Why do we as nurses on med surg units have such a responsibility to manage patients like these? i had a horrid case of PCP (we think) detox for the last 2 days. Pt was absolutely psychotic, running in the halls naked. I had a doc who would not aggressively treat, and so we were left calling secuirty, doing all we could, literally tackling the guy down in the halls. Of course, one of my floor managers was after me, chiding me for not assessing him properly, not being "aggressive" enough in getting more orders for more sedation, etc. I was BEGGING his doc to give us more to work with, but he just would not give us what we wanted. The entire experience was just absolutely demoralizing. Our hospital has a protocol that we use w/ ativan ordered for parameters, and we were using it, but it wasn't doing a thing for him.
I work on a neuro floor, but I do not feel adaquately trained to manage these patients. I'm tired of the risks we incur (the guy came up from the Ed w/ a pocket knife still in his jacket which one of our night nurses found.), tired of the abuse, tired of the drama and the stress of it. Why does our huge hospital not have a special unit dedicated to detox w/ staffed experts who can recognize the specific symptoms of each type of detox, staffed w/ case workers, with psychiatrists -- whatever to take care of these people? They are frightening to others patients, they take up all our time -- I mean -- try managing other patients, discharges, admits all going on while your nutso detoxer is sprinting towards the elevator and/or threatening you w/ physical harm half the day?? I just cannot do it and each one of them presents in different ways.
I learned that PCP is especially dangerous, that PCP users can be extremly psychotic and dangerous to themselves and to others -- yet my hospital sends this patient up w/ no sitter, w/ no advice on how to handle him and assigns a doc that seems to know nothing about PCP detox!
I will admit -- nursing school taught you that DT's are dangerous -- I know that, but that's about all I know and I feel I really could use some expert advice on these types of patients.