Nonviolent Self-protection

It is necessary to always document the circumstances of a violent incident between a patient and a nurse or paramedic, even if it is verbal violence or a stated threat. The record of a violent incident should not only be part of an emergency report, but it is advisable to duplicate this fact by producing documentation, ideally supplemented by the signature of the witnesses present. In the hands of lawyers and forensic experts, medical documentation serves as a good attorney or, on the contrary, a dangerous prosecutor (Mach, 2010). Therefore, we recommend that you do not report this incident immediately after the incident. Elevated levels of stress hormones persist even 90 minutes after violent action. The report and entry in the medical records should be written in peace and with care.

It is necessary to be constantly aware that the record will be read by a forensic expert. In addition to the necessary sequence (what preceded the situation - how the situation began - how it went and how it ended) the message should be clear and thorough (when the help was called and what). In case it was necessary to use a physical grip or physical defense (weapon at the scene) to defend or solve the problem, it is necessary to write in the report that only such force was used to repel the attack. We also recommend listing all the options that could have prevented injury to both parties in a given situation which were used, or not used (Bennett, 2012). Unfortunately, the current situation regarding incident reporting is such that most victims do not report or record incidents (Hoffmann, 2010). It is important to keep in mind that whatever we write in the medical documentation serves for our protection. It is important to note that what is written in the medical records can be held at any time by the patient, his lawyer or the family. The medical records should include all information about the violent incident, including exactly what preceded the violent situation. In a situation that will be dealt with by the court, it is difficult to say that something has been done (in other words) unless it is recorded in the medical records. We do not claim that any contact with the patient must be recorded in the documentation, however, it is definitely advantageous. It is thus appropriate to write about the incident, not only how the whole incident began, took place and ended, but what preceded it (Mach, 2010).