long post:

I’m a male nurse and 3 days ago, my female colleagues had to deal with an asocial, violent family: the patient’s daughter, her very big and tall husband and 4 other family members that weren’t that aggressive, but said nothing and did nothing to stop the violent family members.

Cardiac unit, they wanted to take the patient for a walk, except that the patient was under monitoring, meaning you cannot.

The nurse in charge, a small woman told the family they couldn’t take the patient out of the unit and the daughter and her husband lost it. Literally. They turned to pure karen mode, started yelling and insulting my colleague, words I’m not going to repeat but it was very denigrating and happened repeatedly, like they were trying to elicit an aggressive response from my colleague so they would have an excuse to get physical, they got 3 inches off her face, the man told her in a very aggressive way he would be waiting for her when she finishes her shift, the woman told her if her father dies, she would hunt her down, also insulted her some more.

All my colleague did was telling them that the patient is under monitoring and cannot leave the unit. My colleague tried to calmly repeat the same line another 2 times, but these 2 people just wouldn’t listen, they started being that aggressive directly.

Security was called, but they never reached the unit on time, cops were not called, a doctor was called as well who came running, repeated what my colleague said, the doctor informed the family the patient could leave against medical advice, the patient refused, the family left, complaining about my colleague, didn’t apologize to her, my colleague needed 30 minutes alone to cry.

Now I’m a male and I have no idea how to react, should that happen during my shift. I have the feeling my female colleagues expect me to intervene, because I’m a man, but I’m not a strong person and I don’t know how to react when an intimidating and aggressive, bigger man than could easily punch me unconscious tells me 3 inches from my face he is going to wait for me when I finish my shift.

I have thought about several scenarios:

  • I simply say ‘I’ll call the doctor’, disengage, call security, call the police saying I fear for my security and for my patients’ security and ignore them till they come. Then I tell security and the cops to escort the violent family from the unit. Document. Call the union.

  • I confront the violent family: ‘Im not gonna talk to you unless you behave like an adult, call me when you’re ready to do that’. I disengage, call security and the cops and ask for them to come silently because, even though there is no violence, the situation can escalate very quickly and unpredictably and I fear for my safety, my coworkers’ safety and that of my patients. Document, call the union.

  • I try calming the violent family: 'calm down, you don’t let me talk, repeat that twice at most. If they don’t behave, I stop engaging, call security and the cops, because I fear for my safety. Document, call the union.

I also don’t know what could I say or do if they keep pestering and goading me when I disengage. Do I try to ignore that? Tell them to stop, looking them in the eye? Repeat ‘I’ll only talk to you when you act like an adult? Repeat ‘leave me alone’? Say ‘I don’t want any trouble with you, but if you attack me I’m going to defend myself?

I also need help to stay safe for the 10 minutes our internal security sometimes need to reach our unit and whatever time the police needs to reach us. Do I make the aggressive person focus on me so my female coworkers are safer? Do I ignore them? This must be one of the creepiest experiences a person has to live.

thank you for your help

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    11 months ago

    Ah, hospitals. I feel for you.

    I haven’t read the comments here yet, but scenario 1 and a modified scenario 2 in combo sound like the best approach. DO NOT TELL PEOPLE TO CALM DOWN, IT WILL ALWAYS MAKE THEM ANGRIER. The best way to do it IMO is to model the behaviour you want to see - remain calm. Explain (to the degree that you’re authorized to as a nurse) why they can’t do the thing, and the potential outcome of doing the thing. While trying to calm them down, have the more vulnerable target disengage and make the call to security. Remember that your duty is to your patients’ health and safety - make it as clear as possible that you’re not doing this to be a power-tripping douchebag, but to make sure their father gets the best possible care they can so they can go home ASAP.

    My work experiences are not exactly the same, but similar in some respects. I’ve found it useful to consider the following - in a healthcare-related scenario, the person who is super pissed and aggressive is usually more scared/freaked out than angry. If you address the fear they will usually calm down pretty quick (or at least the anger turns to other, less dangerous expressions of fear).

    Does your hospital/union offer any training on descalation techniques? They’re not a cure-all but it’s vital stuff to know in a high-tension environment like a hospital.

    Edit: Misread the OP and thought patient was the daughter of the aggressors, fixed to say ‘father’.