How do I Handle Trifling Calls?

[TheLazyCNA]

Hello, allnurses, I am a new CNA with 4 months experience and I would like your advice on a new resident I'm taking care of. He will call every 5 minutes, no joke, for the most paltry things I've ever seen. He might need me to reposition his call light because he can't reach it (how did he call me then?); he might need me to reposition his blanket an inch to the left even though he is already covered; maybe he wants me to change the AC temp to 71 degrees from 72 only to call me again 3 minutes later saying he needs it at 70 degrees instead; etc, etc. Then one day he wants to "sleep" next to the nurses station so he can call out my name every single time he see's me walk by, the dude doesn't even care if I need to use the restroom since he needs attention NOW.

I was told to visit him more often, every 30 minutes but that's not enough for this guy. Nothing is EVER PERFECT ENOUGH and I feel like finding a new career if I have to put up with this worm for the next couple of months!! I understand he is "paying" me 9 bucks an hour but so are the other 17 patients, they deserve my attention too. Some CNAs told me to be "firm" with him but when the Nurse supervisor see's me doing that then he starts ******** bricks and caves in to the resident's demand because the resident might say I'm being rude. "Just give him what he wants!"

What would you all do if you were in my spot? Thanks!

[nlitened]

Did you ever think that maybe he is just lonely? And having him up at the nurse's station might be a good idea. Or how about staying in his room to chart? My advice would be to talk to him...maybe he is scared or maybe he is use to being waited on hand and foot (is his wife still alive?). Yes, he does need to be told that you need to assist other patients/residents, but I think there may be a reason behind his neediness.

[TheLazyCNA]

Actually that was the first thing did; had a conversation and built raporte. I even believed that he was not that bad in the beginning but time proved me wrong. As for charting, we use electronic Kiosks and mine happens to be right outside his door where he can see me. His wife is alive and visits him daily and so do his friends.

[meanmaryjean, DNP, RN]

I'm disturbed by you calling a patient a 'worm' and dismissing his requests as 'trifling'. I'm certain he's able to pick up on your attitude.

[TheCommuter, BSN, RN]

To be fair, this resident does sound like a time-suck and a manipulator compared to the other 17 residents under the CNA's care, although every story has at least two sides.

The OP has 18 residents. Although this resident is probably lonely and craves attention, some of the calls do seem 'trifling' to me, IMHO. Pressing the call light to get the aide to reposition that very same call light? Calling every three to five minutes? There needs to be a limit to this behavior.

Compassion is necessary, but it isn't always efficient. With 18 residents in the LTC setting, and with one of those residents sucking up a disproportionate amount of time via q5 minute calls, someone needs to put their foot down on behalf of the other 17 residents who have apparently been forgotten.

[RainMom]

Had a similar pt a couple weeks ago on the floor. Each time I asked if there was anything else she needed before I left. After the 3rd light in 30 minutes at the beginning of the shift & spending several minutes each trip with her, I point blank asked again if there was anything else & stated I would likely be in one of my other pt's rooms that I had not seen yet if she thought of something else in 10 minutes. Helped for a little while so I could get around to my other assessments at least.

[icuRNmaggie, BSN, RN]

The OP described the behavior of a needy narcissist. These people have the maturity of a 2 year old child. This isn't loneliness. It is a constant craving for attention and an audience and they lash out if they don't get it, do they ever. They are incapable of empathy for you or anyone else.

Good management means rewarding appropriate behavior with some attention. If this person makes absurd requests respond with reality orientation and withdrawing attention. " You have to do as much as you can for yourself" and leave.

Sleeping in the hall and yelling your name is disrupting the whole unit and he knows it. He wants to be the center of everything. I would give him one warning thathis behavior is unacceptable, then move him to a room as far away as possible from my work area. This person is harassing the aides and that needs to stop.

[TheCommuter, BSN, RN]

The OP described the behavior of a needy narcissist. These people have the maturity of a 2 year old child. This isn't loneliness. It is a constant craving for attention and an audience and they lash out if they don't get it, do they ever. They are incapable of empathy for you or anyone else.

You are spot on. We must remember that just because someone's a sweet-looking elderly man or woman, he/she is still capable of outrageous behavior.

A narcissistic patient/resident sees the members of nursing staff as objects to be manipulated, akin to a gum wrapper that is folded, then wrinkled, then crumpled, then tossed into the wastebasket. The world revolves around a narcissist, so nobody else matters, not even the roommate in the next bed who might be coding.

[caliotter3]

How the story never changes. I remember the same situations from my CNA days when the nurse would always respond, "Give him what he wants". That answer is for the nurse's benefit, not that of the CNA, the resident in question, or the other residents on the CNA's assignment.

[Missingyou, CNA]

Sleeping in the hall and yelling your name is disrupting the whole unit and he knows it. He wants to be the center of everything. I would give him one warning thathis behavior is unacceptable, then move him to a room as far away as possible from my work area. This person is harassing the aides and that needs to stop.

You, as a CNA have to be careful how you handle this resident. If you are "firm" with him, another aide/nurse/family member(next door even) may view you as being too horifice and uncaring and will report you as such. It will get ugly for YOU.

Talk to your nurse and if they are no help, talk with the DON about this behavior and your concern that it takes time away from your other residents. ASK how they want you to handle the situation.

In the meantime, everytime you pass by him, say hi. (I know, you're in there all the time anyway!)Sit him next to another resident he may be willing to chat with. Hand him an activity of some sort.

When his call light is on, peek in his room to make sure he is safe, and when you realize it's something minor, tell him from the doorway (if he sees you) I'll be right back, I'm in the middle of something else. He may yell and get angry, but you really are in the middle of something else and meeting more important needs at the moment. You have to set priorities in order to meet everyone's needs.

You really do need to address this with a supervisor and ask the other aides that work with him to back you up.

[icuRNmaggie, BSN, RN]

All good points. It should be a team effort.

I was speaking from the RN perspective because I had to deal with a person like this recently. It is exhausting.

[johndough]

The patient probably does not like living in an LTCF and that's why he is lashing out. I've been to numerous LTCFs to know that I definitely do not want to live there no matter how nice the facility is or not. You're not in the wrong to be upset with it. He's probably reverting to child-like behaviors because he's not getting what he wants.