Concerned about Daughter's Assignment

[imenid37]

My daughter is in psych clinicals right now. Her assignmnet in the a.m. is a HUGE schizophrenic guy who thinks he's Satan and acts out sexually to female pts. and staff. He has cornered several staff and is well-known to the police. My daughter is 19 yrs. old and under 5 feet tall. She told instructor she is a little worried about caring for this man. Instructor states "too bad, you won't choose your pts when you get out of school." Sounds like a line of bull to me. We weren't allowed to have very violent or manipulative pts. in psych. We weren't equipped to handle them, as our instructor said. She was not cutting us a break. She actually was known as the "worst" instructor. I think it was our school's unwritten policy. I can't believe this assignment. Maybe I am in a 1980's time warp, but I am really upset w/ this. Pt. has hx of lifestyle putting him at high risk of blood-borne diseases. and my daughter has to give him an injection. I know I just have to pray she is okay. I can't do anything else. I think the instructor just sounds like a real jerk. Have other students been given these type of pts.? (I hope he's in seclusion again tomorrow) There are lots of little geri-psych pts and non-violent schizo pts on this unit. As for the argument, that you get this when you are out of school, as an experienced nurse, if a new grad has a complicated pt or acting out family, I have their back or another experienced nurse does. They are not alone w/ dangerous pts. This is like giving the student a pt. in trauma triage in their critical care rotation.

[widi96]

We had a couple of patient's in my psych rotation that I certainly wouldn't want to be alone with (one of our patients was a convicted murderer - very brutally killed his wife and I believe attacked another individual). Students had this patient every week - but for our mental health clinicals the nurses on the floor always did the meds, we were never remotely alone with the patient, and they had security in the department at all times. We typically talked to the patients in the 'day room' where there were lots of other patients, usually 3-4 other classmates and a nurse at all times. There was NEVER an instance of going near any potentially violent patient's room. I felt just about as safe there as I do on a Med-Surg floor - sure, things can always get bad, but I felt like there were enough measures in place to keep me safe.

[ebear, BSN, RN]

I would suggest that you click over to the psychiatric nursing forum. I 'll bet that they can tell you EXACTLY what to do.

ebear

[EmmaG, RN]

Our rotation was ~3 months, during the summer. We had to write a 10 page (type-written) case study on our patient. Mine ended up over 80 pages long... He was diagnosed homicidal, suicidal schizophrenic. He'd enucleated himself, because God told him to 'pluck out that which offended him'. He was violent and in lock-down. All the other students had milder patients, and none of them were locked up--- they had picnics, volleyball, etc., while I was locked in with this guy. I was instructed to keep at least 10 feet between us, and to keep my back to the door. :stone

My first day with him, he was in shackles because he'd tried to drown himself in a washtub while simultaneously attempting to twist off his testicles. After he was un-shackled, he went wild and tore up the day room.

When I asked my instructor why they chose this one for me, I was told they thought I could handle him. I did. But I sure as hell wouldn't do it again...

[lpnstudentin2010, LPN]

....He'd enucleated himself, because God told him to 'pluck out that which offended him'. ....

oww. It is painful enough to have an enucleation under anesthesia with pain meds post op. ouch.

[canoehead, BSN, RN]

It sounds like even an experienced nurse would not be expected to be alone with that patient. She should have a chaperone at all times.

[time4meRN]

I agree, a student doesn't have the experience to care for someone of his nature. I work critical care/er , I wouldn't expect a student to care for a new open heart pt. by them self . Psych is the same.

[Jolie, BSN]

imenid37,

Any updates on your daughter's clinical experience? I sincerely hope she had a positive experience, either by negotiating for an alternative assignment, or by caring for the patient with the constant supervision and assistance of the professional staff.

[linzz]

I am so sorry that your daughter is being treated this way. This instructor, in my opinion is doing the wrong thing. Safety of her students should be her first concern. I have a friend who is a police officer and one day we were talking about violent patients and he said, you should always expect problems with certain people and to never let your guard down. I am sure everyone here knows this. I hope it all goes well for your daughter. Best of luck to you and your daughter.

[Jo Dirt]

No, she won't get to choose her patients as a nurse but she is not a nurse yet and this is totally inappropriate.

[imenid37]

So glad to say, my daughter is still alive and I am too. This guy behaved well, for him at least, most of the two days she had him. He did become angry when she refused to refer to him by his proper name-Satan and had to leave the day room once due to being "stimulated", but all in all it was not as awful as it could have been. I just think that instructor was clueless. If we have CYS coming for an ob pt., we would never give the students that pt. due to the potential for violence. This guy already proved himself to be violent/aggressive-DUH!!! She has two guys in their

30's in clinical w/ her and they stuck pretty close. It was quite creepy. Thanks to everyone for your advice and comments. It was nice to know I was not alone in my thinking. One more week for psych for her. I hope ole Lucifer is off to the state hospital this week and she doesn't have to see him again.

[donsterRN, ASN, BSN]

I'm certainly very happy for this outcome, but I agree with everyone else here; it was a dangerous assignment for someone still in school. I think following up with the instructor's superiors is still in order. That assignment was unsafe and frightening, and the rationale that she won't be able to pick her patients after graduation is garbage. Trade-offs happen all the time. Your instincts about the potential dangers were spot-on!

[leslymill]

Yes, Glad Satan is behind you and your daughter.