terry8025

I can't remember the exact number since it was in 1996 but I have seen a BP around what you describe. This was an ER patient. The MD and a team of nurses were actively treating the patient. That's about all I remember.

That is very interesting. There is a significant difference between a precise death threat such as this and the "normal" cursing we all experience from time to time. Is the Resident physically able to attack you in the parking lot? Is this a secure unit? You must first consider this. If the unit is not secure and the Resident is able to carry out the threat then your first concer should be safety and this should be addressed by management. After security is ensured I would then reconsider the psychiatric diagnoses. It is not rational to make such a precise threat so it is possible they have something else going on there. Good luck and keep trying but be safe.

All patients/residents have "a reason to act this way". I do not say this to justify their actions but in the hopes that you, and others, will develop a little more empathy towards all of our Residents. They are going through a difficult period in their lives and many of them, even those without a psychiatrical diagnoses, have never had a need to develop adequate coping skills. They are now coping in the best way they can. That being said you absolutely deserve a work enviornment free from abuse but often, as nurses, we fail to recognize that we participate in the creation of the culture within our communities. In reading your posts it seems to me that the true problem here is an adversarial relationship between the direct care staff and management. I sense this only because you mention that the problem has persisted and "they" do not take action. I remind everyone that as the patient advocate it is up to us to take action. In a sense "we" are "they". I saw some good recommendations for psyche evals and such. I think this should be your course of action rather than just looking for a new job as others mentioned. Just remember that psyche also includes psycholgy, not just psychiatry and medication. It is entirely possible that a counselor can help the Resident develop better coping skills and move past this difficult time in their life with a bit more ease. In your defense I agree that you should accurately document the behaviors/symptoms as you describe but remember that you are doing it to help communicate to the team an accurate description so the Resident can receive proper treatment. You are not doing it to show management what they need to correct. It is, afterall, completely about the Resident and how we can help them. You are a good caring nurse. That shows because you took the time to ask for help and to document accurately so please do not take this response as ill towards you in any way. I would not have responded to your post alone but after reading the many others responses, coupled wth your posts, I thought I would share my perspective in the hopes of directing us back to the Resident's needs. Thanks for understanding.