So I'm a nursing student. I'm in my very last clinical rotation in an ADN program. I got assigned this patient, 81M with dementia and during report it was said that the patient "has a history of violence against nurses." Seriously, that's what it says in the chart and that's what the night nurse said to me and my preceptor. It kind of piqued my interest, but report was so rushed, I barely had a chance to ask about it before we were off to the races. I took his vitals and his blood sugar, and he's like ANOx1. He had a sitter (a CNA). He was nice enough in the morning but was gradually getting more agitated the closer we got to noon. My preceptor had me retake his blood sugar - just in case. The sitter says to me, "he needs something to relax. He's getting agitated." I said, I agree. My preceptor comes in and does her own assessment and goes, yeah, we need PRNs. So she looks in the MAR and now realizes that we have no PRNs for agitation. No haldol, no ativan, nothing. So she puts in for a perfect serve and goes on with her day. Ngl, I was scared - not for me but for the CNA. I wanted the sitter to just leave him be. Let him pull out his foley and IVs - it's not a big deal, we'll fix it later, maybe when he calms down. Meanwhile, the patient's daughter comes to see him - and things come to a head. He assaulted her so terribly. She landed on the floor, and I thought she was knocked out. The CNA was holding back the patient and two other nurses and the nurse manager have to hold him down. Eventually security gets there and they put him in restraints. Finally, the haldol order comes in. My question, if you know that a patient has a "history of violence against nurses", why not preemptively have a PRN sedative on standby? Why wait for someone to get assaulted before getting an order?   submitted by   /u/Phantom471 [link]   [comments]