this may come across as mindless venting but it really isnt......
I work on a med surg unit that of course gets many patients of the non med surg variety, I have come to accept this but right now myself and my fellow nurses are dealing with something impossible.
patient has a major psych history , on a combination of all kinds of antipsychotics etc nothing working , he is also a COPD'er , which is why he was first admitted to our floor,okay I understand that but now the psych thing is the more pressing of the two issues. Honestly medically we are doing NOTHING for this patient,he refuses all treatments and meds and even vital sign assessments, MD covering him medically has seemingly given up after taking social works advice and discharging him home months ago only for him to have beat the heck out of his wife and return the next day to us......
I have had this patient for months now, social work says they are trying to place him and all of that but why do the poor nurses have to suffer with this? I usually am assigned to this patient because people are delusional enough to think I can handle him for some reason...thats fine but last night he wasnt even my patient and he was following me around and he threw hot soup at his sitter and a full pitcher of water at me.... which of course it soaked me thru and thru, this patients decline has been so obvious to everyone in the allied health that I cannot figure why psych wont take him. They claim its because he is MRSA positive but they have private rooms and have taken isolation psych patients from mental institutions before.....I brought up my concerns (I'll admit that I am now afraid of this patient) to the incharge RN who apparently relayed it to our new U/A .....nothing was dealt with and I'm annoyed because they have me taking care of him all next week. I have tried to explain that I feel he is focused on me and that his violent outbursts have become worse- uncontrollable even - and none of our other medically sick patients are getting any rest at nights because of this one person.
I feel like everyone is waiting for this guy to hurt someone and knowing my luck since I seem to have him as my patient all the time, it will probably be me........
I dont know what to do, I completely dont want to go to work - and that bothers me cuz I usually dont feel this way....
File an incident report on the soup and water pitcher. Then put in writing your fears regarding the possibility of someone being hurt in the future, and make sure copies get to your supervisor, social services, the patient's doctor, risk management, the medical director, and the facility's Board of directors...You may want to add in there that IF you do get hurt, you would have no recourse but to contact a lawyer regarding the facility's lack of action to prevent the injury...
And in the meantime, refuse to take care of that patient and CHART...CHART...CHART...Every word and every move that patient makes, don't go into the room alone and have the other nurse chart their observations as well.
Last edit by KaraLea on Aug 10, '02
If the pt is competent, you can call the police if your facility won't protect you - you are legally within your right to file assault charges.
Had a similar situation on our ward years ago - a pt had fixated on one of our nurses and was going to "get" her.... this nurse had hospital security guards accompany her on all of her breaks and walk her to her car after work, for weeks on end.... the hospital REFUSED to move this pt to any other ward. The other managers all said "his injuries make him an innapropriate candiate for amission to our ward".... so he stayed on our ward and this one nurse had to suffer fear every time she came to work. Police were alerted in case he ever came after her at home.
What did the staff do? They finally threatened to leave, en masse. Not quit, but leave... they said that this patient had to be off the ward in one hour or they would all just grab their coats and walk out. That did the trick. It makes me so angry that it had to come to that, but it worked.
Wendy - tell your staff to stick together and INSIST on action. There IS strength in numbers. Even your union is only capable of talking - but you are capable of acting.
Last edit by pebbles on Aug 10, '02