One particular guy comes to mind reading this. His hemoglobin was ridiculously low- I think he turned out to be an occult GI bleed- so if he hadn't needed blood so badly, I would have been more than happy to raise holy hell and insist on him going to jail the night he was admitted.
Except I knew from his labs that it just wasn't feasible. So. He got tied down, he got stuck full of haldol, he tried to break my arm, he kicked the sup in the head, etc. He got 4 point restraints and hurt his wrists on them from 6 hours of struggling against them violently. Very bad night, he got all my attention and then some.
Okay so fast forward a month. He's in (not in icu thank god but I really feel bad for the floor nurses and CNA's) for some other thing. His relatives confirm, he's been that mean and that nasty all his life, and he's been in so many fights that he's got longterm subacute brain injuries I'm sure. Then the low oxyen from the night I had to put up with him seems to have pushed his dementia over the edge a bit. The language is beyond the pale. The racism he's had all his life and I can not stand to have my coworkers and friends treated the way he treats them. Everytime he's admitted he has to be tied down just to be treated. He doesn't get very good care because people don't want to be verbally or physically abused and that's what he does.
Here's my problem. I don't care. I don't care if he doesn't get treatment and dies at home. I don't care if he gets hit by a bus running down the street with his butt hanging out. At this point, I don't care if he dies in jail, flailing around like a wild animal. A person who treats other people as badly as he does, should not have complete freedom from consequences. I don't know of anyone in the facility who would hurry up if he coded; maybe the doctors since they aren't subject to his abuse for longer than 5 minutes or so per day.
I don't know what the answer is. For anyone who can muster up the compassion to care for this dude, please, feel free to try and bathe him.