Getting hit!

I am not yet a nurse, but I would report every incident to upper management. If nothing is done, I would let the management, doctors and families know they will have to take care of the patients themselves.

Futurenurse...little advise here for when you become a nurse. Never tell a doc or management "take care of the pt yourself", or anything like that. The reason, you accepted the patient and it is your patient for the next 8-12 hours (dependant) and they will be most happy to remind you of that...uhgggggg! If you even mention that you can get abandoment charges if someone wanted to teach you a lesson...Not to mention you will get one heck of a bad rap with folks. I am not dissing you...I felt the same way big time...and really wanted to...but uhggggg rock and hard place kinda deal.

Nope, once accepted you get that patient for your shift. I accepted him, so I had to deal. Sadly I got hurt despite trying hard not to...but still provided care for a man that couldn't do it for himself...that is my goal and pleasure being a nurse.

I was candid with the Doc when she came up and assessed the PT. I basically stroked her ego by telling her that the IM injection (I talked her into) was very effective for the first 2 hours...Then showed her what we did to try to quell things (which she thought was great)...and then did say "well...I did in some dark horrid place in my mind hope he would act out so you could see it...I mean...diagnostically speaking of course!"

Thank Goodness this Doc and I are on good standings and she laughed..."I bet you do! And everyone else here too! LOL!". Then she looked over the CNA to make sure she was okay and sent her to ER for wound cleaning since the patient threw that MRSA tainted pee on her".

So basically I let the MD know...one, good job on helping (even though it was far little)..two here is what we did (helps with any questions that we nurses are being "lazy" or slacking...which some Docs feel that sadly)...and three, letting the MD know how it felt (this differs in communication styles between MD's...tread carefully!).

With family...I tried...got them in for 4 hours of the shift and the patient did much better. But most families work or have children and tending to a loved on all day isn't possible for them..that is just a reality we get to live with (or the ones that simply won't). So I try hard to work with family schedules the best I can while being direct about the situation. Sometimes I am lucky and can get a one on one in the room (dependant on scheduling)...and can try to organize having a one on one, family, then me.

And yes...always report these things and document document document!!!!!

yeah, used to do this on night shift with diaper changes on a violent pt. I would open the bed from the bottom, not the top, so the blankets were laying on her arms while I did a speedy change, and them would pull them down quickly when I was done. the advantage was she did not get as cold, she couldnt find her arms fast enough to hit or pinch or scratch, and she would actually thank me when I was done. Go figure. Hope this was legal!

TriageRN from all that you have done to try and help this man you sound like an awesome nurse.

I'm not a nurse, but I am a CNA on a dementia unit so my ideas might not be quite right.

You seem to have taken a good approach talking to the family about meds, that dementia is a disease that needs treatment just like any other. Have you maybe tried to explain what is going through his mind. The fear and loss of freedom he must feel from being confined to a bed all day long. Chances are he doesn't understand that he's sick in a hospital and needs to stay in bed for safety reasons. Maybe talk to them about a PRN stressing that once he's in an environment where there is structure and he has the ability to wander that his behaviors may change so he doesn't need medication.

It's hard for people to understand what maybe going through the mind of someone with dementia and the fears that they face. So I would definately try to stress things from his perspective.

TriageRN from all that you have done to try and help this man you sound like an awesome nurse.

I'm not a nurse, but I am a CNA on a dementia unit so my ideas might not be quite right.

You seem to have taken a good approach talking to the family about meds, that dementia is a disease that needs treatment just like any other. Have you maybe tried to explain what is going through his mind. The fear and loss of freedom he must feel from being confined to a bed all day long. Chances are he doesn't understand that he's sick in a hospital and needs to stay in bed for safety reasons. Maybe talk to them about a PRN stressing that once he's in an environment where there is structure and he has the ability to wander that his behaviors may change so he doesn't need medication.

It's hard for people to understand what maybe going through the mind of someone with dementia and the fears that they face. So I would definately try to stress things from his perspective.

I think you suggesting a very wise approach.

I agree. Any family refusing to medicate a combative patient but have their butt in the chair next to the bed 24/7!!!!

I got hit by an elderly, demented patient. Then he proceeded to enter the elevator, tell me he was leaving, and walked around the hospital, and to the end of the street. I called security, they were with me, and proceeded to call the local police dept. The elderly man became very SOB, (with the dx of CHF and COPD), and physically had to stop walking. We got a wheelchair, wheeled him back to the room. The police asked me if I wanted to press charges! The family then came, and the police said legally I could press charges for battery, and the power of attorney would also be held liable. Info I didn't know.....The family took action quickly to talk to the physician for behavorial management issues. Of course, I didn't press charges, and wouldn't. It only took one time for me to get hit, now I am more aware, better assessing dementia associated with hostility, and calling hospital security, if needed, to be with me all day, entering the patients room. I am not willing to be beat up, and it is the hospital's responsibility, as an employer, to protect the employees.

I feel your pain, although I am not a nurse yet i will be one soon and i work in a nursing home and get hit bad all the time. I just went to a conference and they had some videos that they were showing that showed you how to avoid getting hit when someone was attacking you, basically the idea of ducking before the punch with out actually ducking. Check with your DON or your admin for some ideas. I hope you can find a peaceful solution to your problem. Good luck!

I had worked with a few alzheimer's patients that would get very out of hand also. Again, family refused to have any medication administered. The nurse that I had worked with would call the family members and have them come in to see if they could calm the patient down. Sometimes it worked, but sometimes not. Eventually, after the family had been called very frequently, and saw the behaviors (that they didn't beleive in the first place), they finally agreed to the use of prn meds.

On my floor we have been getting alot of dementia elderly, combative patients. Just the other day we had a gentleman start that nonsense, kicking and biting and what not. We porceded to call security who put him in 4 point restrains after taking him down. We are not expected to handle 250lb plus old men who are punching us, dementia or not. If anyone gets hurt, its a big deal. We restrain, then call md. If he as a problem with that we invite him to babysit the pt. If we have to call security and the md doesn't want to cooperate, it goes over his head. restraints are not to be used lightly, but no one gets abused where I am, NOBODY.

:angryfire I bet the family that is very particular about how YOU take care of dad is the one that never lifts a finger to help him themselves. They would freak out at the sight or smell of poop and don't want to know that he pees too. They are so particular about how you do your job because the very same things making them guilty. They think that you are being paid, so they bought you.

Girls you don't have to take that crap.

Problem with nursing is that it is a woman's job and people are used to giving **** to women and women are used to taking it. Think REFUSE! There are other jobs, other places.

Where I work, they always try to give you an eighth patient, and those nurses who don't complain end up getting them. I always refuse, be nasty about even anyone offering me an eighth patient and no one dares offer me one.

I would rather lose the job than the license. After refusing a couple of times and getting sent home, they have realized they cannot do that to me. So they even don't ask me.

I would call Osha/Jcaho/lawyer/safe harbor whatever applies to your case. Remember DOCUMENT! DOCUMENT! DOCUMENT!

Make photocopies of all correspondence. Ask them to give you all communication in writing.

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