How do you handle that "crazy" patient?

Long Term Care Columnist / Guide · Dec 11, 2004

Psych consult, STAT!! :chuckle

Just be sure to document every encounter with this patient, what she says and does, as well as your nursing care. And yes, if not already done, you'll want to ask her attending about a mental health eval.

Good luck with this patient........she's like a loaded gun with a hair trigger.

DutchgirlRN, ASN, RN · Dec 11, 2004

Psych consult, STAT!! :chuckle
Just be sure to document every encounter with this patient, what she says and does, as well as your nursing care. And yes, if not already done, you'll want to ask her attending about a mental health eval.
Good luck with this patient........she's like a loaded gun with a hair trigger.

Very good advice. Thanks! I do believe a psyche eval has been ordered. I heard her talking on the phone. " you know how it is when people think you're crazy but you know you're not, that's how I feel" Her labs show her dig toxic and she's not on dig. She is on Mepergan, Xanax, Lortab, Oxycotin. That would be enough right there to make me crazy!:rotfl:

Pattiecake · Dec 11, 2004

Very good advice. Thanks! I do believe a psyche eval has been ordered. I heard her talking on the phone. " you know how it is when people think you're crazy but you know you're not, that's how I feel" Her labs show her dig toxic and she's not on dig. She is on Mepergan, Xanax, Lortab, Oxycotin. That would be enough right there to make me crazy!:rotfl:

Sounds like someone has taken one of her "goodies" and switchd it for dig. I guess there's another one just like her rattling around out there.

**canoehead, BSN, RN** · Dec 11, 2004

When someoen threatens me with a lawsuit, or to go to my boss, I always say, "that's your right, but we still need to....." Makes the threat a nonissue as far as manipulation goes.

Pattiecake · Dec 11, 2004

When someoen threatens me with a lawsuit, or to go to my boss, I always say, "that's your right, but we still need to....." Makes the threat a nonissue as far as manipulation goes.

To tell the truth, working in a prison, it seems every other inmate says he is going to sue for whatever way you look at him, or whatever it is he wants and doesn't have. Been there 4 years. Nobody has sued. As long as the nurse conducts him/herself professionally, and follows the MD orders, what is there to sue about?

Nurse Ratched, RN · Dec 11, 2004

Had a family member take my name today over the phone because I wouldn't give information on patient, saying she wanted to know specifically who to complain about. (Gimme a break lady, at least spell "HIPAA" correctly when you tell them WHY I wouldnt give info .)

I do grow weary of being threatened with lawsuits over silliness.

MandyInMS · Dec 11, 2004

Seems this time of year the 'nuts' are running rampant..ughhh :/

Guess it depends on what mood I'm in @ the time how I handle it..some days I just try to suck it up...others, when I've HAD IT , I suggest they discuss their concerns with the MD giving them paper and pen to be sure they don't forget anything...or offer them an AMA sheet, explaining that if they are that unhappy with the services we provide that there are no bars on the doors and are free to go elsewhere for care (said in a very nice way of course )

barefootlady, ADN, RN · Dec 12, 2004

I once had a patient, a man with a history of drug abuse and psych problems, not taking meds and so forth. He had a mediport for long term antibiotic therapy d/t other issues. He was ordered a antibiotic bid, he was always complaining about his line or something. I was assigned to care for him, went in to check him, he had removed his needle during the night, said it was not easy to sleep with it in, when I told him he could not do that, it was not safe, he told me he had been doing it for days and no one had said a word to him. He reported me to the charge nurse for not knowing my job. I smiled and told her I would not accept responsibility for him and she would have to take care of him. After a day, he was put on po antibiotics and released 2 days later. I guess when he was made a supervisory problem it was time to ship him out the door.

rngreenhorn · Dec 12, 2004

3mg IV push of Ativan

Mystery5 · Dec 14, 2004

I've had a pt call 911, I've had a severly paranoid delusional guy railing on all night about a government conspiracy and the bible code, I've had a nacsisistic anorexic gal who comes in and is obsessed with taking baths many times a day.

Last night I had a 25 yr old ETOH-er with pancratitis and other psyche problems who started getting paranoid and hallucenating on days. At 0100 I got a call from his mother (quite an enabler in our estimation) who said that he had called reporting that there were tarantulas all over the ceiling and walls of his room. I went and brought him up to the nurses station and called her back. She sounded very stressed so I invited her to come on in, which she did most gratefully. It sure was a Godsend for me!

Stitchie · Dec 14, 2004

Sometimes, I swear, I'm going to invent an Ativan dart gun and just aim it at the people (staff, docs, patients, families, myself) who are driving me nuts.

Sometimes all I can think with one of those screaming/drunk/ lunatic ER patients is "there but for the grace of God go I" and then I wish I had my trusty Ativan aiming device.

But wouldn't work be boring without the nuts?