Nurse Stabs Autistic Teenager with Syringes – Loses License

Needles were used to discipline a young patient

Reported by the Associated Press, a New Jersey nurse was caught on CCTV stabbing a patient with syringes. Apparently, the teenager with autism did not follow the nurse’s instructions. The incident occurred on May 2016 with the Nursing Regulatory Board issuing a statement this month.

The hearing detailed several other incidents of stabbing in the teen’s room. However, the nurse in question tried to explain that another nurse instructed her to use threats to discipline the patient. Apparently, the patient was unruly during her shifts. The nurse detailed her experiences with the patient such as her hair getting pulled, sheets thrown at her, verbal abuse, and sneaking off to visit other patients during sleeping hours.

In 2017, the nurse was charged with aggravated assault and terroristic threats. Additional charges included child endangerment and possession of a weapon for an unlawful purpose.

Prior to her license getting revoked, the nurse pleaded for suspension instead, citing her track record of 8 years. Unfortunately, the New Jersey Board of Nursing pushed through with revocation and authorities also ordered her to pay 10% of the cost of the investigation.

Source: Nurse Loses License Stabbing Autistic Boy with Needles

Practical Thoughts:

It’s unfortunate that something like this could happen. There are very few instances that allow nurses to ‘fight back’. Some say in cases of self-defense when a patient will actively cause harm to a nurse. Others say the best recourse is to leave the room when the patient can’t be placated with therapeutic communication.

Abuse in the workplace exists, handle it professionally

In this case, however, there are quite a few lapses that may have led to the revocation of her license even with the reports of hair pulling done by the patient.

1. Unreported Deteriorating Relationship

The nurse admitted that her relationship with the patient was already deteriorating. The failure falls on the nurse and her immediate supervisors as they may have been remiss in documenting the incidents properly. With proper documentation, a new plan of action could have been made to help manage the behavior of the patient.

2. Use of Threats to Discipline the Patient

In all my years of nursing education and experience in work, I have never heard of using threats to discipline a patient. You can’t even berate a patient.

3. Actual Harm Done

Needle sticks are dangerous. In the case of needle sticks, we must document and then report the incident. After that, prophylaxis may be prescribed if there is doubt of the sterility of the needle. In this case, the nurse actively stabbed the patient but did not report the incident. This only solidifies the guilt of inflicting intentional harm.

4. Alleged Instruction from Another Nurse

The nurse also says that she was instructed to use threats by another nurse. It’s not specified though if this was a nurse in a position of authority or just a co-worker. This will never justify the actions of the nurse.

How to Handle Unruly Patients

This is just a guide to help you deal with unruly patients.

Know Your Hospital Policy

Some hospitals have policies in place to help nurses and other health practitioners deal with abusive patients. If you’re aware of the policies of your hospital, then you will be guided in your actions. Should the written policies end up with unwanted results, then at least you will have hard evidence that you only followed hospital protocols.

Always Follow the Nurse-Patient Interaction (NPI) Process

Perhaps nurses can become jaded after working for several years in a hospital. You can get desensitized to the needs of the patient. Just be reminded of the principles of NPI. Most nurses forget about the following NPI protocols:

1. Introduction
2. Setting boundaries
3. Verbal contract of confidentiality
4. Building trust
5. Active listening
6. Other therapeutic nurse behaviors
• Self-awareness
• Respect
• Empathy
• Cultural sensitivity
• Goal setting with the patient
• Ethical practice

Document and Evaluate

Documentation and evaluation are things hammered into us during our educational years in Nursing. I remember making many nursing care plans. If you have proper documentation, you can review the case and evaluate the situation to help you formulate a new plan of action. The nurse in this situation could have used her documentation and discuss the case with her supervisor on how to deal with the patient. If the first plan of action fails, document again and re-evaluate.

Conclusion:

It’s unfortunate that this has to happen. The reality in most hospitals is that workplace stress can bring out the worst in any nurse. The odds are stacked against nurses as we must always be professional. It makes sense as failure could mean patients losing their lives. If you’re already desensitized or jaded in your workplace, take a step back and return to basic nursing concepts.

If you're no longer happy with your job, it's okay to look for other nursing positions.