Pt threw a bedpan...

Red Kryptonite · Mar 20, 2015

Oh good lord....Thank you for explaining it that way. I don't know WHY this confuses me so much. I remember having a really hard time with it in psych, too. It's a processing thing, i'm sure.

When we discussed positive and negative symptoms of schizophrenia in class, this confused many of my classmates too. Positive symptoms are things that are added, like hallucinations or delusions. Negative symptoms are the ones that take something away, like flat affect or poverty of speech. Think of it like that.

Nola009 · Mar 20, 2015

I would call the police or at the very least, security.Then I would probably get an order for haldol.

classicdame, MSN, EdD · Mar 20, 2015

notify facility authorities, even if tech does not. Consider suing the idiot for assault and battery

Kooky Korky, BSN, RN · Apr 5, 2015

I was assaulted by a patient who assaulted staff before me and after me. He was not a psych patient but he was allowed to continue his behaviour without consequence. At no stage was he medicated or restrained or charged. I was left with injuries that required surgery and I now suffer chronic pain. The worst thing was the ordeal that I had to experience to claim workers compensation. That was just as traumatic. So you;ll have to forgive me if I seem quick to shut violent situations down before anyone is left with life altering injuries.

I hope you have an attorney and go after the hospital, the doctors, your managers, etc. None of them gave a hoot about your safety and well-being. They need to learn respect for you and for staff in general.

jadelpn, LPN, EMT-B · Apr 5, 2015

Omg. I just wrote a long reply and lost it all!!
I dont have much else to say about pt. pt is in acute care, extended stay r/t placement issues. Most interactions involve cursing at staff. Psych has been involved but I'm not sure of outcome
Pt was angry at response time from tech. Tech was in alone and she wisely chose to leave room when pt threw bedpan i do not know what the nurse said to pt, if anything
Ive never had this kind of incident happen to me and wanted to hear whT others have to say
Not much at all was said on my shift.
Thanks to all responders

This may seem like a dumb question, but why in the world is this patient using a bedpan? Can they not walk to bathroom? Can they not get up to a bedside commode? If the patient is awaiting placement, no time like the present to get some PT and OT while they are waiting. I am not sure that many long term skilled facilities or nursing homes run about putting bedpans under patients.

If anger is an issue, and the patient declines getting out of bed, then a visit from social work to begin working on anger management would also be a thought.

This patient may be mentally ill, but seemingly needs some further behavioral modification assistance.

Gooselady, BSN, RN · Apr 5, 2015

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

Dive to the side!

Actually, this exact situation happened, only it was the nurse manager who got hit. The patient, a young, pregnant bipolar girl, didn't throw the bedpan, she just picked up her firm feces out of it and lobbed it at us, and hit the nurse manager in the center of his chest. It made a loud wet *smack* and then slid off onto the floor (missed his shoes). I was standing to his right, about seven or eight inches away.

We couldn't medicate her (due to her pregnancy), and so we pulled back, put on plastic kitchen aprons and face shields, and re-entered as a show of force, placing what limbs weren't in restraints back into them. I think she was in 2 points at the time she used the bedpan, and ended up in 5 points.

What can you do? She couldn't help what she was doing, and we couldn't 'help her' with Lithium or any other available mood stabilizers.

RubicsCube · Apr 5, 2015

Charges should be filed for any assault, mental illness or not

proud nurse, BSN, RN · Apr 5, 2015

Gooselady,

Perhaps I'm feeling particularly silly right now, but your description of this scenario with the nurse manager caused me to have a laugh attack that was much needed.

But getting back on track...I'd like to say that this would be the last bedpan that patient ever threw because I'd teach them a lesson they'd never forget. But I know in that moment I'd be immobilized with such disgust I wouldn't be able to think straight. It would be hard for me not to react and still remember I'm on the job.

Red Kryptonite · Apr 5, 2015

How many managers are there out there whose underlings would massively enjoy watching them take a thrown handful of fecal matter to the chest? :yes:

Anna Flaxis, BSN, RN · Apr 6, 2015

How many managers are there out there whose underlings would massively enjoy watching them take a thrown handful of fecal matter to the chest?

I like my manager, so I wouldn't enjoy that. Managing a nursing unit is no easy task. You're the filling in the sandwich, caught between the slices of bread that are upper management and the nurses in the unit. You are often unpopular. It is not a job I would want.

NanikRN · Apr 6, 2015

This may seem like a dumb question, but why in the world is this patient using a bedpan? Can they not walk to bathroom? Can they not get up to a bedside commode? If the patient is awaiting placement, no time like the present to get some PT and OT while they are waiting. I am not sure that many long term skilled facilities or nursing homes run about putting bedpans under patients.
If anger is an issue, and the patient declines getting out of bed, then a visit from social work to begin working on anger management would also be a thought.
This patient may be mentally ill, but seemingly needs some further behavioral modification assistance.

This pt is on an acute surgical floor. I dont want to talk too much about specifics but pt was recovering from a major surgery. PT/OT were involved but you cant force a person to get up. There were a lotof issues surronding this case. This pt is no longer on our unit

Ruby Vee, BSN · Apr 7, 2015

The best thing to do in this situation is to remain calm and have a minimum of two people approach the patient from a distance. I would try to distract the patient by focusing on something else, such as her health. "You seem upset, can I check your B/P to make sure it isn't elevated?" I'm always taking note of presentation or appearance - clenched fists, raised arms, vocal tone and volume. If distraction isn't working and the patient is maintaining a hostile presentation, then it's time to medicate. I know time is everything in acute care, but you have to slow down and try not to over react to the patient's behavior. If you keep a calm and relaxed demeanor, the patient will de-escalate to your level - that's modeling. It's not always picture perfect, but when these patients are dealt with in a harsh manner, it becomes a traumatic experience for them. Safety of the staff is important, but most of the time a psych patient starts to de-escalate after they've done something like throw a bed pan. It's the staff's reaction to the behavior which causes the further escalation (everyone rushing the patient, shouting, etc). I'm not saying this to throw blame at nursing staff btw; my intent is for acute care nurses to just be aware.

Ya know what? If the reaction an alert and oriented patient gets from throwing a feces-laden bedpan at staff becomes a traumatic experience for them, they are reaping what they've sown. Safety of the staff is more important than not "traumatizing" a patient who has just assaulted a staff member. Bipolar disease is no excuse -- especially if they're taking their meds and alert and oriented.