To think this nurse didn’t do anything wrong?

[WeirdHandDryers]

Situation - nurse working night shift on hospital ward.
One elderly patient with dementia thinks she’s also a nurse and spends all night trying to see to the other patients. If staff try to get her into bed she becomes distressed. All night she’s wandering around the ward. All the staff at wits end with her.
So this one nurse gets a bag of dressings and tells the lady that she’s hurt herself. She then sits there writing her care plans with this elderly lady in the office whilst the lady ‘bandages’ various parts of her body (including her head!). The woman was occupied for hours and for the first time, all staff had a decent night, no chasing her around, no distressed old lady, no angry patients getting poked and prodded ...
did she do anything wrong? Someone has let it ‘leak’ to manager and she’s been told off. I thought it was a decent solution!? (No it wasn’t me).

I'm not a nurse nor a dementia expert but that sounds lovely. I'm guessing they cited that the other patients might be missing out on care?

I think that is exactly what nursing should be.

What’s wrong with that? No harm done and the lady probably felt calm as a result. What would they suggest - chase her around the ward all night and wrestle her into bed with a knock out pill?

My grandmother-in-law was similar in her care home - she used to be a nurse, and had regressed to that in her dementia. They let her do 'duties' (under supervision), as it stopped her from becoming distressed, kept her active, triggered memories (and probably helped with some basic tasks, heh).

Sounds like a perfectly reasonable way to deal with the situation. We often do enhanced observations on patients who need 1 to 1 support, with the idea being we should get an extra staff member sent to assist. Doesn't always happen due to staffing issues, and in this situation you often end up firefighting, it's a nightmare. I would in face say a massive well done to that nurse, and log it in my list of solutions for exactly this scenario!

It stopped a ward full of patients being disturbed, gave a patient comfort and meant the rest of the staff could get on with work without having to watch over their shoulders

Sounds like a caring and effective solution. I can’t see why the nurse was criticized. While her time was taken up looking after this patient at least the patient was calm, not disturbing others and the nurse got some work done. If the nurse had not occupied the patient this way presumably time would have been spent anyway on getting the patient back to bed, trying to keep her there, etc.

This is how dementia care should be handled. The nurse should be given recognition, not disciplined by some jobsworth.

I personally don't see anything wrong with this, I once gave a confused lady a duster and asked her to dust the window sills, she had the most contented few hours doing a job and felt useful.

The danger is/was that someone may not agree with what I or they were trying to achieve and it could come across as they were taking "the mickey" or its inappropriate.

That nurse sounds lovely. It would be a real shame if she ends up in trouble over this

Perfect. I work in healthcare and as long as the shift went well, everyone was cared for then no issues at all!

We are taught to get into the patients reality. If the patient thinks she is a nurse then finding something to keep her occupied is a fantastic thing. I've cared for ex nurses and I've often had "help" when writing care plans or restocking drawers when they are unable to settle down to sleep. I've also had patients rewind bandages and 'polish silverware'. The patients are wanting to do something that their bodies remember doing ie being a nurse or cleaning or being a mum and if it gives them a tiny bit of pleasure then I will keep doing it as God knows dementia is an awful disease.

Sounds wonderful. Anyone who has issue with it is frankly an arse.

Perfect. Paperwork gets done, patient is supervised and not distressed. Other patients can rest and nurses can get on with what they need to do.

I am sure there is a staffing ratio somewhere which is what has caused the report. Or maybe she was in a non-patient permitted area. But imo it was absolutely the most caring form of treatment for that patient at the time. One nurse and one patient. How many nurses would it take to keep returning the patient to bed, or even keep her there.

Glad you all agree with me. Should have added the nurse was going to be sat in the office all this time anyway as she was writing careplans, then she stayed through her break to let her bandage her and stick plasters all over her while she had a cup of coffee and when she did have to leave the office, she told the old lady that her student was injured, and got the student to sit with her being bandaged. I thought it was a good lesson for the student too personally!

How lovely. It would be awful if she got into trouble for this, she sounds like a great nurse.

If this was on a children’s ward it wouldn’t be a problem, so why is it a problem because it’s an adult? We get children to play all the time!

She was doing a wonderful job, such a shame a jobs worth felt the need to tell her off!

She was told off about having a patient in the office where confidential information was.

Someone will have reported her for 'skivving off'. People are sad sometimes.

I saw a lady on a ward on our Trust who was sat at the nurses station first thing every morning and last thing at night. She was probably there most of the night tbh. They gave her a stack of scrap paper, some pens and other stationery and she was happy as larry 'helping' the nurses with their paperwork. She never actually touched their paperwork, but wasn't aware that she wasn't really 'helping'. She usually just sort of shuffled the scrap paper, you know how when you want it all lined up?

My gran often helped make the beds in the nursing home she lived in. It’s a great thing to keep them busy and feeling useful.

She was told off about having a patient in the office where confidential information was

Well, the lady with dementia that advanced was hardly going to read it all and go and blab to the rest of the world, was she?

I have a lot of experience in dementia care and it sounds as though the nurse is a very good one. She found a perfect solution that did no harm to anyone!

What would they prefer? Her going round and disturbing the rest of the patients, or maybe doped up to the eyeballs and a falls risk the next day!

It used to be advised that people with dementia should be corrected/challenged because to go with the situation would be collusion. Current good practice is that if it's safe and not likely to lead to further distress, to run with it. The old guidance would result in dementia patients being retraumatised over and over again (eg with being told someone had died who they thought was still living)
It sounds like what the nurse did was a perfect example of that, but I can see that if it's not part of a care plan someone would probably want to check that it was ok and not at the expense of other patients.

Who would want to be a nurse in this country anymore. Criticised from every angle.

I work with dementia patients and this would be applauded, and recommended to other staff and wards. This is EXACTLY how you should be.