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A Mannequin in my Room!

Nurses   (622 Views | 9 Replies)

Davey Do has 41 years experience and specializes in Psych, CD, HH, Admin, LTC, OR, ER, Med Surge.

15 Followers; 1 Article; 80,901 Profile Views; 6,509 Posts

I was charge nurse Saturday night and was walking down the hall in the wee hours of the morning to compliment an LPN on her charting when a patient, Dobbs, came out of his room and asked, "Why is there a mannequin in my room?!"

I replied, "There is no mannequin in your room". Dobbs then asked, "Well then, what's that?!" and pointed to the roommate, lying in bed. I said, "That's your roommate". Dobbs then said, "You'd better check on him. I think he's dead".

I did as requested, shining my little pocket flashlight on the roommate who said, "I'm okay".

I told Dobbs, "The patient is fine. You need to go back to bed". Dobbs became very animated, speaking rapidly and nonsensically, throwing circular punches in my direction. I said, "Dobbs, you need to stop this behavior because it's not safe". When Dobbs continued the behavior, I said, "Dobbs, stop his behavior or you'll need to deal with the ramifications of your actions". Dobbs continued to throw the circular punches and moved closer to me. I got Dobbs in a therapeutic hold and loudly said, "Call a Code Green!"

The LPN working the floor answered "Okay!" and was back in a matter of seconds to assist .

We escorted Dobbs into the Quiet Room and several staff arrived within a few minutes. I talked to Dobbs, giving the reason for the therapeutic hold, focusing on safety, and said that the intervention would be increased or decreased, in accordance to the responses received.

Dobbs had had 50mg of scheduled Seroquel at HS and could have 10mg of Zyprexa PRN. A choice was given to administer it IM or PO. Dobbs consented to take the Zyprexa PO.

Dobbs sat on the floor of the Quiet Room, took the Zyprexa, and I asked questions to ascertain a perception of reality. As Dobbs calmed and was behaving relatively appropriately, the other staff members slowly left the Quiet Room.

By the end of our discourse, Dobbs was able to relate the reason, with relative accuracy, for his admission, the events that led to this intervention, and the criteria to leave.

Dobbs had been brought into the ER after visiting a relative in a LTC facility, informing the staff that, as an inspector, he would close down the facility. The Police were summoned and Dobbs informed them of his Super Hero status and that he lived in a Yellow Submarine. He became agitated and the Police brought him in to our ER.

Dobbs was furnished a pillow and cover and choose to sleep in the Quiet Room that night on a mat. In the morning, as I was leaving, Dobbs stood at the Quiet Room door and asked to be allowed into the general population. Dodds assured me staff's directions would be followed, was allowed to leave the Quiet Room, and the oncoming charge nurse was informed.

Just sharing an experience.

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adventure_rn is a BSN and specializes in NICU, PICU.

3 Followers; 1 Article; 1,270 Posts; 18,281 Profile Views

Strong work de-escalating the situation. I have so much respect for psych nurses! It's pretty remarkable to see the delusions that people's brains can construct.

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nursel56 has 25+ years experience and specializes in Peds/outpatient FP,derm,allergy/private duty.

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I even felt calmer after I read through that, Davey. 🙂 I imagine in psych nursing you can't always expect to have outcomes such as this one with you, your staff and Dobbs, it's heartening when it does. 

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Davey Do has 41 years experience and specializes in Psych, CD, HH, Admin, LTC, OR, ER, Med Surge.

15 Followers; 1 Article; 6,509 Posts; 80,901 Profile Views

1 hour ago, adventure_rn said:

Strong work de-escalating the situation. I have so much respect for psych nurses!

Thank you, adventure_RN, and back atcha for the respect. Seeing medical nurses in action in a intense situation has me feeling a tremendous amount of appreciation!

It all comes down to experience and technique- fathoming the variables and acting accordingly, right?

Plus, trying not to let our emotions get in the way.

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Davey Do has 41 years experience and specializes in Psych, CD, HH, Admin, LTC, OR, ER, Med Surge.

15 Followers; 1 Article; 6,509 Posts; 80,901 Profile Views

52 minutes ago, nursel56 said:

I even felt calmer after I read through that, Davey. 🙂  

It is good to hear from you nursel56, and if you're ever in need of de-escalation, I hope you'll think of me!

52 minutes ago, nursel56 said:

I imagine in psych nursing you can't always expect to have outcomes such as this one with you, your staff and Dobbs, it's heartening when it does. 

Having good backup can make or break a situation. From the LPN who was there to call the code and assist me with Dobbs, to the security guards who stood silently and strongly by, to Jason Hiney who ran to the unit and called Dr. Dadda to get orders, the situation was almost picture perfect.

It's also heartening when these situations are consistently handled well. Friday night, I was pulled to the men's psych unit and worked under a quality charge nurse and staff there.

One patient was starting to go off, but consented to take his HS meds which included Haldol 10mg. He still went off and needed to be restrained both mechanically and chemically.

In that situation, the Techs and charge RN handled everything. All my job was to do was to inject 2mg of Ativan into his gluteal muscle!

A lot went on this weekend, and it feels good to process it with my allnurses friends! 

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sirI has 30 years experience as a MSN, APRN, NP and specializes in Education, FP, LNC, Forensics, ED, OB.

14 Followers; 19 Articles; 13,221 Posts; 138,697 Profile Views

6 hours ago, Davey Do said:

I was charge nurse Saturday night and was walking down the hall in the wee hours of the morning to compliment an LPN on her charting when a patient, Dobbs, came out of his room and asked, "Why is there a mannequin in my room?!"

I replied, "There is no mannequin in your room". Dobbs then asked, "Well then, what's that?!" and pointed to the roommate, lying in bed. I said, "That's your roommate". Dobbs then said, "You'd better check on him. I think he's dead".

I did as requested, shining my little pocket flashlight on the roommate who said, "I'm okay".

I told Dobbs, "The patient is fine. You need to go back to bed". Dobbs became very animated, speaking rapidly and nonsensically, throwing circular punches in my direction. I said, "Dobbs, you need to stop this behavior because it's not safe". When Dobbs continued the behavior, I said, "Dobbs, stop his behavior or you'll need to deal with the ramifications of your actions". Dobbs continued to throw the circular punches and moved closer to me. I got Dobbs in a therapeutic hold and loudly said, "Call a Code Green!"

The LPN working the floor answered "Okay!" and was back in a matter of seconds to assist .

We escorted Dobbs into the Quiet Room and several staff arrived within a few minutes. I talked to Dobbs, giving the reason for the therapeutic hold, focusing on safety, and said that the intervention would be increased or decreased, in accordance to the responses received.

Dobbs had had 50mg of scheduled Seroquel at HS and could have 10mg of Zyprexa PRN. A choice was given to administer it IM or PO. Dobbs consented to take the Zyprexa PO.

Dobbs sat on the floor of the Quiet Room, took the Zyprexa, and I asked questions to ascertain a perception of reality. As Dobbs calmed and was behaving relatively appropriately, the other staff members slowly left the Quiet Room.

By the end of our discourse, Dobbs was able to relate the reason, with relative accuracy, for his admission, the events that led to this intervention, and the criteria to leave.

Dobbs had been brought into the ER after visiting a relative in a LTC facility, informing the staff that, as an inspector, he would close down the facility. The Police were summoned and Dobbs informed them of his Super Hero status and that he lived in a Yellow Submarine. He became agitated and the Police brought him in to our ER.

Dobbs was furnished a pillow and cover and choose to sleep in the Quiet Room that night on a mat. In the morning, as I was leaving, Dobbs stood at the Quiet Room door and asked to be allowed into the general population. Dodds assured me staff's directions would be followed, was allowed to leave the Quiet Room, and the oncoming charge nurse was informed.

Just sharing an experience.

Most EXCELLENT! 👏

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Hoosier_RN has 20 years experience as a MSN and specializes in LTC, home health, hospice, ICU, ER, dialysis.

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@Davey Doyou are a gem among the stones! Your pts may not deal in reality, but your calm guidance keeps them, and staff, safe.

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tnbutterfly - Mary is a BSN, RN and specializes in Peds, Med-Surg, Disaster Nsg, Parish Nsg.

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Davey...GREAT job!  Thanks for sharing.  I hope you'll share more of your experiences.  

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Daisy4RN has 20 years experience and specializes in Travel, Home Health, Med-Surg.

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Having a good team always helps, I have worked with good ones and bad ones. Either way, you do seem to be able to keep a calm head and demeanor in those situations, not a small feat for anyone and especially with your past history (that you have shared here). 

Sounds like another "extraordinary" job well done!!

 

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Davey Do has 41 years experience and specializes in Psych, CD, HH, Admin, LTC, OR, ER, Med Surge.

15 Followers; 1 Article; 6,509 Posts; 80,901 Profile Views

17 hours ago, Davey Do said:

I was charge nurse Saturday night and was walking down the hall in the wee hours of the morning to compliment an LPN on her charting when a patient, Dobbs, came out of his room and asked, "Why is there a mannequin in my room?!"

mannequin.thumb.png.712c2816a69eb3e5903e5fdf8e125cd4.png

Thank you, sirI, Hoosier, Mary, Daisy for the compliments and kind words. 

Knowing we do a good job is one way pursuing peace and being happy with ourselves, but it sure is satisfying to be acknowledged by respected members!

Thanks again!

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