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'I Am Fine' but Violence in the ED is Not

Working in the emergency department can be very unpredictable; the day can be very busy or uneventful.

This particular day was very busy and stressful.  Patients were critically ill, ambulances were backed up and patients were restless and agitated.   

One of the nurses I was working with had a very difficult and violent patient. The following is her story, it affected me and the rest of the staff, and unfortunately incidents like this are much too common.

"I looked up from my patient, after hearing the stretcher from EMS coming into the Emergency room, another patient, where can we put him? The ER is full! I thought to myself.

EMS stated to me during their report, the man had an argument with his family and the police were called. Once the police were called and assessed the situation, EMS was called to bring the man to the hospital. This isn't the first nor will it be the last time that people have arguments at home and call the police for assistance.  

When the police refer a person to the hospital for evaluation there is always a good reason. There was a question of chest pain after the argument, and when the EMS took his blood pressure it was very high.   

The ED was at its worst, full to capacity, all healthcare personnel were stretched to the limit.  I knew I needed to find a room and assess this patient quickly, complaints of chest pain and high blood pressure are very serious. The man was put on a stretcher and wheeled into a room, I was putting on the blood pressure cuff, O2 monitor and cardiac leads.

The patient was demanding to call his wife, I explained to the patient that as soon as I was able to take his blood pressure he could call his wife.

I knew this patient from another hospital admission when I took care of him every day. I tried to calm him and started to say something when all of a sudden the patient punched me. He punched me so hard in my face that the force of that punch moved my body against a cart that holds our supplies.

I yelled for help, security and EMS was right outside the door and when they heard me yell, they came right in. The patient jumped off the stretcher and was punching himself in the chest and head with his fists. The patient was yelling "Come on! Get me! I am ready!"

Security with the help of EMS were able to get the patient on the stretcher and restrain him. The patient at this time was totally out of control. The patient needed be safe and gain his self-control. Restraining a patient will not only keep the patient safe at this moment but it will assist the medical people to talk to the patient and calm the patient down. Another option is medicating the patient and it is a lot safer to put an IV in someone's arm or give a shot when the patient is safe.

At this time when I was asked if I was hurt and I stated "I am fine."

I was willing and thought able to continue working until my shift is over; the ED was too busy for me to leave. However, I knew I didn't want to take care of this patient, only I wasn't sure what to say about it.

The charge nurse came into the room and asked me to leave and go to another room where the physician and nurse were standing waiting for me. I was handed an ice pack for my face to help with the swelling. Again the nurse asked, "Are you alright?" I told her, "I AM FINE!"

I was getting a little tired of her asking me this. I needed to tend to my other patients as I hadn't seen them and I was very concerned that I wasn't doing my job. I was getting very nervous.  

The police were called for me to make out a police report because I was assaulted. I was punched in the face!. The police came and at hat time I decided I wouldn't press charges. I made out the incident reports, one because I was hit in the face and one incident report on the patient that assaulted me.

During this time I was getting more and more anxious. I had patients to attend too. I really didn't feel the need to be relieved from work because the ER was so busy and it would leave us one nurse short. "I am fine," I stated again as I was getting my discharge papers and walking out of the ER with my husband at my side.

I couldn't believe they sent me home; the ED was so busy and really I felt fine.

My husband was furious, he kept saying to me "Are you alright?" Of, course I told him "I AM FINE!" I was thinking, what is the matter with everyone? Why are they so concerned? Why are they asking me am I alright, I only got punched in the face, it isn't like he took my arm off.

As Nurses we always put our needs last. I stated I felt FINE even after I was assaulted. Never given the thought to being in shock or disbelieving this really happened to me. Was it that bad?!

When I said I was "fine" after I was assaulted doesn't mean that I was fine, it can mean so many other things. I am so glad that my coworkers realized that I wasn't fine and sent me home.

Then next day I was having breakfast with my daughter before I drove her to school. At breakfast we were talking and discussing the weekend plans. When we were in the car driving to school I heard my daughter gasp and say, "What happened to you mom?" She noticed my face was red, bruised, and swollen. I told her that a patient had hit me in the face, she started to cry.

That's when it hit me, "I am not fine, or, rather it is not fine for me to accept what happened to me." This shouldn't have happened. Violence shouldn't be accepted or tolerated. That is when I realized how violence affects everyone around you.

I called EAP (employee assistance program) and just thinking about the incident scares me but having someone listen was very helpful. I still can't believe that a person that comes into the ED for help assaults the person taking care of them. I was fortunate to have EMS and security right outside the door; I feel they saved me from further harm.

Being assaulted is a traumatic experience; never say "I am fine" after being hit.

Because of circumstances like this in my every day experience I have become active in supporting nurses against violence.  Trying to increase public awareness and support the abused nurse is a main focus.  

Supporting nurses to report without embarrassment and file incident reports and make their institution aware of this problem. I now have a website, lecture, and continue helping abused nurses.

Not everyone is "fine" after something like this. In fact, to help spread the word I have created a video about the assault which is posted online at http://www.stophealthcareviolence.org/

Sheila Wilson,
North Quincy, Mass.

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Tell Us Your Nursing Story Archives
 

While working in another state I was almost run over when assisting as triage in an ER when going to assist a patient in a car who wasn't breathing. After opening her airway the driver stomped on the gas pedal and came close to crushing me with the car. I wrote down the license plate number and received a call shortly thereafter. It was the driver of the car asking me not to call the police as the patient I assisted had to leave because she would lose custody of her kids if it was discovered she was doing drugs again. I called the police, a report wasn't taken and no follow up occurred. While pregnant I was assaulted twice. When I relocated two nurses who worked in a psych unit in our town were killed along with three patients I could go on and on. Until hospitals and police take the safety of the healthcare workers as seriously as the patients this will continue. I have seen a change in the trend, and I am glad. Forward progress on this issue is growing and I'm hopeful. I am so glad this topic is being addressed and is no longer shoved into a closet!

Joan Kirby,  RN,  THRFebruary 25, 2014
Denton, TX



I was left alone with a violent illegal drug runner who was in spinal precautions a few years ago. He had not been cleared and although I was speaking to him in Spanish and English etc he raised up to rip of his equipment. I held him in spinal precuations as I again ask for more assistance, but he bit my left breast- I eventually had to have surgery and lost some of it. The worst part was NOT this- I was made to work injuried, an later after pt. was stable then arrested, this ER staff told him where I lived and he stalked me x2 to kill me. I was never supported by the management.This was supposedly a "magnet" hospital they did not care nor did they know what to do as an ER. For a long time I never wanted to be an RN again but healed though I have not returned to direct care.

G Goss,  RN,  ColoradoOctober 20, 2013
Colorado, CO



I too, was pulled by the arm and my torso twisted, when a Bipolar Manic refused his DC instructions. He threw me to the ground, and my co-workers pulled him off me. They were punished for using brutal force! I pressed charges, and this pt served 6 months in jail. IT IS A felony to assault a healthcare worker!

Angela ,  RNAugust 30, 2013
Fort Lauderdale, FL



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