Group Forums >> Public Health Nursing >> How do you deal with a combative resident ?
How do you deal with a combative resident ?
|
Posted 7 months ago How do you deal with a combative resident lets say for example if you have to get a blood sample from him or her? |
|
| Posted 7 months ago I have had a lot of experiences with combative residents, one thing to do is always have another person go with you. Usually it works with a CNA who the resident seems to really take to who can help to distract them if things start to go downhill. Make sure that you have everything ready, but out of eyesight so the resident doesn't stress out from it. Then calmly explain that you need to take a blood sample for the doctor to run some tests with. If the resident starts to stress that's where your CNA comes in...they can talk about something the resident enjoys so the resident can calm down. Then you work quickly. Most of the time it works, once you get everything in, just continue to reassure the resident that it will be over soon, that you aren't trying to hurt the resident, you want to make sure there isn't anything going on to make the resident sick, etc. Have the CNA hold the residents' hands gently, so they can't pull anything out. If the resident is not easily calmed down, put your stuff away and wait for later. |
|
| Posted 7 months ago You can always check with the nurse and see if the patient is taking any anti-anxiety meds. Sometimes if you plan your care after they have had their meds, they are much calmer and more receptive to care. I also agree with soco38nurse...take someone with you! Celebrate breastfeeding! |
|
| Posted 7 months ago soco38nurse said: My experiences were sometimes very difficult, but i got the perfect solution, yes go with two persons, but also bring some literature with you and give it to the resident and explain to him/her what the consequences can be if he/she refuses and treatment or other give them a brief explanation of what their illness can develop into as they keep on refusing treatment, and 90% of my cases it did work if you use some medical terms and explain what it all mean, they will not understand what it all mean but it will scare them and they will be cooperative, and those who are hard headed? it varies in countries ans states, here we will call the doctor out if necessary . |
|
| Posted 7 months ago starcrush said: This is common in dealing with dimentia residents in the nursing home facility where I work. It consistently needs to be started at the team level where it may involve alternating staff or using creative/innovative approaches to suit the residents needs. In a facility where their are social workers on the staff, it is important to involve them initially and let them know what is occurring before things start to get out of hand (which typically occurrs in many instances). It is always important to keep the resident from harming themselves first and others. I always consult my supervisor / RN routinely to make sure something isn't going on that I am not aware of initially. |
|
| Posted 7 months ago My experience with dealing with a combative person is simple, .....redirection. If they start off combative, leave them alone, attend to someone else.....and com back. Yes I would have back-up, and a smooth conversation....that I would use for a distraction. I come in with a warm smile and interesting conversation.....as well as a reassuring hand that everything will be ok. |
|
| Posted 7 months ago Last night I had a resident who at first was so cooperative when I told her about taking a shower. As soon as we enter the Tub Room she started to say NO! NO! NO! and was going for the door. I had a male student with me to observe and learn how bathing is done. When the male student spoke to the resident she turned to him and smile and was listening. I instructed the student to feel comfortable and keep on talking to her while we were trying to get her into the chair and to the shower. She tried to bit me, slapped me but I am in a good distance from her so she didn't get to me at all. I told the student that the resident always mention about her husband so that a male figure would be a great help in that situation. We managed to bathe her without so much struggle because of the student's presence and by talking to the resident, redirecting and reassuring her that all we want to do is to help her and everything is gonna be okay. |
|
| Posted 7 months ago When the patient is combative I leave them alone and try at another time or: 1) offer them something to eat they could be hungry 2)ask if the patient has pain 3)Does the patient want to use the bathroom or need any thing, if this does not work ask someone they like to offer them emotional support or assist you with explaining to the patient the purpose of your being there. I next reevaluate the necessity of my intervention and if its absolutely required, if not follow the patien's desire.then notify your team leader and md. |
|
| Posted 7 months ago griercamille said: Excellent advise griercamille. Something that is not emphasized enough in nursing/patient care schools. There are many factors contributing to an altered mental status, not just Alzheimer’s... Pharmacological, environmental, metabolic/endocrine, emotional, ect... and/or a combination of. When a resident/patient/client cerebral cortex is not functioning well, the medulla/ponds take over in response to the internal and external environmental stimuli/changes. There is no magic bullet to this issue, but we as care givers have to be the ones to be patient and understand that the patient/resident/client is in a perceived temporary crisis, sometimes we will be able to manipulate the crisis and sometimes not. I guess that the key is knowing your patient/resident/client not only personally, but also their medical history. |
|
| Posted 7 months ago First I'll state I'm still a student so I don't have a license to lose, then I need to know if the pt understands what is expected, there's a big difference in a combative pt and one who doesn't understand what is happening. Now the hard part if the pt understands and refuses care thats it, legally there is nothing more you can do. Now is the time for tact, or maybe guile, you have to convince the pt thats whats needed really is needed. I have always been the tough love kind of guy. I prepare them I prepare myself, and I tell them this is what we're going to do, Bluff them make them think they have little choice, I'm not evil i'm trying to help them sometimes that strength that you show is all they needed to see. Don't ever lie to the pt but you don't always have to tell them " you know you can refuse this if you want " Be their advocate and if that sometimes means being refered to as nurse cratchet thats a price I pay. I once worked an oncology floor where they always gave me the pts who wouldn't bath, or didn't want to get out of bed, that kind of thing, I was tough I used every trick I had to and when that didn't work I really got dirty and got there families involved. People just hate showing weakness to some of there family members. I say whatever works is good. Always remember they're weaker than you and use that to your advantage to help them. A gunny I once had told me that" tact was the ability to tell someone to go to hell and make them happy they were on there way" I guess my point is this be nice when it works, but be whatever it takes to help your pts. You can teach a pt or come back later but now is the time I'm here and I don't know when later will be, or if the pt will refuse again. be strong you can do it. for you and them |