What they didn’t teach you in nursing school Part 1: How to duck punches
I could literally go on for days with a topic like “What they didn’t teach you in nursing school.” Rather than bore you with a long entry, I thought I would expound on this topic in parts.
Part 1: How to duck punches.
Nursing is not the most glorious job despite what your nursing school leads you to believe. Don’t get me wrong, I love my job. BUT, I’m not quite sure where the system breaks down in nursing school in the sense that you really don’t get a full picture of what real nursing is until you are on the floor. Sink or swim time.
Many patients who suffer with dementia come in to the hospital due to co-morbidities such as heart problems, stroke, or trauma sustained by falling. These people are quite possibly my favorite demographic. Despite some confused speech at times, they really bring so much wisdom and character to quite a grim situation—during the day, that is.
Be careful, new nurse. As night approaches, so does a little symptom called sundowning. Sundowning, I’ve learned, is not just a term for the severely demented patients. Many detox patients become very agitated at night, a typical time for binge drinking. More so, patients who have been in the hospital a long time (add painkillers) can suffer from depression and confusion which can worsen at night.
Imagine you are a patient and someone comes in your room and wakes you up in the middle of the night to stick a needle in your arm and draw blood or to put a cuff around your arm and squeeze it as hard as they can. Not so pleasant for anyone. Now add confusion, cloudiness, anger, aggression—all which are typically associated with the afore mentioned patients. What this mixture brings, so I’ve seen many times, is an angry right hook.
Nurse: It is imperative that you protect yourself. First, left arm up to cover your face. I’ve found, if you duck quickly towards the wall at the head of the bed, you are somewhat out of range. Do not forget any needles or sharps in the bed! While ducking, make sure to grab the sharp and stab it directly into the bed mattress to protect from a stick (although this move is quite risky and you can feel like you are in the Matrix), or simply kick across the room and deal with it later. Make sure you keep the safety of the patient in the forefront of your mind, and call for back up if it gets out of hand.
Always remember: Treat these patients with the utmost respect. One day your family, or even yourself, could end up with these symptoms.
You may also be interested in this discussion regarding psych patients.