Dementia patients on psych unit?

[MSN Student]

Our doctors are consistently accepting elderly dementia patients on our psych unit. These patients are then in amongst other patients with psychosis and other psych problems. The dementia patients often become violent towards the nurses. We are not allowed to use a geri chair, and basically have no way of keeping them save. The patients are a huge fall and violence risk. The other patients become afraid and agitated. Dementia patients are often 1:1 with one nurse. Thus far we've had 8 nurses injured from being punched. Two nurses now have back injuries, due to the patient falling to the ground and the nurse having to catch him.

Does anyone else experience this problem? And what do you do about it?

[Davey Do]

pammc000:

Yes, I can identify with your situation. And since Dementia or Alzheimer's is not an acceptable axis I, these patients are usually admitted under the diagnosis of Psychosis nos.

I'm sorry to say that I have no solution to relay to you. We all just do the best we can.

I, myself, have been waylaid by such an individual.

A lot of the time, the Psychiatrist will prescribe one of the newer antipsychotics. Once they kick in, the patient is usually less agitated. But, until then, and sometimes throughout their hospital stay, we just have to ride herd on those confused, agitated, and sometimes combative patients.

As former President Clinton said, "I feel your pain."

Dave

[Mandychelle79, ASN, RN]

I work in a geri psych unit and most of the patients we get are dementia patients. We can use geri chairs, and all of the fall risk patients get bed and chair alarms... I hear those alarms in my sleep. We usually dont have a problem but if they were with the general psych group (under 55) there would be. A lot of the local psych units that do not have geriatric specific unit will transfer to us.

[MSN Student]

That's the problem with our unit. We are not a geripsych unit and we don't have the resources to keep them safe.