I am new to the LTC environment and am working nites as a CNA in a subacute center until I pass my boards. I need some suggestions about dealing with a resident.
My first 2 nights at work, Ms. X rang her call bell every 10-15 minutes the entire shift, requesting help to the BSC so she could move her bowels. Most attempts resulted in nothing; a few times she moved a pea-sized or quarter-sized nugget of soft stool. After about 20 times of answering her call bell (I'm a S-L-O-W learner) I told her she was not moving her bowels and she needed to rest and give her bowels a chance to "move things along" to the point where she could have an actual bowel movement. Her response was to (WARNING: Put your snack down now) dig chunks of stool out of her rectum with her sharp fingernails, ring her call bell every 10-15 minutes, and "show" me that she did indeed need to use to BSC. After these actions, she passed pea-sized and quarter-sized nuggets of stool with frank blood. Needless to say, by the end of the shift I was exhausted.
Last nite, I heard in report that she had been to the hospital for a surgical procedure and was therefore on bedrest for the night. Further, they had cleaned her bowels for the procedure, so she no longer felt constipated. Hallelujah!
10 minutes into my shift, the calls started again. This time, she was calling for the bedpan so she could void. Each attempt resulted in approximately 20 cc of urine. If I did not IMMEDIATELY answer her call bell, she screamed "HELP ME!!! HELP ME!!! I HAVE TO GO SOOOO BAD!!!" at the top of her lungs, waking the other residents. After 4 visits with the bedpan, I put a brief on her and told her she was not voiding enough each time to feel a full bladder. I assured her that the brief would keep her from getting wet if she "accidentally" went, and that I would be back once every hour to check her and put her on the bedpan if she needed to go. This resulted in an even greater acceleration of her demands, claiming that she "couldn't let it go" into a brief, and screaming at me that I "don't know what it's like to be on medicine that makes you have to go so often".
The nurses tell me she has "other things" going on (what, exactly, they won't say) and that there is nothing ordered to calm her down. One nurse helps me with her constant demands, but the others turn a deaf ear or pop their head in long enough to tell her I'll be there as soon as I can (which causes a new round of screaming).
I'm running my @$$ off trying to keep up with her and my other 25 residents, and I'm already dreading work ON ONLY MY 4TH DAY!! Any suggestions?