Tuesday, October 9, 2012

Assaulted By A Patient On The Medical Floor

October 9, 2012. 03:50 a.m.
Twenty four hours ago, I became a victim of an assault at work. A patient I was watching on the medical floor punched me on the back of my head and face while I was assisting him in going to the bathroom. But first let me backtrack to the events that led to this assault. I reported for work in South Campus and saw that one of the mental health workers had to float to 1 South. I checked the log book  to see whose turn it was to do it and it was me. I drove to the main building and when I arrived in 1 South I was assigned to watch an elderly Filipino man who the staff reported created no problems during that day, although he had acted out the day before, becoming violent because he wanted to leave the hospital. After getting a snack and receiving his medications, he went to bed and I thought it was going to be a long but easy night for me. At about 10:30 p.m. a nurse discovered another patient having a seizure in his room and the Rapid Response Team was summoned to check him. This patient was just transferred earlier in the day from South Campus for assaulting another patient. He had a previous history of having an adverse reaction to medications causing him to become unconscious. In fact a few days before, he was in ICU because of that. The family also reported that this has happened while the patient was not in the hospital.
 After being evaluated by the doctor, the patient was ordered transferred to the medical floor (2 North). He had apnea and had to be hooked up to the Bi-pap machine. A staffmember was needed to watch him for breathing problems and in case he throws up while hooked up to the machine. Having no other options, the nursing supervisor pulled me from my duties of watching the elderly man and sent me to 2 North to watch what turned out to be a crazier version of Mike Tyson. At first there was no problem because the patient was very sedated from the medications he got earlier in the evening. He was even taken to the radiology department to have a CT scan of the head done, and a chest X-ray in his room to make sure he didn’t breathe anything solid in his lungs while he was having a seizure earlier. Well, after all those tests were done, the patient suddenly woke up and jumped over the siderails of his bed to the ground. He was convinced by the staff to return to bed. As the respiratory therapist was trying to hook him up to the Bi-pap machine, he kept taking the mask off. He was given a regular oxygen mask instead. Then out of the blue, he got up and tried to punch the respiratory therapist. A code gray was called requesting assistance to control an assaultive patient. It was the beginning of a long and difficult night for me.
Due to the recent reactions the patient had to medications, the doctor didn’t want to order anything to sedate the patient for fear that he would go into respiratory distress (I’m assuming). Just a second after the patient tried to punch the respiratory therapist, he looked calm as if nothing happened. He jumped off the bed a second time. A second code gray was called. Again, just as soon as the patient was agitated, he was quiet again. This was a dangerous sign because he was unpredictable and could strike at any time without provocation. Still, a sedative was not ordered. The rest of the staff went about their business after that and I was left alone with the patient. He was also hooked up to an IV and he kept punching numbers on the keypad of the IV machine. When I asked him what he was doing, he glared at me and told me to leave him alone. I checked with the nurse to see if what the patient was doing would affect the operation of the IV machine and he said it did not, so I let the patient do whatever he thought he was doing. He even got angry at a nurse when she told him to put his oxygen mask back on.
The patient fell asleep for about an hour or so, but woke up suddenly at 3:50 a.m. wanting to use the bathroom. I lowered his siderails, unplugged the IV machine, then as I was ready to escort him to the bathroom, I felt a very hard punch land in the back of my head. I felt another one near the same area, then on my left cheek. I yelled for help as I was falling to the floor and a bunch of staff showed up at the door. Then just like a couple of hours earlier, the patient appeared calm right after he assaulted me. He even gave me a urine specimen that the nurse asked me to obtain from him earlier. He was finally placed on soft restraints which I wasn’t sure was going to hold him because he appeared to be too strong for them.
In the meantime, I had other concerns. My head was throbbing and I was dizzy from the punches. I felt a bump where the first punch connected in the back of my head and had some pain on my left cheek. I told the nursing supervisor that I needed to go to the employee injury clinic as soon as possible because I was afraid that I had a concussion. He asked me if it can wait until 7 a.m. because he didn’t have enough staff to cover the patient, and I said it couldn’t. He went to get the paperwork. When he came back, he asked me to fill them out while he contacted the clinic. He planned to have the hospital van take me there because I couldn’t drive myself due to the dizziness. I learned much later that the clinic was supposed to have a shuttle to pick people up but it wasn’t available and not only that, there was no doctor available at the clinic. The nursing supervisor managed to get authorization from the administrator on call to have me treated at our own emergency room. I was escorted there at about 4:15 a.m. and more paperwork had to be completed. Soon, I was evaluated by nurse Jack whom I knew from being floated to the ER once in a while. He obtained an order for a head, neck, and face CT scan. Funny to think about it now, but other than getting my vital signs, neuro checks were not even done on me, nor a doctor see me until was discharged several hours later.
So I was assigned a bed and while waiting to be taken for the CT scan, I just sat there and read a magazine. Pretty soon, I got a text message from Michelle, one of the nurses I work with at South Campus, asking how I was doing. Our charge nurse Jim was checking for possible admissions from the ER and saw my name as a patient there. They haven’t heard about what happened to me. I texted Michelle back saying I was waiting for the CT scan because a patient punched me on the head a few times.
After waiting for more than an hour, the radiology technician showed up and escorted me to the CT room where she took the three ordered tests for the head, neck, and face. She was the same technician who did the CT scan hours earlier, of the patient who assaulted me. After the scan I was back in my ER bed to await the results. My headache and dizziness were still present but felt lesser. Michelle asked me if I needed a ride home and I said I would let her know. Feeling less dizzy an hour later, I told her that I may be able to drive myself home and thanked her for her offer.
Change of shift came at 7 a.m. and I was still in the ER waiting for the CT scan results. This was the worst time to ask a nurse for it as hospital workers would agree, so I just waited until night shift to day shift report was done. I checked with Olga to ask her if radiology is going to call in the results or if they had to check the computer if it was already in. She said they just got the results and the doctor was reading it. Then Jim, my charge nurse and Paulette, the psychiatric emergency team nurse (she was working the ER that morning) showed up to check on me. I told them what happened and that I was just waiting to be cleared by the doctor. A few minutes later, a doctor came to ask me a few questions while I asked him a few as well about my condition and CT results. He said I might have suffered a mild concussion since I didn’t lose consciousness , I was not disoriented, I answered his questions without hesitation, and didn’t have nausea and vomiting. Those were all signs of a concussion by the way. He offered me Toradol for the headache, but I declined fearing it would impair me from driving. He said it wouldn’t but I said no anyway, saying I would just take a Motrin when I get home. After that, with Paulette facilitating the paperwork, I was discharged from the ER. I’m glad she didn’t put me on a 5150 – 72 hour hold J.
My long night wasn’t over yet because I still had to report to the nursing supervisor to find out what to do next with this workmen’s compensation issue. He gave me an authorization for treatment at the employee injury clinic and I was finally able to clock out from work close to 8 a.m. I called the clinic asking them if there was a time limit after the injury for me to show up and the lady said no. I’m planning on going there today for a follow up and see if I can be cleared to return to work tonight barring any complications the rest of the day.

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