I don't understand why they don't make these assaults felonies. These nurses often have to work with the same POS's police officers do and it's a felony to assault a police officer if I am not mistaken.

I had no idea it was this bad.

EMTs should reroute violent patients to psych ERs instead of sending them to normal ERs. Its pathetic that some idiot decides to get high or drugged up or drunk and everyone has to suffer the consequences while trying to save his own life. They are just as dangerous in the ER as they are when driving in the streets yet physicians and nurses are told never to fight back because if they do, they get sued.

We, as Americans, really need to fix our priorities

the nurse who said it doesn't mater how drunk, high, in pain you are it doesn't give you the right to hit another person. I 100%. The state shouldn't make cuts to theses clearly much needed programs, they should always start with their own paychecks and bonus. If they cared so much about the people government officials should get off their high horse and out of their fancy mansions and get down here with the rest of us and actually do something. Theses people who got into theses professions just wanted to help people and now the very people they're trying to help are putting their lives at risk because violence is the only way they know or can deal with whats going on but that's not true. They need help or we need stricter laws.

ER staff do have options. But depends on the hospital. Our security responds pretty fast and if psych or any other patients get to the point of being really dangerous... we can quickly bring them down and strap them to the bed.

We do have a high % of males among the nursing / tech staffs and good portion of the medical staff are prior military. Couple of our docs used to be in special forces. That helps alot.

It should be a felony to assault any ER staff. My wife is a ER nurse and has been assaulted several times. The last one, a drunk women being brought from a concert bit into her forearm and actually took a chunk out. She had to go through a round of anti-hiv drugs not to mention the pain and recovery from the bite itself. The woman was charged with assault eventually, but I doubt it got the point across since she only got probation and a small fine, She didn't even have to pay for the nedical costs associated with the assault. I say make em pay if they are able. That would get the point across to some of them at least, as well as pay for the workmans comp that had to be paid to my wife.

None of this is surprising.

Any student of history will recognize that people 'self medicate' in times of high stress. Given the current economic stresses in the U.S., we should expect to see much more of this (and other kinds of crimes), as people fall deeper and deeper into despair.

All cases of assault needs to be taken more seriously. You can beat the crap out of somebody and get a slap on the wrist in this country. I've always said that this country needed to get it's priorities straight as far as crime and punishments go.

As far as the health care professionals, of course they don't deserve to get beat by patients........but, some of those patients described aren't exactly "all there". In treatment facilities and mental health institutions, they are prepared for this kind of thing. They have the sleepy shots and restraints, paded cells, etc. Some of these people are so crazy that they honestly don't understand things like: there's only one of them (multiple personality); or that dogs do not tell you to kill people. So really, charging people who couldn't understand the concept of "consequence" with a felony is a bit pointless.........maybe even wrong considering the living hell they experience in thier minds on a dailey basis. Some people coming off of certain drugs experience such severe withdrawal that they also are unaware of thier actions. They can have delusional moments, though not constant like a person with psychosis.

It's very tragic that these programs are being cut, putting the nurses lives at risk. However, I don't know if you can just "punish" this problem away. Like I said before, people who are extremely crazy do not respond to punishment, and some patients aren't aware of their actions. More security and a panic button is certainly a good idea. Maybe they could get one of those orderlies with the sleepy shots to patrol. This isn't a good situation for anyone, ER's, rehabs and mental homes shouldn't be in the same area!!

In the case that Gary Cook describes where some skanky drunk drink took a chunk out of his wife's arm..........yeah, that's a bunch of crap. That girl definantly deserves some time. I don't know if that's a program cut issue, though, like the article was describing.

I like Dani's idea - do a criminal check en route then take them to a prison hospital. Physicist - responsible adults don't self-medicate and shouldn't be subjected to those who do. Prison hospitals are equipped to handle them.

Fortunately, there are PatientFirsts in my area (ER alternatives). You have to pay to get treated there (self pay or insurance), so I can avoid the large quantities of human filth in the Baltimore region. The problem is wait time, as all decent people flock to these places, and for some reason people bring there whole families with them, hogging up space and increasing the noise level (due to noisy, undisciplined kids).

What scares me is being unconscious or injured to the point that I receive ambulance transport and have no control where I go. It's very hard to transfer to a better hospital once you've been taken to a public one.

EMTs should reroute violent patients to psych ERs instead of sending them to normal ERs. Its pathetic that some idiot decides to get high or drugged up or drunk and everyone has to suffer the consequences while trying to save his own life. They are just as dangerous in the ER as they are when driving in the streets yet physicians and nurses are told never to fight back because if they do, they get sued.

We, as Americans, really need to fix our priorities

It is those very Psych hospitals that have been closed requiring bringing these patients to regular emergency rooms. And they can really tie up matters when the ER staff is trying to treat seriously ill medical and surgical patients.

We don't need ER nurses.

We need more Hedge Fund Managers and Credit Default Swap Traders....with billions, and billions, and billions, and billions in bonuses for creating nothing.

What do ER nurses do (sarcasm tag)?

There is no such thing as a "psych" ER, except maybe in NYC. It *is* a felony to hurt a hospital employee, but that doesn't prevent attacks. A "prison" hospital consists of an RN with orders to medicate daily (no diagnostics, no MDs). These patients go to the nearest hospital as per the law. As for "criminal checks", can you imagine the law suits if a drunk person with a criminal history is rerouted somewhere and dies?? I had a "drunk" patient once who turned out to have extremely low blood sugar and that is why he was unconscious. If he had gone to a drunk tank, he would have died.

As an ER nurse, I am for 24 hour security and metal detectors, which are both expensive. My ER is in the process of proving that we need 24 hour security. This consists of writing violence reports *after* the violence has occurred. I have also worked at an ER where they didn't want to get metal detectors because it would "ruin" the ambiance of the lobby.

It all comes down to money. My life is at risk, because of funding cuts.

I work on a pysch unit at a county hospital and from my experience I would have to say that the idea of implementing "criminal checks" would only make matters worse on a given situation.

Many of these individuals will deny that they have a problem and become very agitated simply because the cops were called or because they are being taken to the hospital. The same applies for many addicts.

One thing that is nice about my Hospital is that we have a dedicated "wing" in the ER that is devoted to pysch patients and those that are out of control.

Good point Eris.

I wish they would make it a felony to assault personnel in the ER. My mother is an ER nurse, and she was actually out of work for several weeks when a drunk guy tried to make his escape from the police in her ER. He bowled her over in the hallway and messed up her back badly. And of course, the guy got a slap on the wrist and was back on the street in no time.

It varies from state to state, but in WV the first 2 assaults against police, corrections officers and EMTs are only misdemeanors. The first two groups are given training and some equipment to counteract, but it still doesn't prevent it. Nurses and other medical staff should be seperated from the charge and changed to felony time.

State legislatures who refuse to make hospital assaults a felony are out of touch with reality and need to wise up that if we don't protect our medical people, we'll lose even more of them. If they're not careful, there will be nobody willing to work in emergency rooms.

I don't understand why they don't make these assaults felonies. These nurses often have to work with the same POS's police officers do and it's a felony to assault a police officer if I am not mistaken.

Except the nurses don't wear badges and they don't "sacrifice their lives to protect the public."

Why do you think it is acceptable to assult nurses----do you also think it is ok to assult anyone who does not wear a police uniform or badge?

Perhaps you have a habit of assulting people and don't wish to go to jail.

By the time we are done every group will have its own little special category for assaults. Then we will be back to ground zero and will have to start to categories of special. Seriously, does anyone think a psychotic or strung out doper will care that he will get extra time for assaulting a health care worker?...

This is a good point. A crime is a crime is a crime. Doesn't matter who you are. If you are a victim, you are a victim. It makes me wonder if we should open our emergency room doors for everyone. What did people do before they had emergency rooms?

chris -

Do those kinds of people get a free pass when they lash out and assault law enforcement?

Medical care professionals should be given the same protections under the law as law enforcement. They are even in more danger from these people; they don't have guns and/or tasers, and they aren't allowed to slam them down and put handcuffs on them.

Just send the drunks to a cell, hospitals should build some, those can also accomidate the psychotic ones also. Our hospitals should be a safe place for people to get treament, not a filthy rat house where people can injured even more. Perhaps a "Right to refuse service to mistreatment of hospital staff" should be in order? Probably not any of the above mentioned idea's, but I can only hope.

It does not work that way.

Drunks can vomit and aspirate. Probably have cuts and scrapes that need to be seen by the doctor. Chances are that the drunks did not go into police custody quietly. Psych patients can cut themselves or swallow large amounts of poison. Majority end up in ERs that needs to be cleared by the ER doctor before going to psych.

I am concerned about these types of laws, because there are many diseases that can come to violence in an emergency room without the patients control (Diabetes, Epilepsy, etc!). That being said assualt is assualt!!

The other problem is that there are many prosecuters who use written law against people for money to the state, and higher penalties to suspects in order to achieve success! Look at California's Three Strike laws! Great law, but nobody inteaded to have three time losers spending life in prison for a Drunk In Public Parole Violation!

I'm not necessarily advocating to single out violence against nurses, but I do vehemently believe that as a healthcare provider I should be protected, not face harm, and be able to deliver care to patients in my charge. Nursing is a tough enough job- being on your feet 12+ hours a day, caring for the sick, exposing ourselves to viruses/bacteria/etc without the added threat of being spit on, hit, kicked, bitten, etc. If you (collectively) think that nurses should have to endure this type of treatment, then you should agree that hazard pay should comparable to the daily violence that we face!

It does not work that way.

Drunks can vomit and aspirate. Probably have cuts and scrapes that need to be seen by the doctor. Chances are that the drunks did not go into police custody quietly. Psych patients can cut themselves or swallow large amounts of poison. Majority end up in ERs that needs to be cleared by the ER doctor before going to psych.

Then restrain the violent ones. Belly chains and leg irons don't interfere with most medical care. If ER staff is expected to provide care for some nutcase, they need at least one security guard or cop in there with them. Since that would be too expensive, then use restraints. State hospitals for the mentally ill use them all the time with no worries about civil rights or patient safety; ERs can do likewise.

The application of any form of restraint is governed by Federal and State regulations which are very stringent. It is a patient safety issue when you slap patients into them. Putting patients who are intoxicated and violent to self and others still requires close oversight of the staff to avoid bad outcomes like death. Psych hospitals face the same issues as acute care hospital emergency departments.

Also FYI ever heard of EMTALA...the law that requires hospitals to care anyone with an emergency medical condition that is life threatening.......whether you are a "legal" or not. These patients are not all illegal but they are coming from a society that has lost some measure of self control.

Putting a patient in restraints is a paperwork and logistical nightmare. They are putting more and more psych patients on regular medical floors and expecting the nurses to have the time to check on them every 15 minutes, hourly, or whatever, and chart chart chart chart!

Then,if they are not restrained for whatever reason, and since they are not on a locked unit, we end up chasing them down the stairs or out the door on a regular basis. Then when they try to punch or kick us we have to call security to come sit with them.

Meanwhile, we have 4-5 other patients that are not getting attended to. I quit nursing: got burned out big time. Sad to say, I see a lot of young nurses getting burned out early by this kind of crap.

Yeah that is a stupid move on the hospital. Admins who have no clue what is going on outside of their offices.

I'm lucky that I work for a county hospital at a large city who understands the importance of techs and security. And since the police mainly come here to drop off drunks, immates, and psych patients..... we also have a presence of city police at our workplace.

But yes, I have noticed a rise in number of psych patients coming in. Combination of rude patients with non-emergency illness demand to be seen first didn't help either.

A violent patient responds to one thing, greater violence or the threat of it. I am an MD. Once while an intern working the ER at Charity Hosp. in New Orleans (this was 1964), a patient tried to attack a nurse. Fortunately one of his buddies was with him. He grabbed the guy by the head in an arm lock and slammed his fist into the guy's face breaking his nose and sending a spatter of blood 6 ft. in all directions. That patient quieted down in a heart beat. Of course we had to fix a broken nose as well as the guy's other problem. The security that is needed are 6 ft 2 in ex MP's from any of the services. Believe me thses guys have dealt with drunks and others who are a threat.

I too worked in the ER at a county hospital. That god that the County sheriffs had an office with 2 lock up cells, and a holding area. All Patients that were under arrest, were put into a holding area, where they were hand cuffed to the gurney. Then they were taken to the Jail ward. If a patient is out of control, in the er, the sherriffs were there in a heart beat. But, staff still got, punched, kicked, spit upon, etc. We even have a van take the drunks to a special drying out place, that does no good, once they sober up, they leave. As a county hospital, we can not be put on divert status, we have to take everybody no matter who, or how full the er is, due to the Level one trauma rating. I have seen gang fights in ER, I have seen people walking in with weapons, you name it, I prob saw it.

Every shift, was "Welcome to the Jungle" Be it Day or night.

I say make the administrators do a shift in the E.R. Let them get abused and then maybe they will quit cutting staff. But I doubt it.

I'm sorry you've had to put up with that crap. It saddens me that people who should be under their own control are so rude and abusive. You guys should be allowed to hit back as self defense...can't slap and punch your nurse if you are out cold on the floor and then subsequently tied to the bed.

Right -- a punching match between nurse and patient. What a wonderful idea. Grow up. Adults thinking and behaving like three year olds is the problem, not the solution. It has become endemic in this country, from the top down.

Expect it to get worse.

It leads to the upbringing by parents. Back in your grandfather's days, majority of people were taught to be respectful to adults, be polite and be honest.

Now these youths and adults raised by television, taught to be like Paris Hilton or those other rich brats..... now its cool to be snobby, rude, and obnoxious. Demand to be waited on hand and foot. That is the American way. Watch those reality tv shows. It's obvious where they learned it from.

These drug addicted patients and their families are not able to be respectful, polite, or honest. It's a drug issue, not a nurse and hospital issue. When state hospitals for drugs and psyche had to close their doors, the result was homeless, needy, angry, addicted and psychiatrically ill people with no where to go and no one to blame except whoever they encountered at the ED. One night I was working and someone sprayed the entire ED with machine gun fire. I've been punched, hit with telephones, pushed to the floor, spit on, etc. etc. It's a terrible situation and drugs are at the heart of it.

Had -enough i can not agree more, if you look at this country right now every body seems to be mad at every one. It seems as if you can not talk to people ( except friends and family) about anything with out somebody getting mad and throwing in-salts.Look at the talking heads on T.V. most have a point of view and if you disagree you are stupid at best and probably a communist or worse. I know it is probably human nature for some people to be crude and rude but most people use to try and see your side, and have a civil conversation but now it seems as if it is a badge of honor to be as rude and condescending. That is not the way we should treat each other.If we live in a world where the meanest and rudest people rule then there really is no god and we are just a bunch of smart animals.And again i agree alot has to do with the way life is portrayed on T.V.

Right -- a punching match between nurse and patient. What a wonderful idea. Grow up. Adults thinking and behaving like three year olds is the problem, not the solution. It has become endemic in this country, from the top down.

Dear Brain-Damaged Person:

It's called self defense. The nurses and CNAs have every right to go about their jobs without being attacked, but maybe you didn't get that memo.

Nobody except you is talking about a punching match between nurses and patients. Catch up with the rest of the conversation. The topic is patients assaulting medical staff and how it can be stopped. Absent any security measures, the staff is going to have to do something to protect themselves, and in case you've missed it, violent drunks and druggies don't respond very well to flowery chit-chat.

Using physical force to protect yourself is not only legal and moral, it's also the intelligent thing to do when there's no other option. Come back and try again.

RE 7.6

As a psych nurse, I must totally disagree with you, PistOff. That type of retaliation only serves to escalate the situation, not diffuse it, There are many non-violent ways to handle an out-of-control patient, but in an understaffed unit, they don't work very well. You need enough people to just be there and solid, enforceable consequences.

You are so right. I am an RN in long term care. I had been a long term care nurse for a few years in the late 1980's and the patients and families' behavior was so different then. They actually appreciated our care and treated us with respect. I returned to long term care in 2000 and what a change. People have impossibly high expectations and are rude, demeaning and at times violent. One pt's dtr, walked up to nurses station with her mom's dinner tray and threw it at us yelling "Would you feed this s#*t to your families?" We get the brunt of people's anger and it is things that aren't in our control. These people are not made accountible for their behavior. We are supposed to "understand" when they act out.

As a psych nurse, I must totally disagree with you, PistOff. That type of retaliation only serves to escalate the situation, not diffuse it

As a former prison guard who dealt with mentally ill inmates, I'm here to tell you that when it's necessary, physical reaction is vital and necessary. By all means, talk him down or use staff presence to defuse the situation, but when he comes at you and starts trying to kill you, how do your people skills work then, with a shank in his hand or his hands around your neck?

You need to be prepared to either defend yourself with the minimum amount of appropriate force or have your will filled out.

Unless they hit you first. Then its open season.

Shelly,

What do you think the answer is? We are face with overwhelming healthcare expenses as a nation, it has divided our country. We hear that taking care of the uninsured in our emergency rooms is a big part of the problem. Are junkies and violent criminals part of the problem? Should we leave them out on the street or send them to a special emergency room? That is a real question.

Shelly- I am sorry that you have to go through this. I want to thank you and all ER nurses for all you do. You are heroes.

Shelly, I reread my comment, and it sort of sounds bad. It is a real question. Maybe we should not allow people that are potentially dangerous into our medical facilities. Maybe we require them to go to a special facility with extra security. I always believe that the people that live in a situation day in and day out have the best ideas on how to solve it.

This nurse cares. Tough job but we are dedicated to it, or we wouldn't have done it. Bless you all who are nurses.

Of course you shouldn't leave them on the streets, we don't do that to people in this country. We don't torture the mentally ill with ice cold baths or shock therapy either anymore (or at least they aren't supposed to). The only answer I know is to increase security and protect the nurses, if they can't have separate facilities. If this is truley an issue of program cuts, then you can't begrudge people who probably aren't aware of what they are doing. No, I'm not talking about drunk chicks or rude people who want to fight with anything that moves. I'm not talking about the cast of "Jersey Shore". ;-) I'm talking about people who belong in rehabs or mental homes. Leaving people to suffer is something they do in other countries, not here. Leaving crazies and addicts on the street to terrorize civilians is certainly not a good idea.

Hahahaha........I don't know, I sometimes wonder if "Snookie" doesn't belong in a mental home!!

Shelley - Good comment about PTSD and fear of going to work.

I have been subject to physical assaults by patients many times. Once even by a patient's family member who hit me with her stilleto heeled shoe.

Our security staff is a joke; made up of old men and skinny little boys. Hospital management offers little empathy to abused staff.

Well, unless you waited 18 hours before dying on the floor, which has also happened. It seems the abuse goes both ways.

Yes, Hestia, it does go both ways. The difference is the patient gets to take you and the hospital to court, or their family does, and any one of the nurses, if found negligent, can be sent to jail for abuse. However, this is not the case for abused nurses.

The city I'm in has large amount of hospitals available. There are a county hospital and there are for-profit hospitals. At a for-profit hospitals, you have to have insurance or some means to pay for the bill before being seen. Not so for a county hospital. Everyone gets seen over here because it does not matter if you can pay your bills or not. The city end up footing the bill if patients can't pay for it. That is why majority of people that come to the hospital I work for have no insurance and poorer. And that is why there is a high wait time. You would be surprised some of the reasons some people come to the ER. i.e. wanting to get their prescription refills. All it does is increase the wait time for everyone else.

It is also a level one trauma center too. So good influx of gunshot victims, car accidents, psych patients, immates, and many more come here. It's not the hospital's fault if they have limited amount of beds available and 2-4 times of patients wait to be seen. Remember, we can't turn anyone away. Triage and treat the worst patients first. If you come to the ER wanting to get your meds refilled, chances are, you have no business being there. Wait til the morning, call your doctor and get it refilled there.

Yes, Hestia, it does go both ways. The difference is the patient gets to take you and the hospital to court, or their family does, and any one of the nurses, if found negligent, can be sent to jail for abuse. However, this is not the case for abused nurses.

I'm surprised that you must sign away your legal rights to become a nurse. I'd never heard that before.

But in any case, a dead patient probably is not gratified by winning a lawsuit.

It's not that I'm unsympathetic. It's just that not long ago when I argued with an ER nurse who was trying to perform a procedure appropriate to the patient next to me, who was coughing and hacking and almost certainly had pneumonia -- but not to me, who was there due to a chronic heart condition -- she become quite obnoxious. When I finally got it through her thick skull that she was trying to treat the wrong patient, and I, with my heart racing and skipping and my blood pressure through the roof, tried to get up and leave, she shoved me down onto the gurney and started yelling that I had tried to hit her. When I informed her that we would both be taking polygraph tests as soon as I could reach my lawyer, she shut her mouth in a hurry and started tying to make excuses.

I went to a different hospital, where I was immediately admitted. It could have ended in tragedy for me. I probably should have sued, but I didn't.

As I said, the abuse goes both ways.

That is a super dramatic account. If your heart was having issues like that you should have called 911 instead of going to the ER. If they took your vitals and you were stable then yes, the other patient would come first. Having a chronic heart condition, you have medicine and hopefully put that on your reports.So the triage nurses knew already your condition. You probably threw a fit because you were not admitted right away. If you have time to go to another hospital and get admitted there, then it was not that big of an emergency. Polygraphs don't mean anything, and why should you have sued? The abuse does go both ways but day after day patients walk in expecting to be seen for a problem only to have a stomach ache. My daughter hurt her arm and could not bend it. We went to the ER and waited while a woman sat there moaning and groaning and then flopped on the ground in pain. So dramatic. The staff just looked the other way since they had seen it before. Others in the ER were yelling at the staff but it turns out she had gas. We were patient and we were put in the room next to her. I could hear everything the doctor said and all of that drama for gas. They see it everyday and yes it desensitizes some of the staff. You just added to the problem.

Are you a nurse, Amber? I'm sorry, but what about that job makes you women so hostile? You're going to sit there and say that someones heart condition is just "drama"? You shouldn't be a nurse, if you feel that way. One of these days, you're going to get somebody hurt assuming that their just putting on a show and not taking them seriously. Did it ever cross your mind that some of these patients do not know what's happening to them until the doctor tells them, and they are frightened?

I understand that nurses are human, but Hestia, you're not the only one who's ran into a nurse with a real bad attitude. Some of these women are fantastic, some of them make you even more miserable and scared then you already are. My neighbor died after waiting six hours in the ER while his bowels ruptured and poisoned him. Is that a dramatic account, Amber?? Am I a liar too?

What are you trying to say, Amber? Are you saying that it's not possible that this person could've have had a heart condition, and that a nurse could've not done a very good job treating her? Are you saying that all nurses, who happen to be as human as the patients, are 100% perfect all the time? Seriously, I hope for other people's sake that you aren't a nurse.

The difference is the patient gets to take you and the hospital to court, or their family does, and any one of the nurses, if found negligent, can be sent to jail for abuse. However, this is not the case for abused nurses.

It should be. Assault is assault, and just because someone's intoxicated or "not in their right mind" has no bearing on it. Let the medical staff have their fair chance in court and let the judges and juries deal with these idiots.

If you are talking to me, Amber, you apparently cannot read. Your spin has nothing to do with my experience. I was brought to the ER by ambulance and that has nothing whatsoever to do with what I experienced.

You need remedial reading comprehension and possibly anger management.

Also, I want to say again that I am not unsympathetic to nurses being abused. I don't think either nurses or patients should be abused. I was simply pointing out that it does go both ways. The difference is that a nurse can get banged up, and that's bad enough, but patients can die, and have.

Seemingly not thought of behavior such as popping an antihistamine for an allergy symptom and having a beer with a dinner sometime later .. and only one beer with the allergy pill on board can double the the level of intoxication and cause DWI and aftermath...What would the charge be on that one for a person.....Involuntary what? Is the person negligent who " causes" some type of sequela to occur afterward and what now .....Unbeknowst to them .....They perhaps didnt realize that one casual beer and an antihistamine they forgot they popped could cause ......Well .....Trauma to self and others and drama ......Innocuous behavior seemingly .........EMERGENCY......So this is a quigmire ....The New Mexico project may shed light on edumation to the youth but how about the old gray mare where does he or she stand in court when they get there if they didnt know or were not aware of this or any other reactions of chemistry of pharmacy and biochemistry of body ....Should the book be thrown at them

For all of you who say that nurses should fight back, don't have a nursing license. It is written in the scope of the practice that you can not hit a patient (though, you like to, when you are assaulted by one) or your license will be revoked. It is considered patient abuse, just like if your replacement does not show up, and there is nobody to take over those patients, if you leave you can be charged with abandonment of your charges. Your license can be revoked as well. Any medical staff hands are tied when it comes to people abusing us. Did you know that we can not restrain a patient physically or Chemically, with out the state coming down on us. The list goes on and on. I understand the patient bill of rights, but that ties the hand of the care giver. There is no medical personal bill of rights, there should be.

I think starkey is having an adverse reaction to some medication.

Another thing that goes both ways - stress. Much hay has already been made about mentally ill/intoxicated patients; however, stress can also push perfectly sane, sober people to thoughts and acts of violence. It's a natural (but inexcusable) inclination to turn that stress toward an authority figure, such as a nurse or a doctor - especially when the patient feels as if he/she is being slighted, or as if the nurse/doctor is witholding information. This, in turn, increases the stress factor on the nurse/doctor, with an enormous negative effect on job satisfaction and productivity.

A large contributor to the stress is the ER system, and the health care system as a whole. People without a primary care physician (be it by necessity, by opportunity, or by choice) are left with the ER as the only option for medical care - even for minor ailments such as stomach aches or the flu. This influx of acute, but non-emergent, patients creates a burden on an emeregency room staff. Additionally, there are many people with chronic conditions, such as diabetes or asthma, who aren't able to afford the medications and care needed to control these conditions. When they have an episode, they also head to the ER. The ER is thus burdened with patients with emergent, but preventable, situations.

Between just these two populations, the staff at an ER have their hands full. Throw in true trauma situations, such as bullet wounds, or acute, emergent situations, such as heart attacks, and it's no small wonder that wait times aren't longer than 6, 12, or 18 hours. The patients and their families are stressed, the nurses, doctors, and techs are stressed, and violence erupts.

Straightforward solutions - everyone should have access to a primary care physician, 24 hours a day. Hence, create a system of acute-care clinics with round-the-clock staff. No one with a chronic condition should go wanting for medications; create a scaled prescription plan for everyone, based on ability to pay. Leave the ERs for the worst of the worst - accidents, life-threatening conditions, victims of violence. After all, that's what they were created for, right?

Hopefully, this will ease the burden on ERs, ease the stress felt by patients and staff, and reduce the number of acts of violence against caregivers. Not saying it would eliminate these acts; it SHOULD be much easier to deal with them, though.

Baltimore Chris - While returning home from vacation with friends, one of our friends had a medical situation - we fortunately ended up at a regional hospital in Fredrick, MD. They had the most well organized ER set up I've ever seen - a Cardiac Unit; a Trauma Unit and an urgicare-type unit for the other things - seemed like that unit did the stitches, broken arms, nned seen, but not really serious or life threatening illnesses and injuries. It was impressive, orderly and the care was top-notch - they discovered a malignant tumor that would have been fatal - we thought it might be pneumonia or the beginning of a cardiac episode.

Interesting model for an ER - best use of resources, triaged and routed patients quickly into treatment areas, which seemed to help people feel attended to. Not the total answer, but one piece.

For all of you who say that nurses should fight back, don't have a nursing license. It is written in the scope of the practice that you can not hit a patient (though, you like to, when you are assaulted by one) or your license will be revoked

There are dozens of non-violent holds, blocks, or joint locks you can use to subdue a hostile patient. It doesn't have to be boxing.

But if you're okay with keeping your nurse's license while you're bludgeoned into so much meatloaf...okay!

Insurance companies continue to pay less for services while continue to give pay raises to their top brass. Same goes for all the way down the food chain.

Insurance companies, government, hospitals....... the people that do get hurt are the little guys. So in the end, budget cuts end up reducing the staff at hand.

had enough hit the nail on the head. Insurance Companies.

Actually, insurance companies reimburse far more than medicare and medicaid. I won't disagree that insurance company execs can be greedy like anyone else. The real issue lies with the fact that there are far too many people out there that think they can do and say whatever, get as drunk, drugged,etc as they want, because society has taught them this behavior is acceptable. It's too bad that these people can assault doctors or nurses in the ER and very rarely are charges ever pressed. It's about personal resonsibility more than hospital budgets. With regards to charging for medical care, there are outrageous medical costs associated with basic care, for example, charging $50 for a pulse oximeter.. ridiculous! As far as greed goes, it cuts both ways.

Unforturnately for alot of nurses, they cannot walk away.

Certainly, you can walk away, you aren't licensed to care for that patient. However, if a nurse walks away, and the patient then injures themselves, the nurse is liable, up to , and including possible jail time.

Have no idea what your rant was about. First it started about your friend who had surgery then it veered way off course and ended up ranting about Obama. Nice one. Not going to waste my time reading junk.

Seriously off topic.. but say what you want about your friend.. if your friend has DT's they have a drinking problem.. and the person responsible for that drinking problem.. your friend. That is no excuse for her acting like a maniac. I won't even comment on the rest of your diatribe.. it makes no sense.

Same here - sympathy stopped with the words "maintenance drinker".

How do we remain a democracy, yet rid society of these burdens? Some think we should make some things legal in a defined geographic area, make the vices free (stock w/ booze, drugs, clean needles), and then let them go; they'll all eventually kill themselves.

Um, Roberta K Starkey, you are taking the medication Femara for postmenopausal hormone symptoms or possibly breast related issues. You may need to try Amitriptyline, Adavan or Clozapine to help with your delusions of paranoia. Speak with your healthcare provider regarding your mental health issues.

Starkey, as in "stark raving mad?" Way off topic and unwelcome.

Back on topic, Jay should count himself lucky that he can just walk away from assaults. Nurses can't do that, especially if the patient is of a mind to pursue her. They have to rely on increasingly rarer instances of security presence or additional staff. They don't have the luxury of running and hiding to let someone else deal with something unpleasant or scary.

But hey, if you're the type of "man" who can sit back and just allow a woman to be assaulted, beaten, or even killed because you don't want to get your hands dirty, enjoy the show, coward.

Yes, Roberta has posted one of the more wacko entries of the ones above. Most of us did read it, but I, for one, didn't see any sense in it. However, anyone can post here, deluded or not.

Hey Starkey.....WOW.

Sounds like you may need the psych ward. Or maybe different meds.

as commented above..."Same here - sympathy stopped with the words "maintenance drinker"."

Thanx for making my point, 'so called' medical professionals who are making judgment calls about the worthiness of a patient rather than simply doing their job...and believe me a patient can certainly interpret such an attitude towards them, and react accordingly, and bottom line, if your are there to treat those suffering, then who are you too make any sort of judgment on their WORTHINESS based on how they were hurt? Your judgement and the concurring judgment of others like you are exactly what makes the mistreatment of patients possible and you sure s hell shouldnt be in the medical profession.

Or they just send them to the med/surg floor and expect the med/surg nurses to take care of them. God, I'm glad I quit.

Sometimes psych patients have real medical issues and NEED that med/surg care. Psych patients deserve considerate, compassionate, comprehensive care, just like every other patient.

I agree, the lack of respect, for all people because there is no self respect. One can not have respect for others, if they have none for themselves. You ladies in white, I take my hat off to you for you are there for altruistic reasons, and get dirty in the process. Luckily cakah is easy to wash off, unfortunately, a soul is not so easily cleaned.

Now we have to figure out why we have so many more crazies and criminals THAN ANY OTHER COUNTRY on this planet? We may find the key to this problem. But the detective path will lead you down a path of downright inhumane activity within the system that governs us.

Actually the Pentagon laid off over 1000 workers yesterday with the announcement that many more were coming!

THE GOVERNMENT needs their paycheck. They need the money that is being squeezed from you. Notice how many more revenue collectors there are? Per capita, they can sting any given area and make bookoo bucks from people breaking their rules. Rules they say, which are put upon us, due to the good of all. But really, it is for their good. They need to be fed...and they are really big...and they are not going on a diet. We turn our eyes, until we have to wear other unfortunate's shoes...then it matters - BIGtime. You might as well slit your wrist right now, and feed them well. This is how MAFIA gets a hold, becomes stronger, until only WAR declared by the victims will eradicate it. I say, let's stop it before it gets any stronger. We have been lied to, had pertinent, important knowledge withheld from us, 'because we, the little people, couldn't handle it". Well here we go, NAZI Germany, all over again. History is repeating itself and it is now.

You can tell the future?? Not alright what this person did, but are admitting to committing a misdemeanor in all 50 states!

earl -

Congratulations on your quick thinking. I saw a man grab the breast of a teenage Candy Striper a long time ago. She slapped him and the ER nurse yelled at her asking her what she thought she was doing.

She might have been working in registration and not a nurse. Nurses usually wear scrubs not dresses. FYI.

Good for YOU Earl! do you know how many people would have done nothing?

Thank you, Earl. On behalf of women everywhere... THANK YOU!!

You should have let him escalate. That would have given you a valid excuse to really kick his a55.

good for you earl, self righteously assaulted someone not in his right mind or capable of defense...your the man earl....and the nurse you say, actually realized you had assaulted him but due to your heroic chivalry she looked the other way and allowed a person in need of hospital care to be assaulted. So you and she and many readers evidently believe its ok to assault those who are intoxicated, ill, and in the hospital? Once again earl...wow Im in awe of such a "man" The more i read the more i realize this thread is indeed not about protecting nurses, but abusing patients.

Smart Move!! How big is your hospital? What Hospital?

You are partially right.

ERs are stretched thin because of all the uninsured. You know, those service jobs that offer minimum wages with no health insurance. Rather hire part-time workers so they can avoid giving benefits to the low paid workers. You know them. Walmart, McDonalds, many retails, etc. Same corporations that continue to report record profits. Laws state that ERs cannot turn anyone away. They sure found a loophole alright.

Enough that is just about every job, today! The Federal Fines will be less to companies then the costs!

But guess what? Individuals will need to get insurance (NOW Out of Pocket) or get fined!

"The ERs are stretched thin because of all the illegal immigrants. They are bankrupting our country."

Yep, it's the fault of the illegal immigrants and the Obama administration. I'm sure that none of these problems existed, when GWB and the Republicans were in charge.

If by illegal immigrants you mean Americans.

Not everything's the fault of immigrants, illegal or otherwise.

You're an idiot!

To blame all our greedy capitalist problems on illegal immigrants. we are all illegal

Dum Dum Dum. Illegals don't carry insurance, but where do you think they have their babies after being illegally in the states for 2 weeks???

They goto the hospital just like everybody (ACTUALLY MORE!!). They know they wont have to pay by going to the ER!!

This is not about capitalism, this is about safety and being able to afford it! End! Hospitals and Medical Insurance Companies are not and have not been making profits for about a decade. Those are the facts!

Obama, July 22: Now, you know, there had been reports just over the last couple of days of insurance companies making record profits. Right now, at the time when everybody’s getting hammered, they’re making record profits and premiums are going up.

http://factcheck.org/2009/08/insurance-co-profits-good-but-not-breaking-records/

You're nuts. If anything Illegal aliens are afraid to go to the ER.

God, why all the hatred. I just don't get it.

You haters are probably all bible thumpers too. Love thy neighbor my butt, sure as long as that butt is white.

Interesting; nothing's been said by the "legalize drugs" crowd...

PAT: Do your research before posting false info....illegal immigrants pay more taxes out of there paychecks, than they will ever see in return, whether through medical assistance, or SSI at any point in their lives. As a mother who's been unfortunate enough to spend days in the ER with my American toddler, the majority of ER patrons tend to be stereotypical "white trash," "hood-rat, welfare leeches," and very, very few Illegal Aliens, as they're are terrified to be questioned by police officers dropping the White/Ghetto Trash off for drunk and disorderly conduct, and their most recent drug overdose....I've seen it with my own eyes. While in labor, I was passed by some drunk moron in the ER; obviously he deserved more treatment that the pregnant woman in labor.....just sayin'.

I've seen more Americans come through the doors on my psych unit than I have immigrants.

I'm at a county hospital in a major city so I can say that I see my fair share of folks coming through the doors. And when the immigrants come in, many of them are extremely grateful to be receiving treatment whereas many of the "legals" come in with the mentality of demanding service and expecting any and all treatment as if they are in a 5 star hotel.

The only reason people are going to throw immigrants into this equation is because they are looking for any and all little reasons they can to throw the books at them while looking the other way when there are Americans that are mooching the system just the same. But that is a completely different argument than what this thread is about.

Thank you to all who set the record straight. The current trend is to demonize the Illegal aliens and blame them for everything that is wrong or broken with the great American way of life.

My family and I were illegal immigrants from 1978-1987, during that time, my father worked very hard, earning half the salary that his work as a gifted Mechanic would deserve. He never once missed a day of work or visited a Hospital to get free medical care, yet a good portion of his check went to pay taxes and FICA like all the other workers in the NY state area.

After getting our immigrant status legalized, my family has been productive in the American culture, my sister owns a day care and I have been serving in the Armed Forces for 14 years now, all of us have become American Citizens, but that would not matter in Arizona, where they would stop me and ask for my "papers" just based on my physical appearance.

Don't believe everything your politicians tell you in the media, when the economy flourishes again, who do you think wil be hammering the shingles on the roofs of all those new houses? Think about it.

Wow. It amazes me how any story on here can be caused by illegal immigrants.

Pat-668773 -

The ERs are stretched thin because of all the illegal immigrants. They are bankrupting our country.

I guess all the poor people or people without insurance (yep, some hard working people out there cannot afford it) in your opinion are doing the same. On a side note, I find it repulsive that a comment like this can get to be so highly rated.

beyonddisgust -

They know they wont have to pay by going to the ER!!

Oh yeah, because no one else in this country thinks like that. Do you think that all these gang-bangers that get shot 6 times are paying that hospital to save them to get shot again?

Let me state the facts. In the Southwest and West, where my wife has been an ER director, illiegals use the ER as their primary care facility. Now, do to the economic times, people of all ethnicities are coming there for their care. The illegals are not afraid to come to the ER. Approximately 30% of the ER's patient load is illegals who do not pay, nor do the others coming there now. It is true that Americans are definitely ruder and seem to be less thankful than the illegals.

As to the assertion by Southern Belle and Soldier that they pay taxes and do not get them back in return. You people are in some alternate reality. What they pay doesn't even come close to paying for the services they use here in California. Illegals receive WIC, subsidized housing, food stamps, free health care, and their children receive educatiojn as well as free breakfast and lunch. They use all public services such as water, sewer, and roads. Now this is not to say that all illegals receive these benefits, but there are literally hundreds of thousands that do. Why should taxpayers foot the bill fo illegals when we are already footing the bill for our own fellow citizens who have fallen on hard times.

As to the post from Douglass, if they are paying Social Security, they are doing it with a stolen SS card which could be impacting a real citizens life. Many citizens have had their identities stolen and purchased by an illegal so that they could work in this country. This work by illegals in certain industries have repressed wages. Mainly within the construction, meat processing, and hospitality industries. Would I be willing to pay more for these services if they were held by Americans making a decent wage, YES. Now I know that many jobs illegals do are jbs that many Americans would not do, such as picking crops and lawn care, though I did bith these jobs as a young man.

I think that all illegals need to go back to their country of origin and apply lawfully to enter the country. Sure, we probably need to overhaul our immigration policies, and for all of you out there who would say I'm a racist, well I'm not. My son's girlfriend is hispanic and my first granddaughter is half hispanic. Hispanic is not even a race, it is an ethnicity and culture. Many Hispanics have European ancestry too. This is about following the law, which others applying to this country do every year.