combative patients

Nurses General Nursing

Published

Specializes in CNA/Nursing school student.

How does one work with combative patients? I am a cna and had a patient that kept taking his nasal cannula off. Every 5 minutes I kept putting it back on for him and telling him to leave it on. Eventually he became combative and I had to tell the nurse several times. What do I do in a situation like this? I was a sitter.

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Specializes in Acute Care, Rehab, Palliative.

Sometimes there is nothing you can do. If he won't leave it on you can't make him and trying to force him to leave it on will only aggravate him. You can only do so much.

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Specializes in Med-Surg.

I am assuming that the patient was confused. If you weren't able to re-orientate him and he repeatedly removed the oxygen then you should notify the nurse. Continuing to replace it could agitate him further. As soon as he becomes combative he nurse needs to be notified and they can go from there.

The doctor would need to be notified and depending on circumstances, restraints/sedation could be necessary.

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Specializes in Family Nurse Practitioner.
Sometimes there is nothing you can do. If he won't leave it on you can't make him and trying to force him to leave it on will only aggravate him. You can only do so much.

I agree but definitely try distraction and being as comforting as possible. With confused patients if you get agitated with them it will only make things worse.

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Something I always did in that situation was talk loud enough for everyone to hear in the hallway/nurses station, as well as narrate everything that is going on. Just helps speed along the process of getting measures to mitigate any further combative issues. When the nurse would ask if I needed anything generally I always ask for a precedex gtt, but that would only every happen like 1/10 and only if I was sitting in the ICU at the time. And generally it was more of an inside joke. Because I was a float aide I would always be the first to get pulled to sit, especially if the patient was combative. Haha, I once had an etoh patient take his tele leads off and start whipping me with them.

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Specializes in Rehabilitation,Critical Care.

Confuse patients should be dealt with in a calm manner.

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Specializes in hospice.
Confuse patients should be dealt with in a calm manner.

Easy to do until they start punching, biting, and scratching.

I agree that repeatedly replacing the cannula and scolding about it probably caused the patient to become agitated. Next time just tell the nurse that he won't leave it on and let her decide what to do about it. She can call the doc and discuss it.

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