I have similar conversations with student nurses when they come to psychiatry about how to (informally) calculate risk when making decisions like how close to stand to someone or whether or not you can go into a patient’s room alone. My one-liner is “don’t be scared, never be stupid.”
First of all, we’ve got a bunch of highly unpredictable people, but 7-11 often has a similar quantity, and at least on the psych unit you can be around 99.9% that they don’t have a gun or even a knife. They might not be kittens, but you don’t have to treat them like rabid bears, either. Well. Most of them anyway, and I’d tell you if we had one at that time.
It also helps when you’re dealing with a high violence patient to take account of all their strengths and weaknesses. Back when I was a sitter I had a patient who was delirious from low oxygen but kept trying to clock me every time I tried to get the O2 cannula back on, but also was too weak from the low oxygen to even sit up. So I just backed off to the foot of the bed and phoned the assigned nurse and just explained what was up and that I needed a second set of hands (to hold his until we got the O2 back up enough for him to listen to reason). She walked right past me and almost got decked and the conversation went more or less:
“oh shit, he’s really aggressive”
“yeah, that’s what I said”
“you sounded so calm though!”
“…well he can’t get me over here!”
I had a similar conversation much later in my career about a patient who was trying to break my fingers but lacked the strength to even do that. When the other nurse expressed concern that he was trying to hurt me all I could think to say in that moment was,“…he’s not very good at it.”
It’s the same when you’ve got a super violent patient in ambulatories. They’ll be ready to beat the shit out of you but if their feet are tied together by a 6 inch strap you can just walk away from that ass-kicking at a leisurely pace, that’s the point of the restraints. Just make sure they’re on right and you won’t have any problems.
Also statistically speaking people with mental illness are much more likely to be victims of violence than perpetrators, but that’s a whole different discussion.
I have similar conversations with student nurses when they come to psychiatry about how to (informally) calculate risk when making decisions like how close to stand to someone or whether or not you can go into a patient’s room alone. My one-liner is “don’t be scared, never be stupid.”
First of all, we’ve got a bunch of highly unpredictable people, but 7-11 often has a similar quantity, and at least on the psych unit you can be around 99.9% that they don’t have a gun or even a knife. They might not be kittens, but you don’t have to treat them like rabid bears, either. Well. Most of them anyway, and I’d tell you if we had one at that time.
It also helps when you’re dealing with a high violence patient to take account of all their strengths and weaknesses. Back when I was a sitter I had a patient who was delirious from low oxygen but kept trying to clock me every time I tried to get the O2 cannula back on, but also was too weak from the low oxygen to even sit up. So I just backed off to the foot of the bed and phoned the assigned nurse and just explained what was up and that I needed a second set of hands (to hold his until we got the O2 back up enough for him to listen to reason). She walked right past me and almost got decked and the conversation went more or less:
“oh shit, he’s really aggressive”
“yeah, that’s what I said”
“you sounded so calm though!”
“…well he can’t get me over here!”
I had a similar conversation much later in my career about a patient who was trying to break my fingers but lacked the strength to even do that. When the other nurse expressed concern that he was trying to hurt me all I could think to say in that moment was,“…he’s not very good at it.”
It’s the same when you’ve got a super violent patient in ambulatories. They’ll be ready to beat the shit out of you but if their feet are tied together by a 6 inch strap you can just walk away from that ass-kicking at a leisurely pace, that’s the point of the restraints. Just make sure they’re on right and you won’t have any problems.
Also statistically speaking people with mental illness are much more likely to be victims of violence than perpetrators, but that’s a whole different discussion.
The slow motion punches always amuse me.