Hello fellow nurses and readers. I know it’s been a while since my last post. Thank you for being patient. The truth is, a lot has been going on. I moved into a new apartment, got busy with the holidays, took some time to get back into the flow of things….and I got assaulted by a patient at work.
Now, to nurses this may not sound like earth-shattering news. Why? Because it happens. Depending on your clinical setting, it can happen more often than at other places. But the bottom line is this–direct physical assaults to nurses do happen.
What do I mean by assault, though? An “assault”, as defined by Merriam-Webster, is “a violent physical or verbal attack.” An assault is also listed under the category of “workplace violence,” as stated by the American Nurses Association (ANA).
Assaults are more common than you think (and we’re talking about reported ones only). In the ANA’s 2013-2016 Health Risk Appraisal, 25% of the nurses who were surveyed were physically assaulted at work by a patient or a patient’s family member, and 9% of them were concerned for their physical safety at work.
Knowing this, I wanted to share with you a little bit about what happened, and how I personally overcame this obstacle. Because frankly, even after working in a psychiatric unit for almost 6 years, I had never been assaulted like this before. And it was really, really scary.
How to bounce back after a physical assault
I had been caring for a patient who was about three times my size. This patient had a history of being hostile to staff and verbally abusive, but had not been physically abusive in the past. However, for whatever reason, this patient had been fixated on me and saw me walking in the hallway (after already taking routine psych medications). Without warning, this patient immediately charged at me and grabbed my arms, digging both of his/her nails into my wrists. Frozen stiff, I did not know what to do for a second or two until I remembered my CPI training. I yelled “STOP!” at the top of my lungs, over and over until my charge nurse came running to the hallway to intervene. Then I ran away.
Here is what helped me, personally, overcome this incident. In retrospect, the patient could have done more and could have inflicted more physical damage to me. Even though this may have been considered a “minor” injury to some, psychologically I was actually frozen and shocked from the whole experience. The following is what helped me through this:
Get your charge nurse on board and on alert
I had taken care of this patient since yesterday and informed my charge nurse that we had to transfer this person to a higher acuity psych unit due to the unpredictability in his/her behavior. Thankfully, my charge nurse responded quickly when I yelled for help.
Ask your leadership team about existing nurse assault protocol
What resources are available for someone who has gone through this? Is there an Ethics Committee available at your hospital/work place? Is there a counseling center available to your staff? Take time to talk with your unit leaders and ask them what arrangements can be made after an event like this. My unit director was understanding and allowed me to go home early. My unit director and charge nurse also worked hard to get the patient transferred to a higher acuity unit on the same day.
Have a conversation with the doctors about the patient’s medications
After this all happened, the doctors had a very understanding and empathetic conversation with me. They said they would change the patient’s medications accordingly as this patient was obviously not safely contained within the unit. I was so grateful that they were supportive and wanted to make sure I was okay.
Take the time off
After I went home that day, I literally didn’t feel like doing anything. Obviously, this is strange for me as I am fairly known for being a physically active busy-bee. I love to work out and train for Ninja Warrior. But for me to lay down and do nothing in the day time is weird. But in cases like this, that’s okay. I had to rest to just process everything and calm myself down. It was as if my nervous system was frozen like a computer and I needed to go to sleep to rest, reboot, and get back to normal.
Talk about it with someone who understands
When I finally went back to work, I felt ashamed and humiliated. I replayed the incident several times in my head, telling myself “I should have done it this way” or “I should have done it that way.” My perfectionistic tendencies were kicking in, and I was starting to sabotage my self-esteem. I got this off my chest before I started my shift by talking to someone at work about it. And this helped me sooo much. This person validated my concerns, validated my feelings, and said I did nothing wrong. After that conversation, I was able to start my day (almost) as if nothing ever happened.
As soon as you can, get back into your usual routine
The day after the incident, I didn’t skip my morning workout. In fact, I woke up early and got it done. I did some lifting and pushed myself to do some power work like single-arm dumbbell snatches and burpee box jumps. And I’m so glad I did, because I felt so much better getting in that morning sweat.
(If you’re really interested in what I did for my workout, try this out–a burpee box jump descending ladder from 10 to 1, with 10 seconds of rest in-between each set of burpees.)
Although my “solutions” are not generalizable to the entire nursing population, and they are not “research-driven” or “evidence-based”, I could at least speak to the fact that all of the things I mentioned above were helpful in my recovery. I would love to hear about what you think and what you have personally gone through if you were ever assaulted by a patient or patient family member.
Because it’s time that we as nurses start having these conversations. Yes, they are painful to talk about. And yes, they are difficult. But they are life-saving conversations that could help prevent the injury (or even death) of you or a nurse you may know. Let’s be #UnbreakableNurses together.
“Assault.” Merriam-Webster.com. Merriam-Webster, n.d. Web. 21 Dec. 2017.
American Nurses Association Health Risk Appraisal: Executive Summary. (2017). Retrieved December 21, 2017, from http://www.nursingworld.org/HRA-Executive-Summary
Workplace Violence. (2017, January). Retrieved December 21, 2017, from http://nursingworld.org/workplaceviolence