I Feel Like a Bad Nurse: Alzheimer's/Combative Patients

[Tait]

I feel like a bad nurse.

I feel like I am not doing the best by my patients, those of confused/combative/Alzheimer's/dimentia status.

I don't want to go into any details about my patient care, but I find myself anxious lately about taking care of combative patients. Now some of you are probably thinking "well duh, combative patients suck". However this hasn't always been the case with me.

I have had many families tell me I have the "patience of Job" with their families, but lately it just seems like I can't manage combative patients.

Last night a patient started grabbing me when I was attempting to recheck her BP. I looked at her sternly, like you tell a child, and told her not to grab me. Another patients family member walked by and overheard me reprimand the woman and I felt like I was about two inches tall.

The patient did stop hitting me, for a second, but I just can't shake the feeling I am losing patience.

I try to look at them and think of them as they might have been, I try to be calm, smiley, and agree with whatever tangent they are on, but I seem to lose compassion quickly when someone hits me, or tells me I killed their family (like last week).

Maybe I am just worn out this month since it seems the floor is littered with combative patients.

I am not really looking for support or sympathy.

I just don't know some days if I am beating myself up, or letting go of my compassion...which scares me to no end.

Tait

[LDunfield]

I have to thank you... I have been dealing with a couple combative residents at the nursing home I currently work at. Today one of my residents fell, and hit her head. Part of our protocol when someone falls and hits their head is to do neuro checks. Well part of that is getting vitals q15 min x4, then q30 minx4, etc... well this resident had been refusing to have her vitals checked. She had been reproached numerous times and kept refusing. I decided that this time I would have an aide take her BP and I would talk her through it, and distract her. This resident immediately got combative, I tried asking her questions about her family, her past, and just about her. She kept saying that it was none of my business asking these questions and to stop. She was hitting, and kicking, me. We did end up getting her BP, and when I was getting her sweater back on her she reached up and slapped me. I grabbed her wrist and sternly told her NO, that it is not ok to hit. She then head butted me. I reached up and moved her head away from mine to prevent her from doing it again. At this point another nurse suggested that I walk away. I was done with her anyway so I did. I then also went on my lunch break. Well apparently the other nurse only saw me reach up and move her head back because when I came back from lunch, I had a call from my DON telling me I was suspended pending investigation of abuse. I have been very upset about this because I would NEVER hit anyone. I feel that I was acting out of self defense, considering that she had head butted me and had been hitting and kicking me.

I have had residents, hit, and scratch me to a point that I had blood dripping down my wrist, and I didn't hit back. I have been slapped across the face and called abusive names and I haven't retaliated. I am almost always calm and collected, and when I get frustrated I walk away and go cry in a storage room. I never take it out on the resident.

The posts on this thread have helped me realize that I'm not the only one dealing with a situation like this, and I now have new ideas and tools on how to deal with the combative residents I have.

Thanks

Laura