Recently, Ms. Nase took care of a Veteran in the CLC.  The Veteran was admitted to the CLC for some rehab and had a discharge plan of discharging to a Medical Foster Home.  Upon admission to the CLC, the Veteran was on constant observation, at night only, because of confusion and concern for elopement.  Within a couple of days of admission to the CLC, the Veteran was assessed to have increased confusion and risk for elopement as he would leave the unit.  The staff was not aware that he had left the unit and other staff in the facility escorted him back to the CLC.  His constant observation was increased to all day, with the goal of ensuring his safety. 

Two days after starting all day constant observation, Ms. Nase recognized that the Veteran was having multiple episodes every day of anxiety and angry outbursts.  The episodes didn’t last long, and each time the Veteran apologized for his anger.  Ms. Nase took time to sit and talk with the Veteran.  The Veteran shared that he had been a POW for 10 days while in the service.  The Veteran told Ms. Nase that he had never shared that information with anyone because he had done some things that he wasn’t proud of during those 10 days bud did what he had to do to survive.  The Veteran said that having someone constantly with him, as is the practice for constant observation, took him back to his POW time.  Having someone walk with him or “follow” him everywhere he went all the time was unbearable to him.  He confided it was causing him severe anxiety and he was struggling to “keep it together”. 

Ms. Nase was so supportive.  Not only did she listen to him, but she also approached her nurse manager to describe the mental anguish the constant observation was causing the Veteran.  She shared information about changes in his vital signs and behavior to support her assessment of his mental anguish.  She also shared with the nurse manager the conversation she and the Veteran had about making sure he was safe, including telling staff when he was going to walk outside the unit for exercise.  She requested that his continuous observation be discontinued, at least during the day to relieve his mental anguish.  She included input from staff who had also been working with him that supported her observations and request.  The changes she requested were made. 

The Veteran thanked the staff for listening to him, supporting him, and not judging him.  His remaining days in the CLC were without incident and the Veteran was discharged to a Medical Foster Home without experiencing any additional anxiety.