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"How can I avoid getting bitten by patients?"

Updated: Jul 24, 2019

Dear My Occupational Defense,


I've been an ED nurse for the past 10 years. One of the most frequent injuries that occur, or that we try to prevent, are patients that try to bite us, and sadly, sometimes succeed. Sometimes, it's a violent patient who's drunk or high, but sometimes it's just an elderly patient who suffers from dementia or who's had a brain injury. 


As a nurse, I have to get close to place IV's, provide medications, as well as other medical care. What can I do in a busy ED where resources such as extra personnel are scarce? 


Signed,


Not-in-Silence-of-the-Lambs


Dear Not-in-Silence-of-the-Lambs,


Thanks so much for opening up this discussion and for helping to care for patients, who are our family and friends.  I can imagine the daunting task of trying to provide care, at the same time trying to protect yourself. That is one of the challenges in dealing with violence and harm in healthcare.

One of the functional things, and most simplistic a healthcare provider can do, that we recommended is never reaching across the patient. For example, if administering IV medications, always stay to the extreme left or right of the patient if possible. ie. if the IV is on the R side of the extremity, always approach from the right, never reaching across the width of the patient. 


Similarly, if placing leads for an EKG, work from the left side, never reaching across the patient's body. 


We do realize and appreciate, however, this may not be possible in all instances, for example, during a acute medical or trauma code. In these situations, we do acknowledge the fact that when the patient is in extremis, and they need to be cared for immediately, the last thing we think about is ourselves. We are so focused on keeping that patient alive and stabilizing them, that we forget about ourselves.  And there in lies the challenge, keeping ourselves safe, while simultaneously providing care. 


But having said that, it only takes a moment for a patient to bite us and cause damage and introduce infection. It only takes a moment for a needle stick to occur and chance our lives. forever If this simple case situational awareness can preempt that from happening, it's well worth it.


Hope this helps! 

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