Have you ever been in a situation where you have been verbally assaulted in your line of work? I'm talking about a situation where a person threatens to cause you harm? What did you do? Did you report it? and to whom? What would you expect to happen to the person who threatened you?
Have you ever been physically assaulted while performing your course of work? How did you handle it? Were there any repercussions for the actions you took? What action did your employer take? Did anything happen to the person who caused you harm? Was laying charges an option for you? Did the matter get resolved to your satisfaction? What course of action would you have liked to have seen happen?
I ask these questions because in my line of work this happens all to often. Most recently on Friday. This past Friday we had a patient on the unit who was verbally abusive and combative. The patient presented as being paranoid, delusional, and sleep deprived. A bad combination and the potential for a violent outburst was present. I can't tell you much more about this person due to confidentiality, but this person was also of the age where dementia could be considered.
We were in the middle of report and the person starts to call out, my colleague who was responsible for this patient goes in to asses the situation. She ensures that the patient and the environment are safe and tries to reassure the patient that everything is all right and orientates the patient to their surroundings. We finish report and we all start our morning duties with assessing our patients. I'm in the next room, I hear my colleague call..."I need some help in here" I go running into the room. The patient is yelling and swearing and swinging out. The patient has all sorts of lines attached and we fear that they will pull them out. We need to restrain the patient both chemically and physically. I go to get the restraints. I ask someone at the desk to call security. I'm in the process of putting on the restraints when the patient started to swing at me. I got their wrist restrain so now the patient decides to use their legs and feet and makes a kick right for my head ....good thing I duct...if that had connected I would have been out cold. We are still waiting for security ....we page them overhead....few minutes pass and still no security......a few members from the Code White team arrive...by this point myself and two other nurses both much smaller in stature than myself, have manage to restrain the patient chemically and physically.
During this situation, I was verbally abused and threatened, swung at, pinched, punched and almost kicked in the head. Was I upset? You bet....do I have recourse? Not at all. It's considered part of my job. I appreciate the patients condition and once they were settled they became more cooperative with care. But should I have to endure that and just accept that? The College of Nurses has no position on this and my unions position is that it is my employers responsibility to ensure I have a safe working environment. Well I am not sure how any employer can prevent anything like this from happening. They are however responsible for ensuring that their is assistance readily available....I don't think this happened in this case.
My situation is not unusual. Many health care practitioners care for aggressive patients. Some have the option to just walk away. Not so for nurses. It is the nurses who are left behind to mind the patient.
I read on a blog the other day where a nurse who was visibly pregnant got kicked in the stomach by the patient. Although she admits the patient was drunk and stoned she felt the patient did it intentionally, and needless to say she was irate about the situation.
I don't think I know of a nurse that in their career has not been spat at, verbally abused, swung at, kicked, pinched or punched. It seems to be the norm and accepted as part of our duties.
We were very lucky on Friday that none of us got hurt. But should that be the case....luck?
When things like this happen, I wonder why, why do we as nurses have to accept this? If I was a police officer or any kind of law enforcement officer I would have grounds to take what ever action was necessary to subdue this person and lay charges. Not so when you work in the health care profession, it is considered part of the job. I don't remember signing up for that in nursing school. Self defence 101 was not in the curriculum.
Don't get me wrong I love my job there are many rewarding features to nursing. I just don't like the physical or verbal abuse I must endure. I put my self at risk every day when I go to work. I am potentially being exposed to respiratory diseases such as TB, or gastrointestinal bugs and MRSA, or blood and body fluid exposure, Hepatitis or HIV and AIDS and/or needle stick injuries. Everyday when I go to work I put my life into the hands of the health care system, the system in which I am to help protect and save the ill and those down and out, but who is there for me?
16 comments:
Wow. I'm sorry that happens and I know it does and I admire the nurses and the doctors that go through that. How many times have I sat in the ER rooms have I heard in the next "cubicle" of an irate injured prisoner/patient that has come in with a police officer that is extremely verbal. In some ways I say let the drunken SOB bleed but I know he needs medical attention but my goodness, the obscenities he was throwing out at the police, the nurses, and the doctors and for all patients in the ER to hear were awful and I still to this day shudder at seeing and hearing this experience.
I can say you truly all do a remarkable job with patience and if it was I in that job, I don't think I could have the courage to take it.
On the flip side, I was thinking of my illness where I suffer seizures and there have been unfortunate times when I have wandered out into the streets. Not so much now that I have proper AEDs but if to an untrained eye as to what is happening, if I'm restrained at this point, which I have been a few times by police and other medical technicians, I will become aggressive and combative during the seizure and, so I'm told, will become very strong and quite verbal! I have even be mistaken for a druggie and handcuffed but that's another story. I don't mean to be aggressive but the more you restrain me during this time the worse I will get but no one knows that until the seizure ends. But I don't want to hurt anyone. I'm the nicest person you will meet.
But in your case I don't know why it took so long for security to get there. They should have been there much faster. People in that state tend to get much stronger and you and your colleagues could have been seriously hurt.
In retail we are verbally assaulted almost daily. Yes daily! Ask anyone working in the field and how often do we at the end of the day go home, slam the door and rant at our spouses about the rude customers that told us to shove something up our a**. Many times we will go through this and all we can do is smile and listen to them talk smak about our goods and services while spitting in our faces and demanding we do something now or they will make sure we never work at another job in this city. How many times have I gone to the washroom at work to see a co-worker crying because she was told off by a customer and it just pushed her over the edge that day. We have to take it if we are working in customer services. BAH!
I know your case is much more extreme and I'm sorry you have to go through this. I hope that maybe something will happen out of your post here. I know you folks at the hospitals and clinics are fantastic! I admire you all. Stay safe.
~Michele~
I think the heart of the issue is where was security! I can't believe how long it took.
I've been verbally abused by customers and I usually just take a deep breath. We did have one customer who seemed drunk and flung a shopping cart at me - our security came right away and her husband showed up and explained that she was having serious emotional issues and had wandered away from him. she wasn't drunk, she was having a reaction to meds. I let it go - her husband was clearly in charge and she was instantly sorry when she saw him and calmed down.
years ago I worked for a lunatic who threw staplers!! I was told to 'just deal with it' as he was a top salesman and 'brilliant'. I didn't stay there long and in hindsight I'm sorry I didn't do something official. I was young.
I'm glad you're OK and I hope they review security back-up.
Michelle, thank you for your kind words and for sharing your story. As I said I know I am not alone out there. I also recognize that by physically restraining someone can exacerbate the situation and hence we try to avoid that at all cost and try a variety of methods ... but some times you have no choice.
smalltown: As a speech path, I've also bee bitten, spit on, scratched, and kicked. Mostly by children but have been concerned on a few occasions about the adults, too. Usually, if I'm working for someone else (not private), there is some protocol in place to follow. I know the Dept of Corrections has certain protocol to follow in their health care units (but of course, the would). No matter how you slice it, though, we are easy targets. Especially nurses! You're giving injections, IVs, trying to help with toileting and cleanliness--just to start the list. And so many patients are emotionally and cognitively confused. Whew. Makes it tough. I guess we need to wear safety beepers that we can activate to alert the security people to "Come Now!" Maybe ask the hospital administrator to meet with you to form a committee who could address these concerns and come up with a viable plan of action. If one is already in place, review it and improve on it. Then IMPLEMENT it.
Take care of yourself and watch your back! Donnetta
I don't envy your line of work at all for situations like this. I thankfully do not work in a place where such incidences are accepted as "normal".
My mother works in the office of the Mental Health unit, so she has seen a lot of bad situations, and been involved in situations that have left her totally frazzled.
I don't think you get paid enough for the situations you are required to handle. But I thank you for doing the job so many of us (myself included) couldn't do. I really respect you for it.
Holy sh#t! That is horrible! Number one that is totally unacceptable that you and all nurses have to put up with that and number two, the security should be the ones responsible for handling combative patients. I'm sure doctors don't have to put up with that kind of abuse so why should nurse? Hugs, Tammy
It never ceases to amaze me that nurses are expected just to put up and shut up about this kind of abuse - it's just ridiculous!
Oh my gosh, this is such
a scary story. And in the
end no matter what anyone
says you are alone, as it
is your body which will
sustain the trauma.
I am so grateful for the men
and women in your field. My
sister is a nurse and
recently left the field
for many of the things you
mention.
My prayers and my gratitude.
Be safe...a very effective
post..
Dorothy from grammology
remember to call your gram
www.grammology.com
Hey you,
You're going to think this is crazy (because it is) but you've got it good. You mentioned security, chemical and physical restraints, the first three strategies when dealing with violent clients. Here in the UK they don't believe in that. There are no security guards, restraints and quiet rooms are non-existent and their med interventions are so weak they're useless. The nurses receive regular training in how to subdue clients (and to do it in a way so as to avoid a lawsuit) but little concern is given to the nurses who get hurt. And a LOT of them do. Industrial injuries they call them and most of my colleagues have been hurt at work.
It's a very common occurrence in mental health and part of my nurse training did include physically restraining clients but as we're not as litigious in Canada as they are in the UK, all those things you mentioned are available there; drugs, restraints, and big, burly security guards.
I am so sorry to hear about this situation, but I saw my own father become aggressive and violent towards nurses and care aides when we had to take him to the "home." He actually kicked a nurse so they put him in the "violent" area and kept him medicated until he became oriented better. It was all due to vascular dementia that came on as a result of some serious strokes.
And, I've seen my own late husband and my younger daughter become extremely violent - both verbally and physically - due to their mental health issues. I have been literally afraid of them at times. It's amazing what strength comes to a person when they're ill like that.
Even as a teacher, we had to become a lot more aware of the physicality of students. Some high schools have to be careful of weapons on students' bodies. I think this situation is everywhere. My daughter tells me of situations she has to deal with in customer service, I've had to deal with it in the teaching profession, and you have to deal with it in the nursing profession. The problem for you in that latest incident was "WHERE THE H*ll WAS SECURITY WHEN THEY WERE CALLED?"
I think you should have every right to restrain/subdue anyone who is being physically abusive.
We carry personal alarms at work now. It's attached to the key ring so that if you tug it it lets out an incredible shriek and everyone is supposed to come running. Unfortunately they go off so often that staff have habituated to them much as they have to the fire alarm and do not respond.
The medical profession isn't the only one with bad behavior. My daughter in law is the director of a daycare center, and was also kicked in the stomach while pregnant. Fortunately, everything was fine with the baby. Unfortunately, most people don't want to deal with their children. I cannot understand how they won't dicipline their own kids.
My father in law also had dementia, and acted out aggressively. He was the sweetest man in the world before he got sick, and still was most of the time, but sometimes he just lost it. I have the greatest admiration for the nurses and aides of the nursing homes too. Thanks to all people dealing with the public!
First let me say that I am so very glad you or your co-workers were not seriously injured in this incident. In my opinion, security was most obviously lacking in thier duties here. I understand that your profession places you in dangerous situations on a daily basis, but as you metnioned 'self-defense 101' was not a course option while you were studying! Perhaps a most unfortunate lapse in scheduling the courses for this profession.
And before any other readers have a chance to criticize me for stating these thoughts, I fully understand that when people are ill, sick, frightened, etc and need to be restrained they become more combative and I do not have any answers for this. But I do believe that people in all professions should have a form of security available to them at a moments notice should the need arise! Again, I am so very glad you are okay! Hugs to you for doing what you do, my friend. I truly admire you!
I can understand the aspect of the nurses kind of being expected to "take" this type of abuse because of the wide variety of issues you may have to deal with on any given day. Dementia or the issues the first commenter made about her own medical situation can be very difficult to deal with. My grandfather, normally a sweet, quiet docile man, developed almost super-human strengths at times when he was having dementia issues and one time (thankfully, ONLY ONE time) did he get violent with my Mom and Grandmother. Mom opened the kitchen window and screamed for the next door neighbor and as soon as he entered the house, my grandpa calmed right down. Strange the effect the neighbor had on him ya know.
But in this circumstance as you dealt with, frankly I find the security dept. very lax and I think perhaps a good sit-down with administration, working out a solution to issues like this is in order.
Also, as you stated, when people on the street become combative and the police are dealing with them, they can press charges and I think in some circumstances, that should be applicable in medical care too -ie: dealing with drunks, druggies, etc. As long as there is no known history of mental issues that would cloud the entire scene, you know. Sadly, those individuals often don't understand, don't comprehend their actions but drugs/drunks, although when in that condition may not be lucid, but one would hope upon sobering up they would and then should be called on the carpet for their actions.
I can share two points of view on this.
The first one is:
I do home care. When I get client I don't know real anything about them. But before one gets hired on at most health care agency they have to fill out a very large job application and
have a complete back ground check with finger prints.
Now I real don't think they check out the clients like they do for the care takers.
I been lucky to have nice one.
But they're dirty ole men, the one who completely take advantage of there workers...mainly a slave driver.
and their the ones who verbal and emotional abuses to there client.
But they worry about someone going into a client home and being abusive or steeling from the client but sometime it the other way around.
Now for the second story but a little off the subject.
My hubby was being called racial slurs at work (tree nursery) from this one Mexican (White people aren't the only one who are racists) so he report it to the owner of the tree place and he got real angry and told him to "Just put up with it"
In few days later he was fired. But he did get his unemployment benefits and in Idaho if you get fired you can't draw unemployment but the only the reason the owner of place change his story why he fired him.
Now this other guy who also white was being called a nigger, white boy and all kinds of rude name he also complain and lost his job.
That Mexican is still on the job and still go around making racial slurs.
See Idaho is what they call a right to work state.
As a worker you real don't have much production.
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