Charge nurse Laura Bowater, 33 - who had four years' unblemished service - said: "It's months since I have been in this position", as she straddled the man while helping her colleagues control him.
She was dissmissed for gross misconduct from her £25,000-a-year post at London's Central Middlesex Hospital. Bowater was on her way home from a shift in July 2006 when she stopped to help staff restrain the "extremely strong" 31-year-old patient, whose trousers had been removed so doctors could inject his buttock.
Bowater sat on his ankles to control his flailing legs, but the patient span on to his back, exposing himself, and kicking her forward. It was here that she made the "humorous" comment, which senior staff investigated six weeks later.
An employment tribunal at first agreed the hospital had unfairly dismissed Bowater. But its decision was overturned on appeal because, although the comment was heard only by other medics, it was made in a public A&E department.
The tribunal heard Bowater's actions had made it possible to sedate the man before he harmed himself or others. But it held she had used inappropriate restraint, despite accepting she was helping in an emergency and lacked proper training.
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