"problem patient" - page 2

Im having major issues right now with a patient that I do multiple 1:1's with. Heres the HX: Pt came in almost comotose from being noncompliant with his DM. He also has a HX of multiple heavy... Read More

  1. by   Cattitude
    Quote from Nurseducky86
    I Because he respects some nurses but not others.
    I try to be nice and constantly try to reinterate that we are only trying to help his situation.

    Are his actions possibly a result of his loss of mental capacity due to the extensive drug use??
    Don't try and be friends. Use limit setting and be firm. That will gain respect. He needs to see that you will follow through as well. Don't waver when you say something, do it.
    And stay at the bedside!!!!
    Good luck.
  2. by   Cattitude
    Quote from Nurseducky86
    There are also been times where I or another nurse has turned around to do something and he slips out of his room only to be found in the kitchen again.

    !
    Ok, I guess you can't turn your back on him then, right? He has proved what he will so don't do it. I know that for 12 hours it is very hard to sit with one person and stay in one place but it is for his health. He needs you to do this.
  3. by   RNDreamer
    Quote from TazziRN

    The bathing......unfortunately he has the right to refuse a bath.

    wow! question (anyone can answer this): I understand that a patient has a right, but when does it get to a point where the patient is interfering in another patient's right not to smell him/her...I guess my question is: How long will hospital/ nursing home allow a patient to refuse to bathe, before something can be done? Is it days, weeks, months?
  4. by   Nurse2bducky86
    When I said turn your back for a second I literaly mean a second, We have computer charting and the way its set up you have to look down to see the screen.

    The reason I have nurse in my name is because 1. I consider myself a nurse (I guess people do not consider us CNA's nurses, sorry for the confusion) plus 2. I will graduate soon from a nursing school.

    our 1:1's are done by us Nurse Techs (CNA's) which is my position as of this moment until I get through school.
  5. by   MedSurgeNewbie
    I might get into trouble for this, but really if he is his own man, let him sign out AMA, really hospitals are not prisons. If he's pinked you have a different situation but really you are not a guard, there is only so much you can do - Sometimes people make choices we dont agree with, and you have to let them do it
  6. by   Nurse2bducky86
    I'm assuming that he is legally unable to leave because there are court proceedings in the future and for a while they were going to bring in off duty cops to watch him.
  7. by   TazziRN
    Quote from Nurseducky86

    The reason I have nurse in my name is because 1. I consider myself a nurse (I guess people do not consider us CNA's nurses, sorry for the confusion) plus 2. I will graduate soon from a nursing school.

    Uh-boy............................................... ............:uhoh21:
  8. by   MedSurgeNewbie
    I understand tehre might be court in his future, but if hes not pinked, or there is someone else in charge of his care - then he can sign out. I only say this becuse I have had a similar kind of thing, so long as you cover your self. When I have had patients say they are going AMA I just get the paper work calm as possibe - lots of times it helps them realize were just trying to help and that they are not stuck at the hospital. Good luck sounds like an really tough deal. One idea if you are stuck with the guy, can you "hide" the snacks he can have in the kitchen so if he "grabs" its the right thing? Or can you get somthign he can have and have it bedside so its less tempting to wander?
  9. by   Cattitude
    Quote from Nurseducky86
    The reason I have nurse in my name is because 1. I consider myself a nurse (I guess people do not consider us CNA's nurses, sorry for the confusion)
    :smackingf :smackingf

    CNA does not = nurse, NOPE, NO WAY, NO HOW!!!

    Nurse = RN, LPN, LVN
  10. by   Nurse2bducky86
    All I am asking is help with a problem patient who I am having problems with. I do not want to defend my name or title or whatever you want to argue about. Thank You to those who have offered their experience and wisdom.
    If this continues to be too difficult a task to stay on subject I will ask a moderator to close this discussion.

    Thank You
    Ducky the lowly non nurse CNA
  11. by   Cattitude
    Quote from Nurseducky86
    All I am asking is help with a problem patient who I am having problems with. I do not want to defend my name or title or whatever you want to argue about. Thank You to those who have offered their experience and wisdom.
    If this continues to be too difficult a task to stay on subject I will ask a moderator to close this discussion.

    Thank You
    Ducky the lowly non nurse CNA
    Just a word of advice. Before posting to any forum, it's really a good thing to lurk for a while to get the flavor and see how things are done.

    You would have done a LOT of reading that way and maybe avoided this. Also actually reading the terms of service is a good thing.

    The mods here are great, if they feel a thread needs to be closed, they'll do it.

    As nurses we're a bit sensitive about UAP calling themselves such. There's a thread about this here already, it got a little heated.
    And we appreciate CNA's, We do! But they are not nurses.
  12. by   TazziRN
    In many states it is actually illegal for a non-licensed person to refer to oneself as a nurse
  13. by   canoehead
    A CNA is a nurse's aid- that's why the NA part stands for "nurse aid"

    If he is allowed to refuse baths he can make his own decisions, and I would imagine he can make his own decisions about dietary intake too. You can refuse to provide junk food, but if he gets it he can eat it. I second the person who said tolet him sign out AMA. What is the point of keeping him in there if he is unwilling to maintain the plan of care if he's not forced? He can't stay on 1-1 supervision his whole life.

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