CNA/HHA difficult patient

[SirAmbala]

Hi. I'm a CNA that has been doing homecare for the last six months or so. In December I picked up a midnight shift full time with an ALS patient. I've been a CNA for six years and this one patient has to be my most difficult yet.

At first I attributed the difficulty of the client with the disease. ALS is a horrible and difficult disease for the patient and the family to deal with, but after being on the job for a few months now I don't know. I've come to realize that empathy and sympathy can only take you so far.

To start she is very high maintenance, which I can deal with but she's becoming impossible. I understand she has limitations but it's gotten to the point she just finds things for me to do. We do range of motion 6-8 times in an 8 hour shift and I don't know how many times I have to massage her feet.

Last week took the cake though. She recently started on a sleeping pill. Which she seriously needed. Most nights I get called every 20 min to rub her feet, fix her pillow. Yada yada. And with this new pill she is very out of it and sometimes confused. Instead of going back to sleep though she wants me to do random things and fights going to sleep. So last week she work up roasting. So we got rid of the blanket. 15min later the sheet was rolled up off her legs. And 15min after that I did away with the sheet entirely. After that she fell asleep for 20min and called me again. This started the almost hour long fiasco as to why her sheet was off and how could I possibly do that to her. That in doing away with the sheet I did horrible patient care and should be ashamed of myself. And quite honestly I didn't know what to say to that. She through a fit over a sheet?

Well after getting the sheet back on and her comfy again she dismissed me. By the time I left she had dropped the subject and I thought maybe it was just the confusion again. Wrong. Came back into work after my weekend off and got a nice lecture from her and her husband. I was told that I am here to provide care to his loved one, and he could not believe what I had done to her. So due to the "sheet incident" I was accused of neglecting and abusing her. Umm... What?

I've taken the matter to my boss, but until she figures out how to handle them I'm here just trying to make it through a shift without losing my marbles. Which my client is doing everything in her power to make me do.

She started stuff again tonight. Called me in numerous times for nonsense and kept falling asleep. After half an hour of back and forth she screamed at me and said she needed the bedpan. Not five min after of me being in there to fix pillows and turn her. So I ran grabbed the bedpan and supplies. She sees me and still keeps yelling for it. Course this woke her husband up and what not. Got her on and off then she starts telling him I'm saying bad stuff to her. Because I had told her earlier she was a little out of it due to her medicine and that's why she was having a hard time deciding what she needed and kept falling asleep.

I'm seriously at my wits end. She's trying to get me in trouble and spends the whole night playing dumb. I do everything I can go help her, but it's not enough. She would rather spend half an hour giving me vague wants then just telling me what needs to be done. "I wonder about me feet?" which usually means she wants them rubbed or moved. And when i try to ask what she wants me to do her response is always something to the effect of "honey I'm sick, and you're supposed to be helping me." oh I know this but I'm not dang mind reader.

How do I stop from losing it eventually? It's to the point im scared to say anything to anyone.

[bluebirdflyx]

Hopefully someone else has something more constructive to say because all I can say is that if it were me all she'd be seeing is my rear end high tailing it out of there and never coming back (after giving proper report to the next staff member, of course).

She sounds very whiny and needy. This could be her trying to gain a sense of control over her situation or that could just be her baseline personality. Either way don't torture yourself and don't let them falsely accuse you of neglect or abuse. In the acute care setting it's more tolerable for me because I know these types will only be there a day or so. At most I'll have them my entire three day run but it's rare they'll still be there the following week. In home health this could be long term patient and it's just not worth it. I'd rather work at Taco Bell.

[Missingyou, CNA]

I agree, I wouldn't continue working there. They will have you fired for neglect.

Have a long talk with the nurse or supervisor and ask for direction. It may mean documenting every single time and reason that you enter her room.

It seems to me that this is her way of gaining control of a situation that she has no control over.

Perhaps they are both insecure about having a stranger helping her. They don't know you, and honestly, there are too many stories out there of caregivers and neglect... I'm sure they've heard them....maybe they need reassurance that you will do everything to provide top notch care.

Watch your body language when you are called in for the 5th time in the past 20 mins. to move her feet. If you are annoyed, the slightest eye roll or sigh will come across as very negative...and can be very unsettling to someone who depends on a stranger for all their needs.

Put "lots of sugar" on everything you do. Smile, be bubbly, sweet and charming. When she says "I'm so sick" show sympathy, even if you aren't feeling it because she's driving you crazy with her confusing demands. If she wants the blanket on & then off all in the same breath, just do it. If she yells at you, say yes mad'am. If you can't do that (not everyone can..)then it would be best if you asked to be reassigned for your own protection.

[SirAmbala]

Thank you for the advice! I've already talked with my supervisor. This week has been horrible. She's been taking anything I say and turning my words to make me look bad with her husband. I've done all the faking I can do at this point.

Last night they had their son come and stay the night to babysit me and make sure I didn't mistreat her on my last shift of the week. Ha. I told my supervisor I'm not going back unless something dirasticaly changes over the next two days. We'll see what happens but I'll probably be reassigned.

[SirAmbala]

She is very whiney and needy. The worst I've ever dealt with. Which is sad coming from a hospital that was more promoted for being a hotel than a hospital.

Last night was the final straw. They had their son come in to babysit me all night. I'm officially not going back unless something changes drastically. They can have fun finding someone to stay.

[Kiki1970]

Hopefully someone else has something more constructive to say because all I can say is that if it were me all she'd be seeing is my rear end high tailing it out of there and never coming back (after giving proper report to the next staff member, of course).

She sounds very whiny and needy. This could be her trying to gain a sense of control over her situation or that could just be her baseline personality. Either way don't torture yourself and don't let them falsely accuse you of neglect or abuse. In the acute care setting it's more tolerable for me because I know these types will only be there a day or so. At most I'll have them my entire three day run but it's rare they'll still be there the following week. In home health this could be long term patient and it's just not worth it. I'd rather work at Taco Bell.

ding, ding, ding! What she said. ^