When Family threatens you (vent)

[Genista]

Okay, I went into work tonight in good spirits. Had a nice group of patients, all except this one pt's family (patient not the problem). I recognized the patient immediately from previous admissions & recalled lots of drama & the MD having long (1hr) talks w/ family in room QD, due to family always being upset/angry.

One family member in particular came in tonight w/ huge chip on the shoulder. It was my 1st night with this patient this admission.I had a feeling that no matter what I did, it wouldn't be right in the family's eyes. They arrived angry, with lots of questions. I tried to address them quickly & thoughtfully.

Without revealing the details, it seems this family member's "final straw" was when they felt "insulted" by something in my tone of voice or choice of words. Our discussion was witnessed by other staff in the hall, who didn't think I was being rude in any way. Nonetheless, I told this family member that I was sorry if I upset them, and that I fully did not intend to offend at all.I spoke in a calm, what I tried to convey (caring) earnest tone. I really did want to help them, despite it all. I told this person that I think there was a misunderstanding, as I really wanted to help, and that it seemed we were having a problem communicating.

This family member was having none of that! They threatened to "punch me out" and made a gesture with the fist. It was witnessed by another staff member. They didn't actually do anything, but when I look back on it, I feel 1)angry (how inappropriate) 2) a little scared (yikes, who knows how unstable this person is?).

There have been multiple medical staff (MD,RN, etc) who will no longer care for this patient due to past experiences w/ the family (another MD "fired patient" last admission).

Now I know why.

People that know me, know I am not a mean spirited person, and several staff told me not to take this episode personally. How can I not? I decided (on my drive home) I am not caring for this patient ever again, period. Tomorrow I will ask for another assignment when I go into work (just not that one patient).

I would be willing to quit my job over it, if it came down to it, to tell you the truth.

I'm not afraid to speak up about this to my nurse manager...we will have to discuss it when she returns to work after Thankgiving.

This has never happened to me before (I work the hospital floors, not ER). Oh sure, I have had confused pts (etoh, or post op) swing at me.But this threat was different- from a stone cold sober angry family member. Of course, I tried the empathy approach & offered support & help to the family, but as I said, there was no reasoning with them. They saw the enemy & it was me.

All my nurse peers were supportive & understanding tonight, but I just feel so sad & emotionally drained. I'm having a hard enough time putting up with the cr@p of nursing as it is, let alone this type of behavior. It makes me want to quit my job and go work on an assembly line again, where I didn't have to deal with people.

Thanks for listening. I needed to vent.

[deespoohbear]

Originally posted by kona2

This family member was having none of that! They threatened to "punch me out" and made a gesture with the fist. It was witnessed by another staff member. They didn't actually do anything, but when I look back on it, I feel 1)angry (how inappropriate) 2) a little scared (yikes, who knows how unstable this person is?).

I would have called the police and filed a formal complaint against this person. I would have called the administration next and inform them of the situation. I am not a big fan of our administrator, but he will not tolerate that kind of nonsense from someone who is alert and oriented. Just because we are nurses does not give anybody the right to use us as their personal whipping "boy." I would also refuse to accept the assignment of this patient unless the family was not allowed to visit. This family has overstepped the line and you do not have to put up with it. Let us know what happens.

[deespoohbear]

Originally posted by montroyal

. The state of South Carolina inacted a law with reguards to nurses safety. To verbally threaten a nurse is a Felony with a mandatory sentence of two years in the state prision, to assualt a nurse is a Felony with a mandatory sentence of ten years in the state prision. This law was enacted after nurses went to the state legislative branch with horror stories of abuse. This law basicly treats the threatening or assaulting of a nurse the same way they treat the same crimes againts a police officer. South Carolina was the first to step up and ensure the safety of its nurses, but other states are now looking to follow there lead, especially in this time of such a shortage of nurses willing to work in the healthcare system.

Way to go South Carolina!! By any chance to you do you know where I can find reference to this law? I sure would like to write my local representatives and give them a copy of the law. I think I am moving to South Carolina! I love the south anyway!!

[kmchugh]

Being 6'4" and weighing 270, I was subjected to this behavior a little less than the average nurse, but it did occasionally happen. I have the attitude that "you get to do that ONCE." When it happened, I calmly, in front of other nurses, I would tell the family member something like this:

"I understand you are very upset, and concerned with the care(the patient) is receiving. Rest assured that we are all doing the very best we can. However, threats of violence against me or any other staff member will not be tolerated. Should this happen again, I will call security, and you will be escorted out of the hospital. I am willing to listen to you concerns, provided you tell me those concerns in a calm, rational manner. None of us will tolerate any more threats."

Then stand by what you have said.

Kevin McHugh

[Larry]

Maybe this chap and his disfunctional family feel guilty about not helping your patient more/their relative. This guy has come from a low class home or has a chip on his shoulder. Had he been drinking? Did he smell of alcohol?

[SmilingBluEyes]

Workplace violence is a HUGE issue threatening many in the USA today and nurses are among the most vulnerable. I can't add to the above except to say I agree. This person should be escorted out by security, police notified and a ZERO TOLERANCE policy in place, no EXCEPTIONS. Such threats are never to be taken lightly and can have deadly consequences if they are. Not only were YOU at risk, but the entire unit was, as was anyone in this nutcase's path. Best of luck to you. I am truly sorry for the traumatizing situation you were in.

[mattsmom81]

The only thing I could add to the excellent advice is I would have immediately called for help....nursing supervisor to the floor STAT (or code white) and spoken to this man with witnesses to lay down the law. I think most nurses have been exposed to violent behaviors ..and it sure does happen more and more frequently these days than 20 years past. Society is more violent and demanding in general.

Hooray for South Carolina!! I think it's wonderful making assault on a nurse a felony! :)

Why are so many managers so willing to excuse violent acting out against the nursing staff. I agree...it sucks.

Do you have a code that can be called for a violent person --patient or otherwise? 'Code white' is our call for help when someone goes crazy on the staff. I've seen it called on a doc too when he flung instruments in OB...all the strong, big guys come running to help out. :)

The threatening punch- out gesture would have warranted a call for a 'code white' with me. These bullies calm down real fast when the big strong 'white coats' show up. :)

[Nurse Ratched, RN]

I've had similar type issues - the nature of the unit I've been working on, unfortunately. People get escorted out by security. If they've been really obnoxious, their visiting privileges are revoked for the length of the patient's stay - one of the few perks of working in a locked psych ward.

The legal definiton of assault can include "merely" putting someone in fear of imminent harm, with or without actually physically harming or touching them. So waving a fist and threatening to punch you out is assault. I have no problem reminding anyone of this fact when they start to get out of control.

I'm sorry the human race has to consist individually of a few idiots. Wonder what this family will do when they've burnt their bridges to ALL the healthcare workers and there's no one left to care for their loved one?

[BMS4]

You've gotten great advice from everyone, so I don't have any to add.

Big {{{Hugs}}} and I hope you have a nice quiet Thanksgiving Evening. :)

[Irishcreme]

I found a copy of the law. Its from http://www.lpitr.state.sc.us/code/t16c003.htm

SECTION 16-3-635. Assault and battery upon emergency medical service provider, firefighter or home healthcare worker.

(A) As used in this section:

(1) "Emergency medical service provider" means an individual or employee of a health care provider who provides medical or health care services in the course of his employment or training which includes, but is not limited to, emergency physicians, nurses, emergency medical technicians, paramedics, members of rescue squads, and anyone directed by these individuals.

(2) "Firefighter" means an employee of a town, city, county, or state fire service including, but not limited to, firefighters, volunteer firefighters, fire investigators, fire inspectors, and any one directed by these individuals.

(3) "Home healthcare worker" means a licensed nurse who provides health care in a home under the direction of a physician, county or state public health agency, or medical facility.

(B) A person is guilty of the misdemeanor of assault and battery upon an emergency medical service provider, firefighter, or home healthcare worker and, upon conviction, must be fined not more than one thousand dollars or imprisoned not less than two months nor more than three years, or both, if he knowingly or wilfully resists or obstructs a person listed in subsection (A), or commits an assault on a person listed in subsection (A), in the lawful discharge of that person's official duties and the resistance, obstruction, or assault is unaccompanied by any of the circumstances of aggravation listed in subsection ©.

A person sentenced under this section for a second or subsequent offense shall not have his sentence suspended to less than six months' imprisonment nor shall the person be eligible for parole until after service of six months.

© A person is guilty of the felony of assault and battery of a high and aggravated nature upon an emergency medical service provider, firefighter, or home healthcare worker and, upon conviction, must be fined not less than one thousand dollars nor more than ten thousand dollars or imprisoned not less than one year nor more than ten years, or both, if he knowingly or wilfully resists or obstructs a person listed in subsection (A), or commits an assault on a person listed in subsection (A), in the lawful discharge of that person's official duties and the resistance, obstruction, or assault is accompanied by at least one of the following circumstances of aggravation:

(1) physical injury to a person listed in subsection (A);

(2) the use of a deadly weapon;

(3) great disparity in the physical conditions of the parties;

(4) great disparity in the ages of the parties;

(5) great disparity in the sizes of the parties; or

(6) indecent liberties with a female.

As used in this section "deadly weapon" means any instrument which can be used to inflict death or serious physical injury.

[prmenrs, RN]

I think I would print what Kevin wrote, place it somewhere you can find it, and use it as needed. And mean it!

Document the incident, and if it's an ongoing issue w/ this family, which it sounds like it is, have a team meeting, and decide to prohibit them from visiting the hospital.

We had to do that with some of our parents that were "inappropriate", and security never once failed to back us up. Social workers usually broke the bad news (?) that they would not be permitted to visit, so that definitely let them know that it's not just the nurses, the whole team was onto them.

Sorry you had to deal w/this at all much less on a holiday!

[mario_ragucci]

Originally posted by kona2

They threatened to "punch me out" and made a gesture with the fist. It was witnessed by another staff member.

***Humor***

That would have been my green light to launch my fist directly into said person's trachea at the same time I stomped as hard as I could on their foot. Then i would have estimated their position in the next 0.5 seconds, accelorated my fist to at least 100 KPH by spinning around one time, and landed my fist on their anterior face. Then I would have tackled them to keep them from injuring anyone. If they still had it in them, I would have then wrapped my body around them from the shoulders up like a python.

Just like a firearm, you shouldn't "draw your hands" unless you intend to do harm, which will set off a cascading-effect.

***humor***

[Tweety, BSN, RN]

Good advice from everyone. Every blue moon we have to go so far as to have the police put a restraining order on the person, not allowing them to come to the hospital. Usually the do it to drunk people in the ER, but it's not unheard of on the floor.

Good luck in dealing with this situation. As you said, recognize there is nothing, absolutely nothing that is going to please these people. Oh you could be understanding, "they are just really venting their fear...." yeah right, security!