When to run?

Whispera, MSN, RN · Nov 27, 2012

I've worked psych for many, many years, and have never had a patient come after me. I don't know what others' experiences are, but from my experience, I think you're assuming something will happen that might not. It's not like in the movies. Psych patients are mostly people with problems who are more likely (much more) to hurt themselves than a caring nurse.

sharpeimom · Nov 27, 2012

I was a psych nurse for twenty years. When I first began, the older, very experienced nurse who oriented me told me that some of the patients I'd be meeting would seem just a little different, a few would be downright bizarre, most would seem

"absolutely totally normal." She was right!

She also told me never to wear a necklace or dangly earrings that an out-of-control patient could grab and choke me with and never to allow myself to be backed into a corner by a patient, and not to turn my back.

I only had one patient chase me in all that time. He thought I was a dead relative and he didn't want him to leave.

elkpark · Nov 27, 2012

I've been in psych nursing for nearly all of my career (close to 30 years now), and have been involved in plenty of emergency situations and physical altercations, but I've never run away from a situation -- I've moved around plenty to avoid being assulted/injured, but (IMO) it's my job (as the RN in charge) to be present and dealing with and directing the situation. (I've known some psych nurses whose response to any potentially dangerous situation was to run to the nurses' station, close themselves in, and call for help -- they got no respect from the clients or their co-workers.) I can't say what I'd do in a situation that involved a gun; I've never been in that situation -- that's the only scenario I can think of, offhand, in which it might be appropriate to remove yourself entirely from the situation.

Meriwhen, ASN, BSN, MSN, RN · Nov 29, 2012

Never had a patient come after me. Had a couple throw things at me (1 hit, 1 miss) but I've never had to run from a patient.

pamnock · Dec 1, 2012

Building trust and a rapport with patients will help to keep them from directing their anger at staff. I've never had a patient come after me. In most cases, they will punch/kick walls or throw something, but it has been rare on our acute inpatient unit for staff to be asssulted (although it has happened).

Pam

allnurses Guide · Dec 1, 2012

I have never run away.

I've done some smooth talking and some casual backing up... oh, and maybe some fancy footwork to avoid a direct hit, but no running.

Even if I have to get away from a dangerous patient, as soon I get help, we all have to face the situation in order to get it under control. In other words, I can't just hide, I must return once I've got safety in numbers.

There is no respect for staff who runs and hides.

Some patients will actually thrive off any fear you may betray.

No matter how you feel on the inside, you absolutely must be cool on the outside.

There is nothing that makes staff angrier than a coward who would save their own skin (by running and hiding) while letting others get hurt (and when we firmly state, "hold his hands tight... do not let go!" we mean it!) :madface:

Actually, these situations are not an everyday occurrence, as people may think.

If everyone is doing their job well, violent situations are usually de-escalated before they get out of control.

Meriwhen, ASN, BSN, MSN, RN · Dec 1, 2012

There is nothing that makes staff angrier than a coward who would save their own skin (by running and hiding) while letting others get hurt (and when we firmly state, "hold his hands tight... do not let go!" we mean it!)

We had a nurse do that: the code exploded and instead of coming to help, he ran the other way and was hiding in the outer room. Not only did it aggravate some of us, it made ALL of us feel like we couldn't trust him to have our backs the next time something happened. And that trust among staff is very important.

MrChicagoRN, RN · Dec 2, 2012

We had a nurse do that: the code exploded and instead of coming to help, he ran the other way and was hiding in the outer room. Not only did it aggravate some of us, it made ALL of us feel like we couldn't trust him to have our backs the next time something happened. And that trust among staff is very important.

That's a definite DO NOT RUN AWAY situation, unless it's to summon more help. If One is in, Everyone is in

kennybania · Dec 4, 2012

The only time I could think of running away is if: A. You are the only staff member on the floor at the time B. clearly out of view of everyone else and C. your life is in immediate danger. Granted this doesn't happen too often, but it does happen. If you are a petite woman with noone there to help you and you have a 300 pound truly delusional man chasing you, it would probably be for the best if you run. With that said, I do not often advocate running. Some patients will use intimidation to manipulate staff into getting what they want and if you run away or cower down, the relationship isn't therapeutic anymore. The patient now knows he can get whatever he or she wants by intimidating you.

akoisme · Dec 4, 2012

From my point of view, It would be right to run away the moment your life is on the line. Say you know your patient could easily overpower you or manage to get their hands on a weapon, that is the time you flee for safety.

tristessa · Jan 5, 2013

Ive worked in psych/mental health nursing for approx 15 years. I have never experienced a patient chasing after me. Mental health/psych nursing teaches you much about observation and you develop fabulous peripheral vision (I can be talking with a patient directly in front of me and be aware of whats going on over at the left or right side of the ward). You spend your shift with your patients and observe their behaviour throughout. Because of this, you pick up on any deviations in their behaviour and their "affect" as we call it. As such, early intervention to address this is essential - to curb any escalation/deterioration in behaviour/mental state/aggression.

Just to finish, nurses that work in this field struggle to "medicalise" and "normalise" mental illness - there is so much stigmatisation, even within the health care sector. These patients are not to be feared....they are just patients with an illness, same as anyone else...