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Nurses on the front lines: When patients attack

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All nurses have stories to tell about “problem” patients. Usually, these stories are funny rather than scary. There’s one patient who finds ridiculous things to complain about. Another wanders the halls singing show tunes.

But some patients pose a danger to themselves, other patients and the nurses charged with caring for them. Here, we look at some of these tales from brave nurses who have met the challenges posed by violent patients and answered the question “What is it like to be attacked by a patient?”

Which Patients Are Most Likely to Attack?
In our informal survey, the patients most frequently reported as violent were also among the most vulnerable. Almost all were suffering from dementia, psychosis, PTSD or traumatic brain injury.

Elderly dementia patients are especially likely to lash out. Nurse Kathleen David-Cote’s story is a common example of how quickly things can go wrong: “I had a dementia patient grab my name badge lanyard and try to strangle me with it. When I ducked my head out of the necklace, she took her fingernails and scratched my arm, making it bleed. Very frightening. Her eyes were so scary.” Bonnie Holman Erwin says she has been attacked many times. “I worked in an Alzheimer’s unit in a geriatric facility…don’t ever believe that feeble old people aren’t strong! You definitely need to be alert, quick and, most important, understanding of their condition.”

Psychiatric instability can also make patients, even young children, act out aggressively. Sometimes, nurses endure many non-life-threatening acts of anger in a single shift. Nurse Kim Ostrander Crum gives this account of what it’s like for her: “I work in a children’s psychiatric facility. I’m attacked routinely—trash can thrown at my head, punched, kicked, bitten, spit on and (my particular favorite) breasts pinched. That was all in one day.”

PTSD is another condition that can make an otherwise peaceful patient suddenly dangerous. Gina VaVerka tells this story about a patient who was a veteran: “I am an army nurse and I was working on a telemetry unit in an army hospital in Texas. My patient started screaming in the middle of the night and thrashing around the bed. I went to see what was going on. As I leaned over the bed, he grabbed onto my stethoscope and scrub top and started choking me with it. My coworkers had to pry us apart. Turned out he was having a full-blown PTSD attack from the war in Iraq. It looked like he was wide awake and looking at me. Apparently he saw me as someone completely different.”

Next: How Should You Respond to an Attack? →

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2 Responses to Nurses on the front lines: When patients attack

  1. knear1991

    There is one resident at the facility where I work that is one of our Alzheimer’s/dementia patients, and as soon as his wife leaves his room at the facility, he sometimes will do a total 180 with his mood. There was one night I had taken him to the bathroom right before suppertime, and the second his wife walked out of the room (although he couldn’t see her) he turned on me. He was screaming that he would not expose himself and he started trying to hit me while I attempted to hold this 200 pound man up with just the gait belt I had around his waist and my knee to support his bottom so he didn’t end up on the floor. He kept swinging and cursing until I had his pants up and got him safely into a wheelchair. It was the scariest thing for me to endure because I was so afraid he’d hurt himself or end up falling on the floor and breaking his hip. The happy part of the story came an hour later when I took his supper in to his room for him (since he refused to come to the dining room) and he smiled and told me how grateful he was for the food and we sat and prayed together. He didn’t remember the incident at all, but I’d rather he didn’t. He’s one of the nicest gentlemen I care for.

  2. ruralnurse RN

    I work [volunteer] as a rural nurse/ambulance volunteer in a remote part of Western Australia. A month ago, I had a 30 yo woman present as having a reaction to antibiotics. Fairly straight forward. Within an hour, she had degenerated into a psychotic, extremely violent wreck. I had to call the “local” police who are 120 miles away. They agreed with me that the pt had probably od’d on some bad drugs. She was unbelievably violent—took the 3 of us to restrain her. She was kicking, biting punching—you name it. We had to handcuff and tie her down and still she was trying to bite chunks out of me. Poor girl was like a wild animal. It turned out she had contracted encephalitis. I had to transport her 200 miles in my ambulance with the police sitting on her.
    I can only feel compassion for her—-she did not intend to harm me.