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Does it make sense to hold a confused and disoriented patient criminally responsible for punching a nurse?

Monday February 25, 2013
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Dear Donna,

What are the nursing ramifications of ED nurses pressing charges against patients? I am very concerned that my 18-year-old nephew who was taken to the ED by ambulance after being found unresponsive, blue and foaming at the mouth by his parents was then sent to jail after he punched the nurses attempting to catheterize him in the ED. He has a history of mental illness and sleep apnea, which was provided to the ED staff by his parents. Neither of the nurses had serious injuries, but the hospital recently toughened it's policy regarding patients hurting staff. As an RN with more than 20 years’ experience, I cannot imagine holding a confused and disoriented patient criminally responsible. Is this a new direction in nursing?

Concerned About Charges Being Pressed

Dear Concerned About Charges Being Pressed,

Violence against nurses has been on the rise not only in frequency but also in severity of injuries, especially in EDs. Unfortunately, there also has been a longstanding culture of tolerance of that violence. As a result, most EDs and healthcare facilities have more stringent policies — as this facility apparently does — that include pressing charges against patients who exhibit violent behavior toward nurses. There are always exceptions. But judgment calls have to be made at the time of the incident, and action is taken when deemed appropriate. I have worked in both psych and the ED and know there can be a fine line between whether or not a patient is in control of him or her self. And staff, patients and families may all see the line differently.

What happened in your nephew's case is very unfortunate all around. If the family believes their son was wrongly charged and incarcerated, I'm sure they will retain an attorney who will view the medical record and talk to those involved. That process may provide more information for you and the family about what actually happened in the ED that day.

As a nurse and a family member, you may find the following article noteworthy. It outlines the challenges ED nurses face and the dilemma of whether or not to press charges. http://www.securitymanagement.com/news/culture-tolerance-enables-violence-against-nurses-says-hospital-administrator-009412.

Best wishes,

Donna Cardillo, RN, MA, well-known career guru, is Nurse.com’s “Dear Donna” and author of “Your First Year as a Nurse: Making the Transition from Total Novice to Successful Professional” and “The ULTIMATE Career Guide for Nurses: Practical Advice for Thriving at Every Stage of Your Career.” Information about the books is available at www.Nurse.com/CE/7010 and www.Nurse.com/CE/7250, respectively. To ask Donna your question, go to www.Nurse.com/Asktheexperts/Deardonna. Find a “Dear Donna” seminar near you: Call 800-866-0919 or visit http://Events.nursingspectrum.com/Seminar.