What is wrong here?!

[Disney Doll]

Well, first of all, venting on the DIS is an acceptable alternative to beating the snot out of your demented patient!

Second of all, a nurse having a bad day and venting about it is not the worst thing in the world.

Third of all, there are many different types of nursing, and many different types of facilities a nurse can work in. We may all have similar experiences, but no two can ever be the same. I would imagine working on a medical floor in an inner-city hospital is a lot different than working on a medical floor in Palm Beach, if you KWIM.

I think often a nurse's frustration lies less with the patient and more with what is pewrceived as a lack of support form the administration. Nurses are "expected" to do everything that no one else wants to do, they are expected to always be smiling, happy angels of mercy no matter what the circumastances. Meanwhile, there are fewer and fewer of us and we are asked to do more and more by way of patient care, to make up for cuts the hospital has had to make in other areas...say for example, housekeeping. In my hospital, if a patient vomits on the floor, I am expected to clean it up. Not the housekeeper...me. I am to wipe it up first, and the go to the housekeeper, borrow her mop and wash the area. Why??? Because where we used to have 2 housekeepers we now have one and she is busting her butt just to do her routine cleaning duties so if she has to keep stopping to do "extraordinary" things, her routine things fall by the wayside. And that is one example...i can give you millions like that. Does it mean I hate my job? No...but it dsoes mean that I wish I could do the nurse job without having to do all the other jobs so that I could maybe spend a bit more time with the patient. I do, after all, like people, and taking crae of them...I just don't get much of a chance to do it anymore.

Nursing is in a crisis. There are not enough of us, and it is only going to get worse. Within the next 20 years, when all the nurses who are now average age 48 (because that is the average age of a nurse today...48) retire, there aren't going to be a lot of nurses left. Younger folks today aren't going into nursing, because they have so many more opportunities to do so many more exciting things. Let's see...work for a big company where I have the opportunity to grow, earn a really big salary, and maybe travel a bit, or become a nurse, clean people's butts, deal with demented people who try to fondle me, and work weekends, evening, nights and holidays...which would you choose?

It's a crisis in the making, and unfortunately, no one really seems to be addressing it.

 

[Am_I_There_Yet]

I know that with severe dementia, inappropriate sexual conduct is very common, especially with men. My Dhs grandfather got this way before he died. It was tough because it was so unlike him, he was normally a very respectable person. We can only hope he didn't know that he was humiliating himself this way. (believe me, that would be the ONLY blessing in his last months of life, they were awful) And God bless the nurses who had to deal with him. I am sure they had bad experiences with him, I hope they were able to handle him and also have compassion for his situation.

Sorry you had a bad day. It sounds like this guy is having some bad days too. Unfortunately, it will probably only get worse for him. I can't imagine being in either of your shoes...yours for the job you do and his for spending the last days of his life without having his senses to depend on.

I hope your next day of work is better. I thank God there are people who are willing to work with people who are in a vulnerable position, sometimes inappropriate, combative and often not in their right mind.

Very well said!

My grandfather had Alzheimer's and while it was horrible to watch, he never got violent, or had outbursts like the one described here. Thank goodness - it was hard enough on my mom as it was.

We had a wonderful nurse that lived at his home that took care of him. It must have been a very tough job. We were blessed to have her!

OP, you have a tough job indeed, and there are lots of people who appreciate it!

 

[MrsPete]

I think often a nurse's frustration lies less with the patient and more with what is pewrceived as a lack of support form the administration. Nurses are "expected" to do everything that no one else wants to do, they are expected to always be smiling, happy angels of mercy no matter what the circumastances . . . I wish I could do the nurse job without having to do all the other jobs so that I could maybe spend a bit more time with the patient . . . Nursing is in a crisis. There are not enough of us, and it is only going to get worse . . . It's a crisis in the making, and unfortunately, no one really seems to be addressing it.

You could say the very same things about teachers and preachers -- probably a few other professions too. It seems that jobs that seem to be considered "callings" rather than plain old careers -- jobs that are considered "noble" and "helpful" . . . the people in those jobs are supposed to be above the rest of humanity: always understanding, giving of their time (even after being treated badly), etc., etc., etc. Soon the only ones left in these jobs will be the missionaries, those who are willing to do it at any cost.

 

[Lisa loves Pooh]

Does the family know he does this?

 

[Lisa loves Pooh]

What would you like done?

Honest question--but is it possible to restrain an unruly patient for a procedure? If you can't cooperate (and fondling seems a bit on the uncooperative side to me)..can other nurses or staff (if available) help to restrain a patient?

 

[MrsKreamer]

I am a nurse

First off thank you, nursing is something that not everyone can do. I know your job is difficult.

He is elderly and has severe dementia and is confused.
He ripped out his IV and flung blood around the room, he hit and kicked, and he yelled out the most vulgar, sexual comments to all the nurses in the room (6 of us, all female). I however, was the lucky one who got to restart his IV and administer the meds to calm him down - here's my problem: while I was doing this, he was fondling my crotch! Of course, this behavior is totally unacceptable, but I can't retaliate like I would to any other man who would do this (like beat the snot out of him) because he's a patient in the hospital.

No you can't retaliate because he has SEVERE DEMENTIA!

Why is it acceptable for people like him to behave like this

People like what? Severly Demented? It is not his fault if he is indeed severly demented!

(I know he's confused, but he knew what he was doing because he made vulgar comments about it) and nothing gets done?

First off, as a nurse you should understand the difference btw confused and having severe dementia! Second, what on earth would you have done? Couldn't you or the other nurses put him in restraints?

If I had done something back to him, I could be sued for abuse but he can just fondle anyone he pleases and it's ok.

Huh? If you had done anything(like beat the snot out of him) hopefully you would have had your nursing license taken away, because you would have been abusing a very ill paitent.

Well, it's not OK and the public needs to realize what we go through as nurses. Patients and their families can physically and verbally abuse to their hearts content because nothing is ever done about it, and the nurses have to "take it".

First off I agree that the public does need to know what you go through. You do have a hard job and again I thank you for it. Seriously though, families of paitents and paitents in their right mind(ie not severy demented ) cannot legally abuse nurses, doctors, hospital staff, etc, if they do you should refuse to care for that person or report the family memeber. As for verbal abuse, there are just too many *******s in this world and unfortunatly we all have to deal with verbal abuse in any line of work. You should have heard some of the things I was called while working at Blockbuster .

I am sorry, and I understand your need to vent, but honestly what did you expect them to do to that man for fondling you? Put him in handcuffs? Dementia is a horrible disease and I hope no one you love ever has to suffer through it.

 

[swea_pea1]

I am too grateful for the work nurses do and watched first hand how my nurses had no control over a situation.

When I was recovering from emergency gall bladder surgery, I was put in a room with another woman. When I first got there, she pulled out her IV and left the room....to go outside to smoke! The nurses had to chase her down and bring her back. She had visitors walking in and out all night long (and I mean all night long). They were loud, turned the TV up to maximum volume (while watching shows about police chases ), and occassionally helped her remove her IV to go outside to smoke some more.

I begged to be moved to another room but the person who could authorize that had gone home for the night. I couldn't get any sleep, even with the meds, and boy did I need it after the day I'd had! The nurses felt bad but their hands were tied.

My nurses tried to make the best out of a bad situation and eventually did move me. They had to call whomever it was that could authorize the move at home. I was extremely grateful, but felt bad that they still had to deal with a woman and her family who had no regards for either them, the rules, or the other patients.

God Bless all the nurses on this board and those that try, against adverse circumstances, to give quality care to all patients!

 

[Cool-Beans]

Yes, I'm sure it was the OP's fault that she got fondled ... don't we all love being felt up by elderly men??

Just out of curiosity, cool-beans, if you had a friend who came over and said, I had a bad day at work would you respond, "shut up... quit your job if you hate it so much ... and anyway, the whole thing is your fault." I hope not! The OP wanted some emotional support for having an unpleasant event happen to her. And you think its okay to give her crap about it?

I do not believe that anything should be done about patients with dementia...except to kindly take care of them.

I believe something should be done about nurses who complain that they can't beat them up and want something done about the patient.

And I've seen and heard a lot more of this that you even want to know.

 

[SuperSteelerFan]

In response to those who have asked, yes, he was being physically restrained at the time by 4 other nurses so we could get the IV back in - one nurse was holding each limb to keep him as still as possible, but it's sometimes amazing how strong elderly people still are. And no, it's not legal - at least in PA - to place a patient in restraints without a doctor's order and the doctor who was called prior to this incident occurring would not order restraints.
A number of you have misunderstood what I have said about his confusion. Patients with dementia can not know where they are or what time or day it is, etc, but still know right from wrong and behave appropriately. He did not behave appropriately and made it clear that he knew what he was doing was offensive to us. And no, I have never been sexually assaulted at work before and I hope it never happens again - whether he understood what he was doing or not, it's horribly degrading even if it was only a quick feel.
As far as actually "beating the snot out of him", I have already said that I would never hit a patient - it would be clearly unacceptable behavior on my part and yes, a nurse could lose her license over an incident like that. I'm sorry to those whom I have offended with those comments - they were out of line, but the first thing I thought of was to protect myself by fending him off as I'm sure many others of you would, but it was worded poorly on my part.
The point to this thread was to attempt to point out that nurses as a whole have to suffer through incidents like this that we have to just accept as part of the job when they are various forms of assault elsewhere. All I asked was for a place to vent my frustrations with the job at hand - I thank those of you who allowed me to do that with understanding in return and I apologize to those whom I have offended - sorry I'm not perfect!

 

[poohandwendy]

. Patients with dementia can not know where they are or what time or day it is, etc, but still know right from wrong and behave appropriately. He did not behave appropriately and made it clear that he knew what he was doing was offensive to us.

I understand your vent about this happening, but I have to disagree with the above.

The fact that he acknowledged what he was doing and even your reactions does not, by any means, show that he has control of his facilities and/or behaviors. The fact that this happened while he was agitated points to classic dementia based inappropriate sexual aggressiveness. I am sure he also knew that he was agitated and that you were not happy with him, but that does not mean he could control himself.

I totally agree that it's a shame that health care workers have to deal with stuff like this, but I don't think it is fair to rule out his illness as a cause of this behavior, particularly because it is known to be a complication of the illness.

 

[4cruisin]

I apologize in advance, this is going to be a long rant! I am a nurse and I was at work last night when my friend and co-worker had an unruly patient (I'm being kind). He is elderly and has severe dementia and is confused. He ripped out his IV and flung blood around the room, he hit and kicked, and he yelled out the most vulgar, sexual comments to all the nurses in the room (6 of us, all female). I however, was the lucky one who got to restart his IV and administer the meds to calm him down - here's my problem: while I was doing this, he was fondling my crotch! Of course, this behavior is totally unacceptable, but I can't retaliate like I would to any other man who would do this (like beat the snot out of him) because he's a patient in the hospital. Why is it acceptable for people like him to behave like this (I know he's confused, but he knew what he was doing because he made vulgar comments about it) and nothing gets done? If I had done something back to him, I could be sued for abuse but he can just fondle anyone he pleases and it's ok. Well, it's not OK and the public needs to realize what we go through as nurses. Patients and their families can physically and verbally abuse to their hearts content because nothing is ever done about it, and the nurses have to "take it". There is a situation right now on the same floor where anyone who does not answer a certain patient's call within 5 minutes will face disciplinary action because the family complained that it takes too long to get "service". In the meantime, the staff is now afraid to go get something to eat or use the bathroom and other patients are neglected because of this one family - don't you dare take longer than that 5 minutes - they stay 24 hours a day and they actually time us. We also have a policy that states no visitors in a semi-private room after visiting hours end, but there is no consistent enforcement of this policy. My friends have been "turned in" and disciplined for both not allowing people to stay (which is the policy) and allowing people to stay (which is against policy). There are many, many more situations like this that occur daily as well. It's things like this that are pushing people away from careers in nursing - nurses shouldn't have to put up with crap like this.

Um, I'll be nice and just say maybe you should change careers. You obviously don't have compassion for a patient w/ dementia. Get another job.

 

[SuperSteelerFan]

Um, I'll be nice and just say maybe you should change careers. You obviously don't have compassion for a patient w/ dementia. Get another job.

You try to be compassionate when you have an eighty-something year old strange man's hand in your crotch and let's see how you feel about him then. The things he said to us can't be posted here. I DID NOT allow him to do this and I DID NOT enjoy it and I DID NOT do anything to hurt him regardless of what I said I wanted to do. My bark is worse than my bite so to speak and I tend to have a violent streak when I vent. My patients are well cared for and are not abused or neglected, but there are times when you just cannot feel compassion any more. When you are being physically or verbally attacked, it's a little hard to be compassionate. When you have urine, feces, or blood thrown at you, it's a little hard to be compassionate. When you have patients and/or families threaten to have your job because they just don't think you are good enough, it's a little hard to be compassionate. Some days when you are being pulled in 25 different directions and just can't seem to get anything done or please anyone, it's hard to be compassionate. You would be hard pressed to find someone who can be compassionate all of the time and never experience feelings of anger and frustration. Just because I had a really bad experience and wasn't feeling real compassionate towards this patient doesn't mean I need to change careers, it just means that I am human, with a full range of human emotions, who felt completely degraded after what had happened and perhaps needed a little compassion for myself.

 

[noodleknitter]

I understand your vent about this happening, but I have to disagree with the above.

The fact that he acknowledged what he was doing and even your reactions does not, by any means, show that he has control of his facilities and/or behaviors. The fact that this happened while he was agitated points to classic dementia based inappropriate sexual aggressiveness. I am sure he also knew that he was agitated and that you were not happy with him, but that does not mean he could control himself.

I totally agree that it's a shame that health care workers have to deal with stuff like this, but I don't think it is fair to rule out his illness as a cause of this behavior, particularly because it is known to be a complication of the illness.

Well said.

My mom was a Nursing Home RN for years, and it is incredible what she had to deal with. I could never have done the job she did. It is the fault of the facilities for not having resources to protect their nurses/staff adequately. You can't blame a patient with dementia for acting like they have dementia.

 

[4cruisin]

Nope, sorry, I cannot find much compassion for anyone that says they wanted to beat the snot out of an ill, elderly patient w/ dementia. I don't care how bad things got. You took an oath to care for and treat people w/ respect. If you cannot uphold that oath, it's time to move on.

Why didn't you request security to hold the man? And, if I read correctly, there were 4 nurses holding him and he still managed to fondle you? Ok.

I have respect for nurses that have respect for their patients and families. I have respect for nurses that deserve respect, not for someone that wants to beat the snot out of a patient. You really should be ashamed of your post.

 

[chrisney]

Nursing is a difficult profession, but one that can and does truly make or break the lives of people who are in tough situations. I've seen both sides of it with my family.

My mom was in one hospital over 300 times. If I could adopt the majority of the nurses who cared for her I'd be blessed. They are each etched within my heart, and I treasure each of them. There was, on the other hand, one nurse who singlehandedly almost killed her during/after an intubation. I wonder if the staff got upset that we would no longer allow him to care for her? No, in this case I know they didn't because they were as upset as we were. On the other hand, the ER department chair wasn't made aware of the situation, and we had to stand up to him on one admit. By the way, my mom was a nurse and would have no part of initiating a complaint.

My son has Crohns and his colon perforated. He was in a tiny hospital in rural North Carolina. I was concerned, but he received wonderful care from the nursing staff. I reciprocated by doing all I could do for them, including bringing whoever was caring for him dinner when I ran out for mine. The doctor was another story...he wanted to totally remove the colon and do a small bowel pullthrough to a boy who had just celebrated his 21st birthday in surgery and intensive care 300 miles from home. I simply requested that we be permitted to seek a second opinion in our home area. No hysterics, no WTH are you thinking if we can avoid that option we most certainly will at his age.

After basically good experiences with nursing care, I was shocked when he was admitted to a nationally known, supposedly superior hospital for the reversal of his colostomy. (thank god we hadn't agreed to the small bowel pullthrough) The nursing care was almost non existant. I'd been encouraged to stay with him--the hospital even provides rollaway beds for parents/spouses. I did (and I even brought my own sheets so as not to bother the nursing staff since I DO know that they aren't there to serve me). I'm so glad I did, because when he finally needed to use the bathroom we rang for the nurse and waited.....after 15 minutes I went to the desk to explain that he needed to go and was still hooked up to both IV and catheter and reminded them of the procedure he'd had...we then waited another 15 minutes, and finally I had to help him to the bathroom. Mind you, it was his first time out of the bed after major surgery, and it was to go to the bathroom for the first time since the colostomy repair. He and I were both terrified (there is always a chance that the repair wouldn't hold), but as my 21 year old son said with tears running down his face, he couldn't wait any longer. We both survived, but I will tell you that after he was resettled I went down the hall and threw a major fit to the staff. What happened was unprofessional, irresponsible and potentially dangerous. And you know what? They could have cared less. His care did not improve at all. They didn't even go to check him to be sure that he was okay after our excursion. I was glad to leave that hospital, and will certainly not opt for it again if there is a choice.

So, you see, it goes both ways. I'm truly sorry for the day you had. It shouldn't have happened. Just know there are frustrations on both sides of the sheets.

 

[Cool-Beans]

In response to those who have asked, yes, he was being physically restrained at the time by 4 other nurses so we could get the IV back in - one nurse was holding each limb to keep him as still as possible, but it's sometimes amazing how strong elderly people still are. And no, it's not legal - at least in PA - to place a patient in restraints without a doctor's order and the doctor who was called prior to this incident occurring would not order restraints.
A number of you have misunderstood what I have said about his confusion. Patients with dementia can not know where they are or what time or day it is, etc, but still know right from wrong and behave appropriately. He did not behave appropriately and made it clear that he knew what he was doing was offensive to us. And no, I have never been sexually assaulted at work before and I hope it never happens again - whether he understood what he was doing or not, it's horribly degrading even if it was only a quick feel.
As far as actually "beating the snot out of him", I have already said that I would never hit a patient - it would be clearly unacceptable behavior on my part and yes, a nurse could lose her license over an incident like that. I'm sorry to those whom I have offended with those comments - they were out of line, but the first thing I thought of was to protect myself by fending him off as I'm sure many others of you would, but it was worded poorly on my part.
The point to this thread was to attempt to point out that nurses as a whole have to suffer through incidents like this that we have to just accept as part of the job when they are various forms of assault elsewhere. All I asked was for a place to vent my frustrations with the job at hand - I thank those of you who allowed me to do that with understanding in return and I apologize to those whom I have offended - sorry I'm not perfect!

Not perfect?!

I am not perfect. I'm a loooong way from perfect. Having compassion for others doesn't make a nurse (or a person) perfect! But if you're going to nurse, you pretty much have to have it. Not just so that you can derive satisfaction from the job, but so that the patients are well cared for.

You clearly have no idea what dementia is all about or how people in the midst of it behave. It isn't all about being alert and oriented x3. And you say this never happened to you before. I don't know if you are brand spanking new or just lying your butt off.

Nurses have to deal with stuff like this all the time. You need to reach down deep inside you and find the place that does have compassion for people that hit you, try to touch you, scratch you, or throw urine on you. If you find that you don't have it, or can't call on that when in the middle of dealing with your patients, you should quit.

The patients aren't going to change for you and nothing is going to be done about them. Nurses deal with a lot of things that aren't pleasant. You have to get over that and get on with the nursing.

If you find that you can have compassion for those folks, you will also find that your job is easier. It is much easier to put up with unpleasant things from people you care about (ask any parent who never thought they could handle being vomited upon), and you feel much better when you help them in spite of all the obstacles. Your compassion will do your patients a world of good, too.

People who are out of their minds due to dementia, drugs, whatever, need love, caring, and compassion, too. They might even need it more.

 

[Mono~rail]

I've kind of skimmed over this thread reading most of it. I'm an RN, and I also have a love/hate relationship with nursing. For the most part, I love it. It is kind of like the good days are really good, and the bad days seem really, really bad.

Sorry you had such a terrible shift and had to deal with the guy feeling you up.

I'm sure everyone knows this, but I haven't seen it mentioned. When a pt becomes combative and aggressive, the first thing I do is check their pulse ox. Usually, the pt has desaturated. If they are already on O2, I check for an obstruction in the tubing. Usually fixing that problem fixes their "attitude." If I don't see any O2 set up, I re-check the order and usually find where it was ordered, but overlooked. (This applies to a pt that is new to me, or another nurse's pt that I'm assisting with.) If there are no orders for O2, I call the MD and let them know about the situation.

I've seen sweet little old frail ladies become raging maniacs with the strength of 10 young men! Quite often, they have desaturated into the 70's or 80's. Get their O2 going again, and you can watch them become sweet as sugar within minutes (or even seconds!) as their sat rises to WNL.

With our twins, I've spent too much time in the past 2 years on the other side of nursing. We've had many great nurses - more excellent than bad. We have had a few at the top of the profession who are angels put on earth and a gift from God. Some have even been "surrogate mothers" to DD when *I* couldn't be there with her. I tear up when I think about how much their loving, skilled care has meant to us and our DD. But, boy oh boy, the few truly bad ones that we've encountered were hard to stomach.

 

[Mono~rail]

I only mentioned hypoxia in my post above. That's just a point that I've learned to start with because it is the most common.

Another source for aggression in pt's experiencing dementia can be pain. Once their pain is controlled, the aggression resolves.

Sometimes the pt just is confused and feels totally out of control in the hospital environment. I've learned that talking nicely to them helps. One elderly gentleman in particular is coming to my mind. He was confused and fighting every nurse. He wasn't my pt, but I was very good friends with his nurse that had been assigned to him that night. His wife had gone home for the evening. He was yelling and screaming and trying to pull out his IV. I heard my friend talking to him as if he was a child - telling him to be quiet and go to sleep. He continued yelling and I asked my friend if I could help her out. I went in and introduced myself to him. He responded happily and "sold" me a pound of his imaginary tangerines. He then told me that he was in a parking garage and couldn't find his car. Someone had taken his car and he couldn't find his wife. I listened patiently and took out my notepad. He gave me names and phone #'s of who to call to come help him. I wrote down all the information he gave me and showed him what I had written to make sure I had gotten all the information correct. Within minutes, he went to sleep. All he needed to calm him was for someone to listen to him and treat him like an adult.

 

[Maleficent13]

Nurses have to deal with stuff like this all the time. You need to reach down deep inside you and find the place that does have compassion for people that hit you, try to touch you, scratch you, or throw urine on you. If you find that you don't have it, or can't call on that when in the middle of dealing with your patients, you should quit.

I have a question about the above quote. It is MHO, but the reason the nursing shortage is as great as it is right now is because there just aren't very many people for whom the profession is "a calling" and who are willing to put up with the above listed behaviors and worse. Taking that into account, I am not sure what can be done about that...would it be better to not have nurses who look at it as "a job" at all? If so, you're looking at an even bigger shortage than we have now.

As to the OP, I cannot imagine it is *ever* not a big deal to be sexually assaulted, I don't care who is doing the assaulting. Yes, I do understand dementia; but I also understand that as a human being, being assaulted would cause me trauma, and it would not be very easy for me to shrug it off with, "Oh, well, he didn't know what he was doing." I guess that means I am not nurse material, which is yet one more to add to the shortage.

Is there a solution?

 

[Mono~rail]

A big factor in the nursing shortage is a lack of nursing educators. There are lots of people who want to go to nursing school, but there's a lack of seats in nursing classes. There is a mandated nursing instructor to student ratio. I think it is something like 1 instructor to every 6 or 8 students. This doesn't apply to classroom instruction (nursing theory), but it does apply to clinical hours.

There is not a shortage of people wanting to become nurses. When I applied to nursing school, I was competing against approx. 700 other people who had applied for that quarter. I was accepted along with 47 others. By the end of the first quarter, our class had 12 fewer in it. A few failed and some dropped because they figured out that they didn't like nursing. We actually had an entire clinical group of 8 who dropped because of an incident on their first clinical day. I won't go into details, but it was a huge gross out for all the students who saw it!

My nursing class started with 48 of us. By the time we graduated 2 years later, there were only 21 of us "originals." My graduating class was a total of 24. We picked up 3 who had failed out of classes ahead of us and were allowed back into the program and joined our class.

So when all things are factored in (few nursing instructors, intense nursing education programs) you can more easily understand where the shortage is coming from.

Nursing school was one of the most challenging expreriences of my life.