Dealing with Violence in Mental Health Care
Violence in healthcare is somewhat difficult to discuss but the trends in nursing, particularly with mental health, in this year alone is getting very scary:
Autistic Boy Stabbed with Syringes, and the Nurse Loses License
New Jersey regulators have revoked the nursing license of a woman caught on security cameras stabbing an autistic teenager with syringes when he failed to comply with her instructions.
The state attorney general’s Division of Consumer Affairs announced in a news release that the New Jersey Board of Nursing had revoked the registered nursing license of Naomi Derrick because of the 2016 episode at an Atlantic City hospital’s psychiatric unit.
“Intimidating and terrorizing a developmentally disabled child who is completely dependent on your care is a horror that should not be visited upon anyone,” said Paul R. Rodríguez, acting director of the Division of Consumer Affairs.
The department release said that a co-worker witnessed Derrick threaten the boy with needle-stabbing during her shift in May 2016. It also said several stabbings were captured by security cameras in the teen’s room.
During a hearing over the incident, Derrick said she only showed the boy the needle as a threat. Department officials said she claimed an examination of the boy the next day showed no bruising or bleeding.
Derrick had asked the department to suspend her license instead of revoking it, arguing she had no complaints during her previous eight years as a nurse. The woman said another nurse had instructed her verbally that the threats were the best way to get the teen to comply with her.
Derrick said the boy would call her names, pull her hair, throw sheets at her and leave his room to visit other patients during sleeping hours. She had been charged in 2017 with aggravated assault, terroristic threats, child endangerment and possession of a weapon for an unlawful purpose. Atlantic County prosecutors allowed her to enter a pretrial program in January. In addition to losing her license, Derrick was also ordered to pay 10% of the cost of the investigation.
It’s rare for a nurse to get a license revoked but this situation was sickening. The nurse had the nerve to imply well there was no bruising or bleeding. I’m quite sure investigators know the difference between giving an IM shot versus a stabbing. Proper use of needles usually don’t cause bleeding/bruising but even with improper use, it may not appear something went wrong but this nurse was caught on video. I guess we should be happy that she didn’t use a knife 🙄
The nurse offered NO remorse or apologies, just a poor excuse. If she was having a difficult time with the patient, she should’ve considered changing her assignment, going to management, seeking some type of assistance…anything but STAB the patient. Yes, it can be difficult caring for people with special needs, but NO patient deserves to be harmed, and it seems like the nurse felt justified to commit a crime! I’m done venting.
About Developmental Disorders & Resources for Autism
Safety in healthcare has always been controversial, care providers are supposed to assist and stabilize the patient but that requires time, support, staffing…which is usually not available and could put everyone in harm’s way. A few months ago, there was another incident where a psych patient killed a nurse:
Man Accused of Attacking BRG Nurse who Died Days Later Arrested for Manslaughter
Officials have arrested a mental health patient accused of attacking a Baton Rouge nurse who died days later. Jessie Guillory, 54, of Lake Charles, was arrested on one count of manslaughter Tuesday, April 23.
The nurse, Lynne Truxillo, was attacked at Baton Rouge General Mid City on April 4 and was able to finish her shift, according to reports. During the attack, the nurse tore a muscle in her leg and had other injuries, according to a family friend.
The warrant outlines more details of the attack. It states Guillory came into the nurses’ station and started some sort of altercation with one of the nurses. Guillory then reportedly became violent and charged at one of the nurses. The warrant says Guillory pinned the nurse into a corner and continued to swing his arms at her while also trying to grab her.
Truxillo then intervened and pulled Guillory away from the other nurse. Guillory then began to attack Truxillo, who tried to run away, the warrant says, but he reportedly grabbed her by the back of the neck and pushed her head down into a desk. The warrant goes on to say several nurses tried to get control of Guillory, and as Truxillo tried to pull away from Guillory, she injured her right leg and fell.
After the attack, she went to the emergency room, where she was treated and released. Truxillo returned to the hospital on April 11 to be seen in the emergency room and was admitted to the ICU complaining of trouble breathing. The warrant states Truxillo went into cardiac arrest multiple times and could not be revived. She died just after 1 a.m. on Thursday, April 11.
The warrant provides more details about her death as well, saying the autopsy showed contusions to her head and blood clots in her right leg. Her official cause of death is a bilateral pulmonary thromboemboli (traveling blood clot) caused by a deep vein thrombosis in her right leg from the traumatic knee injury she sustained when attacked by Guillory.
–WAFB
Keep Yourself Safe & Know the Law
I’m not giving legal advice, but you should be familiar with your local health policies. Common sense can be subjective or MIA. State to state laws can be considerably different so be careful giving other people legal advice as well. However, here are a few tips that have helped me remain safe:
- Your job should have online modules or a de-escalation program on how to manage violent or unpredictable patients, if not, stay current with the standards of practice and protocols. Be mindful of the priorities, which are ABC’s (airway, breathing, circulation) and safety. In the first story, the nurse claimed another nurse had instructed her verbally how threats were the best way to get the teen to comply with her, which is another reason why the nurse deserved some type of punishment.
- Never be alone. If a patient is getting more violent, wait for help. In the second story, the nurse who got killed intervened to help her colleague but unfortunately, got the brunt of the attack. Healthcare workers can barely claim self-defense because someone would argue who approached who and which one was supposed to be the professional… Even if you had to defend yourself, the patient will not be the one getting reprimanded (unless death was involved, unfortunately). Try to stay at a distance until extra help is available.
- Read the situation or area and try to maintain your day by keeping everything as calm as possible i.e. turn down the lights, play soft music, make the area cleaner or brighter. If someone is looking angry, scared, or paranoid…try to get more of an understanding before approaching the patient. Lastly, always know where the exits, bathroom, hiding spaces are and stay close to them in case of emergencies. Life, in general, is unpredictable, but being prepared, cautious, and proactive can help keep some of the chaos at bay…
More Tips:
- Purchase your own professional insurance: always make sure you are protecting your future and career.
- Sign-up with Organizations: it helps with networking and learning about state policy.
- Things in the world are getting more hectic but watching the news, reading articles, and being updated also helps with being informed about healthcare and laws. Find great resources to stay current in practice.
- Know a few basic legal terms and about preventing lawsuits.
Communication is always KEY
