Crazy, abusive patient? What do u do? - page 2

I had a very discouraging experience a few weeks ago. I'm a tech on a cardiac floor. One saturday night about 8 pm I saw a stretcher coming my way, so as usual, I went to check out the patient and... Read More

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    P_RN - i am so sorry for what happened to you! This is exactly what i was afraid of with this guy. I hope u recovered and feel better now.

    About the guy again - he refused haldol and all the rest of the meds. Every administrative and non administrative staff member went to visit this guy and when they called his doctor, he basicly said " deal with it till morning".
    The reason why he was on our floos was because he was admitted with chest pain, he had previous cardiac surgery also, so they sent him right up to us.

    Up until this point, I was considering going to medical school some time before I die , but now i am not so sure.
    DO I really want to be responsible for a person like that? Do physicians have the right to refuse a patient?

    Anyway, thanks for all your advice and support. If i ever encounter this again, I will know what to do. I'm not going to try and put my face forward and let the supers deal with it.

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    Anagray, that doctor should be shot. I'm sure from a liability standpoint he couldn't discharge him without a 23 hour observation (sure as he did, the guy would have keeled over on the hospital steps.) BUT, that doesn't mean the doc disavows all responsibilty for this patient's behavior.

    Every hospital should had a medical psychiatric floor. No one wants to float to our unit, but, boy, do they love us when they have these kinds of patients!

    Even when I was working medsurg, tho, such a patient would have gotten the following options: (1) simmer down now! or (2) go AMA and don't let the fire doors hit you in the arse on the way out. Our unit was the dumping ground for drunks, so we got lots of practice. Security backed us up. I am hoping that your nurses and administration take this example as a way to learn how to handle the inevitable future buttheads that will come your way. What provisions do they have in place for an abusive patient if the pt is potentially medically unstable (read: the police won't take him) but is not manageable on a traditional medical floor? This incident should tell then they need to have protocols in place.

    Good luck!

    Oh, and P_RN, I hope you pressed charges against that patient.
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    My husband, a Correction Office, says 'CALL 911, call adm. and state clearly, either he goes or I do". I used to argue the 'nursing mentality' argument with him, now I consider him right! We live in America, noone has the right to abuse us!

    PS, "that's what you're paid to do" is BS, I'd put money on the fact that YOUR taxes are paying for his hospital stay!!!!! (I hate when that happens cause I always want to have a SAY in how I spend my taxes)
    Last edit by RyanRN on Aug 2, '02
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    5 security guards, 10 of haldol, 2 of ativan and a 20 ga syringe. He wouldn't refuse that.
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    oh i am such the expert on
    this sounds like the kind of pt i seem to get ALL of the time.
    everyone, including the docs laff cos i ALWAYS get the whackos.

    went thru a similar situation
    called the nursing supervisor....she blew me off...i told her he had a strong potential for violence...he heard me and he got even more agitated. she heard him screaming, she came to the floor.
    security was called and they sent up ONE female officer. i called them back and told them they better send more. 4 men came to the unit.
    i called the docs. resident came to the floor and tried to reason with him.
    he would NOT restrain or sedate him....issues with imprisonment...
    resident told me not to worry...he would be ok. BULLSHYT
    this guy was out of control. he didnt know what the heck he was saying or doing. there was NO WAY that doc could tell me he was going to be ok.
    finally gave him 5 of morphine....big deal...might as well have given him a drink of water. gave him 10 of xanax, then another 10. no effects at all...didnt even calm him down.
    i told the doc, in front of the supervisor, that i was NOT going to care for this patient. it was a safety risk i was NOT going to take.
    he couldnt guarentee my safety and there was no way this guy was going to kick my azz.
    after i refused to care for him, everything changed. thats when the doc decided to give him the morphine.
    and thats when the doc and the supervisor decided to have security stay with him all night.
    just dont do it. refuse the pt. call the supervisor, call the doc, call whoever you have to. stick to your guns.

    and i have NO problem telling pts like that to settle down. and i have NO problem telling them i am NOT going to tolerate their abuse. AND I DONT.

    i really hate the psych patients. they go from calm to homocidal in seconds. no way to read this and respond until its too late.

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