Getting hit!

bargainhound, RN · Mar 17, 2006

shah..........what kind of license do you have?

KAW1962 · Mar 17, 2006

In patients with dementia, especially those who constantly try to climb oob or chair, see if your facility is able to provide a sitter. Enlist the families aid in having them take turns sitting with the patient. Sometimes someone familiar to the patient is enough to calm them down. If the families are unable to sit and your facility does not provide sitters, I would suggest to the family that they hire someone to come in and sit. Many facilities have listings of agencies that provide one-on-one care at a cost to the family.

For patients who are alert and oriented and still physically abuse the staff, definitely call security or some places have a "Dr. Armstrong." I would also consider calling the local police and filing assault charges. We do not and should not be expected to tolerate physical abuse on the job!

Otessa, BSN, RN · Mar 19, 2006

I have had some problems with patients hitting. I NEVER go into these rooms by myself, distraction and help are often key.

greatshakes · Mar 19, 2006

While working as an nurses assistant, I and many other nurses ended up with so many scratches, injuries and bites after having to hold one patients hands down. Everytime I got attacked I would write out an incidence report. It was always our fault because we weren't handling her correctly. The charge nurse thought it was just a case of bad management until the resident grabbed her by the hair and pulled her onto the bed and started theumping her. I helped restrain the resident but from then on our compliants were taken more seriously. The resident would walk backwards off the lifter and at the staff meeting I was again told it was bad handling but one other AIN stuck up for me and I'll never forget that. Nothing as good as support when everyone else is silent.

Warpster · Mar 20, 2006

I don't know why we as a profession are supposed to tolerate this. I've always been able to get chemical and/or physical restraints ordered for dangerous patients. Remember this guy is a potential liability to the hospital if he is unrestrained and able to attack another patient. THINK of the lawsuit! Run that one by risk management.

And do get that family to get their butts in to sit with him. Explain that if they don't want him restrained, THAT is the alternative.

In the meantime, know that these guys are scared. Sometimes a "Wow, this is really scary for you" will have amazing calming properties. Sometimes it won't. It's worth a shot while you're waiting for risk management to light a fire under administration, the docs, the discharge planner, and everybody else who is obstructing your ability to do your job and get these guys treatment that is appropriate to their illness and that will allow them to be placed.

Jo Dirt · Mar 20, 2006

Just a thought ...what if all the RN's on this unit...CNA's too refused to accept these pt's??? Mgmnt would be forced to deal with it then. I am not a nurse yet, but just trying to think of ways to help. Good luck

That family needs to see some of this that's going on. If they still keep with that attitude they should start looking for another facility where the staff are all masochists.

I was helping a CNA to reposition a patient yesterday and with these long manicured nails she reaches out and gouges our arms. I've still got my gouges, I'm sure the aide has hers.

Blackcat99 · Mar 20, 2006

At the nursing home where I use to work there was this one particularly strong violent male patient. It took lots and lots of documentation and staff injuries but finally something was done. He was removed from the nursing home and placed into the state psychiatric hospital. Many state hospitals have geriatric/psychiatric units and this is where violent patients should be placed if necessary.

ladylynx · Mar 21, 2006

For some reason many of us seem to forget about a "law" that exists outside the workplace. If someone hit you outside of home, criminal charges would be filed immediately. You might want to seek the advice of a legal representative, including risk management. To many nurses are on disability due to workplace violence by patients. Many facilities are teaching self defense...if it is you vs. the patient...run and get security and/or police help. If the family is refusing, then they should be sued for damages. We still live in America, abuse is never acceptable.

Peace and love...nothing less!

Cathy

So for the last two days I have worked with two different demented elderly gents at a local hospital. Both are very demented, neither can get placement outside the hospital because they are combative...and it seems the Doc's and Family members are going 100% against us nurses and CNA's that must care for them!
First day I got hit very hard in the right temple by one of the patients...I thought I was out of arms reach..but he was trying to get out of bed, and it was between me and the floor for him...LUCKY for me he had mittens on because he keeps pulling out his foley and his iv's so now we have a picc that must be protected...NOT THE STAFF..but the picc! UHGGGG~! Then a discharge planner chewed me out for the mittens saying "he will never be discharged if you guys don't let him free of the mitts! (remember..just mits, not tied down or restrained!). I explained that it was to protect the picc and foley and at discharge would not be needed since those should be d/c'd by then....she said point blank "yeah right, you guys are just tired of getting hit!".
Okay...even if that was the case...why not be tired of getting hit..he is a huge very strong man!
Second patient....no mits no nothing. Family wants him free of medication so no prn or any meds to stop him from constantly getting oob, or spitting/hitting/grabbing...and yesterday he aimed himself and peed on my CNA!!!!!!(he is MRSA precautions in urine!!!). I came in to stop him (while my other patient was starting to stroke!!!!) and both the CNA and I got our butts kicked royally!!!!!!! She had bruises all over her arms and sides...I had several on my arms and one on my left cheek!
So I called the MD and begged her to help us with some PRN medication. NO GO! "no, the family doesn't not want medications for him...they say he has a reaction to all medications". I almost said "well I will tell you for darn sure he is going to have a bad reaction from me next time he hurts me!!!" but I didn't! After begging...I got to give 10 mg of a med IM...which worked thank GOD!
I bring both these cases up to RN management...and got a huge lecture on chemical and physical restraints (like I don't already know that and quote the book better!)...and that they were sorry and not to accept that patient again if I couldn't handle him. HANDLE HIM??? I can handle patients quite well thank you...but how to you handle someone that is demented and wants to hit/spit/scratch/grab/urinate/throw feces/wants OOB/ and I can't use any type of restraint to protect myself and staff? It is like saying..okay box this kangeroo with your arms tied, legs bound, and blindfold please!
I know others have had the same experience...what did you do to try to solve it???? THe two men are actually quite nice when they are with it...and I do care for them deeply and they are sweet..but when they are demented they forget they like me and I am helping them and start swinging!!!!!