Why do people abuse nurses?

UM Review RN, ASN, RN · Mar 14, 2008

Why do patients and families either mentally or physically abuse nursing staff? I just can not fathom why they think its justifiable to terrorize nurses and worship doctors. Over the course of my 7 years in healthcare I have been kicked, punched, slapped, bitten, pinched, pee'd on, spat upon, and called every possible curse word in existance. But I have yet to see anything CLOSE to these kind of assaults inflicted on the MD's or even other staff like PT, RCP, case management, or even the housekeepers!

How about because they know they can get away with it?

CABG patch kid, BSN, RN · Mar 14, 2008

position statement regarding violence

against health care workers and patients

"the board of registered nursing expresses concern regarding incidents of violence directed against health care workers and patients. health care administration and staff are encouraged to form task forces

to evaluate each institution's current safety features and then to institute appropriate policies and environmental changes that will increase safety for health care workers and patients while continuing to provide quality, non-discriminatory health care to the people of california. the board of registered nursing favors legislation that would increase penalties for the commission of violence upon the person of a health care worker. the board also favors the creation of "safe zones" contiguous to health care facilities."

board of registered nursing

p.o box 944210, sacramento, ca 94244-2100

p (916) 322-3350 | www.rn.ca.gov

ruth ann terry, mph, rn, executive officer

i wonder if this position statement should be printed out and posted in every nurses station in california as a little reminder to admin that our board of nursing frowns upon violence towards nurses. who knows, maybe this could help someone decide to press charges instead of being bullied by management.

RNperdiem, RN · Mar 14, 2008

I'm sure the police deal with stressed out people and families too. Just try to hit or kick a police officer and see what happens.

RN1980 · Mar 14, 2008

i tend to take the john wyne approach to this abuse thing, as the duke was stated "i will not be cursed or laid a hand upon, i do not do these things to others and i expect the same in return". you got that pilgrim...

abbaking · Mar 14, 2008

Hey Everyone....thanks so much for all your advise. I want to add a follow up/sidestory related to staff abuse that happened last night a my work.

Long story short....16 y/o adolescent male w/ Hx of SCA. Patient had a history of verbal and physical violence against healthcare workers from a different facility. In crisis brought on by cold weather (southern california cold is 55, but I digress). Pt is A&Ox3, VSS, PCA Morphine and additional PRN Vicodin. 02 2L n/c and continous pulse ox - sating at 93-95 range. Pt in severe pain and emotional distress. His girlfriend was inappropriately in bed with the Pt. Girlfriend was asked to use the bedside chair and not be in bed with patient. The other roommates were very exhausted at the patients constant telephone, visitors and TV. During CNA assessment and rounds, the patient refered to the female nurse aide using the "C" word. Myself and Change nurse explained that this is behavior and language is totally unacceptable. Patient became VERY angry and demanded his rights. Back and forth with my charge nurse we explained the rules. Just then he unleshed a string of obsenities. Code Three implemented (security stat). while security was enroute, patient became physically intimidating. Me and other Males on unit (2 RN's and 1 Tech) show of force. Patient was eventually transfered to a private room but guideline we set. No overnighters, TV off at 1am, and mimimal use of phone.

Sorry that was long but i needed to get it off my chest.

miko014 · Mar 14, 2008

That CA Board statement sounds good, but I encounter more verbal abouse than physical. I don't think that should be tolerated either. Not too long ago, I was covering for another nurse while she was at lunch. So I was watching 10 pts total. It was time for my 6pm med pass, and I had 3 people with scheduled pain meds, one getting chemo, and one getting blood. I had just stopped what I was doing to medicate one of the other RNs pts who had asked for dilaudid. On my way out of the med room, with the med in my hand and ready to go, another of her pts requested pain meds. The other RN had just medicated this pt with her scheduled pain meds about 15 min prior. I gave the pain med I was holding and then went back to check the order on the second pt. The husband came out of the room and said, "I said she needs her pain medicine NOW!" I said, "I know, and I'm trying to get it for her." He said, "Well, you'd damn well better hurry it up." I said, "I'm going just as fast as I can, and if I had less interruption, I would be able to see what I can get for her. I'm not her nurse, I'm just helping out, and I don't know her meds. I don't appreciate being spoken to like that." He glared at me and stomped back off into the room. After checking the order, I went to get the med, but we were out in the pyxis on our side. We have another one on the floor, so I went to the other side to get the med. When he saw me coming back up the hallway the opposite way, he came charging down the hall, yelling at me, "What part of NOW don't you understand? She needs her pain medicine!" He stood in the doorway while I scanned the med (I was still in the hall) and got RIGHT in my face and said, "What in the hell are you doing? GET A MOVE ON!" I said, "I have her pain medicine right here, but I can't get into the room to give it because you're standing in the doorway." He moved and let me in but berated me the whole time I was giving the med. I was livid, but I didn't yell back at him, and wasn't going to let the pt suffer just because he was an ass. And do you know what came of that? Nothing but them talking to everyone about how incompetent the nursing staff is. Days like that make me wish I worked at McDonald's. I'm sure people are not allowed to talk to their employees that way. Sometimes I seriously wonder whether I made the right career choice, because I feel like people are just going to continue to treat me this way forever. I don't know how long I'll last if something isn't done. That is just one of many examples.

rnmomtobe2010 · Mar 14, 2008

And they don't really know any better!!!

ASSEDO · Mar 14, 2008

i know if i post this, i should try to find the case i'm talking about but i don't feel like searching for it...
when i was in nursing school, a little over 2 years ago, we talked about a case wear a pt (alert&oriented) punched a nurse and broke her jaw. the nurse pressed charges & sued for medical bills (i'd have to find the story to get the exact details) but anyway the judge ruled in favor of the pt saying that it was wrong for the nurse to sue and that abuse goes with the job.
i remember this because we were talking about protecting yourself from pts. now i really have to google that and find it...

i bet the stupid judge would not feel so self-glorious if one of the criminals in his courtroom,slapped the crap out of him...but, he has uniformed law enforcement in his courtroom to protect him at work. i would love to have this judge as a patient one day......let me think....

HopeItWorksDNP · Mar 15, 2008

I took two cussings just last night because of length of stay issues in our ER (another thread on its own). One of the irate pts actually came out into the hallway and was hollering to all the other pts: "we should all revolt! This is ***ing b*******. We should all just go off!". Uh...that would be fun. At least 8 angry patients plus family members up against 2 nurses and one doctor.

We have asked administration repeatedly to staff "real" security for our safety. We are in a rural area in Tennessee that has a reputation of being the meth capital of the South. So far we have only been told to utilize our hospital security guards: two very elderly (no offense intended) retired cops that are only armed with whistles. Usually they can be found watching tv in an empty inpatient room. If there was a physical confrontation, I would feel like I had to protect the security officers.

My solution? If I feel threatened or that it is going to be more than just a verbal assualt, I bypass our sleeping security guards and call the police. They are usually very quick to send an officer just to hang out until everyone calms down. Absolutely a waste of their time and our taxpayer dollars, but this place don't pay me enough to take a beating. And if they aren't going to get me any protection, I'll get it for myself. The other nurses do the same.:twocents:

miko014 · Mar 15, 2008

Ooh, I had a pt go off on me tonight, and I gave it right back to him, probably thanks to this thread, lol! But I had just gotten out of report, and my tech came up to me and said that the pt wanted his wallet back. I had no idea where his wallet was, because the nurse before me had forgotten to mention that he had given it to her for safekeeping while he was down at a test. Anyway, I found it where we usually lock stuff up and took it into his room. I handed it to him, and before I could even introduce myself (had never taken care of him before), he started yelling about his pills. I asked what pills he was talking about, and he wanted his home meds. I said they were still locked up, because it's against our policy to allow home meds at the bedside. He wouldn't let me explain why, and when I asked him what pills he wanted and why, he went off about how he's been laying there for days without his...let's say claritin. Something minor, anyway. Don't want to give too much info. Anyhow, he continued to yell at me, tell me that I didn't care, etc. I said, "You're yelling at me, and you don't even know who I am." He said, "I don't care what you say, you're not my nurse!" I said, "Actually, I am. You still haven't let me introduce myself." He said, "Well then get your name up on that board!" (We have dry erase board with date, RN name, and tech name.) I said, "It's already there, did you look?" Anyway, I was trying to stay calm, but the more he yelled, the more I got mad. I finally said something along the lines of, "Look, you need to show me some respect. You didn't even tell me your allergies were bothering you, and you won't let me explain why you can't have your own pills. I'll get you whatever you need, but you have to calm down and speak to me like a human being. I'm sorry you're sick, and I want you to feel better, but you cannot talk to me or any other staff member like this." He said, "Why, did they tell you I do this?" I said, "Nobody told me anything. I have had one experience with you, and so far, it hasn't been pleasant." He said, "I'm leaving, pack my stuff. I'm calling my doctor. You want me to leave, don't you?" I said, "Well, right now I'm not having a very good time." Then he started pulling on the tape of his IV. He must have changed his mind, because he laid back down in bed instead, and said, "Just do whatever you want, lady." I said, "I want to help you, but I'm not going to do it if you don't start treating me with respect. What medication do you take, and how often?" Then he started in again about how we won't give him what he needs blah blah blah. I crossed my arms and stared him down and said "Look, I'm going to get you what you need. But you have no right to speak to me this way, and if I hear you speaking to my tech the way you are speaking to me, I'll be back in here." He started yelling again, and I cut him off and said, "look, I am trying to get you what you need, but the longer you keep me in here yelling at me, the longer it's going to take for you to get what you want." Just then, one of his docs walked in. Apparantly he had heard the pt yelling at me down the hall. He said, "Mr. Smith!" in a very "what-in-the-heck-do-you-think-you're-doing" voice, and I said, "Can I get an allergy med order from you, or do I need to call someone else?" I didn't know this doc, or who he was with, but he was very nice, he asked me what the pt took at home, I told him, he gave me a verbal order, and I left the room. I have no idea what happened between him and the pt, or if he thought I was the "bad guy" or not, but he came out and signed the order just as I finished writing it, and left. But after that, the pt was nice all night, and when I left, he apologized for losing his temper with me and said he actually liked me a lot. One of the other nurses who had been in the room a few times asked me what I did to him, and I asked what she meant. She said he had been better behaved today than she had ever seen him. And believe me, I charted my toosh (how do you spell that??) about the whole thing!!!!! I used to run away from confrontation, but dang it, this job is too hard to have to be treated like that all the time! And it is so much more common than it should be!!!!!

tirednursedude · Mar 18, 2008

Because the majority of patients on our floor anyway come to the hospital to seek drugs and to have the power of the call light.im sorry,when you drive to the er with a suitcase packed and a kfc dinner in a bag,it isnt a unplanned visit to the er. But the second you dont bend over and take whatever they dish out,you get a letter sent to admin saying you violated their rights.

ERnurse4hire · Mar 19, 2008

:bugeyes: This issue is an everyday event in the busy ER where I practice, and last night was no exception. I unfortunately was sent to triage for the last 4 hrs of my shift last night, and I knew before walking into triage how my night was going to end, because we were holding several ICU pts in the ER; which caused a huge delay for seeing those other pts.

Last night I was in know mood to be verbally assaulted, but yet there was a handful that tried. One man coming in cause he had a bruise on his wrist (which looked to be several days old) began yelling and cursing at me from the time he entered my triage, because it took an hour before he got called to triage. I nicely ask him to refrain from cursing or yelling at me or I would ask him to return to the waiting area until he was calmed down. :nono: :nono: :nono:

The guy actually looked at me and stated, "you can not refuse me medical care" OMG OMG OMG I informed the man that I had NEVER refused medical care, but I do not go to his place on employment and treat him the way he was treating me. The man continued on with his verbal assault, and I had to call in security to remove the man from my triage...... things only got worse from there. :nono:

People have lost their manners, and understanding, and ALWAYS feel their issues is more emergent than the next. How do you deal with 3 people that sign in back to back with chest pain... and there is no beds to place the patient in... nor a stretcher (now with HIPPA and people sue happy) medical personel walk a thin line when trying to care for those truely ill.

I was written up by my charge nurse last night over one of the CP's. He never answered the call to triage 3 times, but yet his wife didn't care she had a 10 minute assault on me while I was trying to calculate tyl dosage for a febrile infant. The lady stated that she was going to another hospital where the people actually care... I replied "rock on" although it would have been better to just say nothing...but I can also think of many other words that I could have said that would have been much worse. When the pts wife found out there was a 8-10 hr wait at the other hospital she returned to my triage window to continue her abuse.........:banghead:

WHAT A NIGHT. You want to know why there is a nursing shortage... this is it. How many intelligent people do you know that actually choose a career to where we know that we stand a chance at verbal and physical abuse everytime we come to work. Well seasoned nurses like myself are asking ourself WHY... WHY do we have to endure this... and they walk away. And the new nurses not truly knowing what to expect get shell shocked to the reality and they do not walk away ... they RUN

I have received numerous awards in excellance in pt care as an ER nurse, and I love to take care of people but now it is getting to be too much for even me. :nurse: