Question

Description: Review the case study and discuss the incorrect behaviors that occurred the during the study.

Objectives:

• Understanding the use of safety and infection control procedures to keep staff and patient's safe.

Instructions:

Respond to the following:

Patient John Smith had a COVID test a week prior to his test. It returned negative. He walked in for his study late. He says he is not feeling like himself. He tired and he has chills. You note his gait is unsteady. You notice that he smells of alcohol. The patient was assigned to a room while the technician is working with their other patient.  

The patient became agitated and started complaining about his wait.  

How should this patient be handled? What should you do and is there anyone you should contact?

Answer 1

Ingestion of alcohol causes impaired comprehension, attention and concentration and memory resulting in distractibility & inappropriate behaviour.

In hospital settings a drunken patients requires careful assessment and treatment, although they can present challenges to all members of staff. Moreover, staff requires support and training in managing these people.

General principles to be followed by a nurse while handling drunkenness

• Assess the attitude of the intoxicated patient
• Calm, professional, and non-judgemental behaviour should be followed by the nurse.
• Orient and establish rapport, communicating clearly, slowly, and simply.
• Allocate a single health worker but Security department should be ready with handling any issues created by the patient behind the scene.
• Maintain low level of external stimuli by placing away from busy and noisy areas so that agitation can be reduced.
• Avoid provoking the patient.

Behavioural management can be done by;

Pacing: Pace the interaction at the intoxicated patient’s level of cognitive impairment.

Key words: Avoid negative key words (don’t fight us) and use positive ones (let’s be friendly)

Distraction: useful at impasses and with higher levels of intoxication.

Stop and go: Style of interacting whereby you stop positive interaction at the point of unwanted behaviour, deliver a terse message, but return immediately to the friendly, positive interaction.

Contingency contracting: Tell the patient what they need to do and what and when they will get as a result.

Safety Management

A common problem while handling drunken patients is to deal with disturbed and antisocial behaviour. The health care professional has to call for assistance from the security for ensuring the safety of patient , staff & also for maintaining the peaceful atmosphere in the hospital.

Nurse should made necessary arrangement for the restraints incase of handling an agitated client.

A separate room can be allocated for Mr. John Smit in this scenario to avoid disturbance to other patients, which will also helps for minimal stimulation.

Legal Issues

Consent ; A decision also needs to be made about a person’s ability to consent to treatment. Here Mr. Smit came for a test, if it requires a consent, the health care proffessional cant collect it from him because he is not in a state to give a valid consent. But in case of emergency, if a drunken patient needs lifesaving treatment health care proffessionals are allowed to provide for saving the life of the patient. i.e in geneal adults have the right to make decisions about their health treatment. In common law every adult has the right and capacity to decide whether or not to accept medical treatment. This capacity may vary over time in conditions such as dementia, confusional states & mental illness.. A patient who is drunk will almost by definition have some interference in his normal level of higher mental functioning. These issues also relate to the issues of allowing a patient to leave the hospital if there is concern about their safety and welfare.