Thank you all for the thoughtful replies! I see this is a problem that is only getting bigger!
As for dementia issues, in particular Alzheimer's disease, I have a passion for geriatrics partly due to caring for those with this horrible disease. As disturbing as the thought processes can be, generally there are tried-and-true methods that work in caring for this population. When you throw in the residents whom nobody else will take who have a long history of schizophophrenia, bipolar, etc., this is what I'm wondering, why us? And in my psych clinicals, we had plenty of staff (that would be ME who's called if a problem where I work!), we had the use of restraints (in AL restraints are not allowed), meds (already beaten up by the time connect all the dots get meds), and seclusion rooms if necessary (maybe the nursing office in AL!?). It just seems that we who are being dumped on with psych cases are the most vulnerable. While we do have psych services and meds (IF the family signs on and agrees to both), it's truly a far cry from the kind of intervention these poor residents need. Those I've tried sending to ER with psych-related issues almost always get sent back with dx dehydration or something, not even having been seen by psych. In the case of this resident who hit me, the DAY BEFORE, we sent her to the ER because she was out and about damaging items and required 3 staff members to keep her from hurting others. She returned to our facility a few hours later, with her family fuming mad that we'd sent her out, as if why??? That next morning, my incident, I did a prn med, she woke up a few hours later, saw Doc, and sent to a different ER the other side of town. I mean, the little old ladies and gentlemen looking for a retirement community, I didn't really have time to appropriately provide for them...that's what gets me too. And for the advice of brushing up on my psych, yes thanks doing that, and also sent a Christmas email to our psychologist, wished the Psych NP Merry Christmas by phone,...:) trying to keep warm relationship because we NEED their help. I'm also looking at my career goals, as I want to be a Geriatric NP, but I may want to lean more Psych NP for a secure job.