful interventions.

I also wonder if any department endorses pepper spray or something like that.

no you MAY NOT HIT~!

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Lol NURSING is not a good choice for me, but I will tell you why I think I will do well in ED. There are people who sink or swim, and I always swam. ED is no different although it will be tough. Thanks for your opinion but you probably had other people tell you that you couldn't do this or that in your life and you probably just laughed them off. We are on the same page ☺

In my state, felony charges are filed to anyone that assaults ed staff. Trust me, I will be happy to charge criminal charges because man with knife in ED is no different than a man with a knife at the street, and if you are happy to be punched and stabbed and smile with heart full of adrenaline, maybe that's why our treatment is not improving.

NO! NO! NO! NO! You MAY NOT HIT. plain and simple...you may not hit. Period. Trust me I have worked in the ED a LONG TIME! You may not hit. You can delfect and protect but the moment you strike back you are wrong.

While there is a law about violence in the ED that makes it a felony find out from your co-workers how many times they have actually pressed charges and how many time the facility allowed them to press charges. I think you need to think about you move to the ED...it is a rough place...no doubt...however this is why ED nurses are a special breed...we don't put up with crap but we don't use our fists either. You too can be charged with assault and that WILL affect your license.

There are techniques to avoid situations...never get cornered. You may deflect and protect yourself but you may not punch back.

Experienced nurses are trying to give you good advice. Advice that is wise and should be heard.

OP, your state may allow you to file criminal charges against a patient but some hospitals "discourage" staff from doing so by "threatening" the job of those who attempt it. The threats may be subtle and difficult to prove, but real nonetheless. If it were me, depending on the situation, I might still file charges anyway and take my chances. But you should at least be aware of the real possibility of losing your job if you should ever pursue this route.

+ Add a Comment