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Safely working with patients with autism

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by Nurse Jen, RN Nurse Jen, RN (New Member) New Member

Nurse Jen, RN has 5 years experience and specializes in Medical Telemetry.

961 Visitors; 9 Posts

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Hi everyone. I work on an acute care unit in a large hospital. In the past six months two of our staff have been injured to the point of needing to take leave, both by young adult males with autism. Both patients were at least minimally able to communicate basic needs, but definitely not able to verbalize feelings, etc.

Those of us who have requested it have been able to take MOAB, but I feel that those deescalation techniques are more directed to those without the kind of communication difficulties that those with higher levels of autism experience. Plus, one of these assaults appeared to come out of nowhere.

Do any of you know of any training or education focused on patients with autism? Some of our staff are really afraid to take care of these patients now, mostly because of the level of unpredictability that they associate with them, but I think more familiarity and a better understanding may go a long way toward relieving some of these fears. Ideas?

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Sour Lemon has 9 years experience.

2 Followers; 29,290 Visitors; 4,111 Posts

Hi everyone. I work on an acute care unit in a large hospital. In the past six months two of our staff have been injured to the point of needing to take leave, both by young adult males with autism. Both patients were at least minimally able to communicate basic needs, but definitely not able to verbalize feelings, etc.

Those of us who have requested it have been able to take MOAB, but I feel that those deescalation techniques are more directed to those without the kind of communication difficulties that those with higher levels of autism experience. Plus, one of these assaults appeared to come out of nowhere.

Do any of you know of any training or education focused on patients with autism? Some of our staff are really afraid to take care of these patients now, mostly because of the level of unpredictability that they associate with them, but I think more familiarity and a better understanding may go a long way toward relieving some of these fears. Ideas?

Autistic individuals are not inherently aggressive. And people who are non-autistic are certainly capable of assault ...so I'd first get that cleared up.

When I care for any individual who lives with a care-giver, I find that a good chat with the care-giver is most beneficial. They're usually very familiar with any "issues" and can let you know how to best approach and manage the patient.

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hppygr8ful has 15 years experience and specializes in Psych, Addictions, Elder Care, L&D.

5 Followers; 32,069 Visitors; 2,740 Posts

I agree with Sour Lemon. I have worked with autistic children and adults for years. I am also married to a man on the Spectrum. They are generally not violent but they do have difficulty processing incoming stimulation and information. They need to be given time to process information. They also tend to do better with direct simple direction that does not involve choices. Example "It's time to take a shower." as opposed to "Do you want to take a shower?"

I've only been seriously hurt by one patient in my career and he was not autistic.

Hppy

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There are people on the spectrum who also have mood disorders, such as explosive mood disorder.  Also, the more people involved in the situation, the more reward they are getting as at times it is about getting a reaction/attention from someone.  

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hppygr8ful has 15 years experience and specializes in Psych, Addictions, Elder Care, L&D.

5 Followers; 32,069 Visitors; 2,740 Posts

On 6/21/2019 at 7:54 AM, 159Nursesrule said:

There are people on the spectrum who also have mood disorders, such as explosive mood disorder.  Also, the more people involved in the situation, the more reward they are getting as at times it is about getting a reaction/attention from someone.  

In my experience (which is considerable) with autistic adults and adolescents even those with severe mood dysregulation and explosive disorders most aggressive behavior cab be avoided With a lot of patience and right type of prompting. I get at least 2-5 a month on my acute unit and we often have a good day when I have my core staff. Autistic people may seem inwardly focused but they are in fact extremely perceptive and know when you are frustrated. Now your experience my differ and I won't disagree with that. In California we have really good early intervention programs for people on the spectrum that and using previously effective calming strategies can be a big help.

Hppy

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