Recently on my cardio placement, myself and another student happened to encounter a patient with an extremely violent history with unresolved severe mental illness, drug abuse and was Hep C +ive. He was admitted to the ward with a severe chest infection and subsequently stayed for most of the duration of our 4 week placement.
Although we did not directly have to treat the patient as he was deemed too aggressive, we did on occasion have to talk past him and talk to him when he confronted you. The patient hadd 14 code blacks (personal threat) called against him and required 4 point restraint on the bed and sedation on multiple occasions. He also required security guards to follow him whenever he left his room.
The patient became increasingly aggitated and restless as the weeks progressed and his behaviour more unpredictable to the point where he lashed out at a nurse who was not even looking after him and proceded to assault her. Knowing this it made it made me feel anxious and nervous around this patient when I passed him in the ward as he had a tenedency to talk to anyone he wanted to very unexpectably and would demand you reply. I found myself not acting like I usually would and becoming quite reserved around this patient.
Unfortuntely the patient picked up on this and and the change in behaviour toward him and not other patients was enough to set him off into a spat of abusive insults to all staff on the ward.
I learned as the days went on that the best way to deal with this patient was to be alert and on your toes at all times due to his unpredictability but also to treat him like anyone else and ask him how he was and try to relate things to his life even though I was not treating him in any way. The patient responded well to this and would often initiate harmless conversation with me knowing that I wouldn't judge him for his past.
Tuesday, November 18, 2008
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2 comments:
This blog reminds me of north bridge on saturday nights. i think this reflection can help us deal with aggressive people in general
Thanks, Laura for that insight, i would have never thought you'd find this type of patient on a cardio ward. I had plently of patients like this on the head injury unit with frontal lobe behaviours. Being on your toes is the only way while treating them like anyone else.
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