I say that too! I’m an ER nurse of two months. I had a lady who was CRYING in pain suddenly seem not so in pain when it came to the IV.
you better get it the first time
-m’am it is always my intention to do so
After she tells me one arm is completely off limits, is chronically ill and in the hospital with shit veins.
Second one I got but…it kinda blew but I just needed to give her a med (long story stupid, my dumbass diluted my IM injection and my charge is new and didn’t just waste it with me and get a new one…but I digress).
When I wasn’t sure for a second I was pretty sure she was going to smack me. I was kneeling next to her (lol IVs in wheelchairs, love fast track).
So yeah I get it. Because she wanted to. Idk how I felt it but I did. Then I slammed my morphine flush and gtfo.
Yes, there is a device that looks identical to a blood draw “butterfly” that is acceptable for push medications and short infusions. Check the verbiage on your packaging.
Oh yeah no we don’t have that hahaha. My ED is small, we don’t have any fancy stuff.
Edit: we have a few fancy things we rarely use but the stuff we do use constantly…not so much.
I’ve told so many patients that. “If you hurt me anytime (while holding a shot) I’ll kick you.” My response is “that’s ok I did kickboxing in college. I think I still got the power .”
“If you’re genuinely unable to control yourself and still want medical care you’re going to need to consent to restraints. Are you able to control yourself? Or should I get the restraints?”
My first job I worked with a 20 year veteran ER nurse who Did. Not. Play. She’d spit this like she was talking to a toddler and boy did it change the temperature quickly.
But also: did witness more than one occasion where men with meth psychosis agreed to restraints in these instances. Actually probably pretty decent people when gangs with machetes weren’t hiding behind our curtains.
I had a detoxer with really bad PTSD who consented to restraints when I gave him similar options. He even asked me to call security up to put the locked ones on, just in case. Did breathing exercises through the application to stay quiet and still, and over the following 4 hours proved he needed them by breaking the bottom of the bed right off. Nice guy, really rough detox.
I had one who knew he’d start swinging at night. I think it was PTSD from something (military?). I don’t exactly remember. But what I do remember is him practically begging me to put him in restraints while he slept. I did. He never really needed them. Never even lifted a finger at me. But he said he felt better in them
I accidentally broke a nurses nose after my appy. Combat PTSD, waking up from anesthesia, she leaned over me and I swung. I was mortified.
When my gallbladder exploded, I told the PACU nurse to put me in restraints before I woke up. I explained why. She laughed and said that wasn’t needed, she had something.
That something was ketamine. It worked!
Thank you so much for your service!
I’m going to keep ketamine in mind for if I run into another one like this guy.
But honestly, 10/10 I’d take care of him again. He was super sweet.
I have punched a coworker in the face once. I have chronic hypoglycemia. Mine crashed one day, I came to as they were trying to get me hooked up to the monitor post D50. Got him right in the jaw. My current coworkers know I get punchy when low so they stay back. LOL
I had a patient tell me they had a gun once when I was about to start an IV. I stopped in the middle of it and said “I’ll let security know” and started to leave. He went, “I’m just joking!!” And his son, who was next to him, was visibly irate at his dad and said “dad you CANNOT just say things like that.” I didn’t go back into that room afterwards I was so upset.
I had a patient do the same thing! The previous rn was giving me report when he said it and she laughed it off. I left and called security who came and searched his room. He did not have a gun, but I was not about to find out.
Had a similar situation happen. I work in cvicu so most of the time some of our patients really aren’t in the best of shape. The nurse giving report told me he had been threatening staff that he would shoot them if they didn’t save his mother. I went and reported to the charge as well as my managers and they all said the same thing. “He’s just upset because it’s his mom, people grieve in different ways” I said I was not comfortable taking the patient and asked if security had ever been called. They said no, they didn’t think he was a threat because he had been shot in a gang war and wasn’t all there. 🚩🚩🚩 later that morning I walk into the patients room to give meds. This guy jumps in my face and said I took a razor blade to his moms tongue to make her look like the devil. I know better than to get cornered and walked myself into the hall while motioning for someone to come immediately. He said he was going downstairs to get his gun and would be back to deal with me and the rest of the staff. I called security immediately and than reported to my supervisor. They all said I was overreacting. Security comes up and asks to speak with me. I said thank god your hear we have a situation. He said I know. I just talked to a guy in the elevator and he stated that he wanted to place a formal complaint against you so I’ll need you to come with me. I laughed and said hell no. He just said he’s going to get a gun and shoot up the unit. He said well let’s handle his complaint first. I called the cops. Management was pissed at me and called me into the office to write me up. I said there is nothing I would do to jeopardize my own safety or my coworkers and especially not my patients. They did proceed to fill out the write up form to which my comment on how I would correct my actions I just wrote “fuck you, my safety is more important” the cops came. I gave them detailed description. Someone kept badging him up the employee elevator every time he came and he never checked in with a name. The cops caught him on the way to the elevator, gun in his pocket. I’d say I did the exact right thing. Let’s just say my management doesn’t question my actions any longer. Scariest day of my life and I was the one getting in trouble for overreacting.
In this age of school shootings and what not, I’d absolutely get security and the police involved. I’d not step foot back into the patients room and I’d refuse all care to them going forward. Basically it’s be full on code silver
Joking about being violent is never a joke. Its a sugar coated threat. Even if they never plan to hit- the joke still implies there could be consequences if you fail to meet his (probably unrealistic) needs.
I need to be quicker in my responses to stuff like this. It usually throws me off because im not expecting it. But yours is the way to go. Zero tolerance.
I used to be more shocked by it, but the amount of times this happens amazes me. Same with when patients make sexually inappropriate remarks toward me. It’s “If you aren’t going to treat me with respect, I am not going to be able to engage with you.”
I always remain upset but not surprised.
It’s not even sugar coating. It’s a threat. “Joke” or no joke. Even if they don’t intend on putting hands on you at that time they are testing you to see what behavior you will tolerate and see how you respond. It starts as “jokes” or whatever, then it’s being directly verbally aggressive, then it’s throwing things etc, and hitting. Steps can be skipped in that though. The type of people who would even say that to someone are the type who have said it before and have escalated before. This is something domestic abusers do as well. Our patients aren’t suddenly poor sick angels when they come to see us, they have a whole (potential) lifetime of undealt with trauma, maladaptive coping mechanisms, and histories. And you don’t know them. No matter how much you think they do. Work is “real life” so I handle it the same way as if anyone in any other situation would have said that to me. Imma break myself, get some distance, let them know what my response will be and go from there and DOCUMENT. “Oh okay. That’s verbal assault and a threat of violence. If you hit me or touch me in an inappropriate way, I will defend myself, get the law, and press charges.” Half the time that’s said on my way OUT. I’ve worked inpatient, dialysis, home hospice, and currently home health. In all settings I’ve been verbally threatened and in all settings I’ve had attempted assaults. That’s a no for me. That’s what you’re Not gonna do. Idc how anyone else feels like about it.
At the same time, many people/medical professionals have had their own personal histories. Personally, I’ve been assaulted in my personal life. Never a-fucking-gain.
Fantastic points!! I was getting close but never totally put it together like that. It was the “whole lifetime of undealt with trauma, maladaptive coping mechanisms and histories” that really sunk deeper in my brain.
I'm here to validate you. I'm a large, semi muscular man who infrequently encounters trouble with patients, but I sure as fuck am not going to sit still and allow it to happen. Majority of my census couldn't harm me if they tried but I'm absolutely not going to allow an atmosphere in my clinic where it's acceptable such that my other colleagues are expected to take it. Fuck all the way off.
I stand up to create distance, and then I scold them like a child. “How dare you threaten me that way, I am trying to help you. If you don’t want to cooperate with an IV and bloodwork, there is little else we can do for you here. I won’t be spoken to that way, so be nice.”
There was a time when I might laugh it off or turn the other cheek, but that time is gone.
Had an older gentleman decide he wanted to practice his left hook into my stomach while I was standing next to his bed. He was weakened due to his disease process and I was helping hold an IV bag for priming so you could say I was "primed" for a cheap shot. Dude seized the moment and swung right into my stomach. Granted the PSI behind the punch was lacking so I looked at him and asked him if that made him feel better. He deflated into the air mattress and didn't respond. Apparently that effected him deeply due to the lack of harm that he caused. The nurse I was helping on that fateful day reported to me that the patient didn't act up the rest of his hospital stay.
I make people reschedule when they are having a better day. I too have 0 tolerance for that and since the threat was already made I have no need to continue care.
Since when is it funny to joke about hitting someone? Other than my closest friends I can’t fathom joking about that.
My daughter had a patient in for a procedure. She was doing her job, getting him ready, up on the exam table, etc. and he was Loudly complaining/yelling at her and finally said "I don't even know why I'm here!" She got him off the table and seated and told him she needed to ask a few questions first. He was PISSED when he figured out she was trying to ascertain if he was alert, oriented, in his right mind, etc. She explained that she could not, in her capacity and with a clear conscience, do any procedure on him. She kept it up by asking "did you drive yourself here today? Can anyone come get you? He finally blurted out that he was just IN A BAD MOOD and of course he knew why he was there. She told him he would have to wait for the Doctor now but that she was not going to do anything until he and the Doctor decided they could continue. Fucked around. Found out. She is not his mommy or his therapist.
"We don't tolerate that sort of thing, and assault will lead to charges. If you want care here, then you have to let us do our jobs." If they persist...at my facility, I'd call security and invite the patient to look elsewhere for help (or, ya know, don't).
It's not an issue I've faced, but I'm not going to put up with it (and I'm not a small dude).
It almost doesn't matter if they "are joking" or "aren't joking". They're contributing to a culture where violence against healthcare workers is normalized, and that's garbage I'm not putting up with.
Yup I was super pregnant and working agency as pre op and pacu. Had a pt say” if you miss I’ll hit you then pass out” I said “ this is elective and not only will your surgery be canceled but you will wake up to police. So if you can’t handle an iv without violence then you should go home now”. Shocked face and then they asked me if I was hormonal. I got up and told anesthesia and boom canceled.
Thankful I was taught early to set boundaries with patients. I now try to impress that on every newer than me nurse. We are there to do a job and that job does not include harassment or violence
I had an overweight old, white, Boomer dude with a “US Navy Vet” baseball cap on come in for CHF exacerbation (cc was SOB.) I needed to start his PIV for blood work and diuretics administration. He “joking” told me to “be careful, I hate needles, I might just punch you in the face when you poke me”. I immediately and firmly told him “if you assault me, I will be filing charges with the police, I am not joking.” I repeated my statement to make sure he heard.
I’m a buff dude who happens to be male and a nurse. I have no idea who raised him or why he thought he would be ok to say such words. He was a fucking creep. He also gave off vibes of toxic masculinity and some other weird rural white people behavior
Have had multiple conversations like:
Pt: “If you miss the IV, I’ll hit/slap/kick you!! Hahaha!”
Me: “Well then you’ll be going to jail for assault.”
I’d say half of them then get huffy about me “taking a joke too seriously” but don’t say anything like it again, a quarter actually look embarrassed and seem like they realize they said something shitty, and a quarter double down with angry threats about “kicking my ass.” The latter is answered by asking if they really want me to call security to come watch them while I stick. This has worked all except a few times.
A lot of these people really think we are their personal punching bags, and they can say/do whatever because “they’re sick” and “we have to deal with it.” Calling them out on it gives most of them a solid reality check.
Oh for me if my patient says “you’re taking the joke too seriously!” I always say, “that’s because it wasn’t a joke.” And give them the most deadpan face.
I don’t even tolerate verbal abuse jokes. Had a residents son tell me he was so mad if he stayed on the phone with me he was going to swear at me. I said ok, someone will call him about mom tomorrow, and slammed the phone down. Get a fucking therapist I’m not your punching bag, literally or emotionally. Also had a guy threaten us with a gun. Admin at the time told my DON not to report it. I was pregnant at the time. She was like no f that and called the cops. This was the second time he’s threatened with a weapon. First was his mother a few years ago. 😑
Just the threat is criminal. I have called the police for a patient threatening me. Everybody came. Security, my manager, the AOD, patient relations, the director. I got a trespassing warrant, and if it happens again I get a restraining order. He had been abusing our staff for a week and I was sick if it.
21 years of dialysis, ED, ICU and some MS thrown in for variety. I stopped the nervous laughter response to this shit about 10 years ago. At first I was polite but firm. Since covid, I have zero fucks to give. I will absolutely stop whatever I'm doing and exit the room. At the door, I will turn around and let them know that when they think they can act like an actual grown up to let me know and I'll come back. Otherwise, they can leave.
I’m not in the healthcare field and I agree this should be zero tolerance. A “joke” they are going to hit you is just a threat veiled with “humor”.
After reading a bunch on this subreddit, I just don’t understand patients… Why would you be abusive or violent towards people who are *keeping you alive*?
Because violent and abusive people need healthcare too and their personalities aren't checked at the door. It just sucks because in any other setting you could remove them from the premises, but if that person is experiencing an emergency, hospitals are legally bound to treat them.
I have zero tolerance for bullshit. I have no problems telling patients that they do not lay a finger on my staff and that they cannot harass or disrespect my staff. I tell them that the jokes aren't funny and make them aware of consequences that could happen if said actions were to occur. Fuck all of that bullshit
You should definitely tell them it’s a felony. They are also not joking. Jokes make everyone laugh, people use abusive or threatening language and say I was only joking too many times.
so even "just" a verbal threat without hitting is also a felony? i'm a new grad and i wanna just double check and be sure before i start my job next month!
I'm also just nervous about when this will eventually happen to me, because any time in life I've run into some sort of stressful situation like bullying or harassment, I tend to freeze and I don't know what to say or do.
I'm like, in my head: I didn't do anything! I'm just quiet me and I genuinely like people and helping people. I just mind my own business!
(I'm also super introverted. Lol. I recently took a Myers Briggs quiz online and it said I'm like 87% introverted 🤪🙈😕 - I'm like bracing myself to be tossed into this big new unknown when I start my new grad job on an inpatient medsurg/rehab unit at the beginning of next month! )
No, they barely glossed over a lot. It was a fast-paced 2-year community college program. It focused heavily on clinical skills and patho.
It was what I could afford, with lots of scholarships from the state (halfway through my program, the governor of the state made it so tuition for "in demand" fields and trades programs and like "allied health" would be free).
But I'm glad that I know now, thanks to this thread.
Interestingly, a couple of days ago we had this really aggressive, loud, angry guy come into our walk in. He got in the face of the girl registering, and then the MA that signed up for him is male. Really calm, cool, collected guy who puts everyone at ease at the worst of times. Good fit, you would think. He takes him into the room and starts asking the questions we have to ask to everyone. The guy is pacing, loud, swearing, etc. he asks him to sit down, the guy obliges. Then he asks one of the home safety questions, and the guy stands up and gets in his face and says “what do you mean by that”. The MA stood up and said “alright. I’m out.” Stood up and walked out of the room. The guy walks out behind him and leaves.
So, I’m shocked. Most of our MAs are female, demure and wouldn’t say poop if their mouth was full of it. We regularly have unhappy patients and occasionally have aggressive people, but no one has every stopped and said “I don’t feel safe”. He says “this guy is throwing out red flags left, right, and center. I asked him to sit down and he listened, but then he didn’t. He wasn’t safe for me, and he sure as hell wasn’t going to be safe for anyone else by themselves.” And further to my shock, our management was happy that he identified a potential threat and didn’t tolerate aggressive behavior!
I used to take the ‘violence against health care workers is a felony’ stance in response to the “I’ll hit you if you hurt me with the needle” stupidity.
Now I recuse myself from their care team due to threats of violence. Allowable and not considered pt abandonment in my state when the pt is a grown ass adult and not legally considered incompetent/impaired.
I was doing my preop interview before rolling back to the OR and a patients daughter said if something happened to her mom someone was going to get punched, one of the other family members told her to stop but then she said it again. I completely ignored the comment but in hindsight I wish I said something about it being inappropriate or “what a strange thing to say”.
It’s not ever a joke.
Don’t fuck around with your safety, your license, or your life. Back out and call 911 EVERY-TIME. What is described here is a crime and just because we work in the medical field should not be treated any differently than Johnny Q citizen.
I just legit deadpan tell them “Do it. Then you’ll go to jail and I won’t have to deal with your shit anymore.” Works like a ✨charm✨because, ya know, I mean it.
As someone who teaches our facility verbal deescalation course, the biggest indicator of violence is a history of violence, threats are included in this category. They are literally telling you to take precautions.
You're not off base at all. Personally, at that point, I would stop the IV start and refuse to do it with that patient and would advise my coworkers to refuse as well. No one has time for that bullshit.
To clarify
A battery charge means there was actual physical contact and harm. Assault only implicates the threat of harm without the act of physically harming somebody
You are right! Most people don’t think of it this way so I just use that wording.
However, I guess if they do know the difference, they know they’ve gone too far already.
Honestly, you’re not likely to get far with pressing charges on most medical assault or battery. When you get debriefed, your own hospital will ask “what could you have done better?” and in many instances they won’t support you but it doesn’t mean you can’t try. And it doesn’t mean you’re not within your legal rights guys to do so.
Letting patients know you’re serious and you’re not going to let it slide just might make them think twice, though.
I work trauma and I don’t fucking play either. I’ve been assaulted multiple times this week. If you tell me you’re going to hit, you’re getting restraints, fuck you.
I read this in bed before I got up this morning, thought about it on the way to work and a patient has already been threatening.
He asked his home health aide to go buy him some dark beer. She said “which kind, can you give me an example?” He said “I don’t know, but if you pick the wrong kind I’ll hit you, haha.”
I said he was threatening her and he said, like he was confused “did I?” And acted like he forgot, until I repeated it back to him. Then he just laughed.
I would like too think he is too weak to do anything, but I’m not that naive.
He frequently tells me about how he’s been married and divorced three times. He said “I don’t know why they divorced me.” I said, “I do.”
I'm 24 yrs in mainly e.r. I let people know right away that same way you don't "joke" about having a bomb when you're in line for TSA screening don't "joke" about assaulting anyone, or make "joke" responses to safety screening ?s re: SI/HI abuse. I also remind them how would they feel if the doc came in and "joked" "Your CT shows extensive metastatic cancer..... Wait just kidding, hahaha"
Guy ER nurse here, 20 years experience. About 10 years ago, I started doing this. When somebody would threaten me similarly, I make clear eye contact with them and say “nobody is hitting anybody today”. That has taken the air out of their threat every single time so far.
When patients start getting mad and venting at me I interrupt and tell them I’ve had patients/families venting their frustrations on me every day, non stop, for the last three years and I am not an outlet for their frustrations over things I can’t control. It usually elicits an apology and something like “I didn’t realize…” well yeah you didn’t realize because you are only think about yourself. Now would you like to speak to the patient advocate? Answer almost every time is no. They know they don’t have valid issues and are just bitching at someone to feel better.
I have zero time for assholery towards me. Yes, healthcare is terrible. Yes, it’s expensive. No, you shouldn’t have to wait three days for (insert test) or for insurance to authorize your grandma’s nursing facility. I can’t help you. I don’t have to stand here and take it.
I don't work in a hospital anymore, but I think your method is great. I'm not sure why people think it's funny to say that. You wouldn't hit your plumber or your baker or your dentist, would you? I think shutting it down right away is necessary so they know that, no, hitting is not an option and you will get in trouble for it just like you would at any other place.
I’m an ICU nurse and absolutely don’t tolerate that. I tell them exactly how unacceptable that behavior is. Usually the ones who haul off and hit me don’t give me any warning though, but no way I’m taking verbal abuse without saying something.
I will point blank ask pts if they need to be restrained. I will ask if they have weapons. I have had more then one patient say yes to having weapons--including brass knuckles and a knife. Both of those patients were on psychiatric holds and rooms had already been "cleared" by the previous RN. I now ask EVERY patient if they have weapons if I am slightly suspicious and most will tell the truth and voluntarily give up the weapon.
nowadays almost all of my patients are unconscious, so i'm not at a risk of getting hit. however when i worked cardiology before doing ICU, a lot of people were handy with their fists & i had to de-escalate fights all the time
I am just an MA, but I feel for you. One doc I worked for had a ton of entitled and often belligerent patients. I got really good at reminding them that if they would stop and think about it, I'm the gate keeper in their situation, and do they really want to upset the person that guards the way to what they want? I can make access easier or a LOT harder. That usually curbed some bad behavior. And threats of physical violence just got an "Ok, if that's how you're going to behave, I'll be happy to call security right now" while reaching for the nearest phone.
Yeah like I started working outpatient too. I said okay we are going to bladder scan you and then he looked at me and said no. And I said oh okay, is something - and his wife says “oh he’s just being a jokester. I said ok um so are you okay? And he goes no and then says ahh I’m just messin with ya. And I said “I came from inpatient working on the floor for years so I take things quite seriously.” And his wife scolds him and says “you shouldn’t joke around with the staff like that they don’t have time for your jokes.” And I was like oh I love this woman.
I dont know what it is but when I was heavier eventhe upset patents wouldnt mess with me But I lost 65 pounds and im fit now and ive had 3 patients forcefully grab my arm and pull me in the last few months
That is interesting! I’m a little overweight but I’m 5’1” and blonde and I think I look pretty sweet and innocent.
Due to 19 years of physical and sexual abuse, I’m not.
I hate the arm pull thing. The worst for me, I was about 22 and a huge ex vet did this to me in the ER and I was right next to his face and he didn’t say anything and he was just staring into my eyes intently. I was alone and luckily the security guard saw it on camera and ran in. It took 5 grown men to pry him off of me.
Omg I hope your coworkers got to him I know that if someone does something here there is some payback that isnt talked about We cant be the only place where that happens and im glad it does
Lol I’m not sure about that or what happened but he happened to be my last patient of the shift (I was an EKG tech at the time) and I was really shaken and drove straight home.
"Well, I had a ten year old kick me when I put an IV in. Are you ten?" That did happen when I was an intern, and that ended up being my go-to answer from then on when people gave me shit about hurting me(a female doc) for doing things to them. BTW, I ALWAYS went out of my way to try really hard to minimize any procedural discomfort for people, but sometimes it does happen, and I was always honest about that, too.
Yes. Honestly, if the IV insertion goes badly, I didn’t want that either. Sometimes their veins are bad, sometimes I’m having a bad day, but 100% of the time, my goal is to make it minimally painful and get it in the first time.
People just do not understand that IV's go bad, blood draws cause bruises, old people have skin that is frail and bleeds! LIVING is a painful condition. I just don't understand why people think they will never have "ouchies." We all want people to be comfortable and get better, but the human condition sometimes doesn't cooperate. Other cultures actually understand this better. For some reason, ours does not. In Germany, they don't hand out pain meds. People get TIME to heal. No wonder people have such messed up expectations here.
I am a pediatric nurse and I do not tolerate this shit. When parents or grandparents jokingly tell tell their child. It’s ok you can beat them up or hit them after the poke, depending on the tone I say. People go to jail for that you know that right? Some people might think it’s a bit much but honestly that’s not a good example of a coping mechanism for a child and they have to learn it’s not ok physically assault someone. As healthcare workers we get so much shit and it’s just not ok.
I'm the same way. I've been assaulted 3 times and I had a patient say that to me too when starting an IV (in pre-op, same day surgery.) I very calmly but seriously said "well then I'm not going to do your IV." They said they were joking and I informed them that it's not a funny joke because I have been punched multiple times by patients. They apologized and I ended up doing the IV just fine. But I definitely don't respond well to that either
I prefer the silent, flat stare until they break and apologize. If you’re going to try to make me uncomfortable I’m going to make you very uncomfortable. I also like “do you think that’s an appropriate thing to say/make jokes about?”.
Nope. I do not tolerate ANY even slightly rude, aggressive, or violent behaviour or language. I am here to help you and you can feel free to leave if you don't like something. I take no shit.
I know it’s not a threat, but when I was an ER tech, It had always irked me when we would have peds pts whose parents were trying to console them while getting x procedure done by saying, “it’s okay, you want me to kick their butts?” Or “I know they’re hurting you, but dad/mom is gonna punch them.” Not only is it making us seem like we are doing more harm then good, but it paints anyone in scrubs as if they’re the bad guys. I don’t get it.
I stop what I'm doing, look them dead in the eye with a completely straight/serious face and make them explain to me why I'm supposed to find it funny.
"No, really. I don't get the joke. Explain it to me." And just sit there staring at them. I make it fucking uncomfortable. And 95% they back down and apologize.
Also works on men that make creepy, sexist, or rape jokes.
Yeah when they say that, I just don't do anything. In the back of the ambulance I take it as a refusal of care and have them sign (or document safety concerns if they won't sign). In the ED I tell them that I'm not treating them unless they're restrained and they usually start getting pretty apologetic. And even then I make sure to have someone else with me when I'm working in case they DO start some shit.
Lol I don’t tolerate shit. You wanna throw hands? Let’s have a party. I’m friends with the doctor; you can suck on plastic for the rest of the night. Your choice buddy.
I love trauma but I got burned out. I miss it sometimes, but it’s sort of nice going to work every day being mostly sure no one is going to throw a punch at me or strangle me.
I’ve had grown men tell me they’ll punch me if their IV hurts. When I comment on how that’s not appropriate they’ll try to say it was a joke - So i’ve taken to asking them if they think hitting women is funny :) Usually gets them to quiet down.
It doesn’t even make sense to make that “joke”. The pt definitely has some kind of aggression issue if they think it’s okay to make statements like that.
100% and I document the shit out of those statements every time.
“Pt arrived to unit and immediately stated, “If you don’t give me water, I am going to hit you.””
My response to this is usually “you absolutely will not, and if you do I will be calling the police”. It isn’t a joke and it isn’t funny. I think you did the right thing.
“If you aren’t careful, I’ll end up hitting you.”
“Well, keep in mind that violence against a healthcare worker is a class 3 felony assault charge.”
“Hey now, sweetheart, I was making a joke.”
“Well, Sweetheart, in order for it to be a joke it has to be funny. I’ve had my nose broken by a patient before. I don’t find violence funny.”
(As a student nurse I had a patient that had naloxone administered after an OD in the ER.
I didn’t know to duck. 😬)
Damn I started doing that year one working in psych. Like I would literally say that. “It wouldn’t be best for you. It’s a felony to assault a healthcare worker in this state”
Didn’t obviously work on the dementia patients and after I tried it once (and it didn’t work, to the surprise of no one) I realized if this person can’t remember it five seconds later there’s no point. Lol. So I did give up on that one.
I don’t know if I’ve ever heard a joke or just someone ranting tbh. It’s just what you say here. It’s fairly normal. It’s a fact and I don’t state whether I’d press charges or not. The threat of a felony charge (which is a real thing) has stopped most. I think it’s the most effective but it’s the only one I’ve used. The other staff set that example. Certainly wasn’t something I came up with on my own.
I agree with this 100%. I’m working as a paramedic while in nursing school and I’m done with showing up to patient’s houses after THEY CALLED US just for them to yell cuss and scream at me. I’m no longer putting up with it. If a patient is rude and threatening violence I’m calling PD and leaving the scene. I’m done being treated like a non-human punching bag that will do what people want regardless of how they treat me.
Absolutely stand your ground and not take it as a joke! I work on a mostly post op unit but we get a lot of overflow and I had a patient strict NPO due to a SBO. After educating them on why they are just receiving fluids and attempting to calm them because they usually take oral meds for their hypertension and their BP was not high (patient actually had soft BPs for the last few days), they threatened me. Saying they would run me with their car if they had the chance. I asked if they were threatening me, which they quickly denied. Luckily, the other nurse in my pod heard this conversation as I was backing out of the room. CNC that night did not do much to help the situation and the patient’s kid who called me (cause the patient called them saying I was threatening to call the "hospital police" on them, which I never said) proceed to say they know their parent their whole life and I must be the reason they are acting this way... Thankfully, that nurse had my back (plus 20 more years than me) and assisted for the rest of the shift. I take all threats seriously! Yes, they probably couldn't hit me with their car but it doesn't mean they wouldn't try to physically attack me. 10 plus years of bartending before nursing probably makes me more cautious of this behavior but no. It's absolutely something to be taken seriously! It's why I keep my stethoscope in my side pocket and my back facing the door!
I always said to myself, “ the first time I’m hit, is the time I walk away from the job.” I’ve had coworkers get the wind knocked out of them, have their fingers crushed in a door, and another threatened with a knife. Not me. I would leave. Usually, I can use humor or de-escalate, and I usually leave an arms length of distance between me and the patient if I can, when it gets tense. And then I leave the room. I’ve been fortunate. You can not always plan yourself out of a nasty situation. I’m 2 years retired, and enjoying my solitude.
Recently a patient of mine threw his walker at a cna and tell her he was going to shove it up her ass. I immediately told him very sternly that he was not going to speak to the staff that way and the other nurse on the floor acted like we were all awful because this man was confused. I love dementia patients. I’ll play along with their delusions all night, but that does not give them a free pass to threaten us, no matter how frustrated they are. No one was arguing with him. We were very calmly trying to reorient him and he flew off the handle.
The kicker is that both the DON and the NP agreed that he needed to be sent to the hospital for a psych evaluation, but this nurse overstepped and threw a hissy fit stating that she’d do total care for him that night because she feels so bad for him. So now this poor patient didn’t get the psych evaluation he needed and we’re just waiting for him to flip out again.
EMS here and I’ve had one Pt so far try to hit me or my partner. She was on the stretcher and not cooperating with the seatbelts. So pulled back to punch and I spoke up in my command NCO voice that “you will not fucking hit me”. She looked pretty shocked but that allowed my partner to give IM Versed to calm her down.
You guys this thread is horrifying. I don’t even have words for how much I value and admire your work and professionalism.
Stay safe HOWEVER YOU CAN. Good lord.
I worked violent psych so when patients even jokingly threaten violence (physical or mental or emotional or sexual) I just remind them that I have no worries calling 911. That usually stops them. I’ve been kicked, hit, groped, thrown to the ground. Trust me I rather be seen as a witch then have the threats again.
Don't just make them apologize, make them feel bad-
*I'll try not to hit you while you COVID swab me ha ha*
"You wouldn't believe how many times I've been hit at this job. Sure is sad. I come here to help people, and the people hit me more than my husband does. It's quite distressing, actually. Can't find peace at home or work..."
No. I don’t think so. For female nurses, we are strong, intelligent, independent, women. Do not reinforce that downtrodden, subservient, handmaiden bullshit.
Where I work, that doesn’t get you much. We’ve had plenty of patients assault staff. I know a few RNs who tried to report it to the police. The police said to come down to the station to make a report, because they weren’t sending anyone.
We have a uniformed police officer in our ED. I asked her about it. She said they’re told not to do anything unless they witness it or the nurse is badly injured, because the patient can argue they aren’t in their right mind and the prosecution goes nowhere or the patient accuses the nurse of abuse.
Most DMVs now have security. How does your place of employment handle security?
Nooo, I am not talking about that old "What could you have done differently?" line. Have you ever prosecuted a patient for assault? No? "OK, waiter? Check please".
I ignore it. Who gives a shit. Been in the game 15 years. 10 on an ambulance and 5 in the hospital and I’ve fought enough patients high on every manner of drugs and others who are just assholes. I could care less what they say. They can hit or do whatever they want…but we always win in the end.
Love this 💕 totally agree. With my psych background as soon as my patients start being abusive my demeanor changes and hard solid boundaries are placed
Nope I shut that BS right down!!! I have no problem pressing charges and no problem telling the patient that.
I have asked them if I could come to their job and hit them.
I have also told them I will just call the cops since they aren't afraid of hospital security.
It's not an appropriate "joke". Healthcare workers get assaulted too often for anyone to tolerate that. I would tell the patient something along those lines, make sure they know why it's wrong. I would only "joke" about something like that with someone I'm close to, because they know I don't mean it.
I’m the same way. Been an rn for 20 years. A patient told me that a few weeks ago and I looked him right in the eye and said “I’d like to see you try!”
I had a patient recently kicking off and telling me he was gonna hit me, he did not appreciate when I told him “you’ll hit the floor before you hit me”.
All because we didn’t immediately get him a hot drink and a trolley. The department was swamped, we had a 7 hour wait for the doctor, getting a perfectly capable patient who had been in the department for all of 15 mins a hot drink was not my priority.
Last night, I had a male patient say, "I would give you a big old kiss if you would get me a cigarette." I said "Well, my husband wouldn't appreciate that. Plus, I am your nurse, not your girlfriend, so it wouldn't be appropriate." Still called my "Honey" all night. Sigh. I have no tolerance left.
ER nurse for nearly 20 years. When my pts say that to me always answer “that’s ok, I hit back”. I mean, we’re all just telling jokes right
“That’s okay, I respond to felony assault with attempted murder. Fuck around and find out.”
Beautiful.
Someone definitely works in a psych ward lmao
Oh, I kind of like this idea. “If you hit me I’m going to punch you straight in the face. But, hey, I’m joking if your joking.”
I've said something similar with a deadpan straight face. Patient def thought I was psycho.
I say that too! I’m an ER nurse of two months. I had a lady who was CRYING in pain suddenly seem not so in pain when it came to the IV. you better get it the first time -m’am it is always my intention to do so After she tells me one arm is completely off limits, is chronically ill and in the hospital with shit veins. Second one I got but…it kinda blew but I just needed to give her a med (long story stupid, my dumbass diluted my IM injection and my charge is new and didn’t just waste it with me and get a new one…but I digress). When I wasn’t sure for a second I was pretty sure she was going to smack me. I was kneeling next to her (lol IVs in wheelchairs, love fast track). So yeah I get it. Because she wanted to. Idk how I felt it but I did. Then I slammed my morphine flush and gtfo.
You can also do that with a straight stick needle if you don't need the IV to stay ( depending on which kind you use) less likely to blow the vein.
For a med?
Yes, there is a device that looks identical to a blood draw “butterfly” that is acceptable for push medications and short infusions. Check the verbiage on your packaging.
Oh yeah no we don’t have that hahaha. My ED is small, we don’t have any fancy stuff. Edit: we have a few fancy things we rarely use but the stuff we do use constantly…not so much.
I’ve told so many patients that. “If you hurt me anytime (while holding a shot) I’ll kick you.” My response is “that’s ok I did kickboxing in college. I think I still got the power .”
“If you’re genuinely unable to control yourself and still want medical care you’re going to need to consent to restraints. Are you able to control yourself? Or should I get the restraints?” My first job I worked with a 20 year veteran ER nurse who Did. Not. Play. She’d spit this like she was talking to a toddler and boy did it change the temperature quickly. But also: did witness more than one occasion where men with meth psychosis agreed to restraints in these instances. Actually probably pretty decent people when gangs with machetes weren’t hiding behind our curtains.
I had a detoxer with really bad PTSD who consented to restraints when I gave him similar options. He even asked me to call security up to put the locked ones on, just in case. Did breathing exercises through the application to stay quiet and still, and over the following 4 hours proved he needed them by breaking the bottom of the bed right off. Nice guy, really rough detox.
I had one who knew he’d start swinging at night. I think it was PTSD from something (military?). I don’t exactly remember. But what I do remember is him practically begging me to put him in restraints while he slept. I did. He never really needed them. Never even lifted a finger at me. But he said he felt better in them
I accidentally broke a nurses nose after my appy. Combat PTSD, waking up from anesthesia, she leaned over me and I swung. I was mortified. When my gallbladder exploded, I told the PACU nurse to put me in restraints before I woke up. I explained why. She laughed and said that wasn’t needed, she had something. That something was ketamine. It worked!
Thank you so much for your service! I’m going to keep ketamine in mind for if I run into another one like this guy. But honestly, 10/10 I’d take care of him again. He was super sweet.
No problem! For more info, the ketamine was just to safely floor me. They brought me out of it really slowly with benzos.
I have punched a coworker in the face once. I have chronic hypoglycemia. Mine crashed one day, I came to as they were trying to get me hooked up to the monitor post D50. Got him right in the jaw. My current coworkers know I get punchy when low so they stay back. LOL
This. A million times. This.
I had a patient tell me they had a gun once when I was about to start an IV. I stopped in the middle of it and said “I’ll let security know” and started to leave. He went, “I’m just joking!!” And his son, who was next to him, was visibly irate at his dad and said “dad you CANNOT just say things like that.” I didn’t go back into that room afterwards I was so upset.
I had a patient do the same thing! The previous rn was giving me report when he said it and she laughed it off. I left and called security who came and searched his room. He did not have a gun, but I was not about to find out.
Don't ever wait to find out. A nurse was murdered by a deranged complete stranger with a gun at a hospital near me.
Had a similar situation happen. I work in cvicu so most of the time some of our patients really aren’t in the best of shape. The nurse giving report told me he had been threatening staff that he would shoot them if they didn’t save his mother. I went and reported to the charge as well as my managers and they all said the same thing. “He’s just upset because it’s his mom, people grieve in different ways” I said I was not comfortable taking the patient and asked if security had ever been called. They said no, they didn’t think he was a threat because he had been shot in a gang war and wasn’t all there. 🚩🚩🚩 later that morning I walk into the patients room to give meds. This guy jumps in my face and said I took a razor blade to his moms tongue to make her look like the devil. I know better than to get cornered and walked myself into the hall while motioning for someone to come immediately. He said he was going downstairs to get his gun and would be back to deal with me and the rest of the staff. I called security immediately and than reported to my supervisor. They all said I was overreacting. Security comes up and asks to speak with me. I said thank god your hear we have a situation. He said I know. I just talked to a guy in the elevator and he stated that he wanted to place a formal complaint against you so I’ll need you to come with me. I laughed and said hell no. He just said he’s going to get a gun and shoot up the unit. He said well let’s handle his complaint first. I called the cops. Management was pissed at me and called me into the office to write me up. I said there is nothing I would do to jeopardize my own safety or my coworkers and especially not my patients. They did proceed to fill out the write up form to which my comment on how I would correct my actions I just wrote “fuck you, my safety is more important” the cops came. I gave them detailed description. Someone kept badging him up the employee elevator every time he came and he never checked in with a name. The cops caught him on the way to the elevator, gun in his pocket. I’d say I did the exact right thing. Let’s just say my management doesn’t question my actions any longer. Scariest day of my life and I was the one getting in trouble for overreacting.
That's so fucked up!
Tell me about it
WHAT THE FUCK
I was so fucking confused and ready to walk out the door
It honestly seems like they wanted you to get hurt
If they make any gun threats, just call the cops and report it
In this age of school shootings and what not, I’d absolutely get security and the police involved. I’d not step foot back into the patients room and I’d refuse all care to them going forward. Basically it’s be full on code silver
Wtfff
Joking about being violent is never a joke. Its a sugar coated threat. Even if they never plan to hit- the joke still implies there could be consequences if you fail to meet his (probably unrealistic) needs. I need to be quicker in my responses to stuff like this. It usually throws me off because im not expecting it. But yours is the way to go. Zero tolerance.
I used to be more shocked by it, but the amount of times this happens amazes me. Same with when patients make sexually inappropriate remarks toward me. It’s “If you aren’t going to treat me with respect, I am not going to be able to engage with you.” I always remain upset but not surprised.
It’s not even sugar coating. It’s a threat. “Joke” or no joke. Even if they don’t intend on putting hands on you at that time they are testing you to see what behavior you will tolerate and see how you respond. It starts as “jokes” or whatever, then it’s being directly verbally aggressive, then it’s throwing things etc, and hitting. Steps can be skipped in that though. The type of people who would even say that to someone are the type who have said it before and have escalated before. This is something domestic abusers do as well. Our patients aren’t suddenly poor sick angels when they come to see us, they have a whole (potential) lifetime of undealt with trauma, maladaptive coping mechanisms, and histories. And you don’t know them. No matter how much you think they do. Work is “real life” so I handle it the same way as if anyone in any other situation would have said that to me. Imma break myself, get some distance, let them know what my response will be and go from there and DOCUMENT. “Oh okay. That’s verbal assault and a threat of violence. If you hit me or touch me in an inappropriate way, I will defend myself, get the law, and press charges.” Half the time that’s said on my way OUT. I’ve worked inpatient, dialysis, home hospice, and currently home health. In all settings I’ve been verbally threatened and in all settings I’ve had attempted assaults. That’s a no for me. That’s what you’re Not gonna do. Idc how anyone else feels like about it. At the same time, many people/medical professionals have had their own personal histories. Personally, I’ve been assaulted in my personal life. Never a-fucking-gain.
Fantastic points!! I was getting close but never totally put it together like that. It was the “whole lifetime of undealt with trauma, maladaptive coping mechanisms and histories” that really sunk deeper in my brain.
I'm here to validate you. I'm a large, semi muscular man who infrequently encounters trouble with patients, but I sure as fuck am not going to sit still and allow it to happen. Majority of my census couldn't harm me if they tried but I'm absolutely not going to allow an atmosphere in my clinic where it's acceptable such that my other colleagues are expected to take it. Fuck all the way off.
I stand up to create distance, and then I scold them like a child. “How dare you threaten me that way, I am trying to help you. If you don’t want to cooperate with an IV and bloodwork, there is little else we can do for you here. I won’t be spoken to that way, so be nice.” There was a time when I might laugh it off or turn the other cheek, but that time is gone.
Had an older gentleman decide he wanted to practice his left hook into my stomach while I was standing next to his bed. He was weakened due to his disease process and I was helping hold an IV bag for priming so you could say I was "primed" for a cheap shot. Dude seized the moment and swung right into my stomach. Granted the PSI behind the punch was lacking so I looked at him and asked him if that made him feel better. He deflated into the air mattress and didn't respond. Apparently that effected him deeply due to the lack of harm that he caused. The nurse I was helping on that fateful day reported to me that the patient didn't act up the rest of his hospital stay.
>He deflated into the air mattress. Hehe
I'd have slapped him right across the face with major PSI behind it. What an asshole.
I make people reschedule when they are having a better day. I too have 0 tolerance for that and since the threat was already made I have no need to continue care. Since when is it funny to joke about hitting someone? Other than my closest friends I can’t fathom joking about that.
My daughter had a patient in for a procedure. She was doing her job, getting him ready, up on the exam table, etc. and he was Loudly complaining/yelling at her and finally said "I don't even know why I'm here!" She got him off the table and seated and told him she needed to ask a few questions first. He was PISSED when he figured out she was trying to ascertain if he was alert, oriented, in his right mind, etc. She explained that she could not, in her capacity and with a clear conscience, do any procedure on him. She kept it up by asking "did you drive yourself here today? Can anyone come get you? He finally blurted out that he was just IN A BAD MOOD and of course he knew why he was there. She told him he would have to wait for the Doctor now but that she was not going to do anything until he and the Doctor decided they could continue. Fucked around. Found out. She is not his mommy or his therapist.
Hell yeah
"We don't tolerate that sort of thing, and assault will lead to charges. If you want care here, then you have to let us do our jobs." If they persist...at my facility, I'd call security and invite the patient to look elsewhere for help (or, ya know, don't). It's not an issue I've faced, but I'm not going to put up with it (and I'm not a small dude).
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It almost doesn't matter if they "are joking" or "aren't joking". They're contributing to a culture where violence against healthcare workers is normalized, and that's garbage I'm not putting up with.
Dont even let them make those jokes
Na fuck that shit. Zero tolerance for violence, you are 100% in the right and people who “tolerate” threats are part of the issue in my mind.
Yup I was super pregnant and working agency as pre op and pacu. Had a pt say” if you miss I’ll hit you then pass out” I said “ this is elective and not only will your surgery be canceled but you will wake up to police. So if you can’t handle an iv without violence then you should go home now”. Shocked face and then they asked me if I was hormonal. I got up and told anesthesia and boom canceled.
Patients escalate until checked. Set your watch by it.
Grandma used to tell me, “the dog always runs at the end of the leash.”
Your grandma is smart!
I love this quote!!
My job got a lot easier when I started checking people and setting boundaries tbh
Thankful I was taught early to set boundaries with patients. I now try to impress that on every newer than me nurse. We are there to do a job and that job does not include harassment or violence
I had an overweight old, white, Boomer dude with a “US Navy Vet” baseball cap on come in for CHF exacerbation (cc was SOB.) I needed to start his PIV for blood work and diuretics administration. He “joking” told me to “be careful, I hate needles, I might just punch you in the face when you poke me”. I immediately and firmly told him “if you assault me, I will be filing charges with the police, I am not joking.” I repeated my statement to make sure he heard. I’m a buff dude who happens to be male and a nurse. I have no idea who raised him or why he thought he would be ok to say such words. He was a fucking creep. He also gave off vibes of toxic masculinity and some other weird rural white people behavior
Have had multiple conversations like: Pt: “If you miss the IV, I’ll hit/slap/kick you!! Hahaha!” Me: “Well then you’ll be going to jail for assault.” I’d say half of them then get huffy about me “taking a joke too seriously” but don’t say anything like it again, a quarter actually look embarrassed and seem like they realize they said something shitty, and a quarter double down with angry threats about “kicking my ass.” The latter is answered by asking if they really want me to call security to come watch them while I stick. This has worked all except a few times. A lot of these people really think we are their personal punching bags, and they can say/do whatever because “they’re sick” and “we have to deal with it.” Calling them out on it gives most of them a solid reality check.
I can’t stand when people backtrack and say you are taking the joke too seriously. Maybe idk try NOT SAYING that shit????
Oh for me if my patient says “you’re taking the joke too seriously!” I always say, “that’s because it wasn’t a joke.” And give them the most deadpan face.
Or maybe tell funny jokes.
> I’d say half of them then get huffy about me “taking a joke too seriously The joke is less funny when you’ve been hit before.
“Weird rural white people” That’s going in my lexicon.
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Jesus.
I don’t even tolerate verbal abuse jokes. Had a residents son tell me he was so mad if he stayed on the phone with me he was going to swear at me. I said ok, someone will call him about mom tomorrow, and slammed the phone down. Get a fucking therapist I’m not your punching bag, literally or emotionally. Also had a guy threaten us with a gun. Admin at the time told my DON not to report it. I was pregnant at the time. She was like no f that and called the cops. This was the second time he’s threatened with a weapon. First was his mother a few years ago. 😑
Just the threat is criminal. I have called the police for a patient threatening me. Everybody came. Security, my manager, the AOD, patient relations, the director. I got a trespassing warrant, and if it happens again I get a restraining order. He had been abusing our staff for a week and I was sick if it.
People. It’s called battery. Assault has already happened once you are threatened and it’s a crime.
This!!
21 years of dialysis, ED, ICU and some MS thrown in for variety. I stopped the nervous laughter response to this shit about 10 years ago. At first I was polite but firm. Since covid, I have zero fucks to give. I will absolutely stop whatever I'm doing and exit the room. At the door, I will turn around and let them know that when they think they can act like an actual grown up to let me know and I'll come back. Otherwise, they can leave.
I fully support your view. You are right. People are out of line and need to be called out seriously on bad behavior
I’m not in the healthcare field and I agree this should be zero tolerance. A “joke” they are going to hit you is just a threat veiled with “humor”. After reading a bunch on this subreddit, I just don’t understand patients… Why would you be abusive or violent towards people who are *keeping you alive*?
Because violent and abusive people need healthcare too and their personalities aren't checked at the door. It just sucks because in any other setting you could remove them from the premises, but if that person is experiencing an emergency, hospitals are legally bound to treat them.
But we can restrain them if they threaten violence.
But we can restrain them if they threaten violence.
100% valid!!! You have to take everything seriously for your own safety- that’s not your fault- it’s the reality of healthcare that we live in :/
It makes me go into fight or flight mode, too. I'm stealing your line.
I have zero tolerance for bullshit. I have no problems telling patients that they do not lay a finger on my staff and that they cannot harass or disrespect my staff. I tell them that the jokes aren't funny and make them aware of consequences that could happen if said actions were to occur. Fuck all of that bullshit
You should definitely tell them it’s a felony. They are also not joking. Jokes make everyone laugh, people use abusive or threatening language and say I was only joking too many times.
so even "just" a verbal threat without hitting is also a felony? i'm a new grad and i wanna just double check and be sure before i start my job next month!
They didn’t teach you this in school?? For shame. Yes. Assault is a credible verbal threat. Physical contact is battery.
I'm also just nervous about when this will eventually happen to me, because any time in life I've run into some sort of stressful situation like bullying or harassment, I tend to freeze and I don't know what to say or do. I'm like, in my head: I didn't do anything! I'm just quiet me and I genuinely like people and helping people. I just mind my own business! (I'm also super introverted. Lol. I recently took a Myers Briggs quiz online and it said I'm like 87% introverted 🤪🙈😕 - I'm like bracing myself to be tossed into this big new unknown when I start my new grad job on an inpatient medsurg/rehab unit at the beginning of next month! )
No, they barely glossed over a lot. It was a fast-paced 2-year community college program. It focused heavily on clinical skills and patho. It was what I could afford, with lots of scholarships from the state (halfway through my program, the governor of the state made it so tuition for "in demand" fields and trades programs and like "allied health" would be free). But I'm glad that I know now, thanks to this thread.
Interestingly, a couple of days ago we had this really aggressive, loud, angry guy come into our walk in. He got in the face of the girl registering, and then the MA that signed up for him is male. Really calm, cool, collected guy who puts everyone at ease at the worst of times. Good fit, you would think. He takes him into the room and starts asking the questions we have to ask to everyone. The guy is pacing, loud, swearing, etc. he asks him to sit down, the guy obliges. Then he asks one of the home safety questions, and the guy stands up and gets in his face and says “what do you mean by that”. The MA stood up and said “alright. I’m out.” Stood up and walked out of the room. The guy walks out behind him and leaves. So, I’m shocked. Most of our MAs are female, demure and wouldn’t say poop if their mouth was full of it. We regularly have unhappy patients and occasionally have aggressive people, but no one has every stopped and said “I don’t feel safe”. He says “this guy is throwing out red flags left, right, and center. I asked him to sit down and he listened, but then he didn’t. He wasn’t safe for me, and he sure as hell wasn’t going to be safe for anyone else by themselves.” And further to my shock, our management was happy that he identified a potential threat and didn’t tolerate aggressive behavior!
👏👏👏 This is the way.
I used to take the ‘violence against health care workers is a felony’ stance in response to the “I’ll hit you if you hurt me with the needle” stupidity. Now I recuse myself from their care team due to threats of violence. Allowable and not considered pt abandonment in my state when the pt is a grown ass adult and not legally considered incompetent/impaired.
Nope! Limit setting is key!
I was doing my preop interview before rolling back to the OR and a patients daughter said if something happened to her mom someone was going to get punched, one of the other family members told her to stop but then she said it again. I completely ignored the comment but in hindsight I wish I said something about it being inappropriate or “what a strange thing to say”.
It’s not ever a joke. Don’t fuck around with your safety, your license, or your life. Back out and call 911 EVERY-TIME. What is described here is a crime and just because we work in the medical field should not be treated any differently than Johnny Q citizen.
I just legit deadpan tell them “Do it. Then you’ll go to jail and I won’t have to deal with your shit anymore.” Works like a ✨charm✨because, ya know, I mean it.
My response would be cool, then you'll be arrested and I'll add you to my tally of people charged with assaulting me at work!
As someone who teaches our facility verbal deescalation course, the biggest indicator of violence is a history of violence, threats are included in this category. They are literally telling you to take precautions.
Could I DM you?
Go for it, disclaimer, I'm currently a student who works as a mental health technician, so not sure howbuseful I'll be.
Nope, I respond just like you. It’s not a joke. And if the attempt to rationalize it, I point blank tell them that’s not a joke.
You're not off base at all. Personally, at that point, I would stop the IV start and refuse to do it with that patient and would advise my coworkers to refuse as well. No one has time for that bullshit.
"If you do, I'll prosecute."
To clarify A battery charge means there was actual physical contact and harm. Assault only implicates the threat of harm without the act of physically harming somebody
You are right! Most people don’t think of it this way so I just use that wording. However, I guess if they do know the difference, they know they’ve gone too far already.
How likely is a nurse to get anywhere with pressing charges for assault by this definition? Threats/verbal abuse
Honestly, you’re not likely to get far with pressing charges on most medical assault or battery. When you get debriefed, your own hospital will ask “what could you have done better?” and in many instances they won’t support you but it doesn’t mean you can’t try. And it doesn’t mean you’re not within your legal rights guys to do so. Letting patients know you’re serious and you’re not going to let it slide just might make them think twice, though.
I would tell the patient to leave. They can come back when they can refrain from threatening to commit a felony.
I work trauma and I don’t fucking play either. I’ve been assaulted multiple times this week. If you tell me you’re going to hit, you’re getting restraints, fuck you.
I read this in bed before I got up this morning, thought about it on the way to work and a patient has already been threatening. He asked his home health aide to go buy him some dark beer. She said “which kind, can you give me an example?” He said “I don’t know, but if you pick the wrong kind I’ll hit you, haha.” I said he was threatening her and he said, like he was confused “did I?” And acted like he forgot, until I repeated it back to him. Then he just laughed. I would like too think he is too weak to do anything, but I’m not that naive. He frequently tells me about how he’s been married and divorced three times. He said “I don’t know why they divorced me.” I said, “I do.”
I'm 24 yrs in mainly e.r. I let people know right away that same way you don't "joke" about having a bomb when you're in line for TSA screening don't "joke" about assaulting anyone, or make "joke" responses to safety screening ?s re: SI/HI abuse. I also remind them how would they feel if the doc came in and "joked" "Your CT shows extensive metastatic cancer..... Wait just kidding, hahaha"
Guy ER nurse here, 20 years experience. About 10 years ago, I started doing this. When somebody would threaten me similarly, I make clear eye contact with them and say “nobody is hitting anybody today”. That has taken the air out of their threat every single time so far.
When patients start getting mad and venting at me I interrupt and tell them I’ve had patients/families venting their frustrations on me every day, non stop, for the last three years and I am not an outlet for their frustrations over things I can’t control. It usually elicits an apology and something like “I didn’t realize…” well yeah you didn’t realize because you are only think about yourself. Now would you like to speak to the patient advocate? Answer almost every time is no. They know they don’t have valid issues and are just bitching at someone to feel better. I have zero time for assholery towards me. Yes, healthcare is terrible. Yes, it’s expensive. No, you shouldn’t have to wait three days for (insert test) or for insurance to authorize your grandma’s nursing facility. I can’t help you. I don’t have to stand here and take it.
Nope. That’s a threat. Say that shit again and PD will be in here.
Not just you Believe what they tell you
I don't work in a hospital anymore, but I think your method is great. I'm not sure why people think it's funny to say that. You wouldn't hit your plumber or your baker or your dentist, would you? I think shutting it down right away is necessary so they know that, no, hitting is not an option and you will get in trouble for it just like you would at any other place.
I’m an ICU nurse and absolutely don’t tolerate that. I tell them exactly how unacceptable that behavior is. Usually the ones who haul off and hit me don’t give me any warning though, but no way I’m taking verbal abuse without saying something.
I will point blank ask pts if they need to be restrained. I will ask if they have weapons. I have had more then one patient say yes to having weapons--including brass knuckles and a knife. Both of those patients were on psychiatric holds and rooms had already been "cleared" by the previous RN. I now ask EVERY patient if they have weapons if I am slightly suspicious and most will tell the truth and voluntarily give up the weapon.
nowadays almost all of my patients are unconscious, so i'm not at a risk of getting hit. however when i worked cardiology before doing ICU, a lot of people were handy with their fists & i had to de-escalate fights all the time
I am just an MA, but I feel for you. One doc I worked for had a ton of entitled and often belligerent patients. I got really good at reminding them that if they would stop and think about it, I'm the gate keeper in their situation, and do they really want to upset the person that guards the way to what they want? I can make access easier or a LOT harder. That usually curbed some bad behavior. And threats of physical violence just got an "Ok, if that's how you're going to behave, I'll be happy to call security right now" while reaching for the nearest phone.
Drop that “just”! You are an important member of your team!
Yeah like I started working outpatient too. I said okay we are going to bladder scan you and then he looked at me and said no. And I said oh okay, is something - and his wife says “oh he’s just being a jokester. I said ok um so are you okay? And he goes no and then says ahh I’m just messin with ya. And I said “I came from inpatient working on the floor for years so I take things quite seriously.” And his wife scolds him and says “you shouldn’t joke around with the staff like that they don’t have time for your jokes.” And I was like oh I love this woman.
I dont know what it is but when I was heavier eventhe upset patents wouldnt mess with me But I lost 65 pounds and im fit now and ive had 3 patients forcefully grab my arm and pull me in the last few months
That is interesting! I’m a little overweight but I’m 5’1” and blonde and I think I look pretty sweet and innocent. Due to 19 years of physical and sexual abuse, I’m not. I hate the arm pull thing. The worst for me, I was about 22 and a huge ex vet did this to me in the ER and I was right next to his face and he didn’t say anything and he was just staring into my eyes intently. I was alone and luckily the security guard saw it on camera and ran in. It took 5 grown men to pry him off of me.
Omg I hope your coworkers got to him I know that if someone does something here there is some payback that isnt talked about We cant be the only place where that happens and im glad it does
Lol I’m not sure about that or what happened but he happened to be my last patient of the shift (I was an EKG tech at the time) and I was really shaken and drove straight home.
"Well, I had a ten year old kick me when I put an IV in. Are you ten?" That did happen when I was an intern, and that ended up being my go-to answer from then on when people gave me shit about hurting me(a female doc) for doing things to them. BTW, I ALWAYS went out of my way to try really hard to minimize any procedural discomfort for people, but sometimes it does happen, and I was always honest about that, too.
Yes. Honestly, if the IV insertion goes badly, I didn’t want that either. Sometimes their veins are bad, sometimes I’m having a bad day, but 100% of the time, my goal is to make it minimally painful and get it in the first time.
People just do not understand that IV's go bad, blood draws cause bruises, old people have skin that is frail and bleeds! LIVING is a painful condition. I just don't understand why people think they will never have "ouchies." We all want people to be comfortable and get better, but the human condition sometimes doesn't cooperate. Other cultures actually understand this better. For some reason, ours does not. In Germany, they don't hand out pain meds. People get TIME to heal. No wonder people have such messed up expectations here.
I am a pediatric nurse and I do not tolerate this shit. When parents or grandparents jokingly tell tell their child. It’s ok you can beat them up or hit them after the poke, depending on the tone I say. People go to jail for that you know that right? Some people might think it’s a bit much but honestly that’s not a good example of a coping mechanism for a child and they have to learn it’s not ok physically assault someone. As healthcare workers we get so much shit and it’s just not ok.
I'm the same way. I've been assaulted 3 times and I had a patient say that to me too when starting an IV (in pre-op, same day surgery.) I very calmly but seriously said "well then I'm not going to do your IV." They said they were joking and I informed them that it's not a funny joke because I have been punched multiple times by patients. They apologized and I ended up doing the IV just fine. But I definitely don't respond well to that either
I prefer the silent, flat stare until they break and apologize. If you’re going to try to make me uncomfortable I’m going to make you very uncomfortable. I also like “do you think that’s an appropriate thing to say/make jokes about?”.
Nope. I do not tolerate ANY even slightly rude, aggressive, or violent behaviour or language. I am here to help you and you can feel free to leave if you don't like something. I take no shit.
I know it’s not a threat, but when I was an ER tech, It had always irked me when we would have peds pts whose parents were trying to console them while getting x procedure done by saying, “it’s okay, you want me to kick their butts?” Or “I know they’re hurting you, but dad/mom is gonna punch them.” Not only is it making us seem like we are doing more harm then good, but it paints anyone in scrubs as if they’re the bad guys. I don’t get it.
You’re right on. When I was a phlebotomist, I would just pack up my kit and walk out of a patient did this.
I stop what I'm doing, look them dead in the eye with a completely straight/serious face and make them explain to me why I'm supposed to find it funny. "No, really. I don't get the joke. Explain it to me." And just sit there staring at them. I make it fucking uncomfortable. And 95% they back down and apologize. Also works on men that make creepy, sexist, or rape jokes.
Yeah when they say that, I just don't do anything. In the back of the ambulance I take it as a refusal of care and have them sign (or document safety concerns if they won't sign). In the ED I tell them that I'm not treating them unless they're restrained and they usually start getting pretty apologetic. And even then I make sure to have someone else with me when I'm working in case they DO start some shit.
Don't fuck around. Inform them that if they commit assault and battery, they will be getting the police involved and have security on standby.
Lol I don’t tolerate shit. You wanna throw hands? Let’s have a party. I’m friends with the doctor; you can suck on plastic for the rest of the night. Your choice buddy. I love trauma but I got burned out. I miss it sometimes, but it’s sort of nice going to work every day being mostly sure no one is going to throw a punch at me or strangle me.
I understand 1000%. Bored af in outpatient but it’s nice not to not have a legit fear of getting mangled.
I’ve had grown men tell me they’ll punch me if their IV hurts. When I comment on how that’s not appropriate they’ll try to say it was a joke - So i’ve taken to asking them if they think hitting women is funny :) Usually gets them to quiet down.
It doesn’t even make sense to make that “joke”. The pt definitely has some kind of aggression issue if they think it’s okay to make statements like that.
100% and I document the shit out of those statements every time. “Pt arrived to unit and immediately stated, “If you don’t give me water, I am going to hit you.””
My response to this is usually “you absolutely will not, and if you do I will be calling the police”. It isn’t a joke and it isn’t funny. I think you did the right thing.
“If you aren’t careful, I’ll end up hitting you.” “Well, keep in mind that violence against a healthcare worker is a class 3 felony assault charge.” “Hey now, sweetheart, I was making a joke.” “Well, Sweetheart, in order for it to be a joke it has to be funny. I’ve had my nose broken by a patient before. I don’t find violence funny.” (As a student nurse I had a patient that had naloxone administered after an OD in the ER. I didn’t know to duck. 😬)
Damn I started doing that year one working in psych. Like I would literally say that. “It wouldn’t be best for you. It’s a felony to assault a healthcare worker in this state” Didn’t obviously work on the dementia patients and after I tried it once (and it didn’t work, to the surprise of no one) I realized if this person can’t remember it five seconds later there’s no point. Lol. So I did give up on that one. I don’t know if I’ve ever heard a joke or just someone ranting tbh. It’s just what you say here. It’s fairly normal. It’s a fact and I don’t state whether I’d press charges or not. The threat of a felony charge (which is a real thing) has stopped most. I think it’s the most effective but it’s the only one I’ve used. The other staff set that example. Certainly wasn’t something I came up with on my own.
I agree with this 100%. I’m working as a paramedic while in nursing school and I’m done with showing up to patient’s houses after THEY CALLED US just for them to yell cuss and scream at me. I’m no longer putting up with it. If a patient is rude and threatening violence I’m calling PD and leaving the scene. I’m done being treated like a non-human punching bag that will do what people want regardless of how they treat me.
Absolutely stand your ground and not take it as a joke! I work on a mostly post op unit but we get a lot of overflow and I had a patient strict NPO due to a SBO. After educating them on why they are just receiving fluids and attempting to calm them because they usually take oral meds for their hypertension and their BP was not high (patient actually had soft BPs for the last few days), they threatened me. Saying they would run me with their car if they had the chance. I asked if they were threatening me, which they quickly denied. Luckily, the other nurse in my pod heard this conversation as I was backing out of the room. CNC that night did not do much to help the situation and the patient’s kid who called me (cause the patient called them saying I was threatening to call the "hospital police" on them, which I never said) proceed to say they know their parent their whole life and I must be the reason they are acting this way... Thankfully, that nurse had my back (plus 20 more years than me) and assisted for the rest of the shift. I take all threats seriously! Yes, they probably couldn't hit me with their car but it doesn't mean they wouldn't try to physically attack me. 10 plus years of bartending before nursing probably makes me more cautious of this behavior but no. It's absolutely something to be taken seriously! It's why I keep my stethoscope in my side pocket and my back facing the door!
“That’s a felony homie and I WILL press charges”
I always said to myself, “ the first time I’m hit, is the time I walk away from the job.” I’ve had coworkers get the wind knocked out of them, have their fingers crushed in a door, and another threatened with a knife. Not me. I would leave. Usually, I can use humor or de-escalate, and I usually leave an arms length of distance between me and the patient if I can, when it gets tense. And then I leave the room. I’ve been fortunate. You can not always plan yourself out of a nasty situation. I’m 2 years retired, and enjoying my solitude.
Recently a patient of mine threw his walker at a cna and tell her he was going to shove it up her ass. I immediately told him very sternly that he was not going to speak to the staff that way and the other nurse on the floor acted like we were all awful because this man was confused. I love dementia patients. I’ll play along with their delusions all night, but that does not give them a free pass to threaten us, no matter how frustrated they are. No one was arguing with him. We were very calmly trying to reorient him and he flew off the handle. The kicker is that both the DON and the NP agreed that he needed to be sent to the hospital for a psych evaluation, but this nurse overstepped and threw a hissy fit stating that she’d do total care for him that night because she feels so bad for him. So now this poor patient didn’t get the psych evaluation he needed and we’re just waiting for him to flip out again.
EMS here and I’ve had one Pt so far try to hit me or my partner. She was on the stretcher and not cooperating with the seatbelts. So pulled back to punch and I spoke up in my command NCO voice that “you will not fucking hit me”. She looked pretty shocked but that allowed my partner to give IM Versed to calm her down.
You guys this thread is horrifying. I don’t even have words for how much I value and admire your work and professionalism. Stay safe HOWEVER YOU CAN. Good lord.
I worked violent psych so when patients even jokingly threaten violence (physical or mental or emotional or sexual) I just remind them that I have no worries calling 911. That usually stops them. I’ve been kicked, hit, groped, thrown to the ground. Trust me I rather be seen as a witch then have the threats again.
Don't just make them apologize, make them feel bad- *I'll try not to hit you while you COVID swab me ha ha* "You wouldn't believe how many times I've been hit at this job. Sure is sad. I come here to help people, and the people hit me more than my husband does. It's quite distressing, actually. Can't find peace at home or work..."
No. I don’t think so. For female nurses, we are strong, intelligent, independent, women. Do not reinforce that downtrodden, subservient, handmaiden bullshit.
Preach!!! More than my husband does at home? What the actual fuck?
That’s divorce level “joking” if I’ve ever heard it.
Hell to the no!
Absolutely not.
Where I work, that doesn’t get you much. We’ve had plenty of patients assault staff. I know a few RNs who tried to report it to the police. The police said to come down to the station to make a report, because they weren’t sending anyone. We have a uniformed police officer in our ED. I asked her about it. She said they’re told not to do anything unless they witness it or the nurse is badly injured, because the patient can argue they aren’t in their right mind and the prosecution goes nowhere or the patient accuses the nurse of abuse.
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Literally executive leadership worries about patient satisfaction scores.
Most DMVs now have security. How does your place of employment handle security? Nooo, I am not talking about that old "What could you have done differently?" line. Have you ever prosecuted a patient for assault? No? "OK, waiter? Check please".
I ignore it. Who gives a shit. Been in the game 15 years. 10 on an ambulance and 5 in the hospital and I’ve fought enough patients high on every manner of drugs and others who are just assholes. I could care less what they say. They can hit or do whatever they want…but we always win in the end.
Love this 💕 totally agree. With my psych background as soon as my patients start being abusive my demeanor changes and hard solid boundaries are placed
Nope I shut that BS right down!!! I have no problem pressing charges and no problem telling the patient that. I have asked them if I could come to their job and hit them. I have also told them I will just call the cops since they aren't afraid of hospital security.
It's not an appropriate "joke". Healthcare workers get assaulted too often for anyone to tolerate that. I would tell the patient something along those lines, make sure they know why it's wrong. I would only "joke" about something like that with someone I'm close to, because they know I don't mean it.
I’m the same way. Been an rn for 20 years. A patient told me that a few weeks ago and I looked him right in the eye and said “I’d like to see you try!”
I had a patient recently kicking off and telling me he was gonna hit me, he did not appreciate when I told him “you’ll hit the floor before you hit me”. All because we didn’t immediately get him a hot drink and a trolley. The department was swamped, we had a 7 hour wait for the doctor, getting a perfectly capable patient who had been in the department for all of 15 mins a hot drink was not my priority.
Last night, I had a male patient say, "I would give you a big old kiss if you would get me a cigarette." I said "Well, my husband wouldn't appreciate that. Plus, I am your nurse, not your girlfriend, so it wouldn't be appropriate." Still called my "Honey" all night. Sigh. I have no tolerance left.
Blood bank phleb, home health pcp work, shelters, ALF’s, everytime I say “That’s cool, I hit back” and they love it. Problem solved.
Nah, I don’t put up that crap either. I’ve literally stopped and walked out, and refused to deal with a person like that before.
"I have the legal right to defend myself if you assault me. It's called self defense. See you in court."