Cruel and Animalish treatment to patient - page 3

by joeyapple59 2,490 Views | 26 Comments

I wrote this when I used to be a nurse assistant.. It's about an incident that changed my life as a patient care person... I hope people can learn something from this...it really hurt me in the past...so read it and hang... Read More


  1. 1
    Quote from crazystudent
    I was moved that you told this story. I just want to add that you are not solely responsible for the care this patient received. Caring for patients like this does not only take compassion, but also some education or experience about the patients condition. Furthermore, the nurse should have used better judgement when loading him up with dilaudid, without assessing the situation, every time the sitter said he needed it. That is unbelievable. No wonder he couldn't communicate his needs!

    When you have done something that you feel that remorsefull about you have to believe it was for a reason. A bad person would not care...and certainly would not cry or lose sleep over it.
    Dying can be a very painful process, and they give pain meds ATC to keep a patient comfortable...that is standard. Knowing he was a hospice patient, the use of meds doesn't surprise me.....the writer's interpretation of WHY they were givng it may have been off base....

    I appreciate your sharing this story. I hope doing so relieves the burden you feel.
    Virgo_RN likes this.
  2. 1
    Quote from cherrybreeze
    Dying can be a very painful process, and they give pain meds ATC to keep a patient comfortable...that is standard. Knowing he was a hospice patient, the use of meds doesn't surprise me.....the writer's interpretation of WHY they were givng it may have been off base....

    I appreciate your sharing this story. I hope doing so relieves the burden you feel.
    Agreed. Someone with a brain tumor is going to have difficulty communicating their needs, period. The assumption that the nurses were using Ativan and Dilaudid as chemical restraints is just that, and assumption. To me, if a person is agitated and no amount of toileting, repositioning, or distraction is helping, then Ativan is appropriate in order to manage that sign/symptom of their disease process, and Dilaudid is also appropriate, because they could be in pain but simply cannot express that, due to their disease process. Keeping the person well medicated in order to control the s/s of their disease is not the same thing as using chemical restraints.

    I remember when I worked in LTC, one of our residents had brain cancer. Her tumor was in her frontal lobe, so it affected her judgment and behavior. She could be very unpleasant to be around at times, as she sometimes became verbally abusive. After a while, I noticed that if I went into the room after a certain CNA had been in there, the resident was almost always angry and "combative" (I dislike the term "combative", because I feel it is overused, and many people with cognitive impairment only appear "combative" because they are either distressed or having difficulty making their needs known). I soon found out why; the CNA said to me one night "I can't stand that woman. She reminds me of my Grandmother, who was such a witch.". Obviously, even though the resident was cognitively impaired, she still had enough mental capacity to know when someone was not treating her right. One night, the nurse overheard such a comment and reminded the CNA "She is not responsible for her behavior. She has BRAIN CANCER.".
    cherrybreeze likes this.
  3. 0
    Quote from Virgo_RN
    Agreed. Someone with a brain tumor is going to have difficulty communicating their needs, period. The assumption that the nurses were using Ativan and Dilaudid as chemical restraints is just that, and assumption. To me, if a person is agitated and no amount of toileting, repositioning, or distraction is helping, then Ativan is appropriate in order to manage that sign/symptom of their disease process, and Dilaudid is also appropriate, because they could be in pain but simply cannot express that, due to their disease process. Keeping the person well medicated in order to control the s/s of their disease is not the same thing as using chemical restraints.

    I remember when I worked in LTC, one of our residents had brain cancer. Her tumor was in her frontal lobe, so it affected her judgment and behavior. She could be very unpleasant to be around at times, as she sometimes became verbally abusive. After a while, I noticed that if I went into the room after a certain CNA had been in there, the resident was almost always angry and "combative" (I dislike the term "combative", because I feel it is overused, and many people with cognitive impairment only appear "combative" because they are either distressed or having difficulty making their needs known). I soon found out why; the CNA said to me one night "I can't stand that woman. She reminds me of my Grandmother, who was such a witch.". Obviously, even though the resident was cognitively impaired, she still had enough mental capacity to know when someone was not treating her right. One night, the nurse overheard such a comment and reminded the CNA "She is not responsible for her behavior. She has BRAIN CANCER.".
    Here is an assumption, you must have skipped over this part of the story...

    Joe begins to get restless…I get all tensed up ..i slip out in the hallway and tell the nurse, to come inject him with somthin to calm him down…and …she does…she listens to me…why didn’t she analyze the situation or …try somthin else…why not sleepin pills or somthin..why listen to me and inject him with diladin..why why ..i don’t know..they think the sitters know it all…..so joe relaxes and …about 1-2 hours go by and the medication is wearing off…and joe is starting to get restless again, tryin to get out of bed, he would throw his covers off and…..i would ask him if he needs water or to go to the bathroom but ..he wouldn’t respond anymore ..like he did 2 days before..

    Or I misinterpreted it...

    I was not indicating that the nurse was using chemical restraints, by any means. I simply thought it was unbelievable that she administered these medications based on the sitters assessment.

    Oh, and thanks for the info, I had no idea that having a brain tumor could be painful.
  4. 0
    I did read the entire story.

    I was caring for a patient going through alcohol withdrawal. He had a sitter. We have an AWD Protocol, which uses the Riker Sedation-Agitation scale to help guide the administration of appropriate medications. The sitter pokes her head out the door and says "He needs some Ativan!". It takes two seconds for me to poke my head in and quickly visually assess the patient to see his level of agitation. I can see, from the doorway, that he does need Ativan. I'm not administering the medication based upon the aide's "assessment". I have assessed the patient myself. But without any knowledge of the Riker SAS scale or our AWD Protocol, it would be easy for the aide to assume that I was giving that med based upon her request.

    Given the OP's limited understanding of the patient situation, I find it highly doubtful that the nurse was simply following the sitter's instructions.
    Last edit by Virgo_RN on Dec 22, '08
  5. 1
    I doubt it would be hard to see very quickly that the pt was agitated....and since he obviously can't express it himself, it is considered a given that you treat hospice patients with pain meds. The writer doesn't seem to have had a good grip on the entire situation with the patient, so I feel that this is probably missing something, too. The OP is upset that the patient got DILAUDID, but would be happier if he got a sleeping pill? The result of both would be that it would "knock him out," as it were. So what's the difference?
    Virgo_RN likes this.
  6. 0
    Yes at the time, I had limited understanding of the entire situation. This is why we go to Nursing school, or med school.

    I apologize to those that found this a horrifying story, I didn't want to post it, but back in the days when I was an assistant, I kept a journal of the things I went through...its kinda tough for a guy to be in the field.

    It's been a long way through nursing school and had I NOT been an assistant, I probably would have not made it through Nursing school. Joe lives in my heart till this day
  7. 1
    Quote from joeyapple59
    talk so mean to him and …tell him to …shutup he began to ..horse around and throw his covers off..it was pissin me off..honestly..i wanted to relax and …do nothing…..but instead I had to keep getting up and .. I would at points be so rough with him ...and…id feel like **** but I was irritated... and at points purposely hurting joe...i really shouldn’t be here…I should turn my badge in and call it even
    I am appalled by your story. If you have to beat up on a defenseless patient to learn that it is wrong, then that is too big a price to pay for your services. All the people saying how you have "learned your lesson" would not feel the same if "Joe" were their father or husband. Instead, they would be demanding your job and your license. Turn yourself in to the BON for abuse, and take the bad marks on your license. Only then should your conscience rest.
    Batman24 likes this.


Top