Can I refuse to work with a certain resident?

[Newbie93017]

Just like a resident can refuse us, can we refuse them? My issue is with a resident who lies about the care I've given her and I'm getting sick of it. And apparently it's something she does.

Example: I asked her do you want to get up on your wheelchair today. She says I'm not getting in the chair. Like 2 times. I said are you sure? She says yes find me some pajamas to wear. I said fine. Washed her up, changed her and put a nightgown on her. An hour later she's telling the restorative aide I didn't ask her and she wanted to get up. I'm like I asked her. And the RA said she knows I did and she does this to everyone. I don't feel comfortable caring for her when she's going to lie and try to get me in some sort of trouble.

What should I do? And I float, so I have no regular assignment, but once in a blue moon I get assigned her room.

[caliotter3]

You can always make that request of your charge nurse, but that does not mean that they can, or will want to, honor your request. Perhaps you can bring about a change of behavior with this resident by bringing in a witness, preferably the charge nurse, when you approach to deliver care. But since she does this with everybody, it is probably ingrained and everyone knows to expect it of her. It is what the supervisors do with any false complaints that should guide your concerns.

[Newbie93017]

I'm a new CNA, only been doing it for 2 months and as much as I know that we all know she does this, I don't want my reputation soiled in any way. Coz one person will take her serious some day when she makes these false claims.

Its disheartening because all I want to do is the right thing by these folks and knowing a resident enjoys messing with us is a little upsetting. Like we're trying to care for you. And you're going to treat people this way. And she's completely aware and present and to my knowledge has no mental issue so she can totally stop if she wanted.

I just am glad I don't have her assignment very often. I don't know if I could take her everyday.

[andielbc]

There are residents like that where I work, so I know what you're going through. It is pretty disheartening because you do want to provide them with care but they just won't let you and then lie about it. I suggest that you continue doing what you are doing and even if she doesn't want to get in her chair, just make sure she's clean, changed, etc. Whenever she refuses, make sure you let the RN know. "Mrs. Smith refused to get into her wheelchair again." I also second what was said above, if necessary, bring someone with you - even if it's just another CNA - so they can witness her refusal. Over time you'll learn how to talk to each of your residents and gently convince them to do things. (I have one lady that refuses to shower unless we talk for about 15 minutes before and I slowly talk her into it.)

[Newbie93017]

Yea I have her assignment today again and I made sure I brought someone in with me. We ultimately got her in the chair. She would stay in bed forever if she could. But anyway, I'm just gonna have to bring backup every time I have that convo with her, I guess. Thanks for hearing me out everyone

[caliotter3]

Make sure that you enlist the cooperation of your coworkers by offering to do the same for them, or by offering to help out with something else in return for the time they take away from their own duties in order to act as your witness. The resident, since they are mentally alert, will probably pick up on the fact that you are using a "witness" when delivering care. We automatically had our witness because the charge nurses had us work in pairs. Working in pairs increases efficiency and safety and you always have your "witness".

[Newbie93017]

I offer to help others regardless, sorry I would've said it but I didn't think something like that needed to be said Haha it's simple common courtesy and team work and that's never been my problem haha

[Apple-Core, ASN, BSN, RN]

Have a witness present and document everything if possible. If not, report it immediately after leaving her room, and preferably have that notated by the charge. Overkill? Maybe, but at least you're CYA!

[Shellikins]

Exactly... document document document! Have a witness, report to the charge nurse, etc. IT's all about CYA, make sure yours is covered and you'll have no problem. Sounds like they know about this resident and her shenanigans already...

[sroseyos]

Another vote for the power of documentation! Even if you can't have a witness in the room with you every time you work with this patient, as long as you tell someone, or better yet document on paper, every interaction you had with her, you'll be protected down the road when she challenges your story.

In answer to your initial question, I would strongly advise against refusing to work with the patient unless the situation becomes so bad that it prevents you from doing your job. Patients have a right to refuse us because it's in the organization's best legal and customer-service interests not to force a patient to receive care from someone against their will. Our responsibility is to care for and accommodate all patients, even the difficult ones. Asking not to be assigned to a particular patient has the potential to cause problems for your supervisor and will also risk putting you in a bad light.