Patient Attacks Nurse. Time for... 'Root Cause Analysis'?

Too many horror stories of violence in hospitals, as #silentnomore attests

by ZDoggMD


Another nurse subjected to violence in the workplace. The response? A "root cause analysis."

A 34-year-old male, Christian Bonnette, is now charged with one felony count of attempted rape by forcible compulsion and three counts of aggravated assault after assaulting a registered nurse at Penn State Milton S. Hershey Medical Center.

After allegedly attempting to strangle his nurse, barricading her in his room, and attempting to rape her, he is now being held on $100,000 bail. According to one nurse who messaged me, he may even be readmitted to the same hospital for further treatment.

The hospital released a statement saying that, in an effort to "reinforce" their mission to prevent harmful events in their hospital, leadership are preparing a "root cause analysis evaluation" for the incident and have notified appropriate regulatory agencies.

You can read the rest of the story here.

Probation but no jail time?

In recent news, a Houston doctor who was convicted of raping a patient in her hospital bed while she was sedated was sentenced last month to 10 years of probation but no jail time.

In 2015, the victim said that she had been heavily sedated when Dr. Sheikh came into her room and told her he needed to check her lungs. What followed ultimately led to his conviction for rape.

His medical license was revoked and he is now a registered sex offender, but the jury gave him no jail time.

Are we doing enough to protect both patients and staff in medical settings?

Is Hershey Medical Center doing enough to remedy this horrific act against one of their nurses?

These aren't the first stories of their kind. #silentnomore has brought to light many acts of violence against healthcare workers. Remember the tragedy in Yountville and the nurse stabbed in her Newark hospital's parking lot?

#MeToo. Is sexual assault in healthcare an epidemic? See more here. And are we holding the perpetrators responsible or is there a double standard?

ZPac, it's time to raise our voices and take care of our own. We work to serve and care for others, but we must not forget that we deserve the same care and compassion. What can we do to change the culture? I want to hear your thoughts and ideas.

This post originally appeared on ZDoggMD.



Not condoning violence, but sometimes doctors and nurses behave in ways that are horrifying.
When the patient is feeling vulnerable and cannot control the actions of others that often are life and death matters.

— Other side of the Bed

Patients attacking nurses? Ha! Try doctors attacking nurses.

In the 1980’s, my assignment for a few weeks was to work on a hospital med-surg floor in Washington, DC.

With my nursing school days not far left behind, I approached a doctor who had one of my patients. Relieved, I went to him and asked if I could talk with him about said patient. He grunted, which sounded like assent to me.

As I was recounting some relevant data, he all of a sudden reached up, and pushed me HARD!

I fell on the floor and cracked my head against a desk.

I was shocked and couldn’t believe it. I should have gotten the Metro Police Department involved. Instead, then a series of stupid decisions, and I went home in a daze. Nothing ever happened to the doctor, but even then they were gods. And I was in my early twenties, so nothing ever came of it.

Why should patients respect us when, even now, the doctors sometimes don’t.

— Bonnie B.

Wow, the first poster chose to take the side of the person who barricaded and tried to rape a nurse, as if ANY BEHAVIOR can justify sexual assault. Talk about victim blaming. Please post your name so we know to avoid you.

— Cynthia Savage

There is no excuse whatsoever for administration to fail to provide a safe environment for nurses and all staff, as well as patients. Adequate staffing levels will help, but a root cause analysis needs to be done in any and all cases of reported violence against healthcare staff, regardless of who the perpetrator or accused is. This echoes the #metoo movement and the longstanding treatment of nurses as second class citizens in healthcare occupations. Having little power or authority in the workplace contributes. We need actively working, direct patient care nurses on hospital boards, we need administrators to get out of their offices and experience the day to day working conditions nurses are subject to, and we need nurse-directed solutions. The hell that direct care nursing has become is not about patient care, it’s about physical and mental self-preservation in an environment that disregards nurses’ human rights.

— Alene Nitzky, Ph.D. RN

This is why I carry concealed everywhere I go, including work. I work in an urban/suburban primary care office. 99% of the pts are AA, I'm not.

No support from office mgr when I'm cursed at, threatened, etc. "It's part of doing business with our pt population"! NO it's not!!

When someone starts going off, I immediately shut down the visit, say 'we're done here', and I walk out. I don't say another word to the pt. I then go to the mgr. 9 times out of 10, with the pt, yelling they don't like white people (imagine if I said I didn't like the color of my practitioner), the pt is reassigned to another provider! This just reinforces that this type of behavior is acceptable.

The last time this happened, one of the docs joked 'welcome to our world, where ur judged by ur skin color'! WTF!!

I can't believe I stayed there 5 years. Just left. Entirely different population - upscale, no MC, etc. Still carry. People are crazy, and I don't intend to be a victim.

In the 5 years of crazy, no-one, including people at work knew I carried - that's why it's called concealed carry. I never plan to pull my gun - I want to retire, not pay a lawyer for the rest of my life.

If I was in the situation like discussed, and it was in that close on contact, I would draw down on the guy so fast, he'd be dead before he hit the floor.

FYI, yes, I do practice often - and am a damn good shot.

— Karen K, CPNP

Amen to Arlene's post.Administration is clueless as to what goes on in the units. They are always at meetings and never resolve anything. All they care about is the damn HCAPS scores. They kiss the patients behind and believe any stories they make up about nurses. If a pain medication is not delivered fast enough they will claim that the nurse was rude to them. While patients have advocates nurses have no one to go to and tell their side of the story because what the patient says is always right, just so their HCAPS score could go up. But I'll tell you this,the only people that answer the HCAPS questions are the same whiners over and over,mostly entitled Medicaid recipients. It's no wonder nurses get burned out.We never get our supposed 15 min breaks 2 times a shift but no one give a hoot.

— Tired nurse

I agree that we need root cause analysis- but an assault by a patient OR by a provider needs to be prosecuted legally- and sentencing needs to respect the crime- not the position of the person who commits the assault. As a nurse, I saw our physicians go into rooms and explicitly tell the patient that we were NOT there to be abused- and often the verbal abuse ended. Hospitals need to learn to give the same message.

I know that patients are frustrated by the lack of relationship and the lack of care- and so are health care providers- nurses, doctors, CNAs/MAs, and our unit admin staff. Anger and aggression are not ever a solution. Safe staffing, adequate time to actually establish a relationship with patients, and being able to meet their needs would all help the situation too.

— Marianne Moore

We have also seen an increase in verbal abuse and aggressive behavior toward staff at our hospital. For me, it has to do with our administrators who placated patients and families for many years in the name of “patient satisfaction”. Nurses and physicians were frequently thrown under the bus. “You reap what you sow”. I doubt any administrator would put up with the abuse that many of our nurses are subjected to.

— David Fregeau

To the nurse who states she works with AA and carry a conceal weapons. Surely because you work with AA is not the reason you feel for your safety. I have worked in places and was called everything from b*tch to the N word and never thought about shooting my pts. Safety to ourselves cannot be attached with preconceived thoughts. If your safety is in danger, get another job where you feel safe as opposed to being ready to shoot your pts.

— Kathy W

Soft targets. minimum of two paramedics sign of a belligerent pt to a 120 pound nurse, and now is his opportunity to express his anger.
Security in ERs has been dismal at best, why is it allowed ? The verbal/physical abuse endured by nurses daily is known well to all who have endured it, administration may outsource security to private firms, who don’t have any ownership in this process. If you personally address it, your manager or risk management will approach with reproach. So, a dedicated security team, employed by a hospital, is desirable, you know them, they know you, this bond is much stronger, yet this approach sadly is rare.

— Jesse Hathaway RN

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