Pt threw a bedpan...

In a facility I'd follow my employer's policy for patient violence and potential exposure. Report to my director and MD, incident report..

In my home health position I would do the above, also make a referral to APS and discharge the patient.

Well that entirely depends on the pt's complaint and acuity because you have to take more than the action into account. The main factor is whether or not the pt is mentally equipped at that moment to understand what they are doing.

A fully independent dental pain patient? Buh-bye! Security will be escorting you out.

A septic/delirious patient? Even more so with an demented total care patient.

In this case, the patient is alert/oriented, but what is complaint and the acuity of their condition?

Code grey! At no point is that ok. No rational person would have done that. Code grey cause clearly she needs to be evaluated.

My immediate response in the presence of the patient would be to show a lot of concern for the tech and not focus a lot of attention at the patient at that moment. Take care of the tech first and foremost.

Second, I would do as Libby1987 above suggested, and follow my employer's protocol on violence and exposure. This is a violent act, and should be treated as such.

What would be your response if a pt threw a bedpan with feces in it at the tech working with you? Pt has bipolar disease but takes medicine. Alert and oriented. Seems to be able to control her actions at other times apologetic afterwards --/- just wondering

At my facility, the policy is to call security, call the doctor and pos. psych consult. If patient isn't alert and oriented, security will help keep patient safe until md can be called and order gotten. If pt is alert and oriented, security will explain rules to pt, and keep staff safe while md is called and orders gotten. Most times, psych gets involved.

Edited because: I really can spell alert!

Flying feces might qualify as a tornado.

We still refer to them as code browns. Would that be a flying code brown?

Flying code brown-- that is too funny. This did not happen to me but another nurse/tech. This pt absolutely knows what is going on.

I think I would have called security too. I don't know what our policy is for something like this. I'm going to check though

Code gray is combative person.

If an A&O patient threw that at me or a coworker I'd have trouble not reacting like I do with a dog who poops in the house. I'm a great believer in rubbing their noses in it to prevent repeats. At the very least I'd tell the tech, in front of the patient, that they are not to return to that room.

I would treat this as a psychiatric emergency and call the code for a violent out of control person, notify the MD and probably pull an AMA form for the pt to sign if appropriate and the pt was medically stable..

I might ask for a transfer to psych and complete the Emergency petition for a psych eval if the pt was in a manic or psychotic state. If he was, I see an IM injection of Zyprexa or Geodon or some other serious psych meds in his future and I would insist on a sitter who is not a female CNA , to deter further violent behavior and ensure the safety of the staff..

I would notify the next of kin just to keep them apprised of the situation.

No one would have to go in that room alone. I would remove anything that the pt could use as a weapon, projectile, or to be self destructive. If he wants to act like a crazy person, I would treat him like a crazy person. He would get the styrofoam suicide precautions trays with plastic utensils. I would not hesitate to put this person in restraints if needed.

A transfer to psych and meds for severe agitation or an AMA discharge would be in order. Your call.

Sounds like attention-seeking behavior. Boundaries need to be set and charges brought against the patient. Absolutely not acceptable period.