eversince i worked in a long term facility, i have been yelled, cursed, slapped and just recently been kicked in the chest. it is so hard not to lose your patience specially if the one who hurt you is alert and orientedx3 with HOH. i have been subjected to these problems because i want them not to fall or got hurt but it seems, i am the nurse that is mostly hurt while others are not. i want to solve the problem but sometimes the residents are having a hard time to understand me maybe because i am an asian or i have an accent. i got hurt, i inform the social service, the supervisor, the staff, the doctor and sometimes they will not even believe. i love being a nurse but i don't want to lose my patience because my residents hurt me physically or verbally. i just hope that the facility will screen the resident's behavior as well as there family rather than money.

Remember most patients act out if they are confused, frightened or feel they have no choices. Give them options to choose from. Try and give your patients several choices. When frustrated it is easy to lose your patience but remember thats what were here for. Try and keep in control of each situation, be kind, honest , give them choices so they to have some control, lastly have and try a little humor about each situation. Always have the goal of keeping both patient and nursing staffs saftey in mind with each situation. Maybe her medications need to be readjusted. Good luck , keep everyone safe and remember the psychiatric skills you have learned.

a patient who acts the way you described is called " a sundowner". They are fine during the day but at night they act quite bazaar. We had lots of these in the hospitals where I worked, Most of them were poseyed at night, but now this is not allowed. Perhaps the patient needs a change in her medication. Document each episode so you will have something to substantiate your claims.

Christianwoman, I have a med aide partner in the alzheimer's unit who's been bitten, slapped, kicked, or scratched. She has been working in the unit for about 5 years but still she gets those abuse from the residents. I am a CNA - for about a year and a half, and like you, an Asian. But I will tell you that I've never been kicked, slapped, punched nor bitten by any resident at all while I am on duty at the Unit. I can not tell you whether I am good in communicating with them or I am just lucky. Recently, we had a very confused resident who refused medication, hence her behavior was like intolerable. All the kinds of swearing, cursing, and b words I heard from her, my ears were kind of "virginal" when it comes to those words. I had to tell myself, "she is in a bad state of her mind, so do not listen to her". I did divert her attention to something else. I asked her to tell me something about herself when she was young. She did tell me some but on and on she went back to saying bad words. When we took her to the bathroom before bed, I turned to reach for a pull up, the resident gave the med aide an upper cut on her eyebrow. The med aide cried in front of me. That was her second attack on her on that shift.
When I am with an agitated resident I do not look away while i am near him/her. I DO NOT TRUST HIM/HER.
Sundowners pace and wander and talk before, or while supper time and after. Toileting is usually one of the first thing to do for them after supper. Some of them thinks they have to go home after supper so they are anxious to ask if their husbands, brothers, sisters, or even mom and dad are coming to pick them up. We have to give them reasons not to hurry or to wait "til tomorrow" for them" to be picked up".

Honey, you don't have to tell me about the abuse you get as a geriatric nurse. My most recent injury was May 11, 2007--a herniated C5/C6 vertabrae that has since ruptured. All because an elderly gentleman who was still dopey from surgery and should not have been admitted to a skilled facility yet wanted to get ouf of bed and go home. He was a bilateral knee replacement and was trying to get out of bed. I guess he sort of won that round but he did NOT get up!!!!

I work in a LTF on the Alzheimer/Dementia unit as well.  About 3 weeks ago, one of our men was halucinating, as he frequently does, and sprained my wrist and hand and pinched a nerve in the thumb area.  My thumb is still numb, but it is slowly coming back.  He had no idea he was doing it, so I couldn't hold him responsible. 

One of the things I do to help bring him back to realty is start talking to him about his kids and things he liked to do.  Redirecting him to a different topic that he liked has helped immensely.  Also playing military somngs helps as well.  He is a former US Marine, so speaking to him in military terms helps as well.  If you can find out what they did in the past, it really helps calm them down a lot of times.

Cahrlita, you are soooo right about the "sundowners"  sometimes it even starts before dinner because they think they should be home for dinner.  With one of our residents, we actaully have to call his wife at night to have her tell him that she will be there in the morning to pick him up.  Another, we have to tell him he has a reservation at our "hotel" and that the bus will come in the morning to take him home.  Being creative is just one of the challenges I actaully like about working on this unit.

Sometimes even though a patient is assessed to be calm but when he/she is approached they lash out.  It is unfortunate that nurses are supposed to take it when they are physically, verbally or otherwise abused.  Many times the nurse is accused of causing the abuse.  Causing the abuse would not hold up in other areas of society.  I am not saying that all patients are lucid when they abuse nurses and other health care providers such as CNA's however, I have had it said to me more than once by a Patient at a facility where I work who is AAO X4 that "I am the patient, I have rights, you don't, I can do anything and nothing will be done to me."  She will kick, bite, and throw everything from food to feces at the staff.  The administration caters to her behavior by telling the staff she must be dealt with dignity.  Dignity?  Why would someone with dignity knowingly throw feces at a nurse because she didn't want to take her pills or at a CNA because of not wanting a shower?  In my opinion, the administration is enableing her behavior.  She KNOWS nothing will be done to her, hense, she does anything to anyone she wants too.