Maybe some of you ER nurses have experienced something like this. I had a patient for 2 days. She was an asthmatic in her 40s whom I received from ER intubated, with a hx of previous intubations and a social history of chaotic and non-compliant personal life. Her drug screen was also postive for methamphetimine. She was put on the vent.
She required quite a bit of sedation, and became extremely agitated if not snowed. Her lung compliance numbers looked good the next morning and she responded well to her frequent nebs, so we extubated her on the morning of my second day of having her.
Upon being extubated, she proceeded to unlease the worst verbal abuse and profanity I have ever heard, and acted like a woman in need of an exorcism. Eventually the doctor ordered a Mental Health eval. She continued to behave like an irrational maniac and threw a full cup of hot coffee at the MHP woman, who ran out of the room covered with coffee. We don't have security at my small hospital. I was advised to call 911. Two police officers came and the patient continued to act in total defiance of them and they were forced to subdue the patient with double handcuffs.
This was a high drama and continued on for a couple of hours, as we tried to figure out what to do. Finally a second MHP fellow came and got the patient to co operate and she was released with a safety plan to the care of some disreputable looking friends, who she also was verbally abusing. Before I could give discharge instructions and make sure her other IV was out (She had DC'd one of her IVs) she walked out of her room, making a scene as she walked outside yelling at her friends and cursing.
I had to fill out a police witness report. The patient showed up 2 1/2 hrs later to have her IV removed. She was feeling much better, most likely after dosing herself with meth.
My coworker and I joked that we needed to call a priest to purify the room with holy water, the patient did seem as if she were possessed by a demon.
