So this is my first post on here but I NEED advice from other nurses and cannot discuss with coworkers.
I am a LPN charge nurse on an inpatient behavioral unit for LTC. Most of my patients are dementia, schizoaffective, schizophrenic or bipolar. Please keep in mind, we are LTC and not "total psych" therefore we do not use restraints or administer psych meds IM/SC to combative patients.
On my unit, a patient dx "dementia with behavioral disturbances" was due her scheduled Trazodone. I approached her in a calm manner per usual, as she is known to get violent (but never with me). Upon telling her it was time for meds crouched down at her level, she proceeded to punch me 3 times (neck, shoulder, forearm). She's 90-something, but this woman was like Muhammed Ali.
Now I step away from her calmly, and she throws water on me. Again, this is part of her dx (ie: behavioral disturbances). I am not hurt, nor angry. But I do need to report her increased agitation to my supervisor, which I do. Her only PRN is Trazodone 25mg, which I had to wait to give her once she calmed down (my supervisor gave it along with her scheduled meds).
Per protocol, I filled out an incident report, contacted the psych PA, updated the family, etc etc. You nurses all know the protocol, it's fairly cut and dry. My supervisor contacted our DON, who stated NOT to call the police or send her to the ER. Strange...but I went on with my night, thinking psych would see her in the AM.
Patient was not seen by psych in the AM, as they only come to the building 3x/week (unbeknowst to me, as I work 3-11pm). On this shift, this same patient calmy walked by another patient who was dozing in his wheelchair and punched him unprovoked in his arm.
I fill out another incident report, this is much more serious, as it is patient-to-patient. Luckily, she did not hit him hard enough to arouse him, but this behavior cannot be ignored. My DON again tells the supervisor NOT to call the police. Really??? This patient was started on Divalproex 250mg PO BID the next morning by psych, FYI.
A few days later, my DON sits down to talk to me. He is condescending, asking me "why did you allow her to hit you THREE times" "why didn't you give her the PRN right away" (hello, she hit me because she didn't want her scheduled meds! Not looking to get punched a fourth time!), "Why did you let her throw water on you" and ended it with "you know, it's a shame this patient ended up on another med because you cannot handle your unit"
My DON then tried to get me to change my statement about the incident of this patient hitting another patient, stating the CNA who witnessed changed her statement to say she was just trying to get the dozing patients attention. She is a per diem CNA & doesn't have a nursing license to uphold, first of all. I clearly saw this patient hit him in anger and I refused to change my statment.
I was outraged. This patient has been a repeat offender of violent behavior on every unit in the building. She was moved to my unit a year ago for this reason. I refused to change my statement, so the DON had to call the police to file a report. Fast forward a week...
I had asked for Halloween off for a bachelorette party 8 weeks in advance. I was told the Monday before Halloween "the DON denied your day off. He said you should have found your own coverage." This information about "finding your own coverage" is NOWHERE in the employee handbook. I have tons of vacation time to use. Halloween is not considered a holiday at work. I am not upset the patient hit me, as this is unfortunately a behavior thanks to her dx. However, I am upset with how my DON treated me.
I feel as though I am being chastised for doing my job as a mandatory reporter, and now having vacation time denied that I deserve. I have NEVER asked for a day off at this job before, as I've only been there 8 months. I work a lot of OT too.
He is such a snake I am scared to report him to our central HR. I feel like he will somehow figure out a way to fire me, although I have no write ups or disciplinary actions on file.
Thoughts on how to proceed or what to do?! Help!!!
