When my hospice patients try to kill me.

It’s only happened twice.

It was nothing I said or did. Sometimes hospice patients hallucinate. Might be the meds or the illness or terminal agitation. Sometimes it seems to me it has to do with memories. For instance, a number of my patients have relived their experiences in WWII. Those who saw the worst combat occasionally have a very bad time of it as death approaches.

Or… The occasional patient is prone to violent outbursts and when his usual filters break down because of a terminal illness, well, shit happens.

So I had this patient, an elderly man. He was German. As in he’d been born, raised and lived much of his life in Germany. I no longer recall when he’d emigrated to the States. His English wasn’t the greatest, but his wife was quite fluent in English, German and French. She was the sweetest thing and she baked the best sponge cakes.

Anyway…

I knew one thing about this guy, he communicated this one thing very clearly. His eyes said I was the devil incarnate. Seriously. Every time I visited I thanked my lucky stars he was weak and bed-bound. Little did I know…

He planned ahead. I’m not kidding. He hid a knife under his pillow and waited for me to arrive to do my twice weekly assessment.

So there I am at his bedside, my stethoscope in my ears, and I lean over to listen to his lungs–

That man grabbed me around the neck with one hand and tried to stab me in the chest with his other hand. I was stunned by the ferocity of his  attack. I managed to grab his wrist and whack the back of his hand against the hospital bed railing until he dropped the knife, but he still had me by the throat. It took all my strength and the help of his elderly wife to pry his hand away. Man oh man, he was determined to kill me one way or another. I called his doctor and shot him up with a boatload of anti-psychotics ASAP.

We had a long staff discussion about him and our safety (and of course I had to file an incident report) and it was decided that for everyone’s sake he’d remain on anti-psychotics, but we put a big red warning sticker on his chart. Everyone involved in his care tip-toed around him like he was a vicious attack dog. I did manage to keep his behavior under control, for the most part. Things were never perfect. He had a propensity to pinch people really hard. He got along well with his wife though, so that was something. It was the rest of us he hated and feared.

wrestlingOnce upon a time I made a visit to another patient, a bed-bound stroke patient, a man who had always been quiet and cooperative, always sweet. I found him trying to strangle his wife. They were rolling around on the floor, these two frail elderly people. Oh, it was just awful. I managed to get him off of her and then he tackled me. The two of us rolled all over the living room, knocking over tables and lamps. It was an insane experience.

I was trying to keep him from biting me and bashing my head against furniture and at the same time keep him from hurting himself. Meanwhile his wife crawled to the phone and dialed 9-1-1. The longest ten minutes of my life. It took two police officers to pull him off of me and seven of us– the police officer, four paramedics and myself to strap him to a gurney and transport him to the ER so the doctors could start IV sedation.

Crazy stuff and fortunately, very rare.

You know, I always wonder why me. Maybe it’s because I saw so many hospice patients – I was super efficient, in demand, and I carried a huge load of patients – or maybe I just attract the abbynormal (Young Frankenstein). Or maybe it’s just that I can cope with the abbynormal. It’s all part of the job, babies.

I really didn’t want to get bitten.

Hey, I have many more stories. Shall I write more books? love, Julia

 

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6 Responses to When my hospice patients try to kill me.

  1. Tom Stronach says:

    write another book, but take your time, I’ll be around for a while ;]

    You do attract the crazies … oh wait you attracted me…. damn, damn and damn cursed by my own writings again

    xxxx

  2. Yeah, you will be around for a good long while, Tom. I think I shall write another book. I’ve always attracted the crazies.

  3. Write more books.

    And tell us how to get good hospice care under the ‘modern’ systems: obviously, your readers are still here.

    Is it a matter of adding private nurses? What are the loopholes in Medicaid? How do you get a good person? How do you manage your own care and that of your loved ones?

    Now that I think of it, you could add a DIY guide to hospice care.

  4. Alicia, hospice nurses try, we really try. We are dedicated, at least most us are dedicated. I am aware of some hospices where the nurses ignore the patients and instead look at their computers. It’s a real pity. But if a hospice wants to be JACO accredited and meet government standards so they can get paid– everybody needs to get paid, can’t survive on donations– they are switching, actually have already switched, to computers and algorithms. Paying less attention to the needs of the individual. I think hospice houses are a good solution but they are few and far between.
    I don’t know what will happen in the near term because Medicare wants to decrease hospice reimbursement and I imagine insurance companies will follow suit.
    There are some for-profit hospices who do, sort of, give hospice a black eye- but even in those cases the nurses are usually quite good. And they have nothing to do with billing. They just want to do their jobs.
    I was lucky. I left a few years back, before most of these changes kicked in. For me it was a golden age. I love hospice nursing. Would return to it in a heartbeat if I could turn back time. We had the luxury of providing patient-centered care, not cost-effective care– but believe me, I worked so efficiently and so hard I provided both. I provided patient centered cost effective care. But I also didn’t have to look at a computer screen or ask patients stupid questions. I could cut to the chase and deal with the issues at hand.

  5. Roberta says:

    I think you should write a non-fiction book of your True Life experiences…….Wacos on the Ward or some title like that.

    And if you can put this one in any fiction book you may write please feel free to use.

    Had 1st grader one year. Knew it was going to be a bad tear – she flunked Head Start and K.

    One day she just went off. I had to hold on to her but she was so strong she wrestled me to the floor. She was strong. VERY strong.

    She told me to let her go or she would bite me…I told her if she did I would bite her back. She said, “You wouldn’t dare.” I said, “Try me.” She looked at me strange but she didn’t. I had a reputation that I did what I said so she did not dare.

    I had one of my students call on the phone intercom to have some one come immediately and sent another running down to office to get principal. Took principal 10 minutes to pry her loose from me.

    Afterwards principal showed me what she did on way to office. She grabbed hold of the steel door of a locker and bent it all the way back.

    Amazing some 8 year old could be that strong. But that is what happened when she went crazy.

  6. Roberta, wow, just wow. My husband’s nephew is like that. Super strong for his size and out of control. He was born with some problems. How scary for you. I do write nonfic so… maybe another book is in the works.