"While it might seem like an isolated incident to those who work outside the health care field, violence against nurses is epidemic, with more than 20% of registered nurses and nursing students reporting they’d been physically assaulted and more than half saying they’d been verbally abused over the course of a year, according to a survey by the American Nurses Association. "

Imagine coming into work and receiving report on your patients. The nurse looks stressed and give you the run down on the patient. "He/she has been combative. Spitting on staff. Tried to pull out his/her IV. Refusing to take medication. Doesn't want to be touch." This was me last week. But not only did I have 1 aggressive patient, I had 3 aggressive patients. Did I refuse to take my assignment? No, but I made sure that I protected myself from harm for 13 hours straight.

No one tells you how to protect yourself in crisis situations. Have you seen the video circling the internet where the psych patient is running after the nursing staff with an iron siderail? Do you think they were frightened? Yes. Do you think they could have fought back? No. In nursing school, we are taught that hitting or causing intentional harm to a patient is assault and battery. Is this fair? No. But as being a caregiver or caretaker causing harm to that said patient is illegal.

Nurses are attacked everyday. There are only a few states that charges patients when assaulting and attacking nursing staff. #NURSELIVESMATTER We have to stick together to protect ourselves and our own from harm.

From experience, listed below are things to do and things not to do when having combative/ aggressive patients:


  • Stay and stand close to the door!It is always important to have an escape plan when in need.

  • Have an aide or RN assistance. Never try to calm or hold a patient alone. Some patients do not know their strength when they are agitated, angry, confused or in pain.

  • Inform primary physician on patient’s state of aggressiveness. If possible, recommend that the physician evaluate the patient and medicate as needed to keep the patient and staff safe.

  • Call security when needed. It is important to know security’s number at your facility. Call them and give SBAR report. “This patient is combative. Refusing to get back in bed and attempting to hit staff.” They are trained to detain patients and WILL get them back in bed.

  • Restraints! Period! Restrain the patient. Educate the patient why they are in restraints and call the physician to notify why they are in restraints.

  • LASTLY!! Document every episode/ incident that the patient has. It is important that you write in the patient’s chart what happened. In case of an attack incident, the physician and superior nursing management will know what happened prior to the nurse or patient being harmed.


  • Never corner yourself in a corner, away from the door or in the restroom. The patient sees this as a sign that you are afraid and will proceed to attack.

  • Do not get close to combative patients. Ask for them to get back in bed. Attempt to get them back in bed, but when they begin to hit, back up and get assistance.

  • Never hit a patient out of anger or fear. If the patient reports that he or she was hit by a nursing staff or member, authorities will take the patient’s side.

  • Never refuse care of a patient when he or she is combative. Refusing care is neglect and can lead you in court and losing your license.

We always talk about protecting our license, but never talk about protecting ourselves! STAY SAFE MY FELLOW NURSES!!!