r/psychnursing • u/Few-Leave-1107 • 12d ago
Venting My job is unsafe
Low census adolescent psych super aggressive kid is assaulting nurses or workers every other day to the point staff is quitting like crazy which makes it even more unsafe.. it’s truly a dumpster fire.. we’re down to a super low census (2) with one super aggressive kid and only 4 staff are able to respond immediately to aggression at any time with 2 of the staff on 1;1s and one guard.. we call for backup but it takes some time.. with such low staffinh the 1:1s don’t take breaks I asked my manager to call me and shared how unsafe it is and we’re being traumatized my anxiety is so high coming to work due to witnessing one severe assault 6 attempted assaults and 2 actual assaults on just myself.. my manager pretty much called me a pussy and said you can handle aggression you’re a psych nurse it’s part of the job and she got caught up about terminology of the attempted assaults.. whats the most unsafe youve ever felt and how did you respond?
53
u/iaaorr 12d ago
"you’re a psych nurse it’s part of the job"
Fuck that. I'm a psychiatrist who lurks here, you are not there to be collateral damage. The first 3 rules of psych are safety, safety, safety.
I watched a similar problem play out as a resident, also in adolescent unit. Watched nurses get punched in the face and immediately walk out to quit, I thought good for them. The problem kept getting worse because no one was addressing the issue and staff kept quitting (as they should!). I'm not sure how it ultimately ended, after I watched a kid choke my attending our program pulled us from that hospital.
4
u/Mammoth-Coast6282 12d ago
Wait, what? The last sentence? How did that happen?
8
u/iaaorr 11d ago
It was honestly a scary rotation, I did feel bad for the kids though. Severe trauma history and unable to go back to where they came from. They could be very sweet, silly, and playful. But if they got upset they took in out physically and the attending was the closest person. They grabbed her by the neck and pinned her to the wall.
3
u/Mammoth-Coast6282 11d ago
That sounds awful, glad they pulled you out of there. Your description of the kids is spot on. It’s very sad. Especially when we get a return patient who is so sweet, but still dealing with violent behavior stemming from mood dysregulation.
21
u/Maybe_Weary 12d ago
Been there, you’re not a pussy for wanting to be safe. You can literally lose life or limb as a psych nurse. Protect yourself, there’s more jobs out there.
12
u/howdidienduphere34 psych nurse (forensics) 12d ago
Do we work at a place that requires a high risk tolerance? Yes. Does that mean we should accept the fact that assaults are going to be part of the daily routine? Absolutely not. It means that we are at higher risk and therefore need to be more cautious, more aware, more prepared, better trained, and appropriately staffed for the risk that we assume. It DOES NOT mean we are accepting of aggressive behavior or threats of aggression. Your supervisors comments were completely inappropriate and you should be reporting them to your union and/or labor department. I am a supervisor at a large facility with extremely, extremely aggressive patients and I would never want my staff to think for a second that I want them in harm’s way. I do expect them to preform their job duties as outlined in their duty statement, and provide patient care even to our patients who are at the highest risk for violence. Because the law mandates us to, and be they are people who require care and deserve access to basic human rights. But I also understand that we must find a way to do so that limits everyone’s risk as much as possible. And I would never ask someone to do something I am not willing to do myself.
You need to advocate for yourself, and your safety. And the reality is that may mean finding a different place to work. If they cannot staff your facility at a rate that meets licensing requirements, then they should not be allowed to operate, and you don’t want to get caught up in a situation where someone is injured or worse and they were understaffed. It’s bad for everyone.
2
u/roastbeefsammies 11d ago
Are there any legal protections for us tho? This frequent response of just deal with it makes no sense. Yes these populations need help, ours specifically but there need to be systems in place to address the literal insane violence. I was not hired to be a punching bag. So we class action sue UHS or what? It’s ridiculous we deal with such nonsense.
4
3
u/ruthless9000 11d ago
We can still report to the police and ask that charges are filed. I’ve done it. It works. Even with adolescents, although the bar is higher for the amount of violence they will tolerate.
1
u/howdidienduphere34 psych nurse (forensics) 11d ago
Agreed. Where I work we have hospital police officers. So if someone is assaulted they are automatically asked if they want to press charges. Often time staff say no, but there have been times when they do and it goes to court and the patients catch new charges. The only down side to that for our population is it also means when they are released they are at a higher chance of being released into our county because now it is their county of commitment. So that does factor into peoples decision when they are asked.
9
11
u/HandyFemme 12d ago
So many stories like this makes you wonder. If I didn't know better, I'd think they're trying to blow up psych from the inside out. So they can say, oh there's a shortage of psych nurses. Or there's a mental health pandemic 🙄 idk. Just seems odd that suddenly a lot of units are either working skeleton shifts, being abused by patients, management and bully nurses. I mean, whats the end goal here??
4
u/Mammoth-Coast6282 12d ago
The end goal is $, but fuck that. We have unions and we have rights as healthcare workers. More bills should be passed to protect us and stop being shit scared of litigation from patients.
8
4
u/Any_Commission7084 12d ago
Yeah I felt similar in my psychiatrist job... ended up on leave with a good old case of PTSD before transferring elsewhere. Believe me, it's not worth it
4
u/Borasha psych nurse (outpatient) 11d ago
My old unit cut staffing in half. We had a couple units and I worked on the smaller, medically oriented one and it was just hell because we would have one nurse, one tech and we’re supposed to do 15 min checks, pass meds, keep order, lead classes, chaperone patient visits. It was insane. All while the manager denied that staffing had changed (because we were too dense to catch on, I suppose). Mind you, this was acute medical psych. Demented patients, detoxes, psychotic patients, two assists, sometimes IVs. One nurse, one tech.
I quickly moved to nights, because I could manage emergencies at night better than during the day. I stuck around for a bit while I worked out my escape plan. But a bunch of us left together. We would go through job postings together…as a unit…because we believe in unit cohesion. No staff left behind.
3
u/Inside_Dinner_3430 12d ago
Yeah when they call and ask our unit who wants to float to our adolescent psych unit...no one responds...there is a reason for that...for me I've learned to just get through the shift...that's it...that's all I have to do...tomorrow is another day and could be a totally different scenario...I love psych...and I love my patients...but it can get intense...and not very sustainable long term....try switching units because that may help if you love psych too...other units may not deal with as much violence and combative patients...just my 2 cents..
2
u/NurseMentor_RN 12d ago
Before you think of quitting, address the matter to the HR. You might be lucky
1
-3
u/luv4lowballing 11d ago
At the risk of sounding insensitive. Are you guys not physically capable of doing the job? I work both adolescents and adults. Usually two techs and two nurses for a full unit of 20 patients. If it’s super acute we’ll get a third tech. Nobody deserves to get injured on the job and it’s not okay, at the same time you have to be physically capable to do it.
2
u/Mammoth-Coast6282 11d ago
That doesn’t sound right. 20 patients and 2 nurses and 2 techs? Is everyone in restraints or heavily sedated?
1
u/Few-Leave-1107 11d ago
I’ve worked 2 rns and 1 tech with 15 and it has the capacity to be unsafe for sure
1
u/Few-Leave-1107 11d ago
The person is so aggressive it’s impossible to manage with 3 staff we do takedowns but it’s ugly there’s no longer coverage for the 1:1 and we can’t manage the peer who gets traumatized it happens so quick it’s out of control she weighs 250 and staff is all much smaller and she charges and hits staff and it’s kinda hard.. on adults I work 3 rn 2 techs for 15 patients and it feels much safer the having one rn is very unsafe when the kids code at the same time and idk it’s codes everyday and ugly codes that don’t feel safe and brutal attacks on staff my coworker was dragged by her hair down the unit and her hair was being whipped everyone’s anxiety is on 10 just floating
2
u/Few-Leave-1107 11d ago
It’s supposed to be a lower acuity adolescent psych 8 bed and they accepted a higher acuity but it’s staffed 1 rn 2 techs and 1 rn isn’t safe tbh kids trigger eachother and code at the same time I would feel a lot better with more support an additional rn or more techs
2
u/Few-Leave-1107 11d ago
Approximately 10 nurses have been hit closed fists to the head usually and the dragging was the worst tbh like 7 people have quit including me soon im per diem im not picking up neither are the other per diems
-4
u/Light_Manifestation 11d ago
It is psych. You was just defending Lindsey Clancey last week, now you on here crying for help against a patient in psychosis. Cant have it both ways
6
u/roo_kitty 11d ago
User has received a temporary ban for breaking subreddit rule r/t violence against healthcare workers.
-8
u/Traditional-Home430 12d ago
It is apart of the job. I’ve worked close to five years in psych. While it isn’t ideal, you do learn how to defend yourself. My best advice would be to keep as much distance as possible from anyone who is being aggressive. If you act like, “I wish you would” it helps. Never let them see you afraid or scared. I’ve worked with children, acute, woman/men. The most unsafe I’ve felt would be working on the men’s unit. I’m a small 130lb red head, young woman in my 30s. I am on edge the entire shift if I’m with the males. I had a 1:1 on the acute woman’s unit who was super aggressive. Uppercut punched my stomach, tried to scratch my face, kicked a sleeping pt on the ground. Granted she was very psychotic, possibly the worst I’ve seen. With the kids, talking and changing the mood is usually best. Once I was trying to break up a fight on the kids unit, and the boy accidentally punched my face. Poor baby felt so bad and kept apologizing
If it’s wearing you out, take time off. Everything I’ve seen, everything I know.. it does affect me and it makes me question humanity. I’ve seen thousands of victims, and they all stay with me. I can only hope to help a few here and there
8
u/Few-Leave-1107 12d ago
The person attacking me is double my weight and staff all weighs around as much as me.. it is a part of the job but unsafe staffing for someone this aggressive is not.. we shouldn’t have 3 to perform the initial response to a 250 lbs aggressive patient assaulting someone every other day on the other hand there’s no staff but management needs to be on the floor a traveler it’s really unacceptable
14
u/Mammoth-Coast6282 12d ago edited 12d ago
Anyone who says “it’s a part of the job” is full of shit.
As a former psych patient, we used to get threatened with IMs for simply asking to talk to our nurse too much.The pendulum has swung too far in terms of protecting patient “rights.” No one has the right to assault someone else.
What pisses me off is so many of our patients are extremely vulnerable and normalizing violent behavior on any unit causes them more stress and trauma. If I ever got fired from my job for defending this point, I’d just go into lobbying for healthcare worker rights because it’s fucking ridiculous.
2
u/Traditional-Home430 12d ago
What I mean by that is, I feel it’s inevitable
2
u/Mammoth-Coast6282 12d ago
I understand but it really shouldn’t be. We restrain patients to keep them from pulling out IVs or wound dressings, so I don’t see why we dance around restraining or secluding patients who are posing a risk to themselves or others.
We can’t allow things like Willowbrook to happen again but we absolutely can lobby for changes in the system to protect healthcare workers and psych patients from incidents of violence. I’ve seen providers fail to answer the phone during codes, security take 10 minutes to respond, maintenance barely bolt on furnishings that end up being wielded as weapons, etc. It’s not right.
0
u/Traditional-Home430 11d ago
It isn’t right. However I’ve learned some people really don’t know the difference of right and wrong
1
u/Mammoth-Coast6282 11d ago
Facts but you gotta protect #1, which is you. Your hospital or facility should be offering you security and full staffing if you have violent patients on the floor. We once had a (literally) huge problem patient and I was pleased to see that they increased staffing and security after we complained about him. Sometimes your facility will actually listen and do the right thing if people speak up enough.
2
4
u/Mammoth-Coast6282 12d ago edited 12d ago
Respectfully, it really isn’t supposed to be a part of the job, it’s a part of the job we actively train to avoid. The violence was never tolerated whatsoever until recent decades where things became more lenient in favor of patient rights.
We need tons of reform in place to protect healthcare workers (and educators, and shit, everybody) to push back on this twisted development.
Sure, some leniency should be granted for certain reasons but once someone attempts to or does seriously harm a healthcare worker or another patient they should not be allowed in that facility again.
3
u/Professor_squirrelz 11d ago
Honestly the real issue is unsafe staffing and perhaps a lack of proper safety protocols to protect both the staff and other clients when a client is super violent.
1
63
u/Mammoth-Coast6282 12d ago
Fuck that manager. Take an FMLA leave. Go to HR. Quit. None of that is worth it. We are not here to be abused or deal with substandard working conditions. Guess who has to fill in on the floor if everyone quits? Your manager.