Violence against doctors, nurses, and other health-care providers is on the rise; federal statistics record an average of 50 such attacks each day in the United States. That’s likely an underestimate.
Hospitals aren’t required to report such incidents, and nurses say they often “shrug them off,” or are discouraged from reporting them. Some nurses say they get little or no backup if they want to press charges. “Patients who attack health-care providers often get off scot-free because hospitals don’t want to take action against these attackers,” said Jonathan Bestwick, a registered nurse.
California and Minnesota have recently passed laws that aim to make the workplace safer for nurses, doctors, and other health-care workers by training them to recognize and defuse potentially violent situations and by improving security.
Nurses are more likely to be assaulted than doctors. Here are a few first-person stories from nurses who have been attacked by patients. (Have a story of your own? Share it with us.)
By Maria Gaytan: I was attacked by a patient one Friday night as I worked in the emergency department. The EMTs brought in a tiny woman who was very intoxicated. She was agitated, aggressive, and clearly did not want to be in the hospital. She yelled at the doctor, “If you touch me, I will kick all of your asses,” and demanded to leave the hospital.
The doctor said that the patient should be restrained since she presented a danger to others. Another nurse asked me to help, so I went into the room and put on gloves. As I did that, she was suddenly at the foot of the gurney and started kicking her nurse, who was standing nearby and talking to her. I ran toward the patient and used my forearm against her chest to push her back onto the gurney.
She opened her arms and started scratching my face and neck, and then she grabbed my stethoscope and started to tighten it around my neck. I didn’t want to move too much because I knew that would tighten the grip she had on the stethoscope even more. Luckily, the bell of the stethoscope slipped off, which loosened her grip. That’s how I was able to get away.
This was a very frightening moment for me.
When it was over, I asked my supervisor if I could go home because the scratches burned and my neck hurt. I was told “no” and that I had to stay until the end of my shift. During the attack, no one ever called a Code Gray (which summons an emergency response team to deal with a combative patient), and the security guard did not help, even though he observed two nurses being attacked.
My neck hurt so much I couldn’t turn my head to drive home. I was out of work for six weeks with neck pain. I also got counseling for PTSD.
I chose not to let this stop me from being the best nurse I can be, but these days I’m on higher alert. I try not to go into an agitated patient’s room alone, and I’m quicker to call security. I have also chosen not to work on Friday and Saturday nights, because there are more intoxicated patients in the emergency department. This change in my schedule has taken time away from my family and has caused financial problems, since I was paid more for working weekend nights, and I did not have to pay for a sitter.
Maria Guytan is a registered nurse who works in the Los Angeles area. She is a member of United Nurses Associations of California/Union of Health Care Professionals.
By Mary McGibbon: As a nurse for more than 25 years, I have seen many episodes of patient violence directed against clinicians. I’ve personally been punched several times. Once I was cold-cocked in the face so hard my glasses flew off. After that, I stopped wearing glasses to work.
As part of a special squad aimed at identifying potentially dangerous or violent patients, I got to undergo some training about how to de-escalate a confrontation, and how to use certain holds so a patient couldn’t hurt me. It’s been helpful, but I think that all nurses need that kind of training. I don’t understand why nurses learn little, if anything, about this in nursing school or in their orientations to work.
My scariest episode happened during a night shift on the orthopedics floor. Nights can be difficult because the lights are down so patients can sleep. It’s also a time when confused patients or “sundowners” with Alzheimer’s disease are likely to be wandering. I saw an older man using a walker cross the hall and head for a female patient’s room. Thinking he might have gotten confused or turned around, I said, “Hey there, I think you are going in the wrong direction. Let’s head back to your room.”
I turned around to lead the man back to his room. He picked up his walker and hit me in the back, knocking me to the ground. He kept smashing the walker into my back. I was able to roll away and call for help. It took several nurses to calm him down. Some older patients can suddenly get the strength of Hercules. My back was sore for several days.
That attack changed how I approach nursing. I now often practice defensive nursing. For example, I no longer turn my back on patients. And in the back of my mind, I often wonder if the patient I am with will suddenly turn violent.
Mary McGibbon is a registered nurse who works in St. Louis Park, Minn.
By Joy Pumar: We see many homeless people in our emergency department. One night, a homeless man came in quite agitated. I was with him in a triage room, along with a security guard. Despite the man’s anxiety and agitation, he was nice, and was speaking very clearly to me.
I told him I was going to give him a shot of anti-anxiety medication that would make him feel better. He said OK. But as I went to give him the shot in his left arm, he whacked me with his right hand. The syringe flew into the air. I hit the wall and landed on the floor. I’m lucky the needle didn’t come down and poke me.
I was so surprised that I didn’t react for a few seconds. The security officer was also caught off guard. The patient became more aggressive, so the security officer and other nurses who heard the commotion had to restrain him.
I now feel vulnerable and on alert every day on the job.
Joy Pumar is a registered nurse who works in a hospital in the Los Angeles area.
By Jonathan Bestwick: Having worked in emergency departments in southern California for 25 years, I have many personal stories of attacks by patients. One time I was walking down the hall in the emergency department. A patient came out of a triage room and began hitting a security guard. I moved to help and the patient turned to me and started punching. He didn’t stop until other nurses came to my rescue.
I’ve been bitten, slapped, spit on, and verbally abused. I’ve had my head banged against a wall. I’ve been hit with an IV pole. A patient with AIDS once pulled out his IV and tried to splash his blood on me.
I’m not a punching bag; my colleagues aren’t either. We love to take care of our patients, but we aren’t to be abused for being angels of mercy. All hospitals have harassment and anti-violence policies. But they are meant to keep people who work in the hospital from harming each other. I hope that legislation to prevent workplace violence will make hospitals safer for their workers.
It’s a bigger issue than attacks against nurses, doctors, and other health-care providers. If caregivers can’t be protected against attacks, how can patients be safe from other patients who turn violent?
Jonathan Bestwick is a registered nurse who works mainly in emergency departments in Los Angeles County.