When you have a combative confused patient and the attending wants to avoid all psychotropic medications
Dementia is a devastating disease. I agree that we should avoid psychotropic drugs because sometimes they can make the confusion worse.
However, when a patient is agitated and de-escalation is not working, and the wife is crying because this is a rough picture to watch, in addition, she got hit by her husband- and I get hit and my tech gets kicked. Enough is enough- you are creating torture for everyone. I do not come to work to get physically abused by a confused patient because they don’t understand that I am cleaning them up. I literally had a battle of wits with an attending and she ended up staying in the room for a couple hours.
I have gotten hurt before by a confused restrained patient that wouldn’t let go of my arm and all I was doing was fixing a trach collar that moved to the side and he was desaturating. He was very strong and his fingernails were never cut because he was a nursing home patient. I ended up having three bruises on my arm. Luckily, this was completely healable, but that’s not the point. A more dramatic case of not controlling the situation with an aggressive patient is in my class, there is a student who works in psych ER where a patient stabbed his coworker in the eye with a pencil. He no longer can work as a nurse. I think we as nurses do a great job not talking about workplace violence that we experience. I think this reason contributes to a nurse’s burnout (sounds like a great DNP project for someone).