Dangerous Patients

GalRN · Aug 31, 2018

Small feisty people can do a lot of damage when they are psychotic enough. Spice will do the same. The most important factor is the environment. Some places don't take safety seriously until after someone gets hurt, if at all.

When the unit is running well, the same safety measures are followed. Sometimes people just explode. You need a way out and help on the way immediately. If there is a protocol that is followed that is the same for every patient big and small, it will save you from the ones that explode without warning.

Also, do a google search. It is surprising how often there will be articles about people escaping or getting hurt at the bad ones.

BeenThere2012, ASN, RN · Sep 10, 2018

Agree with above and: Adults are no more unpredictable than kids. It's about the disease and their state of mind. Psychosis with paranoia tend to be more unpredictable, but not always. Having a method and protocol in place...following safety guidelines are helpful. Such as, never have yourself in a corner or without a way out when talking to a patient. As much as possible, make sure you are within earshot of other coworkers in order to call out for help when you need it. For those who are unpredictable, try to keep an arm distance away. It all depends upon the setting you work in. Pay attention to the patients as far as increasing agitation etc and try to de-escalate if possible. If needed and available in their orders, give a PRN to help calm them.

Just a few thoughts...

InquisitiveAPN · Sep 13, 2018

Kids without mental illness are unpredictable because they're not inhibited and often without remorse.

Throwing psychopathology into the mix creates too many variables. I'm not a fan of verbal de-escalation among manic and psychotic peoples, but the standard of care of to try this and avoid at all costs physical and chemical restraint.

The training courses hospitals send staff to strike me more as a liability protective course than anything for the employee or patient. Humans, without practice, can't recreate self-defense techniques in a crisis as time goes by. It's a perishable skills. The curve is steep. The same applies to the verbal elements although the opportunity to practice this is omnipreset.

I hope the best for the OP. Speedy recovery!

One thing I'd advise all people is get in shape and practice a martial art. They're also ingredients to my personal recipe to success. Even if you don't use it on your patients, which isn't what I'm pushinging, it makes the trainings provided by employers more practicable.