By Chaunie Brusie

There isn’t a nurse alive who doesn’t know what it’s like to be mistreated by a patient. Whether it’s an unkind word from the very person whose life you’re trying to save or a roundhouse punch from the little old lady with dementia in bed 10 that you didn’t see coming, sometimes, unruly patients are just part of the job. 

But for one Washington nurse, there is a line that can be crossed from just “part of the job” to pure physical assault. And when her patient crossed it, she decided to speak out. 

In a public Facebook post on her own page, Ashley Leilani Schade, a mom of one and a critical care nurse from Washington, described an encounter with one of her patients that she says left her fearing for her life—and wondering why workplaces aren’t doing more to protect nurses on the floor. 

Her post explained how Schade, on her 4th day of working in the ICU, was “doing what God called me to do, to care for those at their worst.” She described how, as a nurse with experience in the ICU, she recognizes how unstable patients can be in that environment, for a variety of reasons, and how that can cause them to lash out irrationally and physically simply because they are scared. “Most of us have been hit, kicked, or pushed out of the way of a scared patient who is trying to run away,” she noted. “Being in the ICU, or the hospital, in general, can be a very scary thing. Mental illness is also a scary thing. I have never hated someone for the injuries I’ve experienced while they were scared or not thinking straight.”

More than patient fear

But during her shift on September 16, Schade’s said it was her turn to be scared, when a patient became violent, announcing: “I’m gonna kill you,” before choking her to the point that she collapsed and was taken to the emergency department. In her post, Schade shared pictures of the alleged incident, displaying the severe bruises circling her throat. Court documents have now revealed that the patient was a 65-year-old man named Bruce Darling, who had become angry after Schade stopped him from removing his IV. 

“Let me tell you, having a strong individual’s hands around your neck, the inability to breathe, let alone call for help, to the point where you can’t see a thing and can only hear an emergency “staff assist” tone going off, is one of the absolutely gut-wrenching, most terrifying feelings anyone could ever imagine,” she wrote. “…it was also followed by a confirmation that this individual was not only aware of what they had just attempted to do but also ‘if anyone else comes near me I’ll kill them too’ followed by a smirk”.

According to Schade’s post, she was taken to the ER to be treated for her injuries, but when she regained consciousness, she was informed by the officers who came to her room for a statement that the patient would not be taken into custody but would remain at the hospital and continue to get care. The fact that the patient was not charged for assault is what ultimately led the frustrated nurse, who had genuinely feared for her life, to speak out. And with the American Nurse’s Association revealing that more employees are missing work as a direct result of violence they have experienced in the workplace, the issue is a timely one. 

The post that started a dialog

“I’m putting this out there to bring awareness of what is happening in hospitals,” she wrote. “Not just in big cities, but right here. Just because you are in the hospital does NOT MEAN THERE ARE NO LAWS AND NO MORAL RESPONSIBILITY. It is not a stupid series of movies where you get a free pass to be an asshole for a specified amount of time. IT’S REAL LIFE. You cannot strangle people. You cannot sexually harass people. You cannot hit, kick, bite, scratch, spit on, or call people names. And by people, I mean those folks who sacrifice time with their families, their bladders, and their SANITY to care for you in every single way. IT IS NOT OKAY.”

Her story has been fiercely debated online, on feeds and nursing forums, with people weighing in on both sides of the issue. “Being a patient is scarcely an excuse to assault someone,” argued one commenter while another brought up the patient’s mental status: “It depends on if the patient was in their right mind.”

However, there is little debate that Schade’s advocacy against workplace violence is an important and timely one, especially in Washington. Just yesterday, a 29-year-old patient at Western State Hospital in Washington shockingly vaulted over the nurse’s station to attack a 63-year-old nurse, knocking her to the floor before choking her and biting her ear off. The nurse was so badly injured by the attack that a spokesperson for the hospital confirmed that the nurse will be undergoing surgery to reattach her earlobe. The attack was the patient’s 6th on healthcare staff, adding to the long list of facility patient-to-nurse attacks the hospital has been plagued with throughout the years. 

Advocating for change

Although Schade did not return any requests for an interview for this piece, at the end of last month, Schade updated her Facebook profile picture to partner with Silent No More, an advocacy group that states its mission is “to aim to protect healthcare workers before, during, and after workplace violence through education, advocacy, awareness, and legislation,” so it appears that she is still advocating through her story and hoping to enact some kind of change to protect her fellow nurses. She also noted in an Instagram post that she attended the Washington State Nurses Association leadership retreat, writing they the organization is “doing amazing things” to end workplace violence and that she hopes to help them accomplish “big things!” 

According to local news sources, the male patient who assaulted Schade has now been formally charged with a felony and his family says “recent medical issues” altered his mental state. Schade expressed gratitude on the platform for “for the support of law enforcement, my prosecuting attorney, WSNA, and the response from the Hospital,” also adding that she needed time for some “self-healing.” 

The dedicated nurse ended her post with a call to action for those in and outside of the healthcare industry to recognize assault when it happens and by thanking the nurses who have supported her, both at work and after her story has been shared. “We are a team and I love you all...we WILL make a difference so that we are safe at work,” she wrote.

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