Is this abuse?

[isthisok]

I am a CNA student and today at clinicals I witnessed a situation that I feel was not right. The CNA I was assigned to and I were changing a resident's diaper. The BM was everywhere and very unpleasant. After the CNA had removed the old diaper, the resident started having a BM again, to which the CNA responded "Why do you do this to me?" (Note- all quotes are approximations. I don't remember the exact words.) As the CNA was wiping, the resident commented that the CNA was being too rough. In response to that, the CNA said "Why are you always so negative? I am trying to help you and you never have anything nice to say. etc, etc" After that, any time the CNA needed the resident turned on her side, she would pull the resident's arm with no warning and it was visibly uncomfortable for the resident. The resident was able to turn on her side using the bed rail but I guess it was not fast enough for the CNA. At the end of the changing, the CNA held the bag with the dirty diaper near the resident's face and said "Look at what you did." Furthermore, the CNA wiped back to front on the female resident. (The BM was in the front already however.)

Is this abuse and should I report it? Besides being uncomfortable during the turns, the resident didn't really seem bothered and was even smiling at one point. Previous interactions between the CNA and resident didn't seem strained either. I couldn't tell if this was just the humor of the CNA or not. I think I should have been more confrontational during the changing, but unfortunately I freeze up in situations like that (something I need to work on). Also, I will be working with her for two more days and didn't want to strain our relationship (although if this is worth reporting I know a resident's comfort is worth some discomfort for me).

If I do report this, what would happen? Could the CNA possibly take it out on the resident?

There was another situation with this CNA and a different resident earlier in the day. The resident has dementia and as far as I could tell is pretty out of it. While we were getting her up for the day, the CNA was pretty rough with her, nearly causing the resident to fall at one point. The resident was screaming and saying things like "You're going to hurt me" which I think is normal for a resident with dementia. Whenever the CNA would turn her back, the resident would reach out a hand to me to get my attention and then mouth/whisper unintelligible words to me, in what seemed like an attempt for help. She seemed very relieved to get away from the CNA when I walked her to the dining room. The CNA had warned me that this resident could be cranky if she woke up too early. In this case, it seemed like the resident was trying to get help from me, but I wonder if she is just confused because of the dementia? Also, in the dining room, the resident would point to random people and say "Oh look, watch this" as if she was showing me something bad was happening when in fact nothing was happening. So maybe she is just paranoid.

Any advice is most welcome. Also, please let me know if anything in this post is a HIPAA violation.

[Red Kryptonite]

Talk to your instructor. Much of that does sound abusive. Unfortunately, it won't be the last time you see it.

[Whispera, MSN, RN]

If the CNA reads here, she surely will recognize the situation. Always be careful what you post on an online forum.

[Spidey's mom, ADN, BSN, RN]

My mom is in a LTC for dementia patients and I'd say YES, this is abusive.

Talk to your instructor and just carefully and calmly detail what happened.

And yes, be careful about posting here.

[mvm2]

I'd talk to your instructor but I'd make sure you just givethem the facts of what you saw. Tell them i saw this and thought I needed to talk to you about it. I would NOT say anything like I think I saw a CNA abuse a resident or anything to that nature. Tell her what you saw and let her do her job and decide what she needs to do about it.

[BuckyBadgerRN, ASN, RN]

Diaper? Really?

[icuRNmaggie, BSN, RN]

The two incidents were emotional and probably physical abuse.

What would you do if someone mistreated your

grandparents like that? I hope that you would

confront the perpetrator. That is exactly what you need to do the next time it happens. Confront the person. Ask her "how would you like it if someone shook a bag with soiled diapers in your face?" And then find the top administrator and report it.

[mvm2]

Unless the resident is in physical danger I don't know if I would confront the CNA especially if I was like OP and being just a student. Go and tell someone definetly but I don't think confronting such a individual when I have no authority is a good idea. Could make the situation worse then better because if this is how she is treating the residents it is obvious she does not care about the rights of the residents and a lowly student would not be saying anything to her where she sees the error of her ways

[icuRNmaggie, BSN, RN]

Human decency compels us to protect anyone who is vulnerable and being mistreated. You do not need authority of any kind to stop it and report it.

[Ndy-RN]

Report what you saw to your supervisor. No need to approach you colleague because it seems that there may be an unpleasantry if she is approached

[missmollie, ADN, BSN, RN]

I would report it. It kills me that anyone who signs up to do this job would treat a resident like that, and you have a responsibility to keep that resident safe. Tell your instructor if you're just a student, she'll take care of it from there.

[Angeljho, MSN, NP]

Report it to your instructor, and then leave it up to him/her to deal with. Do not try to follow-up or be a vigilante. That's where many students go wrong.