Dealing with disturbing patients


I am a float CNA at a small ish (250 bed) medical center. Many of my shifts entail doing 1:1s with patients, including those on the psych unit and the specialized unit of the emergency department. I've seen and heard some disturbing things, but undoubtedly today's experience was one for the books. I sat with a young peds patient who I believe to be a psychopath (I realize that cannot be diagnosed below a certain age, but this patient had hx of animal torturing, threats and plans to harm self/others, etc.) I left my shift feeling very creeped out, to say the least.

How do you cope and leave this type of an experience at work? I am a highly compassion/empathetic person and find experiences like these hard to shake.



Specializes in Psych, Corrections. 33 Posts

laugh. comedy videos on youtube. Bill Burr became my favorite after using comedy to cope....but I'm sure some people find him offensive. And also you might be able to rotate your 1:1 after an hour or two...psych nurses commonly understand a person can't/shouldn't sit with a really psychotic person for 8 hours.

Edited by Psych77
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vintagemother, BSN, CNA, LVN, RN

Specializes in Critical Care, Med-Surg, Psych, Geri, LTC, Tele,. 2,716 Posts

I agree with Psych77. Please know that most pts will not be this challenging. In about a year of work, I had 1 client that really scared me.

And when I began to notice I was actually afraid, I did something about it. I laughed. And laughed. First with another nurse in the med room in private, and then at home.

I had maybe 2 experiences in 2 years as an CNA doing 1:1 that upset me/ creeped me out. In one case, I stopped agreeing to work 1:1 with that particular pt--I was tired of being hit and kicked and calls racial slurs.

That goes back to what Psych77 said about not working all day everyday on a 1:1 who is particularly challenging.


studentbear, CNA

224 Posts

Thank you for the feedback! I appreciate it.


SwampCat, BSN

Specializes in Psychiatry. Has 3 years experience. 310 Posts

I found it interesting that my unit gets animal abusers quite often. I just remind myself that it's not the child's fault. Ot's not like any healthy 7 year old would stab a cat or try to hang himself.



Specializes in Psych. Has 4 years experience. 41 Posts

I have a hard time with working with anybody under the age of 18. It also took me a long time to get used to working with those who have committed sexual crimes, I provide basic care like I would for anyone else, but also limit myself to the amount of interaction I have with certain patients as it may be counteractive to therapeutic environment (perhaps sometimes this is how I justify it in my head, but sifting through legit hyper sexuality for a therapeutic interaction is generally not possible and I spare myself the mental angst).

And sometimes it is just difficult to shake. There's something that always stays with you after being with certain patients and its a very disturbing feeling. I found with time I have become very de-sensitized to different things, which is not always a good thing as that may change your personality as well.

Never an easy solution, but I agree with the commenter above, distraction is a beautiful tool!



Has 3 years experience. 6 Posts

On my unit no one person was stuck on a 1:1, especially the really challenging 1:1 all day. The responsibility for staying with them was rotated through all the staff members, including RNs (though RNs usually only did 1h rotations vs 2h). Even with a patient that is not as disturbed as the one you described after several hours sitting your mind will have a hard time staying alert and may even relax if the patient seems calm or is sleeping. That is a recipe for potential trouble.