When did it become ok for patients to do this - page 2

by mskrisCNA2bRN

3,055 Views | 18 Comments

I've been working as a CNA for a few weeks now and I've been hearing and seeing in the news about the horror stories about patients being physically abused and sexually assaulted by the caregivers. But what do you do when a... Read More


  1. 2
    Totally unacceptable behavior by those patients.
    ...I have had comments made at me, but it stopped quick when I explained that my husband is 6' and 245 farm boy who would have no problem coming in and discussing "professional boundaries" with them!
    The offending patient never did that again! :P
    dpcRN and marycarney like this.
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    It genuinely doesn't bother me when a demented person does this. I'd rather have that than combativeness. But the few times that an alert person had made comments... eww. It makes me glad that I work in a nursing home where even the rehab unit doesn't get a lot of men at all, never mind alert ones. But I used to get that kind of crap all the time as a cashier. A lot of men are like that in their daily life and get off on thinking that since you are "serving them" in a professional capacity that you don't have the power to do anything about it. They LIKE making you feel uncomfortable, and they LIKE the power differential. If they're truly not "like that" but are just making a comment because they're nervous about being in a position of needing something from you, then when you react with surprise or discomfort they will not do it again. If the dude is a jerk then he'll keep doing it and you need to try not to show how uncomfortable you are, and act like you do not notice or care. If they get more explicit after that, feel free to make a cutting, sarcastic remark, but again, don't get emotional about it, because that just eggs them on. You don't want them to think they're getting a rise out of you or making you feel degraded. I know that in this line of work you're supposed to be all nicey-nice and everything is considered abuse, BUT I can't imagine getting in trouble with the nurse for making a wise remark when an alert and oriented patient is sexually harassing you. I feel like in my experience nursing is a lot more supportive than supervisors in cashiering jobs (it's sad how much abuse you are expected to take in those jobs). If you outright insult the patient you will probably get spoken to about the appropriate way to deal with these situations. But I don't think there's anything wrong with saying, "Gee, too bad I'm not allowed to date patients because you're soooo charming!" or something like that.
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    The way we were trained to handle this was as follows. Stop what you're doing. Look them straight in face and repeat what they've said to you. In my experience this will usually stop them when they hear how inappropriate they've been. Next step is to tell them that their behaviour is unacceptable and will not be tolerated. We were taught to treat them like a two year old when these innopropriate behaviours occur (it may sound harsh but it works and we're not there to be ogled and groped). If they think you're nervous or uncomfortable they'll keep at it just to wind you up. Touchy feely dementia patients are a little more difficult. I keep an eye on their hands (and feet) at all times as my residents can try to slap your bottom one minute and box you the next (they aren't sedated). Residents with these behaviours have assistance from two anyway which makes it a little safer.
    aTOMicTom and DizzyLizzyNurse like this.
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    Ugh, blech, yuck. I hate these situations. I am typically a very non-confrontational, bubbly, sweet girl. Many people interpret that as being flirtatious, which I am most definitely NOT. When I first started my job (as an ophthalmic tech), I got many comments about my size/body which were very uncomfortable to deal with (I am very petite/was a dancer). Since then I have learned to minimize my makeup, keep my hair up in a bun, and definitely NOT wear any clothes that show my body -- loose scrubs and lab coats all the way for me. It helps minimize the subject even coming up, though I know lab coats are not commonplace for RNs.
    dpcRN and aTOMicTom like this.
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    The approach that has worked best for me is to look directly at the patient/resident (if A&O) with strong, confident eye contact and say something to the effect of "that is inappropriate and you may not do (say) that" while stepping out of arm's reach (if the person is grabbing me, if that doesn't compromise patient safety). People become uncomfortable with being looked at directly, and will usually break their gaze first. Appropriate, professional, assertiveness is a good place to start, and hopefully will remove the "fun" of making you uncomfortable. With a confused patient, do your best. Redirect and distract, but be sure to also inform them that touching you/saying inappropriate things is not OK. Sometimes these little old demented men get confused in the middle of the night and mistake you for their deceased wife (I've figured this one out based on the name they address me with. . ."is that you, Louise??")

    If that doesn't work, inform the nurse caring for the patient, further on up the chain if you get blown off. (Actually, be sure to tell the nurse caring for the patient so they know what happened and can integrate this challenge into their management of the patient's care.) Also, don't forget to talk to the CNA relieving you about the behavior so they, too, may do whatever limit-setting they need to to manage the patient/resident.

    Thank goodness for male CNAs and nurses! Sometimes they're just the ticket for the resident/patient that can't/won't stop being inappropriate with female staff.
    aTOMicTom likes this.
  6. 0
    Quote from boogalina
    ...Thank goodness for male CNAs and nurses! Sometimes they're just the ticket for the resident/patient that can't/won't stop being inappropriate with female staff.
    I am a male, and I approve this response.

    As I read the first few posts in this thread, I thought about how cool it'll be to see the look on some old perv's face when I walk in to relieve his nurse at his much-anticipated peri-care time. I never thought I'd look forward to doing personal care on someone. But to surprise some old chester? Heck yeah, sign me up! (as long as the nurse helps me out when some LOL grabs my glutes)!

    What movie was it where the dude thinks he's about to get a "sponge bath" from a cute nurse and she switches with some large Village-People-looking dude? Maybe a "Scrubs" episode...
  7. 0
    Quote from boogalina
    The approach that has worked best for me is to look directly at the patient/resident (if A&O) with strong, confident eye contact... People become uncomfortable with being looked at directly, and will usually break their gaze first...
    Careful with this if you decide to work in corrections nursing... there it's called "mad-doggin'", and will get you into a bit trouble! "You mad-doggin' me, boogalina?!"
  8. 0
    I just read a short story in, "When Chicken Soup isn't Enough". There was a group of nurses who brainstormed how to deal with this situation in an empowering, yet non confrontational way. They would have a stack of cards at the work station. If they encountered a patient acting in this way, they would simply hand them a red card. The card stated that their behaviour was inappropriate in this environment. The nurses kept a pink card which reminded them to breathe, state that the behaviour was unacceptable and a number to report the incident. Maybe not the only option, but I thought it was kind of a neat idea.
  9. 0
    Quote from aTOMicTom

    Careful with this if you decide to work in corrections nursing... there it's called "mad-doggin'", and will get you into a bit trouble! "You mad-doggin' me, boogalina?!"
    Duly noted. Of course inmates are a different kettle of soup, so to speak. Used to go "inside" quite a bit in a prior career. Never got accused of "mad doggin'" so must have been doing it right! Not planning on a corrections nursing career except as concerns admits to my hospital from the fine local slams.


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