Physical Violance & Psychological Issues

  1. I am a new LPN and in the past few nights @ work have experienced a client with these issues. Myself nor the nurses I worked with felt qualified to deal with the situation but had to. Are there any CE classes to better help with these situations. Since chemical & other restraints are not an option?
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  2. 4 Comments

  3. by   Kymsaa
    Originally posted by michele_66:
    I am a new LPN and in the past few nights @ work have experienced a client with these issues. Myself nor the nurses I worked with felt qualified to deal with the situation but had to. Are there any CE classes to better help with these situations. Since chemical & other restraints are not an option?
    Hi Michele, first of all I cant stress the importance of safety, safety, safety.
    u safe, collegues safe and patient safe.
    But u must come first. I wonder if this person knows what he/she is doing? U may want to contact your Mental health unit for calm and restrain courses. I suggest you do not go in to the room alone, take at least 2 or 3 other nurses with you in case something happens. You shouldnt have to put up with being hit. the other piece of advice, stay within a area, where the person cant reach u, say by the side, not directly in front.
    talk to them queitly but firmly, and dont give options. Last piece of advice, always know where the door is, so u can make a quick exit. Document clearly this persons behaviour, and mental state at that time. I wonder why meds are not appropriate????
    Contact the mental health teams, they will only be too willing to help. And sounds like he/she needs boundaries place upon him/her. Hope this helps.
  4. by   Mijourney
    Hi michele_66. What type of unit do you work on? What is this person's diagnosis? Is there a psychologist or psychiatrist on the case, if applicable? Is the family aware of this patient's behavior? How often do they visit? Or, are they a part of the problem? Is management aware of this situation? What have they done to find a solution? Perhaps the patient should be assigned to another unit or facility. Like Kymsaa has indicated, have you been documenting incidents in the chart and also filling out incident reports and turning them in to the supervisor or risk management if you have such a department? Like indicated in the previous post, you should be getting safety inservices on this type of situation if you're expected to manage this type of patient. Otherwise, there are plenty of literature online to review. If this is a geriatric patient, maybe you can review topics in The Journal of Geriatric Nursing. Best wishes.
  5. by   michele_66
    Originally posted by Mijourney:
    Hi michele_66. What type of unit do you work on? What is this person's diagnosis? Is there a psychologist or psychiatrist on the case, if applicable? Is the family aware of this patient's behavior? How often do they visit? Or, are they a part of the problem? Is management aware of this situation? What have they done to find a solution? Perhaps the patient should be assigned to another unit or facility. Like Kymsaa has indicated, have you been documenting incidents in the chart and also filling out incident reports and turning them in to the supervisor or risk management if you have such a department? Like indicated in the previous post, you should be getting safety inservices on this type of situation if you're expected to manage this type of patient. Otherwise, there are plenty of literature online to review. If this is a geriatric patient, maybe you can review topics in The Journal of Geriatric Nursing. Best wishes.
    Thanks for the in put. I work in A LTC facility. This resident has had respridol ordered also haldol PRN. She is 102 so the confusion is expected, but people don't relaize how strong elderly people are when they want to be. I was never told to file incident reports, just to chart. Our DON is part of hte problem she doesn't see these people @ noc. When the problems exist.
    The situation is better for the time being. Thanks again for the advise.

  6. by   michele_66
    Originally posted by Kymsaa:
    Hi Michele, first of all I cant stress the importance of safety, safety, safety.
    u safe, collegues safe and patient safe.
    But u must come first. I wonder if this person knows what he/she is doing? U may want to contact your Mental health unit for calm and restrain courses. I suggest you do not go in to the room alone, take at least 2 or 3 other nurses with you in case something happens. You shouldnt have to put up with being hit. the other piece of advice, stay within a area, where the person cant reach u, say by the side, not directly in front.
    talk to them queitly but firmly, and dont give options. Last piece of advice, always know where the door is, so u can make a quick exit. Document clearly this persons behaviour, and mental state at that time. I wonder why meds are not appropriate????
    Contact the mental health teams, they will only be too willing to help. And sounds like he/she needs boundaries place upon him/her. Hope this helps.

    Thank you for the advise on this topic it was Greatly appreciated!!!!

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