Did you just threaten me?

by Angela Brooks

 

Being threatened as a mental health nurse is such a common action in a day’s work that you become stone faced to the words that come out of someone’s mouth. Therapeutic communication is easier to do when your relaxed, calm and do not take the words personally.  Even seasoned nurses will sometimes struggle with not taking it personal.

I have had water, coffee, juice, and spit thrown at me at one time or another in my career. The one that makes me really have to control my temper is spit – such a nasty and disrespectful act.

The phone rang and I heard my name “Angela?” I said, “Yes” even though I answered the phone “Hello Education and Training this is Angela” The voice on the other end quivered and I heard the sobs begin. I sat quietly and waited. She apologized and began to tell me about her shift, a shift from hell, the one that no nurse wants to deal with and specially seeing a fellow staff get hurt. She was still sitting in the hospital parking lot to shaken to drive home yet and needed to talk. She said, “You came to mind immediately.”

She burst out “It was all my fault, I was in charge they depended on me to protect them – I did not do enough – I should have….” I stopped her – “Do you really think that they thought you were responsible for them getting hurt knowing you were there with them when it happened. Not in the office hiding but on the battle field in front of a raging, angry, aggressive human being who wanted to hurt someone and did not care who that someone was?” She sniffled. “I feel so bad” She was not concerned about the red knot she had in the middle of her own forehead where a urine sample cup (thank goodness it was empty) came flying across the desk and hit her between her eyes, leaving a mark but no injury.

One of the staff she worked with was grabbed by the client by the hair and clumps fell to the floor that was jerked from her head. It happened fast; even with staff standing close by it happened in a blink.

Of course she did, as we all do when someone gets hurt, we second guess what we did and look to see what could have prevented the action from happening. No one wants to go to their job and walk out injured. In mental health it can happen in the blink of an eye. In CPI (crisis prevention training) you learn to block and move there is not always an exit and you become face to face with anger.  

I have said many times over the last 23 years there is something special or something wrong with a mental health nurse. Any normal person would run away or hide from someone who is throwing chairs, breaking windows and busting picture frames on the wall. Instead mental health nurses run to the area of violence to help – to encourage – and de-escalate the situation.

I cannot count how many times I have been on a hallway with someone spewing threats, eyes full of fire, body ridge and ready to jump at the first person who makes the wrong move. We stand there stone face listening, waiting, talking, encouraging until they give in or the flood gates break open and the patient nurse relationship changes to protector and self defense.

As a instructor for CPI (Crisis prevention training) the biggest concern staff have is protecting themselves. It seems strange to think that someone has to even stop and think “should I protect myself?” The answer is always YES!! When someone steps into your personal space (1 1/2- 3 feet it can be larger or small space for different people) you have the right to prevent them from causing you bodily harm. A nurse doesn’t have the right to retaliate or go to further measures to punish the person. Everyone safety, well being and security is primary, however when you look up and a chair is flying down the hallway your fight and flight kicks in.

In the book “The Nurses Voice” I share many stories of things I have encountered over the last 23 years. The angels, the fights, the heart to heart talks, the many types of people I have had to privilege to meet. If it were not for mental illness I would never have crossed paths with the people who have changed my life and showed me many windows of the soul. Mental health is a challenge, it is dangerous and it is rewarding.

Angela Brooks is a retired nurse after 25 years in mental health. She used her lunch breaks to build her business part time on the night shift. Her car became a mobile university as she listened to business training, coaching calls on CD and phone webinars. She blogged while she was at her sons' baseball practices.

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