i am am a new nurse. I've been working in long term care for about a year. I am currently working in an assisted living facility. I have an incredibly aggressive dementia patient whom which I am having a very difficult time controlling. The patient is very mobile. They can dress them self and feed them self. In the morning to early afternoon, my patient is very calm, but about an hour after lunch becomes very aggressive. The patient begins with asking the same question multiple times. Like "how would I go about getting to giant eagle". Next, they patient becomes paranoid. We have the patients hearing aid charger in our nurses station. The patient will come in and say "that has my name on it, you stole it from me". Next the patient begins tearful saying that they want to go home. And "why am I here I can take care of myself". I do my best to distract them. But unfortunately the distraction only lasts for about 5 minutes and the patient is back at it again. The facility is small. So only one nurse is onl duty at a time. So, with 40 some patients, I don't have the time to distract the patient every five minutes. After a couple hours of distracting, the patient becomes aggressive. Yelling at the patient and staff that they need to go home. Requesting to call the daughter. Which, if I have time, I call the daughter. And as I'm telling the daughter what's going on before handing over the phone, the patient is yelling "it's me! She won't let me talk to you!" Finally, the real problem is the end of the day. When the patient starts standing by th door saying that they are going to leave. Our doors must be held down for 15 seconds before they open (without a code) and then the door opens and an alarm goes off. My fear is that my patient will hold the door down long enough and get out. I know the elopement protocol. But I don't know what to do with my actual patient when they get out. Everyone says "well try to coerce them to come back inside". But with this patient it's impossible. Am I supposed to call 911 and follow the patient down the street until they show up? But then I'd be neglecting my other 40 some patients. I'm not allowed to touch the patient and physically carry them back in. What am I supposed to do if they get out and I witness it? Follow my patient or no?
