Second day on the floor this week, and the second day of taking care of a geriatric patient who has a habit of being mean and nasty. He's managed to pull out his IV's, his PICC line, and gets worked into a frenzy if you look at him the wrong way.
First day in caring for him, no problem. Cooperative when getting vitals done, bathed, etc.
Today, total turnaround. I went in for his blood sugar, and I no sooner got the lancet to make the skin pierce when he started screaming, yelling, jerked his hand away, and tried to bite me. He's in isolation, so that meant taking off the gown, gloves, and mask, going out for another alcohol pad, lancet, and strips (I only take what is needed into isolation so more than necessary is contaminated. The meter stays outside in the hall). When I came back in after regowning and regloving, he pulled back his covers and pulled up his gown and gave me a show I really didn't need to see. Then he said to me really mean and nastily "Look at what I've got for you! You see that?" I pulled down his gown and pulled up the blankets and said "Gee, we don't want you getting a cold, do we?" Then tried to take the sugar again. Again, no luck. Then he started growling and tried to take another bite at me. I looked him straight in the eye and told him I wasn't afraid of him. Soon as I said that, something must have registered because the evil twin went away and Mr, Nice appeared.
After getting his sugar and charting, I reported what happened to his RN. I didn't report it to the charge nurse or fill out an incident report (mainly because I'm still not sure of floor protocol regarding incidents like this since this is the first time this has happened).
Should I have reported this to the Charge Nurse too? Or filled out an incident report?
Update: I wasn't assigned to him again today, but since I only had 7 patients and 3 were discharged, I took care of my own, and then helped out where I was needed. I came back from lunch and asked his nurse if he needed fed (she had mentioned that he needed fed, but she would find someone else if I was at lunch), and she said his tray hadn't come yet, but could I assist pulling him up in bed. Of course, I said I would help, and while we were pulling him up, his lunch tray came. I offered to feed him, and she was surprised I did offer. I fed him with no incident, and he actually told me he liked the ice cream and pudding. Progress! :balloons: His doctor came in just as we were finishing up lunch and I gave him an update. I also told him he said he wanted to go to the movies, so I turned on the TV for him and he seemed to like that.
I gave a lunch report to his nurse, and reported that he was very good behaviour wise-- no acting out, talking to me, etc. She said they changed his meds and it's made all of the difference in the world. It has. He hasn't acted out since, but he's still confused. She also thanked me for feeding him. I thanked her for letting me do so because I needed to spend time with him after the trying to bite me incident. She told me I did good.
For those who asked, I am a nursing assistant full time, and a student Practical part time.
Thank you everyone who offered advice. It is appreciated.
OK you are officially awesome in my book. Good for you to keep your objectivity and continue to give excellent care. When will you have your nursing complete? I want to know, because you can be my nurse (or any of my family's nurse) ANYTIME! Very impressive.
*Blushes* I'll have my 20th week completed tomorrow. I'm going part time, so my graduation date isn't till Feb. 28, 2009. I still don't feel like I know anything though, but in reality, I really am learning a lot on the floor. I have a great Nursing Assistant preceptor, and all of the nurses on my floor are wonderful about answering questions. One even offered to help me with my Anatomy final on the 23rd. I'm also lucky because there's no attitude.. the RN's don't look down on the LPN's, and the LPN's don't look down on the Nursing Assistants. We all work together, and that makes for a great floor. Plus, the unit manager is very understanding (he schedules my work time around my classes/clinicals, and he's the most unboss of a boss that I've ever had. He calls my Preceptor the "Queen of the Whiners", which she really isn't, but it's funny to hear him say it. He is also very understanding about real time issues and stuff. When I needed to be off to go to court, I volunteered to work the day before in exchange for having the next day off, and he said no problem.)
Thank you everyone. I'm learning a lot from the board too. :yelclap:
deeDawntee, RN
1,579 Posts
OK you are officially awesome in my book. Good for you to keep your objectivity and continue to give excellent care. When will you have your nursing complete? I want to know, because you can be my nurse (or any of my family's nurse) ANYTIME! Very impressive.