Nursing Voices

Tuesday, November 13, 2007

Your Nurse Can Kick Your Butt

I know what you’re thinking. You think that this nurse is clueless, and that she is about to be attacked. But do you see the smile on her face and the twinkle in her eye? Mr. Criminal doesn’t know it yet, but all hell is about to break loose. Security officers are about to storm the unit, and Mr. Criminal is going into four point leather restraints.

Nurses may be angels of mercy, but we have no problem setting aside our halo and wings when we are being attacked. Believe me, the kid gloves come off when someone tries hitting a nurse. Psychiatric nurses are pros at kicking some serious butt, and we have no problem with giving copious amounts of Haldol to a violent patient while we are putting them into restraints. Personally, I will do whatever it takes to de-escalate a situation before it spins out of control. I’ll spend lots of time talking to patients, and I try to understand what they need to help them regain control of their behavior. I do this for many different reasons. First and foremost is the issue of safety. Takedowns are extremely dangerous for everyone involved. I’m too old to rumble, and I don’t want my patients to get hurt. There are times, however, when some people come into the hospital looking for a fight. Some of these patients have criminal backgrounds, and they utter the word “suicide” so they aren’t hauled off to jail. There is nothing that can stop them from acting out, and nurses are forced to respond. If you ever see a nurse smiling while a patient is threatening to harm them, please stand back.

The best is yet to come.


Blogger MY OWN WOMAN... said...

None of us want to see our patients hurt, our fellow co-workers hurt, our selves hurt, or worse yet, innocent patients who just happen to be around the violence hurt. Those wings have been known to fly off to defend others and ourselves.

After all is said and done, my wings fit back on perfectly!

7:35 PM  
Blogger Mother Jones RN said...

Well said MOW.


8:35 PM  
Blogger FetchingGal said...

How come the ativan makes my patients worse and the haldol never works???? Why, oh why???

10:29 PM  
Blogger Mother Jones RN said...

Ativan can disinhibit a patient, making them more violent or bizarre. Haldol doesn’t always work well on patients who suffer from brain damage, or on those who have received large doses of Haldol in the past.


10:46 PM  
Blogger marachne said...

Ativan can have a paradoxical effect--you want to be particularly careful with older folks or those with renal failure (us gero people have a mantra -- benzos bad) Haldol has to be in an adequate dosage, plus you often need to not think of it as a one-time thing but a round-the-clock dosing.

Sometimes quitiapine (seraquil) is another good option

1:10 AM  
Blogger GuitarGirlRN said...

Mother Jones and marachne:

Thanks for that info! I never knew the reasons why, but my experience has been that with elderly people (and those who have had recent strokes--I used to work in a stroke unit) ativan and haldol tend not to work at all, and can even make the patients worse. Geodon or Seraquel tend to work better.

12:37 PM  
Blogger Jean-Luc Picard said...

A good lesson about those drugs.

3:08 PM  
Blogger Varan said...

Bring back Paraldehyde! Best. Drug. Ever.

8:00 PM  
Blogger FetchingGal said...

MJ, Marachne, that makes sense. Thanks! :)

9:55 AM  

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