Almost lost my temper today

[Ms Kylee]

Been on what I call the geriatric wing all last weekend and this week. Lots of completes, and I usually don't mind, except for one patient who I swear, hates me. He is difficult at best, and impossible at worst.

He has been in for almost 3 weeks. He's supposed to have been discharged twice, but family members keep appealing the discharge and we keep him.

I have to feed him as he cannot feed himself. He's on mechanical soft (and yes, I know the food looks/smells/and probably tastes rotten. I sure wouldn't want to eat it either). Mealtimes are like a battle zone... He screams and pitches a fit because I'm feeding him, swears worse than any sailor and truck driver I've ever known, throws punches, etc. The only thing I can seem to get into him is the ice cream or sweet dessert the kitchen sends up, and even then it's usually one or two bites, and then he starts screaming for me to get the (swear word) out of his room.

This morning, I was trying breakfast, and we went through the eating battle yet again. I had to step into the bathroom and count to 10 before I went back in to attempt to get another mouthful in him.

Bathtimes are no problem except that he swears at me through the whole thing.

I've had it.

I'm tired of this assignment.

I don't mean to whine, but it's very frustrating and draining, not to mention the bruises from the punches.

He is really sucking the life out of me.

How do I suck this up and not let it bug me?

I really don't want to care for this patient anymore, but I don't have a choice. I don't get to pick my assignments or my patients.

This one is really bugging me because I'm the one who seems to be able to turn all of the difficult patients around, but not this one.

Sorry for the vent.

[pagandeva2000, LPN]

I think that this assignment should be rotated, at least. It is too much on someone mentally to take this sort of abuse every day. Or you should be partnered with someone. Make an agreement that at such and such time, we get together to deal with this patient. Speak to your charge nurse. And, of course, I am sorry that this has been dumped on you this long.

[barefootlady, ADN, RN]

Report the behavior to the CN, file an incident report, request to be assigned a different patient, and chart, chart, chart his behavior. Leave a note clipped to the physicians order sheet regarding his agitation and combative nature. Request the physician order him a mild sedative if possible. Most of all, tell this patient he is not to hit you or curse you, or you will file assult charges against him.

[SillyStudent, ASN, RN]

Nobody gets to punch you.

Agree with HM2Viking, he needs a psych eval. Time for happy meds. He sounds extremely frustrated.

That STILL doesn't mean he gets to hit you. Talk to TPTB as soon as you can. Next time, I would refuse the assignment. Cite your own safety.

[Ms Kylee]

Thanks everyone. I'm on 3-11 tomorrow, so I'll be sure to talk to whoever is Charge tomorrow. I keep hoping that they'll lose the discharge appeal and he'll have to go.... and I can only hope he'll be gone before I head in through the doors.

I always say I love all of my patients, but this one... I don't even like... and I am so disappointed in myself for my thoughts.

[donsterRN, ASN, BSN]

Thanks everyone. I'm on 3-11 tomorrow, so I'll be sure to talk to whoever is Charge tomorrow. I keep hoping that they'll lose the discharge appeal and he'll have to go.... and I can only hope he'll be gone before I head in through the doors.

I always say I love all of my patients, but this one... I don't even like... and I am so disappointed in myself for my thoughts.

Don't you even think about being disappointed in feeling the way you feel; you are entitled to that. And you're entitled to better conditions. I agree with letting this abuser know that if he touches you one more time, you'll file charges. And then do it. Kinda makes you wonder what his family life is like; no wonder they don't want him returned home.

Hugs.

[Ms Kylee]

Family's big gripe is he came into the hospital walking, talking, etc.. and now he's not... as if we can fix it...

I really hate to say it because it makes me look rotten, but we really need the bed for someone else who is sicker.

[Midwest4me]

I had a patient like that -- feeder too. Complained about everything! The bites were too small, I wasn't keeping the spoon in his mouth long enough, I wasn't giving him a drink frequently enough or I was giving it too much, blah blah blah. Then, when I'd do it wrong, he'd say, "Oh my God! I can't believe this. What the h*** are you doing?" or some variation thereof. He'd also wanted me to stay in his room and change the channels on his TV one day.

I finally got tired of dealing with it. He may be upset about being hospitalized for so long, and I treat my patients with respect because I know they're in a tough spot, but this was beyond acceptable.

I finally said to me, "Don't say 'Oh my God' to me! I'm here feeding you, being nice to you, and you're just being mean! I'm sorry if the bites aren't the right size, but you're not capable of feeding yourself, and I'm feeding you, so you need to bear with me." He shut up. Later that day, I made a comment to him about something, and he told me, "You're not as dumb as I thought you were." Of course, I took that as a compliment from him.

Regarding the TV, I told him, "I have 5 other pts, and you can push the button!" He says the button doesn't work. I started pushing it with little effort (he can use his fingers just not move his arms well), and say, "Oh yes it does. Look!" Then I put the remote underneath his fingers, and he starts yelling at me. "Dont put it there. Oh my God!" I say, "Ok, well I'll just leave it on the side here, and you can get it then." He says, "No no, don't do that! Oh my God! What is wrong with you?!" as I walked out. Of course, as I'm walking out, he begs me to come back in and put a certain channel on, so I did, and he was nice after that.

Bottom line is that, yes, you should treat your patients with respect. You should NOT, however, have to be insulted in the process. If someone's going to hog up your time by being disagreeable, then leave them to their disagreements alone!

Also, you should NOT be leaving work with bruises, unless you're bumping into things!

No--we should NOT leave work with bruises but it's a common occurrence(as well as scratches) for those of us who work on a psych ward or in a psych hospital.

[rizzle]

I'm sorry this is happening to you.

Hospital administration should be aware of this because it is a huge liability for them, and a safety issue they need to address.

Please tell your charge nurse. Do not take report on this patient. If you do not take report, they cannot consider it abandonment.

Document the bruises. Take pictures, etc. If the patient was oriented, I would file assault charges against the patient. If not, I would at least file a report with the police documenting this abusive behavior.

It irks me that patients think they can come into our workplace and abuse us! Please stand up for yourself and report this abuse!

Also, I agree with everyone else who suggested a psych consult for the patient.

Good Luck to you!

:redbeathe

[megananne7]

This guy needs a psych eval.

Of course, I also think all patients need a psych eval and Ativan/Xanax and/or Risperdal are miracle drugs lol.

[Ms Kylee]

I'm really really really hoping and praying he will be gone by the time I get in this arfternoon....

[James Huffman]

1. I ditto everyone who recommended having a word of prayer with your manager. Do that immediately.

2. Reading between the lines, this guy is a jerk, and the family doesn't want to deal with him. The family's problem is not your problem.

3. I would also encourage you to take control of this situation. If you are again given this guy's care, walk in the room, greet him firmly, and announce that if he touches you in the slightest, you will call the police. And do it. Do not call security, don't go in the bathroom and count to 10, don't complain to your manager. Just call 911 -- preferably from your cell phone -- and explain where you are -- give the room number -- and that you have been assaulted. Tell them you need the police. Then file a formal complaint. This is your documentation. Honestly, I would go ahead and call the police right now, file a complaint about the past hitting for documentation, but at the very least, don't allow it to happen again without making it unpleasant for both him and the facility.

4. You may count on your managers being annoyed that you've done this. Too bad. You must show them that you will no longer put up with this abuse. As others suggested, take pictures of the bruises, etc., but let there be no more bruises. This guy is a jerk, your managers know that he is a jerk, and you have been given this case -- I suspect -- because no one else will, and you have allowed them to abuse you as an employee.

5. You won't have to go this far, but if he so much as touches you again, announce to your manager that you are resigning from his care. I would let him starve before I would let him hit me again. People like this who are abusive have done it for years and have been allowed to get away with it. You must be one caregiver who will not allow him to be abusive.

6. A facility that allows staff to be abused like this will probably do it to you again. Have you considered looking for a job elsewhere? Good luck. The main thing I would encourage is, again, taking charge of this situation, and making sure it never happens to you again without some unpleasant consequences for this jerk.

[Ms Kylee]

Yes, I've been looking elsewhere, but I'm tied into a year contract until the end of May. If I am assigned to him today, I'm going to charge and demanding that I not take care of him and I'm going to reiterate why.

Honest to God, I am so sick and tired of this patient. (And this is so not like me. I'm usually very much Mary Sunshine).