Tuesday, April 17, 2007

Fake Florence Nightingale + Fake Gangster = Disaster

Well my partner and I had a little excitement this week. My partner and I were called by a ward secretary because nurses were failing to calm down an agitated patient. Upon arrival I hear someone cursing like a sailor and threatening violence upon anyone who stops him from leaving. We ran to the room because the patient sounded like he was becoming more vulgar only to be stopped an RN. The room had maybe 4 C.N.A.s and 2 R.Ns and a new floor manager. The floor manager tells us, “The patient really doesn’t like people in uniform, so just stay out of the room,” and she stands in the door way refusing to move. The next thing I hear is his RN yelling put the pole down!” Once again staff refuses to move for us to enter and take down the violent patient. One of the C.N.As grab the pole (the piece that holds the IV on the bed) and brings it out to us. After 45 minutes the R.N is able to hit the patient with drugs and knock him out, temporarily.

Thoroughly pissed off my partner and I went back to our office to document what exactly went on. A few hours later we are informed there is an agitated patient threatening violence on staff once again on the same floor. When we arrive this time the patient is standing in the ward’s tiny waiting area with a tube hooked to his chest and connected to what my partner called
“his lunch box.” The reason the patient was upset was because he wanted to go out and smoke, but the doctor would not sign orders to allow him to smoke. The patient had a collapsed lung and for him to leave the floor he would have to discharge himself and his “lunch box” would have to be disconnected. Within a minute his lung would deflate and in minutes he would die. So needless to say he could not leave or discharge himself because it would cause almost certain death.

The patient’s R.N was sitting in a chair telling the patient the hospital’s policies and telling him what would happen if he went out to smoke. The R.N then started asking questions about the patient’s personal life which made him realize he had nothing to loose. He had a new born baby, but wished her gone, his family disowned him because he was an asshole who tried to harm others, and last he was broke because no one wanted to hire him also for the same reasons his family disowned him. Basically this was a punk kid who thought he was a suburb thug. Every attempt by us
to take control of the situation was thwarted by the R.N who was only making the situation worse. 40 minutes had gone by and this kid was still ranting and raving about how he was a thug and how “he was gonna straight bust us upside our heads yo,” the whole time he is swinging his “lunch box.” Our clinical coordinator the whole time was trying to contact the doctor who was unreachable.

My partner finally tired of listening to this white guy using the N word after every other word interrupted the nurse and told the kid his options. The patient stood there for a minute, made a phone call to his baby momma leaving a voice mail threatening her and his baby. After that the patient headed back to his room and stayed there for a few minutes. It seemed like the situation was over and the staff started discussing putting Vanilla Ice in restraints when he walked out of his room fully dressed. My partner, myself, the dumb ass R.N, and the clinical coordinator followed the patient to the elevators. When the doors opened I stepped in front of the door and informed him that he could not leave. The patient reaches into his pocket and pulls out a knife, waves it in front of mine and the clinical coordinator’s face. As my partner and I step forward to beat the crap out of him, the R.N decides to play patient advocate and stands in between him and us. The clinical coordinator reaches for his phone and calls 911. Within seconds we hear the sounds of sirens and a load roar coming up the stairs. I look over at the stair case to find a K-9 and 6 guns in my face. I yell the knife is in the right pocket and push myself and the clinical coordinator flush against the wall, my partner a black man from Chicago was in the corner
hiding from Cujo the K-9. The police started ordering the patient to put his hands up and instead the patient reaches for his pocket and that’s were it goes bad. When the patient reached for his pocket the deputy released the dog at the same time a state trooper was kneeling down to shoot. The dog turns his head and does what he is trained to do, bite and rip. The state trooper’s arm is being torn up by the dog, the patient cursing at the police. The dog lets go and looks right at the kid and all the gangster in the boy suddenly disappears. I pulled the state trooper over to the nurse’s station and asked if someone in the audience could take care of his wounds. The whole time I could hear the kid crying like an infant as he is cuffed. The patient stayed until the “lunch box” could be safely removed and he was taken into custody by the state.

My supervisor had a meeting with our department head, our vice president, and their boss about the situation. They discussed that when security is called everyone is to get out of the way. We are called because talking has failed especially in this situation where this 23 year old kid had already threatened staff. No one in the hospital has a right to risk our safety including R.Ns. You have to go to college to be a doctor or a nurse so you would think they would be smarter than the un-educated. I have started college course and I have figured out why these people seem ignorant at times. It turns out that no college in the United States at least teaches common sense.


Flashlight 1

11 comments:

Mother Jones RN said...

So, what came out of the meeting? Is the dumb nurse having to go to common sense remedial training?
Good grief!

MJ

Anonymous said...

i,m sorry that trooper got injured,but one must remember that K-9's love fresh ganststa meat.DONT GET IN HIS WAY. flashlight -2

Labor Nurse said...

Ok... has anyone at this hospital heard of a nicotine patch?

The Platypus said...

Wow. It didn't take me all that long to realize that these kind of things are best left to people trained for it. You're equipped for this kind of thing, the nurses are not, and they're lucky not to hurt the guy in trying to control him. Worse than that is the risk of injury to one's self. That staff really sounds like a bunch of idiots.

Anonymous said...

Dude-

This is very, very common around the country. The staff you are hired to protect hates you. They think you are incompetent, and barely above 1 on the loc scale. It's not you. Its' them. They are liberal, touchy-feely lovers of everyone that think they can save all of them.

They can't. Calling you is admitting defeat, so when they call you, they are riding a fine personal ego line. That's why they want you there, but not do anything - they fear personal injury, but don't want to be responsible for unleashing the neanderthal or admitting the thug in uniform can handle something they can't.

Lastly, they fear being sued, so even when they do call screaming for you, they will still be biased towards the pt.

DON'T let these people get you hurt. Ask them plainly; do you need me to intervene, or not? I do not do stand-bys. I either resolve it, or I go somewhere else, because my presence may inflame the pt's attitude. Ethically, I can't stand by when I hear that there is a pt out of control. So, make up your minds.

Also, don't let them call the cops, that needs to be YOUR call. You don't tell them how to intubate, they don't have the training to know when Law Enforcement intervention is necessary.

Lastly, you need your boss to get you some clearer rules of engagement, or you need to start holding back a little until they straighten up. You sound like a good kid; I understand the need to do your job, but you can't do it if they won't let you.

Aleesa said...

As interesting as your story is to the non-professional, it only proves that you and others don't know what the LEGAL scope of practice is that determines the seemingly idiotic things that the RN has to do. Just because common sense appears to apply in certain situations--using common sense is not allowed to take precidence when you have a liscence you can loose. Sad, perhaps, but not too many people who work heard enough to get a liscence are willing to throw it all away on "others" believe "ought to be done."

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