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The things we put up with as part of the job

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I work in an impatient palliative care/hospice unit. I take care of patients who are dying, and who are not in their right minds a lot of the time. This was yesterday.

Patient 1- There on respite. Said "Get the F out of my room!" several times. Had family drama about which sibling would be the lucky one to take care of her once she was discharged from the unit. One of them brought their kids and left them to race up and down the halls screaming. I asked them to take the kids to the lounge. God bless whichever sibling agreed to take her home for her last weeks.

Patient 2- On the call light literally every 2-5 minutes. She was confused and anxious. Kept asking me to adjust her pillow, etc. As soon as I would leave the room and before I had a chance to put my butt down in the chair to chart, she pushed the light again. Xanax helped her for an hour. God bless her. I would not want be taking the journey she had to take, the way she had to take it.

Patient 3- Actively dying, comatose. No family. Just needed meds sometimes. Just there, peacefully holding his rosary. God bless him.

Patient 4- Brought in from hospital in respiratory failure, to be taken off respiratory support upon arrival. Was told in report she was "semi-responsive, very close to dying." Patient arrived not adequately medicated "so she would not die in transport." Arrived kicking and screaming and tearing off her mask and trying to launch off the gurney, needing to be held down by four people to keep her safe. MD only gave me PO med orders which I questioned at the time, before the patient came in, and was told to try that first. Had to call MD and get IV orders. As I was approaching patient with syringe, she found the breath to yell, "I will punch your face if you get near me!" Husband said go ahead and give it. Patient became more peaceful, held husband's hand. God bless the inventors of Ativan, Haldol, Morphine, and other similar drugs.

Patient 5- Actively dying man, in terminal restless delirium. Hallucinating. Trying to slide out of bed, reaching up and calling for people who had passed to the other side already. Many PRN doses of Ativan and Morphine, trying to balance not too much drugs to make him stop breathing, with enough to make him comfortable. Very nice family at bedside. At the end of the day they told me, "God bless you and the work you do."

Edited by anon456

At the end of the day they told me, "God bless you and the work you do."

Well, I will go ahead and echo that.

I hope you actually don't feel that you are "putting up with" these situations, but do all you can to embrace your important role and then hit the pillow at night knowing that you've made a difference.

I put up with one particularly rude resident as part of the job. Why, oh why, did my favorite res have to switch to second on the call list? :cry:

I work inpatient psych with forensics and demented patients.

Some are really sick, mentally ill. Some have really good lawyers. And putting up with the risk of violence is very real and a part of our jobs every day. The other day, another female RN was assaulted by this patient with a history of sexual assault. It's been a good ride but this job is killing my faith in humanity and my desire to "help". I plan to move on ASAP.

Cactus Nurse

Specializes in TBI and SCI.

I don't know how you do it. I get sad when I came back after my days off and hear so and so died, breaks my heart. I could never work hospice. You're amazing :)

Do you recall being told violence is a part of the job? Psychiatric staff are taught ways to manage violent pts that get physical. Violent psychiatric patients should not be restrained. There seems to be many, many more psychiatric patients now. As your post reported there are sexual assault patients that are admitted to a hospital and staff may never be aware of their history. There were times when psychiatric hospitals were struggling to maintain enough patients to keep units open and now every facility is full,on diversion or they are at staff/physician capacity. ERs are holding psychiatric patients for days until a bed opens up. Nurses are at risk, we never know who is going to walk in with a gun, knife, be a gang member or it may be the patient on alcohol or drugs.

I meant to ask how many of nurses feel their security officers are trained, and have the physical stamina to protect staff and other patients?

meanmaryjean, DNP, RN

Specializes in NICU, ICU, PICU, Academia. Has 44 years experience.

I meant to ask how many of nurses feel their security officers are trained, and have the physical stamina to protect staff and other patients?

Almost none- and I'm talking about regular hospitals. I have NEVER felt safe in an acute care hospital. Ever,

Party_of_five, BSN

Specializes in ED. Has 2 years experience.

I am fully confident in our police officers. We even have dedicated K9s. They back the staff 1000%

KeepinitrealCCRN

Specializes in SICU,CTICU. Has 7 years experience.

Almost none- and I'm talking about regular hospitals. I have NEVER felt safe in an acute care hospital. Ever,

i agree with this too, plus it takes them forever to get to the unit and we are forced to diffuse the situation ourselves. if there was ever a true emergency it wouldn't be pretty.

I often wonder why hospital security are physically unable to protect staff and patients, how they are afraid and fear getting assaulted themselves. Esp when there are only females in a department, or weekends when its short-staffed.

Here.I.Stand, BSN, RN

Specializes in SICU, trauma, neuro. Has 16 years experience.

I meant to ask how many of nurses feel their security officers are trained, and have the physical stamina to protect staff and other patients?

Our security staff carry tasers. A few years ago, we went through a patch where our security needs were increased; we had sherriff's deputies positioned outside, near the ED, and at the entrances to my unit.

marie.rn2419, RN

Specializes in ICU.

I meant to ask how many of nurses feel their security officers are trained, and have the physical stamina to protect staff and other patients?

II am so grateful for the fact that, at the busy level one trauma I work at right now, our security team is comprised of former/freshly discharged military and current/reserve police officers. I feel very lucky to know that if I call security, and I have had some nerve-wracking encounters, I get the muscle. I've worked at other hospitals, though, where the 'security' is basically a patient greeter, overweight and retired...

rearviewmirror, BSN, RN

Specializes in ER.

Well I am glad I got out of bedside and been doing UR for some time. I don't regret leaving the patient care one bit. One of the best perks of UR is you don't talk to patients. I do miss not working 4/7 days a week and able to go out to enjoy the sun when I know everyone else is at work. If I return to clinical side, probably be a provider.

Patient care sucks... and it wasn't anything but the patient that made it suck for me. So... good luck to you.

I meant to ask how many of nurses feel their security officers are trained, and have the physical stamina to protect staff and other patients?

There are no security officers on my unit. It is a stand-alone building. We have panic buttons we can keep in our pockets if there is a potentially dangerous patient or situation. We can also of course call 911. We keep a lot of controlled meds (as you can imagine, being a hospice) on hand and it's a wonder that we have not been held up yet and robbed for the meds. Occasionally we get a patient who is in police custody, and there are officers posted next to the bed 24/7. Another time I had a patient in an ankle bracelet. I looked up their name and found that they had done a very violent crime years ago and were now on house arrest due to illness. I think this person was still strong enough to cause harm if I was not alert to the situation.

CelticGoddess, BSN, RN

Specializes in Palliative, Onc, Med-Surg, Home Hospice. Has 6 years experience.

II am so grateful for the fact that, at the busy level one trauma I work at right now, our security team is comprised of former/freshly discharged military and current/reserve police officers. I feel very lucky to know that if I call security, and I have had some nerve-wracking encounters, I get the muscle. I've worked at other hospitals, though, where the 'security' is basically a patient greeter, overweight and retired...

The facility I worked for before hired only former military and police. (Reserve okay) They payed more than the city and county and they were choosy. I trusted the security there.

I meant to ask how many of nurses feel their security officers are trained, and have the physical stamina to protect staff and other patients?

Our security don't even carry weapons! They have restraints and flashlights 😑 but since we aren't corrections, they aren't allowed to carry that stuff.

Yup, they told us the risk of being assaulted or st least verbally abused is part of the job. All the de escalation techniques in the world won't work if the male 6feet plus patient decides he wants to attack or punch a tech or RN or even a shrink.

Some of these guys won't ever get better, and that's a fact. One guy has had over 20 admissions since he was young. It's a thankless job but I'm glad I have a great team. I am also very glad that there are places like this for these kind of people.

In an ideal world, we shouldn't have to tolerate violence and abuse even if the patient is demented or psych or high. Sadly, we put up with it as part of our jobs. It is what it is.