The unit now has more combative/violent patients....on a telemetry medical surgical floor
Patients are ruder, and some have become physically violent - Thats were I draw the line. I call security (ex-cops) and they handle the situation. I call the doctor and tell them to order restraints.
If a patient is combative, they get restraints and haldol. No more of this "patients best interest" crap - I am sorry its very nursing school-ish - meaning its very naive and unrealistic to the realities of modern healthcare. IMHO, If a patient gets combative they will face the consequences I impose.
NO Television
NO Phone
NO Visitors
Does this make me the "bad guy" - perhaps, but some people in this world need a reality check. There come a point in time when as a medical professional you realize that the fluffy duffy wholestic model does not work all the time.
There combative patients are not the elderly or confused. They are of sound mind and body and are choosing to act out this way.
THAT IS ASSAULT.
Its time for all of us to take a stand and impose consequences for this kind of behavior. If i get a write up then so be it....But on the plus side my manager and nursing supervisos fully support me and the other staff on this important issue.
Nurses are not punching bags....If anyone ever lays a finger on me or causes me trauma/pain - they will be escorted out and placed under arrest.
I totally agree with you. I once worked in an Alzheimer's unit as an STNA and dealt with some patients who had combative/violent behaviors. I loved those people, and their behavior did not disturb me because they knew not what they were doing. In the hospital setting, I have also dealt with the same type of behaviors r/t certain medical conditions. What I will not tolerate, is people of sound mind (that includes family members and significant others) who think that they have the right to verbally and physically abuse nurses and other health care workers. That bs that they are in a stressful situation does not fly with me. When I am stressed, I do not try to harm others. What other profession would condone violence against their employees? If you walk into a restaurant and punch out the waiter because he did not serve your food fast enough to your liking, you can bet that you will have criminal charges filed against you. Where I currently work, we have security who carry guns and have the ability to place someone under arrest. I let the abusers know this. If that does not work, I call security.
Guess some of you guys are not reading this right- as quoted above. These are the crack heads, etoh'ers, general jerks, etcs. I believe the op is referring to. NOT the elderly dementia and confused.
I think we are both making assumptions because that is not what i read.......it wasn't clarified at all so its really not clear to say.
Is this how you RNs are now? You sound like a scary little biitch. Just my opinion. Suck it up and do your job or change floors. You act like you're going to die, lol. If you want nothing but all nice and calm patients go work in hospice and help em die, lol.
Tha's pretty freaking rude for a student to say. Wait til you get punched in the head by one of those patients( or your face sctratched open) and maybe you will sing a different tune.
Is this how you RNs are now? You sound like a scary little biitch. Just my opinion. Suck it up and do your job or change floors. You act like you're going to die, lol. If you want nothing but all nice and calm patients go work in hospice and help em die, lol.
Lol people. What part of "these patients are NOT the elderly or confused" makes it sound like the OP wants to lock your grandmother in a supply closet? Pretty d@mn clear s/he is referring to the drunken idiots with entitlement and rage issues, especially since she says so right there in black and white.
Charge the SOBs w/ the appropriate crime. Taking away their Jerry Springer is pretty pointless.
Is this how you RNs are now? You sound like a scary little biitch. Just my opinion. Suck it up and do your job or change floors. You act like you're going to die, lol. If you want nothing but all nice and calm patients go work in hospice and help em die, lol.
Whoa! If you meant this to be a sarcastic joke, it's backfired. I suggest you step back and re-think this a bit. Until you walk a mile or two in our shoes and get a feel for what we are talking about, you won't understand where the OP is coming from.
I have been cussed at, swung at and hit, spit on, had more things thrown at me than I can count, AND a broken finger and not one, but two human bite wounds inflicted on my in my 20+ healthcare career. Do I tolerate it? Abso-freakin-lutely not! You get security, restraints, charges and the whole nine yards when it is intentional.
Our silence on this topic is our acceptance. We must speak up for ourselves. OP, good job for speaking up.
I agree completely with evolvingrn.I also deal with a large number of violent combative apts and punishment like no tv and no visitors is inappropriate. Punishing a patient for something they can't control is not going to help.A visit or a phone call will quite often calm an agitated patient.Usually there is an underlying reason, dementia/psych issues are the ones I deal with most often.
Geeessshhhh, people! Please read the OP.
This post is about those who are A&O x 3 and fully in control of their faculties. This is not about those who cannot control their actions.
If you're going to take the time to comment on a post, please read carefully before you bash the poster.
Agree with you, but I feel that the phone/tv/and visitors helps to distract the patient, that is unless those are the things that are firing them up.
Not going to lie, my practice has changed from when I was a brand new nurse. I used to be no BS "battle axe" with a "you can't f with me" attitude (thanks to my time in the military, I guess), but now I'm more permissive. I still do set boundaries, but I really swallow my ego just to make my day go smoother and hopefully not get called into the office.
Assault and battery is no joke, though. There is no room for that crap in the hospital and patients need to know that, and if they forget, it needs to be reinforced. I remember the first time I ever pushed narcan, the patient threw a nasty right hook at me as they were coming out of their heroin induced semi-coma (this was when I was working in the city). I tried to duck but ended up taking four hard knuckles to the forehead. Instinctively, I held their arms with both of my arms and put a knee into their sternum to control them. I guess I pressed too hard and the patient suffered a cracked rib. I think I was about 2 months out of orientation and thought I was going to lose my job. I got called into the office and given a "sh!t happens" speech and 8 hours of paid Non-Violent Crisis Intervention training. I think my boss felt bad after seeing my head steri stripped with a tegaderm over my lac.
Woo!
Thankfully, nothing like that has ever happened to me since.
Lol people. What part of "these patients are NOT the elderly or confused" makes it sound like the OP wants to lock your grandmother in a supply closet? Pretty d@mn clear s/he is referring to the drunken idiots with entitlement and rage issues, especially since she says so right there in black and white.
Charge the SOBs w/ the appropriate crime. Taking away their Jerry Springer is pretty pointless.
Thank you for being one of the FEW you clearly read my WHOLE post.
We have drug addicts, jerks, and DT patients on the unit who are combative - so maybe there not in there right mind but they have more common sense and cognitive functioning than an alzheimers patient.
Our new revised unit protocal is that if a patient is physically combative or violent, we call a code grey (backup) and the person is restrained.
It may sound like a joke or an over reaction, but once youve been hit, punch, scratched, spit on (by an HIV+ patient, mind you), slammed into a wall, bitten, hair was pulled, backhanded, kicked - then feel free to whine about being dramatic.
Specializes in PCU, Stepdown ICU, Home Health Case Management, ED.
tha's pretty freaking rude for a student to say. wait til you get punched in the head by one of those patients( or your face sctratched open) and maybe you will sing a different tune.
she's probably angry cause she flunked out of nursing school. if you read through some of her prior posts, they are pretty immature and crazy.
I too find it very hard to deal with the combatative alert and orientated patients as well.
I agree that the whole fluffy approach does NOT work with this group. I've tried to de-escalate the situation but when someone is not thinking rationally and just wants to lash out, then there is nothing that can be done but to call security. In situations like this my safety and the safety of my co-workers and other patients comes first.
rnccf2007, BSN, RN
215 Posts
I totally agree with you. I once worked in an Alzheimer's unit as an STNA and dealt with some patients who had combative/violent behaviors. I loved those people, and their behavior did not disturb me because they knew not what they were doing. In the hospital setting, I have also dealt with the same type of behaviors r/t certain medical conditions. What I will not tolerate, is people of sound mind (that includes family members and significant others) who think that they have the right to verbally and physically abuse nurses and other health care workers. That bs that they are in a stressful situation does not fly with me. When I am stressed, I do not try to harm others. What other profession would condone violence against their employees? If you walk into a restaurant and punch out the waiter because he did not serve your food fast enough to your liking, you can bet that you will have criminal charges filed against you. Where I currently work, we have security who carry guns and have the ability to place someone under arrest. I let the abusers know this. If that does not work, I call security.