Sorry in advance for the super lengthy post but I really need some good counsel. I have been working so hard recently that it's only now that I have had 2 days in a row off that I have had time to ponder and become alarmed about my situation at my new job.
I am a new LPN of less than 2 months and I currently work in a LTC. I work the 3-11pm shift and I am the charge nurse for 40 residents and 3 CNAs. It's a pretty tough shift with a huge med pass, treatments, GT feeds etc.
I have one resident who is a huge problem and I don't know what to do about her. Also my nurse manager (who is on day shift) is not helpful in the least when it comes to dealing with this lady.
This resident is a transfer from another nursing home where she had a slip and fall accident. She is legally blind (i'm not sure how much she sees) and immobile because she is recovering from surgical wounds that aren't healing properly because of her DM.
This resident has told me flat out that she is engaged in a lawsuit with her previous NH and she says things that make me fear for my license.
She is extremely demanding, tells lies, and is impossible to satisfy. No matter how much we cater to her she manages to find fault with everything that we do and gives the impression that she is being neglected and abused.
She is not senile (she is actually only middle aged) nor does she suffer from any sort of mental illness (recent psych consult has been done).
When she is out of bed she complains that she wants to go to bed. When she is in bed she wants to get out and it's always immediately like right now. When I try to set limits and say that aides are with another resident but I can have them fulfill your request within x,y, z time frame she gets angry and then complains to the next shift that we had her OOB for hours and hours and says that we ignored her.
She hates all of the food so I always had to call the kitchen for substitute meals for her on every shift I worked. So I finally got wise to her and had the dietitian consult with her to select a few things that she likes to eat. So now her new thing is that the food is not fit for a "dog" to eat and that she wants something different. She says I can't wait for my son to get here because I never get enough to eat around here. I asked her to clarify her statement because there is a difference between not getting enough to eat and not liking what you are offered. One gives the impression that we are trying to starve you and the other is that you just don't like the food.
She acknowledged to me that she just doesn't like the food but she says many sly comments like this all the time.
The worse is that she will say that we do not administer her pain meds and nebulizer treatments. She has said this to me about other shifts and I have been asked by other nurse's on different shifts.
I caught her red-handed lying about not getting medication.
I worked a double shift 3-11pm and 11-7am a few nights ago.
I gave her her 10pm nebulizer on scheudle as well as her hs ambien and tylenol 650mg at 9:50pm. At exactly 11:05pm I hear her start to moan and groan and call "nurse, nurse, nurse". I go into her room and all I said was "Yes, i'm here" so I guess she didn't recognize my voice.
She says "I didn't get my 10pm treatment or any medication and I can't breath".
My jaw dropped!
I told her that I am the evening nurse and that I gave her her meds and treatment a little over an hour ago. She was shocked she asked me what time it was and I told her and then she asked where the night nurse was and I told her that I was staying all night.
I took her vitals and listened to her lungs and she had no signs of respiratory distress. So I told her that if she really felt that she needed another treatment at that moment I would have to call the doctor and have respiratory come up because I can't administer nebulizers prn.
She then sighed and said well ok then I guess I will just lay here and die then.
I have tried to listen to her when she wants to talk but I can't stay for more than 5-10 minutes because my time is very limited. Also a lot of what she tells me turns out to be lies.
Everything that I do for this resident has backfired on me.
She was depressed because her children never call or come to visit her so I got the social worker to contact her children and basically made them call her. She was on the phone for 2.5 hours the evening that her son finally did call and what does she do? The next day she complained to the nurse manager that we didn't put her to bed until 10:30pm at night and that she was in pain from sitting in her wheelchair for so long. This is a lie because she was on the phone until 8:30pm and then as soon as she was done the aides put her to bed. Trust me, no CNA is waiting to clean and put a resident to bed at 10:30pm because they are worn out by that time and are just doing final bedchecks to make sure that all the residents are dry.
I got her a new bed because the old one with the handcrank wasn't good enough for her. She wanted one with electronic controls so she wouldn't have to always bug us to come in and raise and lower her bed. Well I get it done and what happens? She says the side rails on the new bed are too short and now the pillow that she uses to prop her side up will fall on the floor. So now she is on the call bell every two seconds for us to pick up her pillow and blanket that keep "mysteriously" falling on the floor.
When I go into her room I explain to her that I am doing _________ and that I cannot come back to her room for _________ amount of time. I ask her to tell me everything she needs but it is inevitable that as soon as my foot crosses the threshold of her door that she will be on that call bell again to tell me one last thing she has forgotten.
The worst was on Friday. She requested to be taken OOB at 2pm by the previous shift. When I came in at 3pm she wanted to put back into bed. I explained to her all of the tasks that have to be done during change of shift and advised her that it would not be until after dinner time that we could put her back to bed.
I am not kidding you guys it was impossible to get her back to bed anytime sooner. The DNS called a meeting for the CNAs at 3:30pm and then one for the nurses at 4:00pm. Between 3-4p I had to count my narcs, get report, do my fingersticks, hang 3 feedings and oh did I mention a resident hurt themself in the elevator so I had to do some impromptu wound care, call the supervisor and then the doc, start an incident report etc. Could her timing be any worse? The CNAs are just as busy running around doing rounds and then 2 of them have to take residents down to the dining hall while one stays on the floor to serve.
Meanwhile I have this lady in her WC complaining very loudly for all to hear that we wouldn't like to be treated this way and says that she is being neglected.
My nurse manager is sitting at the nurse's station trying to finish her work so that she can go home. She is in a bad mood (all of the time) so all she does is bark out that I need to do this and that. Mind you she is always still around long after her shift, taking up space at the nurse's station and in general being a witch. She also likes to leave her orders for me to pick up (like I don't have enough freaking things to do as it is) and complains constantly about how incompetent everyone around her is.
She speaks to me in an accusatory tone of voice at all times. I feel like I constantly have to be on the defense with this woman. One time I came into work and without so much as a good afternoon she jumps all over me about how I didn't do any treatments and pass this or that med because of omissions in the MAR and TAR. I had to (respectfully) interject on her tirade and point out to her that the previous night was my day off. This facility couldn't get an evening nurse for a long time on my floor and now I know why. I find myself writing down my days off in a little notebook so that I can defend myself when I am accused of not doing this and that. I know that I am a new nurse and that I will forget to do things or not do them properly at all times but this woman acts as if I am a lazy, sneaky, good for nothing.
Also this NM held a meeting for us 3-11pm people because of this resident's complaints and claimed that the resident said we are the worst shift. Which I find hard to believe because the same resident has told me that night shift and day shift are the worse on separate occasions. How can this experienced nurse not know that this resident is manipulating us? She basically screamed at me and was flipping through the chart telling me that I need to document what this lady is doing and I am telling her that if she would read the notes that she would see that I have been doing just that! There is rarely a shift that goes by that I don't write a behavior note about this resident but the NM isn't reading this woman's notes and when I pointed this out to her she looked at notes saw how many I do write and then she shut up and changed the subject w/o acknowledging that she is falsely accusing me of not doing my job.
I document, document, and document some more about this lady but is that going to be enough to save me if and when the poop hits the fan? I'm not feeling to good about this woman I can almost swear that she is looking for another lawsuit and I don't feel that my co-worker's have my back in anyway.
There is actually more that this resident has said and done but this would truly be a book length post.
I'm just so inexperienced and I feel like maybe I am the frog in the pot on slow boil. If I get out of this place can I just expect more of the same? Or am I working in a toxic environment? This place should have a revolving door because they lose nurses just that quickly and the only ones who seem to stay are the older nurse's who are close to retirement. All of the nurse's my age or younger are recent hires of less than 6 months. Is that a sign that I need to get the hell out of dodge?
