Gut Feelings...

[Meerkat]

Do any of you get 'gut feelings' on patients, and even though you have no hard evidence, you make clinical decisions based on your hunch?

Here's my thing: Last night I had an ex-prisoner drug addict as a patient. Said "I just want to kill people. I can't help it I want to go back to jail'. Yes, this is a locked ward. He is psychotic. No, I don't feel safe on the unit, but my other concern is that we have some frail, confused old ladies on the same locked unit! One is so confused she has wandered into others' rooms several times. I have a bad, bad feeling about these two types of patients on the floor together. House super won't HEAR of changing rooms.

What can I do? I fear the someone is going to get hurt. And they let visitors visit on behind the locked doors. They have no idea there is a homocidal patient on the unit with their little grandmas.

I'm guessing that the docs feel like his psychosis is under control, or that we can tackle him fast enough if tries something. If this patient loses it during a psychotic episode, and hurts one of these defenseless old ladies, is there personal liability on my part as the nurse (knowing he is violent). (Don't get me wrong, I'm not just thinking about my license here).

Last night my stomach was churning all night and I was on edge. Thanksfully the ex prisoner was calm and cooperative (although he did expose himself to me). But I'm 5'4" and 127 pounds---not much I can do if he decides to go homocidal!