Combative Patients/Body cams/Walkie talkies

[Beldar_the_Cenobite]

One day I was sitting at a Starbucks near a State run hospital. I saw two healthcare professionals walk in in their scrubs. I don't know what their position was but they had what looked like body cams near the v-cut part of the neck of the top scrub near their badge. Those little Nokia sized devices that police wear. It caught my attention because I know some patients(like meth heads on withdrawal) can't be the nicest people in the world when they don't get what they want when they want it on your shift. I'll admit I was far away but it looked like either a body cam or a walkie talkie but I thought why would they use something that would be loud? A body cam, in this day and age, would sound ingenious. It would be like liability coverage for the professional and the facility.

It was like an eyeopening experience in the field I look forward to growing old with knowing the difficulties I'd experience. Patients would know they're being recorded so they couldn't start with their pathological wants and needs they think they can smuggle by using a stressed out professional in the setting.

Then I thought of the people like security in suits at casinos who watch players. Using those corded walkie talkies to remain discreet and undercover. If hospitals give nurses and doctors including the management ones in charge of the others those kinds of walkie talkies, the nursing field would probably be a lot less stressful.

What do you guy think? With people on tv being shot by police and rants about it on the media and the news, it seems body cams are the perfect insurance when you know your job is always on the line. It would seem to make sense considering police, physicians and nurses all have STRESSFUL jobs. I always had this thought that healthcare professionals had to deal with abuse from combative patients but now I see hope out of that. I don't want to be beaten if there's a way I can get around it.

Also, how do you guys deal with combative patients? How do you deal with the yelling and screaming? and the hitting? I learned in my friends CNA school that stepping away from a patient if they're being abusive is considered neglect. I might not have that right but I know stepping out of the room if their being combative is neglect.

I also learned that straps on the beds used against the patient I believe can only be used by doctor's order and that requires a lot of paperwork because strapping a patient to a bed would be considered abuse and neglect.

I'm starting CNA school soon so I hope I can get some good answers on here that I might not get in CNA school.

[Dafabb, LPN]

Yes I noticed that. A nurse is a nurse be it LVN/RN.. I am going to go back a few years where they started the change to RN/hospitals. Before that back 35 yrs(geez that sounds old) There was basically no difference between the 2 (I am from Texas always much more liberal) No discussion from other States about what we (LVN) can or can not do....TEXAS. MY background that you can't see. ICU,CCU,TELE,ONC,REHAB, ORTHO,OB/GYN,MS,NICU(very brief I assure you)Neuro Psych, Psych. Many years in most of these. So do I sound like a Nurse!....Oh really on occasion we have to have fun with that statement.....I also can't find my scissors!.......Is there an RN(real Nurse) in the house. They always have a pair!!!...Humor is always the best medicine!.....Thank you all:yes:

[Dafabb, LPN]

Now to the real topic. Combative Pt. Now if you are talking about the hospital there have been a fair share in my day. When a pt gets combative you move away from him. If he's calms when you are not close stay away. You can call on the call button or stick your head out the door and say help...No you are most certainly not neglecting this person. Yours/My job is not to be a punching bag at close range. Then we have dementia- a little different. Hold their hand, talk,sing,smile. Again if they don't quit call on call light,yell help at the door. Make sure they are not crawling out of bed. You still don't have to be a punching bag...As to Cameras there will never be a camera in a room. We have them all up and down the hall, med room, and even the Nurses Station(so they say) I have yet to see one here. This in in specific hospitals or LTC. It is not everywhere...

If you are talking about a State Supported type place like where I work or State Hospital. Different rules. Behavior problems is the main things and they can get nasty. They do restraints with holds when necessary. Trying to de-escalate first. If unable a mechanical restraint (meds). If they start doing their behavior we (nurses) get out of the way and their staff does all that. Yes nurse have been hit/injured but rarely as I have seen so far. There are cameras all over the halls/DR/LR in all the homes. There are no camera in their rooms/med room. It's been an interesting change to my career....

[Horseshoe, BSN, RN]

How are you an RN? Did I say I was going to stab a patient with a needle? How are you an RN? Why is an RN, who luckily got through nursing school, is saying to me, who isn't an RN but wants to be one, "This post can't be serious". Are you serious? How are you an RN? I didn't even write that I would stab a patient. And then you're going to post your comment because you have your BSN and I don't. I understand you flaunt but you were new as well to this field. Cop a cocky attitude because "hey, I got my RN and you don't, stig" I swear half the RNs on here have to be dyslexic and extremely VILE. I come here for advice and I get ripped apart. For what? For being new? Like you can't come on here without being scolded.

You have some real problems with reigning in your anger and speaking/behaving appropriately when you feel offended or criticized. Your reactions are completely out of proportion to the insult. If you do not get some anger management, you won't last a month in clinicals, forget about ever becoming a nurse.

[elkpark]

If I said I was the one holding the syringe then it would obviously have said "I feel like I'll have to hug an angry dementia patient WHILE holding a syringe.." but I was obviously stating a dementia patient, who scientifically has lost their mind, would use a syringe with needle inserted, as a weapon feeling as if they're being cornered.

You really need to stop hazing. This website was designed for educational purposes. Not some fraternity where you can flaunt your "seniority" and "prestige". If I was an RN I'd keep my ego to myself.

I would imagine that others here, like me, assumed you were referring to holding the syringe yourself because there is little to no chance (unless someone made a serious error) that a demented client would have access to a syringe with a needle in order to be threatening you, or anyone else, with it. If anyone were going to be brandishing a syringe, it would be a staff member. You do seem to have very unrealistic expectations of healthcare settings and roles. Maybe you should do more basic research before flying off the handle about so many unrealistic concerns. Best wishes!

[bgxyrnf, MSN, RN]

So Stig, I really don't understand what you're asking or fretting about.

I answered your question about "how you deal with combative patients" very succinctly and I was not being facetious in the least. You respond with as many people as it takes to overwhelm the patient and physically/chemically restrain them until they calm down.

Please note that I am referring specifically to combative patients, not ones who are agitated or acting out. The latter are labeled 'pre-combative' in my personal taxonomy and I'm generally successful at talking or singing them down... yeah, singing really works (read up on the use of music therapy with demented patients... pretty amazing stuff happens).

Your notion of using a stern voice and invective is generally the surest means of escalating the situation and getting yourself fired and sanctioned.

I really have no idea what you're talking about regarding hugging a patient who's threatening staff with a syringe though I immediately question what dumb-donkey left a needled syringe in a room, particularly with a confused or agitated patient.

[lavenderskies, BSN]

Vocera. That's my vote.