Using the reflective cycle designed by Gibbs (1988), I am reflecting on a recent experience while I was out on clinical placement.

 

I was walking about the ward doing patient checks. Upon coming to bed 13, I saw that the patient had a razor in his hand and had started shaving hair off his head. I alerted one of the AINs who was nearby who said to take the razor off him. Once I did, he started telling me he was going to get out of bed and chase me. He started to get out of bed and in a panic I gave him back the razor. The AIN said to get it back off him so I spoke to the patient in a calm manner, got the razor back off him and walked out of the room. The patient got up out of his bed and started chasing me around the ward, swearing and saying he was going to choke me, all while his pyjama pants had fallen to his ankles. The nurses calmed him down and eventually gave him medication.

 

The feelings that I encountered were fear as I didn’t know what he would do, embarrassed as I didn’t know how to react in the situation and incompetent within myself because I wasn’t sure if the approach I took was the correct one. The good thing is I learnt that behaviours in patients with dementia and delirium are unpredictable and that I did see it first hand, however to be put in such a confronting situation is not one I want to be in again anytime soon. Understanding that it is the dementia that is doing this to the patient and not the patient himself is part of person centred care. Being a student nurse, I was unsure of what to do and I am not sure if I was able to do anything else in that situation at that time. If a similar incident was to arise again, I would seek the advice of the nurse I was working under and talk calmly to the patient about the instructions I was giving him.