Our inappropriate frequent flyer

[TazziRN, RN]

He came in again yesterday. He made another attempt with her but didn't get away with it. We told the house supe and she brought it up with his PMD when he came in for rounds. He was stunned about the harassment, had no idea it was going on. (I believe him, he's the kind that would have reamed him out long ago had he known.) He's got a plan in mind but it would involved the ER chief to make sure all the docs are on the same page, because if one doc refuses to go along, it won't work. Keep your fingers crossed, please!!

[rn/writer, RN]

So glad you are all trying to be proactive. What's the plan?

[TazziRN, RN]

His PMD (who happens to be mine also, BTW...he was shocked when I said the pt has tried to kiss me!), suggested that when his complaint in triage is non-urgent or even low-level urgent, that the ER doc be called to the triage room to do an MSE, that most of the time we could probably have him screened and discharged from the triage room. The pt behaves himself until there's a reason for him to undress. Yesterday he requested his injection in the thigh because his glutes have a lot of scar tissue. No problem....except he tried to insist on pulling down his shorts too. My teammate just told him to pull his shorts back up or he wouldn't be medicated.

The doc's plan won't work, though, unless all the ER docs agree to do this. If even one refuses to follow this plan then it's no good.

[MultipurposeRN]

have they thought about getting a psyche eval for this guy? Have you thought of filing stalking charges?

[Antikigirl, ASN, RN]

Tweety...my best wishes there! I think I would have him cross his arms on his chest "for safety" and not let him pull his own pants down...maybe that can come in handy. I would also tell him how far down the pants will go an not a cm further and do just that! Have another nurse in the room at all times as well for safety purposes!

Also, if you can have someone ask questions, and while he is busy answering get a shot in .

Hey, has a social worker come in and talked to him on how to handle his 'medical probelms' in home? (of course never having a nurse or caregiver come in his home...oh lordie!). But like an outpatient deal where if he is in need he has a number to call and go through? That may be helpful to triage before he comes in?

[meownsmile, BSN, RN]

Nothing says that shot cant be given through his pants. Id just have him keep them where they are and give it through the pant leg.

[HyperRNRachel]

Why not give the shot in his arm. Pants stay on.

[TazziRN, RN]

Why not give the shot in his arm. Pants stay on.

More than 0.5ml is not recommended for the arm. If it's a good-sized person and s/he requests, I will give up to 1 ml in the arm if it's not caustic, but this guy is pretty small and we're talking 2 ml.

Multi, he's not stalking, h's sexually harassing us. Problem is, each incident is subtle enough that if something were said, he could have a reason to say we misunderstood....never mind the fact that it's happened to staff in every single unit of the hospital. We never said anything officially because it's harder to deal with a "he said/she said" issue. It's only been recently that we all realized that he's done this to everyone.

[HyperRNRachel]

Can a male nurse be assigned to the patient?

[TazziRN, RN]

If there's one working. We only have 2 RNs and a tech on at any one time in the ER. The visit before yesterday's, we all refused to medicate him (he's fine with PO meds, but if there's a reason to undress he goes overboard, among doing other things). The house supe called the urgent care across the parking lot that the hospital owns and had their male MA come and medicate him for us. Pt got P***ED!!!

[snowfreeze, BSN, RN]

Document and always assess and treat with another nurse present. File a complain and develop a protocol for all staff to follow with this and other simular patients.

[MS._Jen_RN, ASN, RN]

If there's one working. We only have 2 RNs and a tech on at any one time in the ER. The visit before yesterday's, we all refused to medicate him (he's fine with PO meds, but if there's a reason to undress he goes overboard, among doing other things). The house supe called the urgent care across the parking lot that the hospital owns and had their male MA come and medicate him for us. Pt got P***ED!!!

Why can' t the MD medicate? I know ours would if we told them what was up. They'd be happy to stick someone who had behaved in that manner toward any of us.

~Jen