are they just waiting for an assault??!?

[hapeewendy]

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....

[nursing 101]

I would refuse to take care of him and would let them know in writting that you feel unsecure in his presence.

Someone please tell me that nurses have rights as well... As I am a student this part of nursing is freaking me out!

Hang in there and let us know what happenned...

[researchrabbit]

I had a stalker psych patient. He'd wait in the stairwell just outside my office. Very scary...really, the only scary patient I've in working 12 years in psych (mostly they are more scared than scary). The MD I worked for immediately banned him from the facility when it came out he was stalking me.

Your guy is out of control and needs to be on the psych floor or transferred to the state hospital. Trust your gut and let the-powers-that-be know how difficult this is. If your immediate superior doesn't listen, contact the person above because that's your recourse here.

[jemb]

Isn't throwing something and hitting you with it considered assault? (Just lucky that it was only a pitcher of water!) If that happened to me, I would file an incident report, and a "threat management report" or whatever the particular facility calls it. Since the immediate chain of command is not concerned, I would skip them and go to another level. Keep notes yourself of the patient's behaviors, and keep copies of any memos and dates of reports that you have filed. If a report of personal threat is filed, the facility is obligated to act on it Risk management will have to address it Please do what you need to do to protect yourself!

[lindalee]

I would consider an assault charge if someone was throwing hot soup and water pitchers on or at me. Your hospital administration has an obligation to provide a safe environment for the staff, as well as the other patients. He is a sick man, but that does not give him the right to this type of behavior.

I would not work in a facility that would not take measures to protect me, my co-workers, and my patients. I think you should put your concerns in writing and make certain you keep a copy until this is settled. I would give a copy to my head nurse, the nursing director, the risk manager and this patients primary physician. I would not take care of him and state your concerns about your safety in this letter. This man needs to be placed appropriately before someone is seriously injured. Then if someone does get injured you have proof that you warned the appropriate people of the danger. (that alone should scare them enough to get them into action to place this man)

Believe me, they will not want to chance legal action by you at a future date if this person should injure someone. Perhaps he needs to be placed on a 5150 type psychiatric hold for everyone's protection. If he is a danger to others (or himself) he can be placed in a psych facility without his permission.

Good luck. Please let us know what you do and how administration responds to your concerns. We care and need to all stand together to protect ourselves--and our patients.

[night owl]

How can you have any control if he's refusing to take his meds??? A show of fours (force) might change his mind about taking his meds especially if you can use all men! Until social services can place him, he needs to be transfered to the psych unit where they can stabalize him and soon before he hurts you, other staff members or other pts. It is up to the hospital to protect you from this kind of work violence and at this point, they aren't doing a good job. MRSA or not, he needs at least a psych consult and stat!

I suggest you take it directly to the top Wendy...this guy is a danger to you and everyone else. Definately trust your gut feelings.

[KaraLea, LVN]

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.

[pebbles, BSN, RN]

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.

[Youda]

If you continue to take the legal, moral, and nursing responsibility of caring for a patient that you clearly are unable to meet his needs, then you can be held liable. Refuse to take the patient. Yes, it will make waves. Yes, it will make admin unhappy. But, what if he injures another patient? The nice attorneys are gonna come find you first. Save your license and protect your other patients by refusing to take the assignment. Good luck!

[Mama Val, ASN, RN]

He threw hot soup..thats assault 3, when he threw the water, thats assault 4, you were placed in fear of harm (how did you know it wasn't hot). You really need to file charges, screw the hospital, it looks like they have allready thrown up their hands to the problem. Don't let the hospital try to handle this they are not the law they work around the law, if this guy hurts anybody else he will get off beacause he doesn't have a record of what he has already done to you. I am a correctional officer and this guy need to go to lock up and learn the consequences of his actions, he'll get medical care in jail...if he needs it. We have a few prisoners who are in jail for assaulting their care givers, guys you would never think could hurt a fly but one threw coffee on his nurse, another beat his health aide with a cane. Protect yourself and this will also protect other nurses on down the line.

[Nurse Ratched, RN]

Jail or the jail infirmary sounds like a perfectly good discharge plan to me. In the absence of that, the guy belongs on a psych floor. We deal with crap like that. You have too many sick patients to deal with this nonsense (and what if he gets it in his mind to go after another pt?? HUGE lawsuit potential.)

And why on earth are you being forced to take this guy day after day? When we have PIA's, we trade them around, continuity of care be damned. It's unnreasonable to stick the same nurse with such a patient consistently. Maybe if other staff members have to deal with him, there will be enough people squawking to make a difference and get this guy transferred.

I would raise a big stink about taking this patient again. If no one else wants to take him, then you can say, "So you agree that he's a danger and you don't want to deal with him? When will we be transferring him?" And then let the others draw straws over whose turn it is.

[misti_z]

Sorry to hear about what you are going through Wendy. But you have receive great advice here.......as usual our BB is wonderful!!!! :kiss

jemb gave great advice.

We had a patient who would throw stuff at anyone who came into the room--after restrainted (danger to self and others), he would try to spit, kick, even urinate on us!!!!! We talked with everyone as high up as you can go and nothing would be done

Finally our head nephrologist witnessed the pts behavior and told administration that if the patient was not off his floor today none of his nurses were going near that door. He was transfered to a psych hospital that evening!!

WE LOVE YOU DR. YIUM!!!