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LLLEARNER
Brown Belt
Brown Belt

Joined: 10 Feb 2016
Posts: 687
Location: Central Maine

PostPosted: Tue Apr 03, 2018 10:26 pm    Post subject: Re: Martial Arts for a healthcare employee Reply with quote

neoravencroft wrote:
So I just recently became a healthcare employee for a hospital in my area. I currently take Muay Thai. Because I'll be taking the Hippacratic Oath, I wouldn't be able to use my style of martial arts due to it's striking elements. Seeing as there might be a time where I have to confront an angry patient or an angry relative to the patient, what would be a good martial arts to learn for that kind of situation?


neoravencroft wrote:
So I just recently became a healthcare employee for a hospital in my area. I currently take Muay Thai. Because I'll be taking the Hippacratic Oath, I wouldn't be able to use my style of martial arts due to it's striking elements. Seeing as there might be a time where I have to confront an angry patient or an angry relative to the patient, what would be a good martial arts to learn for that kind of situation?


I am a hospital Security Officer. I also teach other employees use of force. I have felt a patient's joints crack as I applied a technique. I have put patients to the floor or bed and restrained them many times. I have been threatened, had my family threatened graphically, been spit and bled on. I have also been involved with the risk assessment board. (Pro-tip... they are not an employees friend regardless of what they say.) My risk assessment board did not like me, because I am better than them.

A short list of the violence in hospitals...
Biting,
Kicking,
Punching,
Shooting,
Stabbings (needles and knives),
Rapes,
Criminal threatening,
Assault with deadly weapons (IV poles),
Scratching,
Hair pulling,
Domestic Assaults,
Stalking,
etc.

First, there are some legal and policy issues. Laws are government enacted. Policy is hospital enacted. Laws supersede policy. However, you can be fired for violation of either, and your professional license can be suspended/revoked.

Hospitals have use of force policies. If you do not know where to find them, ask for them. Know them. Also, understand the hospital's restraint policies for non-contact, hands-on, chemical and mechanical restraints. Raising a bed really high, or tucking sheets too tightly classifies as a restraint. Doctor's orders are necessary for restraints of patients. Non-patients do not need doctor's orders.

Hospitals also want to cover their rear. Their policies are all designed to shift the blame to the employee should the employee violate them. This is the main purpose of the Risk Assessment Committee. They exist to minimize FINANCIAL risk to their employer, the HOSPITAL, not you as an individual. If you are required as an employee to participate in restraints, the hospital will provide the training to minimize their risk. (It is cheaper than lawsuits.)

There are several programs designed for hospital, schools and corporations for the purpose of risk mitigation.
Management of Aggressive Behavior (MOAB) https://www.moabtraining.com/
MANDT http://www.mandtsystem.com/ (This is used a lot in schools for the mentally handicapped.)
SATORI
ART
and many more.

They have varying degrees of non-contact resolution and contact resolution. Non-contact is understanding verbal and non-verbal cues, and their counters that work for most people in most situations most of the time. Nothing is perfect.

Any use of force/restraint will require written documentation. Make your reports flawless. This is the only contact administration will ever have with a use of force situation. They will be several floors away, in meetings, and never have had the required training when it happens. You will be describing an elephant to a blind man who grew up in a basement with no contact with the outside world, ever. When someone reads the report, they should have absolutely no need for clarification or question as you have described it so well. Describe smells, sounds, actions, feelings and use quotes. If they threatened all kinds of grievous harm to you and your family, QUOTE IT WORD FOR WORD. It is the only thing that can put into context the need for your actions 4 months later across a conference table as they powers that be look for any way to shift liability away from them.

Some of the physical portions of the training will seem familiar as many are derived from martial arts techniques, only watered down for civilian sensibilities. Do not break out proper names for martial arts names for terms. Keep your training manual and use the names from the book. They will not know a Do Jime or Jodan Uke from the hole in their rear. The violence that occurs in hospitals rarely ever seems to make an impact on those responsible for the hospitals.

All that being said...
There are times that the violence presented will exceed the expectations of the training provided. In those situations, I recommend you understand the LAW, and your own willingness to act within its scope.

We have some wonderfully caring people on our staff. Many would not think of intentionally hurting someone. Because they would not consider it, they rarely understand that others hold no such ideology. But, a requirement of there job is to take the training. I tell my students that they always have a choice in any situation. They can choose to react in a manner appropriate with their training and ability, or they can choose to let that 280 lb man smash their head repeatedly on the floor. With the levels of violence increasing in hospitals now, there may come a time which your Muay Tai is justified and legal.

In my professional opinion, Muay Tai striking, or any striking for that matter, as a tool does not violate the Hippocratic oath. That does not mean you should kick the 3000-year-old dementia patient in the head when she refuses meds or feels threatened by someone feeding her. However, a young strong determined mental patient with an iv pole as a weapon could require the kick to the head. The use of force should always fall within your scope of practice, hospital policies, jurisdictional laws and most importantly your personal moral code.

Our hospital uses MOAB. We teach striking when the situation demands it. Period. A determined attacker choking you out might darn well justify any strikes you are able to land. IT DOES NOT VIOLATE THE HIPPOCRATIC OATH.

Pro-tip...Doctors and nurses do not like when a lowly Security Officer takes the control out of their hands and orders them around. But it is kinda fun.

Pro-tip...It also does not violate HIPPA when reporting a crime and any relevant element of a patient's health or treatment to the police.

Pro-tip...Not one person or group of people in any hosptial, no matter their position on the org chart, has the authority to keep you from reporting crimes to the police. Even if the Board of Directors tries to tell you not to report an assault, tell them point blank it is not within their legal power to give that order.
_________________
"Those who know don't talk. Those who talk don't know." ~ Lao-tzu, Tao Te Ching

"Walk a single path, becoming neither cocky with victory nor broken with defeat, without forgetting caution when all is quiet or becoming frightened when danger threatens." ~ Jigaro Kano


Last edited by LLLEARNER on Thu Apr 05, 2018 7:16 am; edited 1 time in total
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LLLEARNER
Brown Belt
Brown Belt

Joined: 10 Feb 2016
Posts: 687
Location: Central Maine

PostPosted: Tue Apr 03, 2018 10:41 pm    Post subject: Re: Martial Arts for a healthcare employee Reply with quote

neoravencroft wrote:
Tempest wrote:
neoravencroft wrote:
So I just recently became a healthcare employee for a hospital in my area. I currently take Muay Thai. Because I'll be taking the Hippacratic Oath, I wouldn't be able to use my style of martial arts due to it's striking elements. Seeing as there might be a time where I have to confront an angry patient or an angry relative to the patient, what would be a good martial arts to learn for that kind of situation?


Ok...
So there are a few things to consider here.

1. You may be faced with some difficult choices in the use of force continuum as part of your professional life. That does not mean that you should stop training. It means you will have to be careful about when the use of force is appropriate and when it is not.

2. There is nothing in the Hippocratic oath that forbids striking techniques that would not also preclude most any effective fighting system.

3. That said, pursuant to wanting to do the least harm possible in resolving a possible violent confrontation, in my opinion Judo and BJJ give you the most tools for addressing that particular problem.


You may be right on number 2. However, on a legal standpoint, there's always a ramification on force unless absolutely necessary. Even still, "no force unless absolutely necessary" is a very subjective term in this day and age. According to a security guard at the site, the only way violence is "justified" is if the assailant is preventing you from escape. Any other time goes under a restricted display of force if that makes sense.


You cannot legally prevent a patient from leaving the hospital except under a few narrowly defined circumstances. You cannot legally force a person into a hospital except under a few narrowly defined circumstances. As a provider, you should have been taught this.

I, as a non-providor, have had to educate more than a few doctors and nurses on these legal aspects. Your ED nurses of any seniority tend to apply this better than those in any other units. It is because they see it far more frequently. They also tend to have a better mindset and attitude for dealing with it than floor nurses.

Also, we prefer the term Security Officer over security guard. Use it. It will help keep you friendly with the guys who are backing you up on those out of control patients.

Our administration lets us operate with a greater scope of practice than many other hospitals. We often have to physically control and restrain violent patients. We carry OC foam and handcuffs as well. I have been known to kick medical staff out of the patients room until they could be brought under control.
_________________
"Those who know don't talk. Those who talk don't know." ~ Lao-tzu, Tao Te Ching

"Walk a single path, becoming neither cocky with victory nor broken with defeat, without forgetting caution when all is quiet or becoming frightened when danger threatens." ~ Jigaro Kano


Last edited by LLLEARNER on Tue Apr 03, 2018 10:54 pm; edited 1 time in total
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LLLEARNER
Brown Belt
Brown Belt

Joined: 10 Feb 2016
Posts: 687
Location: Central Maine

PostPosted: Tue Apr 03, 2018 10:43 pm    Post subject: Reply with quote

neoravencroft wrote:
DWx wrote:
Do they not provide training for difficult or combative patients as part of the job? My sister works in healthcare and they get taught both verbal and physical strategies.

As far as the Hippocratic oath goes, which bit would be cause for concern? As far as I can tell nothing in it would prevent you from striking. I would also consider preventing a patient from further injuring themselves or others as preventing further harm.


They only teach de-escalation tactics to healthcare personnel against assailants. Any training beyond that goes into the realm of security.


That is blindingly stupid on the part of your hospital administration. There will not be a Security Officer with you all the time. Build habits now that prevent you from getting cornered in a room.

We teach all aspects (physical and verbal) to Security and providers as well. The only difference is Security also gets handcuffing and OC usage, but they are different programs.
_________________
"Those who know don't talk. Those who talk don't know." ~ Lao-tzu, Tao Te Ching

"Walk a single path, becoming neither cocky with victory nor broken with defeat, without forgetting caution when all is quiet or becoming frightened when danger threatens." ~ Jigaro Kano


Last edited by LLLEARNER on Wed Apr 04, 2018 10:11 am; edited 1 time in total
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LLLEARNER
Brown Belt
Brown Belt

Joined: 10 Feb 2016
Posts: 687
Location: Central Maine

PostPosted: Tue Apr 03, 2018 10:52 pm    Post subject: Reply with quote

neoravencroft wrote:
MatsuShinshii wrote:
Maybe a Taser. Call the art Stungun Fu.

Better yet purchase a airgun and use tranquilizer darts. We can call it Nighty Night Fu.


lol! I like the way you think. However, both of those items are illegal on hospital grounds, so I think joint locks and holds would be a better option.


Probably not "illegal", but against policy. Two very different animals.

There are times I have more than one firearm on hospital property. I always have at least one. I am not violating the LAW, so it is not illegal. I don't take them in the building. I also highly suspect a few of the docs are armed as well, although I do not seek proof.

Darts would be to inconsistent to use. Besides, they have Haldol, Ativan, Benedryl, Geodone, ketamine and all the syringes they could want.
_________________
"Those who know don't talk. Those who talk don't know." ~ Lao-tzu, Tao Te Ching

"Walk a single path, becoming neither cocky with victory nor broken with defeat, without forgetting caution when all is quiet or becoming frightened when danger threatens." ~ Jigaro Kano
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LLLEARNER
Brown Belt
Brown Belt

Joined: 10 Feb 2016
Posts: 687
Location: Central Maine

PostPosted: Tue Apr 03, 2018 11:08 pm    Post subject: Reply with quote

Sorry. I had a lot to say.
_________________
"Those who know don't talk. Those who talk don't know." ~ Lao-tzu, Tao Te Ching

"Walk a single path, becoming neither cocky with victory nor broken with defeat, without forgetting caution when all is quiet or becoming frightened when danger threatens." ~ Jigaro Kano
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Tempest
Green Belt
Green Belt

Joined: 31 Aug 2006
Posts: 420
Location: Tulsa, OK
Styles: Judo, HEMA

PostPosted: Wed Apr 04, 2018 8:35 am    Post subject: Reply with quote

I would, given the depth of LLLEARNER's response, pay close attention to what they have to say on this matter.

Here speaks the voice of experience and professionalism.

I have done security and custody work before, and currently train a number of law enforcement and security professionals, but I have never worked in the hospital environment.

However I AM familiar with use of force laws throughout the US and several other jurisdictions. With regard to your point about the legalities of what you are doing, you should become as familiar as possible with laws in your area regarding these things as well as the hospital policies.

Do not rely on second or third hand information for this. Look them up yourself, written in your states code. Now, once you have done this, if you have questions, I can help clarify things or point you to lawyers that can clarify things further. But if use of force is a potential outcome of your profession, there is no excuse for not having at least read through the relevant statutes on self-defense/justified use of force for your city and state.
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singularity6
Pre-Black Belt
Pre-Black Belt

Joined: 26 Jun 2017
Posts: 958
Location: Michigan
Styles: Jidokwan Taekwondo and Hapkido, Yoshokai Aikido, ZNIR Iaido, Kendo

PostPosted: Wed Apr 04, 2018 9:08 am    Post subject: Reply with quote

IMO: Always restomp the groin.
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5th Geup Jidokwan Tae Kwon Do/Hap Ki Do

(Never officially tested in aikido, iaido or kendo)
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LLLEARNER
Brown Belt
Brown Belt

Joined: 10 Feb 2016
Posts: 687
Location: Central Maine

PostPosted: Wed Apr 04, 2018 10:06 am    Post subject: Reply with quote

singularity6 wrote:
IMO: Always restomp the groin.


That is a given.
_________________
"Those who know don't talk. Those who talk don't know." ~ Lao-tzu, Tao Te Ching

"Walk a single path, becoming neither cocky with victory nor broken with defeat, without forgetting caution when all is quiet or becoming frightened when danger threatens." ~ Jigaro Kano
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sensei8
KF Sensei
KF Sensei

Joined: 23 Feb 2008
Posts: 14267
Location: Houston, TX
Styles: Shindokan Saitou-ryu [Shuri-te/Okinawa-te based]

PostPosted: Wed Apr 04, 2018 10:14 am    Post subject: Reply with quote

WOW, I must've totally misunderstood the OP question...

Quote:
Seeing as there might be a time where I have to confront an angry patient or an angry relative to the patient, what would be a good martial arts to learn for that kind of situation?


My bad! Sorry!



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neoravencroft
Orange Belt
Orange Belt

Joined: 02 May 2015
Posts: 122
Location: Grand Rapids, MI
Styles: Wing Chun, JKD, Uechi-Ryu, Escrima, Muay Thai

PostPosted: Wed Apr 04, 2018 7:11 pm    Post subject: Reply with quote

sensei8 wrote:
WOW, I must've totally misunderstood the OP question...

Quote:
Seeing as there might be a time where I have to confront an angry patient or an angry relative to the patient, what would be a good martial arts to learn for that kind of situation?


My bad! Sorry!




It's all good.
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"When I have listened to my mistakes, I have grown." ~Bruce Lee
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