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I was attacked by a patient and want my fear to help others

I have been working with psychiatric patients for the better part of 30 years. During this time, I have worked in psychiatric emergency rooms, prison wards, substance abuse treatment centers and inpatient psychiatric units. I have been proud of the fact that, despite working in some dangerous areas, I have never been harmed by a patient. I have been threatened, swung at — but never injured. Once a patient decided to use a metal IV pole as a weapon, and I talked him into giving it to me without incident. Over the years, I did not fear physical injury and accepted the fact that violence was a natural part of my job, a symptom of severe mental illness, and as such, something that can be treated.

I am the inpatient director for a locked psychiatric inpatient unit. While leaving a meeting the other day that was on the unit, I was confronted by a patient. He was a large, 30-ish African American man, weighing close to 280 pounds and measuring six-feet tall. He demanded an immediate release. And when I described the process of discharge planning, he became angry, screaming at me, clenching his fists, striking my arm and threatening to “punch my head in.” Attempts to talk to this patient were met with threats, and a manpower code was called. He was given intramuscular medication and was placed in four-point restraints. Aside from minor bruises, both staff and patient escaped unharmed. His anger, however, did not decrease. He continued to verbally threaten me and his treatment team physician. The nursing staff, concerned for my well-being, advised me to avoid the unit. For an hour, I heeded their advice. I left the locked unit and went to the safety of my off-unit office. Sitting safely away from the unit, I became aware of a feeling that was strange to me: fear.

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