Quote from CNA2016:)
Yes his Dr gave the okay to send him to psych next time he calls the ambulance but he did it again and they didn't send him. The SW told us that he won't be going anywhere unfortunately so I have no idea why. But it's motivating to know that if they ever did send him to psych that our facility could refuse to take him back. Just hard to take so much from a resident and no that you have no other choice unless you want to leave your position or facility. Thank you for your response
My suspicion/answer is based on my ED experience: He won't be leaving you for an acute psychiatric facility because (in my recent observations) his situation is not really a reason that people get placed into an acute psych bed. Honestly we've been flat out told many times in recent years that if there's no real concern about suicidal or homicidal ideations and there's no ACUTE psychosis problem, there is just no case for securing an acute in-patient psych bed. If he gets sent to the ED or wherever, they will face the issue I just wrote about, they will "medically clear" him (rule out any new/acute physical problems, screen him for the above-mentioned acute psych concerns) and send him right back to you.
It's ridiculous for his physician to say there's no mental illness involved in this situation...it is either a behavioral health issue, a psychiatric issue, or a combination (assuming physical causes have been ruled out, such as organic brain disease). People who constantly behave as you describe are not merely "stressed about their circumstances". He needs a mental health eval and a PLAN. Probably medications as mentioned by a previous poster. He also needs a nursing care plan put together between HIM and his care team. He needs some boundaries to be made a part of his CARE PLAN.
Okay, so now, what will you do about it. You shouldn't have to "take abuse"; let me be very clear about that before I go on.
I must ask if there has ever been a situation that got the two of you "off on the wrong foot". Have you done anything to legitimately offend him (which would NOT excuse his ongoing behavior, but still needs to be considered)... OR, do you have any insight as to why he seems to have singled you out?
I have no easy solutions for you, I'm sorry you're faced with this every day. How about having a very calm, low-key and open-minded discussion with your DON or SW about it, explaining that you want to provide good care to him and need some realistic
ideas and suggestions about how to make that possible. If you can
- and I know it's not easy - try to start putting yourself in a frame of mind to focus on "good care" as opposed to conflict. Think about how to be the best at what you do. His behavior is very likely not personal at all, and if you weren't there he would find someone else to treat this way. So separate yourself mentally and emotionally from this.
Here's a (hug)