Top five Martial Arts for Nurses

Greetings all,

A piece about the use of Martial Arts systems by Nurses and allied health workers in self defence. - Naturally, Aikido made the list!

https://dontmakemeangrymrmcgee.wordp...ealth-workers/

Ben White wrote: Greetings all, A piece about the use of Martial Arts systems by Nurses and allied health workers in self defence. - Naturally, Aikido made the list! https://dontmakemeangrymrmcgee.wordp...ealth-workers/

You opinions about daito ryu are completely off. Daito ryu uses a lot less physical force than any aikido that I have seen or been exposed to.

Ben White wrote: Greetings all, A piece about the use of Martial Arts systems by Nurses and allied health workers in self defence. - Naturally, Aikido made the list! https://dontmakemeangrymrmcgee.wordp...ealth-workers/

Hi Ben, a couple of points:

1. A point to consider for your style guide: it's better to use the romanized spelling jujutsu. The kanji are 柔術.

柔 - じゅう (jū)
術 - じゅつ (jutsu)

The phonemes are slightly different in that 柔 has a lengthened u. But transliterating ju as "ji" doesn't hold to any standard of romanization, and there is actually a different kana for it.

You see the "jujitsu" spelling mostly in modern, westernized systems that were founded or primarily transmitted outside of Japan, and it lends an air of cluelessness when applied as a broad term. So if you are referring to "Japanese martial traditions, koryu or descended therefrom, that focus on unarmed techniques" you should spell it jujutsu. Even better would be jūjutsu for your blog.

And in terms of specifics, "Daito Ryu Jujitsu" is incorrect and looks a bit dumb. On the other hand, find any westernized system, for example Sanuces ryu which I am actually a big fan of, and it might be proper to use the term "jujitsu" if that's what they call themselves.

2. You're a bit off on Daito ryu, as Oisin has pointed out. I'd say it isn't that there is more force, its that there is more pain.

3. Including jujustu here is problematic because it is really a very large family of martial arts, its more of an adjective than a noun. You can find pairs of "jujutsu" arts that are enormously more different than just Aikido and Judo, for example. In fact, each of the other four arts you list are essentially jujutsu. Aikido uses jujutsu to study Aiki, Judo is an institutionalized, modernized system of jujutsu with a sport aspect, Krav Maga is a reality-based jujutsu product that evolved from Judo, and Hapkido is a jujutsu system that incorporates Korean pugilism.

4. You should read Ellis Amdur's _Dueling with Osensei_ as he addresses the challenges of self defense and restraint in a hospital and psychiatric environment. But another thing to remember is that nurses work late shifts, hospitals are not always in the best parts of town, and the ability to hurt an attacker badly is something a nurse may have a real need for as well.

In addition to Oisin and Cliff's points, I add - as a longtime student of aikido but a much longer professional RN - moreso that any martial art, what is to be recommended are specific courses on controlling and taking down patients. The professionals/companies offering these are totally location-specific, but local references should be available, and at-risk health professionals (which, for crying out loud, is a whole lot of non-nurses too....) ought to be lobbying their employers for in-house professional education.

One of the things I have heard Ellis talk about is how it can be incredibly difficult and dangerous to have to subdue someone who is agitated for whatever reason, and also that the act of subduing someone is a group effort which is not really what martial arts teach.

I hear the comments on Daito Ryu. My (uneducated) understanding is that this is several different schools. I do not know enough to comment on the list, and really commenting on one art over the other is besides the point.

Aikido is several disparate schools as well, so some Aikido schools actually might not meet your description criteria either. Some are forceful, some initiate. Shihonage - almost easier to harm someone than do the harmless variations as no patient has ukemi training in my experience.

As a senior RN in first psychiatry and then oncology, I have to say I did get into Aikido because of the options offered. I do find I can't use Aikido indiscriminately.

One of my first patients was a 40 year old man with a brain tumour who was acting out when his young children and wife were watching. Even a gentle Shomenate still looks violent to families and employers. In tight quarters with hard floors, heavy industrial strength furniture even otherwise gentle throws are dangerous and even basic Ikkyo depends on some floor space most exam rooms don't offer. Put in someone with leukemia who is at high risk for a stroke or hemorrhage and any impact with the floors or walls that is not controlled is possibly lethal. Surgery - throwing someone can dislodge orthopedic hardware, tear stitches or rip out necessary tubes and drains. A myeloma patient already bruises very easily and has brittle bones; Nikyo or Kotegaeshi to such people just breaks the wrist very easy and I have seen skin shear off from basic grabs. Damage a dialysis catheter, maybe get accused of killing the patient. Patients get badly harmed just falling in the hallway or out of bed; they don't need me throwing them.

Cliff is very much correct that in an effort to avoid struggle or harm to the patient, a group effort of overwhelming force is recommended. Containing the situation is done to protect the other patients, other staff, equipment, and the facility but the patient is still in your care. Security and several staff work together, and chemical or physical restraints are readily used. Communication skills are widely taught to health care professionals - best to never let a situation escalate, or predict and respond to potential issues. Not always possible to de escalate or predict a situation.

As each facility will have their own standards and policies, the only way to know you are acting within policy is to use the training given directly by the facility. Training also needs to include the environment of care - where are the alarms, how to summon aid, how to call security/management/social work/counsellors, how do you release the brake on a bed or chair to move it out of the way?

I do train in Taiji as well, and this lead to me teaching cancer patients for the past two years - good to have other professional skills. I teach from the standpoint of posture helping with breathing, balance, fatigue, lymph edema management, stress reduction, stretching, improved ergonomics, improved function strength and mechanics. It helps the patients, but truthfully patient-on-nurse violence is not the most pervasive and widespread harm health care professionals face - 20 years later, Taiji helps me too.

Cliff Judge wrote: One of the things I have heard Ellis talk about is how it can be incredibly difficult and dangerous to have to subdue someone who is agitated for whatever reason, and also that the act of subduing someone is a group effort which is not really what martial arts teach.

Yep

Cliff Judge wrote: One of the things I have heard Ellis talk about is how it can be incredibly difficult and dangerous to have to subdue someone who is agitated for whatever reason, and also that the act of subduing someone is a group effort which is not really what martial arts teach.

This is why it is very important to practice Aikido in the kitchen with unsuspecting family and friends.

Really interested in this article as it fits in with my current academic research.

Current "defence" training for nurse and other care workers is (at least in the UK) very poor and based on restraint type training. I'm currently looking at changing this to "avoidance" training - based on Aikido taisebaki.
Let you know the results as soon as I can.

Philip Smith wrote: Really interested in this article as it fits in with my current academic research. Current "defence" training for nurse and other care workers is (at least in the UK) very poor and based on restraint type training. I'm currently looking at changing this to "avoidance" training - based on Aikido taisebaki. Let you know the results as soon as I can.

I think there is a need for both.
In the case of someone simply reaching for you (like the little old lady on the gurney vise grip of death) or even swinging at you under limited circumstances, avoidance/evasion is an option.
In the case of someone with real intent to harm self or others, avoidance/evasion may be an opening gambit to buy time, but cannot replace the need for well-trained team surround to either take down or restrain.

I'm not a health care professional, but I don't think I've ever been in an exam room that had what I would consider adequate space for "standard" aikido. Add the enormous availability of improvised weapons and the issues of perception and legal liability, and I would be very cautious about applying or teaching others to apply aikido in a health care setting.

Katherine

As a police officer told me once, "Aikido in a kitchen can get messy". In other words, if you unbalance an unskilled person, they smash into hard counters, furniture and floors.Exam rooms are like kitchens, lots of hard edges.

Robin Johnson wrote: As a police officer told me once, "Aikido in a kitchen can get messy". In other words, if you unbalance an unskilled person, they smash into hard counters, furniture and floors.Exam rooms are like kitchens, lots of hard edges.

My kitchen also contains knives, heavy pots, cleaning solvents, and other potential weapons. Similarly with exam rooms. An unarmed attacker won't necessarily stay that way, and weapons do a lot to offset the advantage of skill.

Katherine

Some great points here,

In terms of the spelling Jujutsu and Jujitsu, that is interesting, what I have noticed is that here in Australia the term Jujitsu tends to be popular, yet I have also noticed that on European english sites the term Jujutsu tends to be the popular dominant term.

In terms of gang tackling someone, that I do agree with also, yet at the same time, I am more coming at the scenario of specifically having to defend yourself, not necessarily a case where there is time to organise a group of people to go in together.

Clearly there is going to be clutter and confined spaces to deal with, my point of the blog is the fact that RN's in Australia are being physically assaulted on a more frequent basis that at any time before and its believed to be as a result of people manifesting behaviour of being affected by drugs like crystal meth. A nurse I know that works in the ED of the local public hospital had a bruise on her face, I asked her what happened and she told me that on the Saturday night shift she was punched three times by different people and that is a common problem at this hospital.. They have security guards there, people who earn the minimum wage and have little skills at dealing with this sort of thing. Hence the staff are left being hit. It is my view that training in Aikido will offer nurses and other allied health care professionals some keys to both avoid being hit, and to be able to defend themselves if required. Hence the topic for discussion on the blog!

Philip Smith wrote: Really interested in this article as it fits in with my current academic research. Current "defence" training for nurse and other care workers is (at least in the UK) very poor and based on restraint type training. I'm currently looking at changing this to "avoidance" training - based on Aikido taisebaki. Let you know the results as soon as I can.

Philip, and it presents a problem
The NHS knows violence is being done in Hospitals etc.The also know the problems this causes both for staff and the public.I am sure the cost of hiring a competent instructor in Aikido or whatever would cost less than the sick pay being paid out to nurses , doctors who get assaulted. I would certainly consider joining a register of skilled, experienced coaches who could demonstrate and deliver responsible, well instructed series of lessons based on aikido /deescalation of conflict strategies.I have occasionally given advice to private people including the occasional Doorman /Supervisor[,These people in fact abide by a code of conduct which I believe is subject to local authorities and the police.As it also happens I was a Doorman / Removal Man [difficult guys gently persuaded to leave premises]when I was younger. I know what the problems can be with some of the public. Joe.

There ARE dangers in the Emergency Room and in the Psych Ward as well as other hospital settings. I'm certainly familiar with them having a trauma nurse/clinical nursing instructor for a wife. But, depending on where the nurses live and work, they probably face more physical danger going to and from their cars in the parking lot at night. Situational awareness is the greatest asset they should employ inside or outside of the hospital. Aikido good - lots of security folks handy better - being aware and alert to potential danger - best.

I've been a nurse in Canada and in the U.S. Retention of RNs is a problem, but patient on nurse violence came in far down the list when I Googled it. More inter-staff hazing and intimidation.

Self defense outside of work is different, for situations ar work it's probably better called intervention training.

At work, everyone goes through a metal detector to get to the ED waiting room, and several police officers and security guards are there all the time. Tazers, pistols, handcuffs, and an immediately adjacent locked ward with full on prison style architecture.

More efficient use of resources to bring a security force up to speed on containing a situation than to try to get a busy trauma surgeon to make time for intervention training regularly enough to maintain the level of skill necessary. I would see an opportunity for training the security forces at the hospital, maybe setting up contracts for various facilities if the situation is that bad.

For the individual nurse, better to be tried by twelve than carried by six. In the U.S., the school offering training to keep medical staff safe could possibly end up being named in a law suit if a patient got injured. If the work environment is unsafe, the employer can be sued by the injured staff for providing an unsafe environment.

Mr. Hillson,

I am not a nurse, but I have visited many hospitals over the years in law enforcement, and I have seldom seen hospitals as secure as you have described. At least here in California, most do not have locked wards, metal detectors, or police agents assigned there even in the major cities. They usually have security officers on the hospital campus though.

I agree that it would be next to impossible to require physicians or nurses to train in any martial art, or to maintain their skills. It just won't happen - just as it seldom happens with law enforcement agents.

While it depends on the state involved, generally speaking an employee's sole remedy for an on-the-job injury is Workers' Compensation and they are not allowed to sue the employer. Even winning a lawsuit won't truly compensate for injuries sustained by medical staff when attacked by an angry or deranged patient or family member.

Learning to forecast danger, learning to defuse a situation, and backing away are probably the safest bets for medical staff. If that fails, defending oneself becomes necessary and appropriate. Aikido is just one possible solution in those critical events. ERs are tough places to work under the best of circumstances, and while violence is relatively rare, can be dangerous as well.

Michael Hackett wrote: Mr. Hillson, I am not a nurse, but I have visited many hospitals over the years in law enforcement, and I have seldom seen hospitals as secure as you have described. At least here in California, most do not have locked wards, metal detectors, or police agents assigned there even in the major cities. They usually have security officers on the hospital campus though. I agree that it would be next to impossible to require physicians or nurses to train in any martial art, or to maintain their skills. It just won't happen - just as it seldom happens with law enforcement agents. While it depends on the state involved, generally speaking an employee's sole remedy for an on-the-job injury is Workers' Compensation and they are not allowed to sue the employer. Even winning a lawsuit won't truly compensate for injuries sustained by medical staff when attacked by an angry or deranged patient or family member. Learning to forecast danger, learning to defuse a situation, and backing away are probably the safest bets for medical staff. If that fails, defending oneself becomes necessary and appropriate. Aikido is just one possible solution in those critical events. ERs are tough places to work under the best of circumstances, and while violence is relatively rare, can be dangerous as well.

All good points. And in neither Nor Cal nor NYC have I seen more security than private agency security guards, who yeah are underpaid and definitely not trained in team restraining or takedown techniques.

I recall a spate of nurse/psych tech injuries at SF General some time back + at Napa State (long term psych) and presumably these are the places that DO pay for specialized staff training...if not I'd want to know why not. HOWEVER....getting sucker-punched is just plain an occupational hazard in psych units and in ER. You can do your best de-escalation technique, you can have situational awareness, but a sucker punch is....a sucker punch.

One of the issues is the time allotted for training. In the UK general nurses have no intervention training whilst psychiatric nurses have one day per year.
Obviously this creates poor retention and skill levels and this is what we are hoping to address. The project will probably take 12 months before it's ready for publication and whether it can improve the situation I don't yet know. Certainly traditional training in martial arts is too time-consuming and difficult so we need to develop an "Eazy- Aikido" form of training which is appropriate for the client group.

Good luck. I hope you post more about the study - what Aikido related information you include, what you drop, what you modify, what you add, what surprises you have along the way. First step to solving a problem is to admit one exists, so good on you.

@ Phillip Smith:

The late Bob Koga sensei did something very similar many years ago for the police. He modified aikido and created what he called "Practical Aikido" which is still the base for most police defensive tactics training in the US. He faced the same types of time constraints that limited training and retention and developed a simple and effective curriculum. Years later, we've learned that it still has to be practiced and still requires refresher training. It might be worth reviewing for your project. Check with the Koga Institute on-line. His students are still running the program today.

Um... there are many people in this conversation who have taken Daitoryu Jujitsu ...yes, I spelled it that way on purpose...because I like it that way technically speaking, jutsu is probably more correct.

none of them were in pain in my class.....no that they can't be, but it is not the goal of the system...kuzushi on contact, incapacitating the uke using a different skill set, not necessarily a forceful joint lock to subdue the attacker

Surprised here......

Michael Hackett wrote: @ Phillip Smith: The late Bob Koga sensei did something very similar many years ago for the police. He modified aikido and created what he called "Practical Aikido" which is still the base for most police defensive tactics training in the US. He faced the same types of time constraints that limited training and retention and developed a simple and effective curriculum. Years later, we've learned that it still has to be practiced and still requires refresher training. It might be worth reviewing for your project. Check with the Koga Institute on-line. His students are still running the program today.

Thanks I'll look it up

Howard Popkin wrote: Um... there are many people in this conversation who have taken Daitoryu Jujitsu ...yes, I spelled it that way on purpose...because I like it that way technically speaking, jutsu is probably more correct. none of them were in pain in my class.....no that they can't be, but it is not the goal of the system...kuzushi on contact, incapacitating the uke using a different skill set, not necessarily a forceful joint lock to subdue the attacker Surprised here......

Larger fish to fry, so to speak, in the underlying assumptions of the OP. I felt the OP was poorly conceived and did both the arts and the health professionals a disservice and this - per many of our follow up posts - needed urgent addressing.
Nope, never felt nor saw people feel pain, during any class with you or Joe.