Im having major issues right now with a patient that I do multiple 1:1's with. Heres the HX:
Pt came in almost comotose from being noncompliant with his DM. He also has a HX of multiple heavy recreational drug use to the extent where his liver is shot and his mind is that of a teen (hes about 27). He is constantly hungery and extreemly verbal about his "misgivings" that the Dr.'s give him (the restrictions on what he can and cannot eat). He has been here since 2/11 and will stay here untill a custody hearing can be arranged and he can be admitted into an assisted living facility.
The reason why he is a 1:1 is because he was constantly in the kitchens (we have 3 on the 65 bed unit) and is a flight risk.
The Dr.'s have made compromise after compromise with him and he still is noncompliant. One of theses such compromises is that he can have as many tomatoes as he pleases, well he took advantage of this and had about 10 bowls of tomatoes delivered to his room per day in addition to his regular meals. well now he is having rectal issues due to the acidity. He refuses to take showers and keep himself clean and he constantly smells of fecal material despite the sitz baths that he does take.
Many times he has tried to change his own diet and "trade" items on his tray. Of course I tell him he cannot do this showing him the long list of restrictions they have placed on his diet. Each time he curses me out and threatens to leave AMA.
There are also been times where I or another nurse has turned around to do something and he slips out of his room only to be found in the kitchen again.
Security has been called many times due to his actions.
As you can imagine this is a very difficult patient and this is a very small picture of what we have to deal with on a daily basis...
CAN SOMEONE PLEASE GIVE ME TIPS ON HOW TO DEAL WITH HIM AS I AM ALMOST CERTAIN THAT I WILL BE PUT WITH HIM AGAIN AND AGAIN UNTILL HE IS DISCHARGED?!?!?!
