Which patients are you most scared to take care of?

Published

Although a variety of patients have brought forth challenges during my time of a nurse, lately I've been finding myself getting very stressed out caring for patients with GI issues.  I've had three patients in the past year with bowel obstructions/bowel perforations who decline no matter what I do.  I've sent them all repeatedly into the hospital.  They've all required surgical intervention.  This really causes me distress, so much to the point that I can no longer sleep at night if a patient hasn't had a bowel movement.  I'm always worried about doing the wrong thing.

Anyone else experience similar things with any patients? Who are you scared of taking care of? 

Specializes in Critical Care.
1 hour ago, Gillyboo said:

Wow thats a lot of severe violence! Yikes! 

How does a caregiver keep their composure during that kind of an episode, I wonder? 

And are initially violent types ever weaned off of the sedation? 

I have so many questions now. 

Sedation is for alcohol withdrawal so it is temporary and usually the patient is of sound mind after.  Violent people are treated with haldol, ativan or seroquel to help calm them down.  They are restrained if they are a danger to themselves or someone else.  A psychiatrist decides what the best meds are for the patient.

It is a good idea to take a self defense class on your own.  Of course you try to de escalate the situation if you are able and call security as well if needed.  Try not to let the patient get between you and the door in case you need to make a hasty exit.

A few things I did in general was pray before work and wear blessed medals.  Maybe that is why I wasn't seriously injured.  One time I was helping move a 300 pound stroke patient who fell and was on the floor.  Six of us were moving her to the bed with a bath blanket as we didn't have lift equipment then.  I felt a hot searing flash go down my leg, but then it went away.  I looked up and noticed one of my medals  I was wearing.  Later my Dr said I might have had a slipped disc temporarily that went back into the right position.

 

Up Vote Up Vote ×
Specializes in Critical Care.

I have very sad news regarding the nurse that was attacked in NYC in 2014.    She was Evelyn Lynch, 69 years old, and preparing to retire.  The man, Kwincii Jones, attacked her with an IV pole and stomped on her head.  She was in a coma and never regained consciousness.  She died six years after the attack.  Brookdale University Hospital in Brooklyn was fined $78,000 by OSHA for failing to protect it's workers from violence.  They were advised to install panic buttons, alarms and CCTV in high risk areas.  Kwincii pleaded not guilty due to mental disease and was sent to a mental institution.

 

Hear is the news article.

Brooklyn nurse beaten into coma by patient dies 6 years later — death ruled homicide

By Brittany Kriegstein and Thomas Tracy

New York Daily News |

Mar 24, 2020 at 3:55 PM

Brookdale University Hospital (Corey Sipkin/New York Daily News)

A nurse beaten into a coma by a mentally troubled patient in a Brooklyn hospital six years ago has died of her injuries — and her death has been ruled a homicide, cops said Tuesday.

Evelyn Lynch died Nov. 11 at age 75. She never regained consciousness after the Feb. 7, 2014, assault at Brookdale University Hospital, a friend said.

"She was just getting ready to retire [when she was attacked]” said friend Dr. Morvo Forde, the victim’s neighbor in Laurelton, Queens. “She baked a lot. She loved baking and decorating cakes.”

The city’s medical examiner deemed Lynch’s death a homicide this week, police said.

Kwincii Jones, 46, was charged with attempted murder and assault after attacking Lynch when she went into his hospital room to check on him.

He lunged at her when she approached his bedside, threw her to the ground and stomped on her head 10 times with his bare feet until she lost consciousness, cops said.

“He beat the crap out of her,” a police source said at the time. “He jumped out of bed and stomped on her. She was bleeding from the head.”

Another nurse responding to an intercom alert coming from Jones’ room found Jones attacking Lynch and called for help. Hospital security took Jones into custody and handed him over to police.

The assault left Lynch with multiple skull fractures. She was rushed to Kings County Hospital where she underwent brain surgery.

She was eventually transferred to a nursing home, where she languished in a coma for years before her death, her friend said.

Her attacker had been admitted to Brookdale University Hospital two days before the attack complaining of stomach pains, police sources said.

He pleaded not guilty by reason of mental disease in 2018 and was sent to an institution run by the city Health Department.

As of Tuesday, Jones was still in the city’s care, officials said.

The Brooklyn district attorney’s office is reviewing the medical examiner’s findings to determine if they should file additional charges against Jones.

A few months after the attack, the Occupational Safety and Health Administration slapped Brookdale University Hospital with a $78,000 fine for failing to protect its workers from violent patients and failing equipment.

A probe of the hospital found that 40 employees at the hospital, including Lynch, had sustained head, eye, face and groin injuries while treating patients.

“Brookdale management was aware of these incidents and did not take effective measures to prevent assaults,” OSHA Director Kay Gee said at the time.

Authorities recommended the hospital install panic buttons and alarm systems at work stations and closed circuit video for high-risk areas.

 

 

Up Vote Up Vote ×
Specializes in retired LTC.

Anybody know if Brookdale fully complied with the recommendations??? Or was it pretty much back to the 'same ole, same ole'???

Up Vote Up Vote ×
3 hours ago, brandy1017 said:

Sedation is for alcohol withdrawal so it is temporary and usually the patient is of sound mind after.  Violent people are treated with haldol, ativan or seroquel to help calm them down.  They are restrained if they are a danger to themselves or someone else.  A psychiatrist decides what the best meds are for the patient.

It is a good idea to take a self defense class on your own.  Of course you try to de escalate the situation if you are able and call security as well if needed.  Try not to let the patient get between you and the door in case you need to make a hasty exit.

A few things I did in general was pray before work and wear blessed medals.  Maybe that is why I wasn't seriously injured.  One time I was helping move a 300 pound stroke patient who fell and was on the floor.  Six of us were moving her to the bed with a bath blanket as we didn't have lift equipment then.  I felt a hot searing flash go down my leg, but then it went away.  I looked up and noticed one of my medals  I was wearing.  Later my Dr said I might have had a slipped disc temporarily that went back into the right position.

 

I deal with home care, so we don't have guards and security cameras and alarm buttons. We also don't have an actual nurse on site to recommend chemical restraints, but my violent one was already prescribed those. 

Her husband just told her it was candy. LOL (my idea!) 

I did have a fella that was bed bound, and it was a sad case.  But he screamed at me for putting on MY OWN GLOVES and was screaming and yelling about me offering to wash his face and upper body first during a bed bath, LOL like WHAAAT???! then completely refusing to let me do any of it, and just basically wanting someone to yell at, I guess. This was a common thing apparently. I spent 45 mins with the man, and 40 mins of those were pretty mind boggling. 

Then as if thats not enough, he threatened to accuse me of neglect, and Im like "Sir, if you would just let me wash you off, that would be really great." But nah he just wanted someone to yell at. I guess he did that to a lot of his CNAs. 

When he got to the point of just getting himself so worked up into a purple faced frenzy, I got a little nervous and called the agency and said "Hey you are going to have to send someone else here. Hes just an angry angry man and I don't want to get hit."

Oh and to be clear, I am a marine corps combat trained vet. I have a blue belt in karate. I have NO issues with self defense. What I HAVE an issue with, is EVER having to actually use my self defense training against a HELPLESS ELDERLY PERSON. 

Its a felony. I don't hit old people. I don't hit women. Period. 

Middle/younger adult aged capable men- Im game. 

NOT PATIENTS!! FFS patients are not people we take self defense classes for. 

Im done here. I have seriously lost all hope in the medical profession..

Up Vote Up Vote ×

Oh and I had initially called the agency after 15 minutes of pleading with mr tantrumer to let me give him care, and him refusing for reasons that just defy all understanding. To the point that the case worker has been involved multiple times. 

So whatever. No Im not using self defense on PATIENTS. Lmao wow. Just wow. To all of this. 

 

Up Vote Up Vote ×
Specializes in Critical Care.
3 hours ago, Gillyboo said:

Oh and I had initially called the agency after 15 minutes of pleading with mr tantrumer to let me give him care, and him refusing for reasons that just defy all understanding. To the point that the case worker has been involved multiple times. 

So whatever. No Im not using self defense on PATIENTS. Lmao wow. Just wow. To all of this. 

 

I don't think this is funny.  I'm not a psych nurse, but am aware that part of working on a psych floor involves being able to take a patient down to the ground, specifically to keep them from hurting you or anyone else.   I would consider this a self defense maneuvor.   I haven't been trained in this as I never worked psych.  But I do think one should try to protect themselves if they are being attacked and flee if able, another reason I said to not let a patient get between you and the door!  So as to not end up dead or injured as the unfortunate nurse in NYC ended up.  Truthfully she probably didn't stand a chance as she was knocked to the ground and stomped on before she could even try to flee or protect herself.  

We live in a world where many people are violent and not all are elderly, confused or demented.  Although the perpetrator was sent to a psych ward permanently, he was an able bodied adult who was there for stomach pain and there was no mention of a psych history when the news first broke in 2014.  The initial story was he was angry about being denied pain meds and being discharged without them so he attacked the nurse.

 

Up Vote Up Vote ×
Specializes in Critical Care.
3 hours ago, Gillyboo said:

I deal with home care, so we don't have guards and security cameras and alarm buttons. We also don't have an actual nurse on site to recommend chemical restraints, but my violent one was already prescribed those. 

Her husband just told her it was candy. LOL (my idea!) 

I did have a fella that was bed bound, and it was a sad case.  But he screamed at me for putting on MY OWN GLOVES and was screaming and yelling about me offering to wash his face and upper body first during a bed bath, LOL like WHAAAT???! then completely refusing to let me do any of it, and just basically wanting someone to yell at, I guess. This was a common thing apparently. I spent 45 mins with the man, and 40 mins of those were pretty mind boggling. 

Then as if thats not enough, he threatened to accuse me of neglect, and Im like "Sir, if you would just let me wash you off, that would be really great." But nah he just wanted someone to yell at. I guess he did that to a lot of his CNAs. 

When he got to the point of just getting himself so worked up into a purple faced frenzy, I got a little nervous and called the agency and said "Hey you are going to have to send someone else here. Hes just an angry angry man and I don't want to get hit."

Oh and to be clear, I am a marine corps combat trained vet. I have a blue belt in karate. I have NO issues with self defense. What I HAVE an issue with, is EVER having to actually use my self defense training against a HELPLESS ELDERLY PERSON. 

Its a felony. I don't hit old people. I don't hit women. Period. 

Middle/younger adult aged capable men- Im game. 

NOT PATIENTS!! FFS patients are not people we take self defense classes for. 

Im done here. I have seriously lost all hope in the medical profession..

You said yourself he was bed bound and was not hitting you.  All you had to do was leave and he was no danger to  you.  You will encounter many angry people that like to yell in healthcare. 

Up Vote Up Vote ×
Specializes in Psych, Corrections, Med-Surg, Ambulatory.
On 5/2/2021 at 12:59 PM, amoLucia said:

Anybody know if Brookdale fully complied with the recommendations??? Or was it pretty much back to the 'same ole, same ole'???

Well, they can install all the hardware and gadgetry they want.  The question is, who is available to respond if someone indicates a need for help?  I'm very skeptical about recommendations for stuff but not personnel.

2
Up Vote Up Vote ×
+ Join the Discussion