CNA Accused of Abuse

[halerac88]

I was recently assisting a coworker with helping provide peri-care to a resident when the resident suddenly became combative and verbally abusive after we had turn her on her side. She began to hit and scratch me and call me abhorrent names. I tried to ask her to stop and she mocked me, I tried to hold onto her arm, but she continued to strike me and even dug her nails into my hand. The next day my DNS Assistant called to inform that the resident had bruising and swelling to her wrist and that it was going to be investigated. I am scared that I am going to lose my job and my license. This resident has been known to make false accusations and even falsely accusing aides of causing injuries. She even told us as we were changing her that she was going to report us and have us fired like she did the others. What should I do?

[FolksBtrippin, BSN, RN]

Take a deep breath and relax.

Your job is very hard. You didn't abuse the resident. You were trying to do your job and the resident got hurt.

Changes need to be made regarding this resident. Firing staff didn't work before.

Something isn't working in this situation. Is there a protocol for combative residents? Were you trained on it? Does this resident have the right to refuse peri care? If so, you may have made a mistake in continuing to attempt care when the resident became combative. Be honest with yourself about this. Making a mistake is not the same as abuse.

Cooperate with the investigation and be honest. Ask for guidance in handling these situations.

Most importantly, think about how you can handle this differently in the future if it happens again. If you don't have an answer you need to talk with management about it abd come up with a plan, because this is a terrible situation for you.

[halerac88]

No one has actually been fired. Her and her family members have even made jokes about being abused traumatizing the cnas. I admit that I should have never provided care when she started becoming combative and verbally abusive. My coworker who was there even said I did nothing wrong, I just feel terrible that the resident was hurt in the process and so was I.

[CryssyD]

You had a witness in the room with you, who can attest that you did nothing wrong. And if this patient has a reputation and a history regarding this behavior and multiple accusations against multiple caregivers, I don't think you have much to worry about.

In general, trying to manually restrain a combative patient is not a good idea. The best thing to do in that situation is to stop trying to do anything with that person, and leave him/her alone if you can do so safely; then, notify the doctor and your supervisor right away; write up an incident report--about the patient injuring or trying to injure you. If you can't provide care without the risk of someone getting injured, something needs to be done--by people higher-up than you. Dump it in their laps and let them figure it out.

Meanwhile, no one should even enter that room without a witness!

[halerac88]

I talked with my DON today and she told me she can't pit me back on the floor until the investigation is over. I wrote a statement and she had me email the pictures of my injuries I sustained from the incident. She even talked to my coworker but I still haven't heard anything yet in regards to the investigation. One of my other coworkers said she saw the bruise and it was the size of a silver dollar and it was on the top of the hand. I'm scared that this could have been from something else and the resident is trying to pin it on me like she did I'm the past with another coworker.

[FolksBtrippin, BSN, RN]

How old is this resident? Isn't it likely that when you tried to restrain her or protect yourself, that she could have gotten the bruise in that commotion?

[VicChic20]

Is this resident alert and oriented at all? If so, next time if she becomes combative , try leaving her be for a few minutes to calm her down, then reapproach her. As for the investigation, take deep breaths and be honest and direct about what you write. I'm sure nothing will happen to you if she's got a history of combative behavior. I hope everything works out.

[neuron]

I would leave the room or mark 'patient refused'. If you were helping a co-worker, remove yourself away from the patient. Your certificate isn't worth losing over an unruly patient.

[highway32south]

If you think there is any chance whatsoever that the resident may be hurt while you are providing any care, stop what you are doing immediately and inform the nurse. We had a CNA who was working a double because management asked her to. On her second shift a resident was being combative while the CNA was providing incontinence care. The resident kicked the CNA and in the process, the resident broke her own femur (osteo problems). The CNA got fired because she didn't stop when the resident became combative.