Seeking guidance on tricky situation

Specialties LTC Directors

Published

Specializes in LTC, Hospice, Case Management.

Here's the problem... I have a resident that is "out to get me". Yep, I can't even believe I actually typed that. Sounds just like something some very inexperienced "whiny" person would say...but I'm telling you I'm in trouble and I don't know how to handle it. This resident is alert & oriented X3 with no cognitive problems per MDS. Has no actual psych diagnosis on file, although has history of use of psych meds & family admits he has spend time in a psych facility when younger.

Several weeks ago, DURING STATE SURVEY he reported me for abuse (verbal & general mistreatment) to a STATE SURVEYOR. As per policy, I was suspended pending investigation immediately. These allegations were investigated separately by both the facility staff and by the surveyors. In both investigations, the resident was unable to give even one example of something concrete that I ever said or did to him. Both investigations reported that resident consistently strayed off topic.. told of things how I used to lock him and his wife up in the basement..years ago wouldn't give him food, etc. (Before I forget..my facility is on a concrete slab and doesn't even have a basement)! Anyways, I was returned to regular duties and the state surveyors ended their investigation as unsubstantiated complaint. Needless to say, the whole incident was more distressing to me than I can begin to put into words. In 20 some years of being a nurse, I have always had excellent evaluations and residents/families alike have always "loved" me.

Within a week of being back to work, the resident and his son come into my office (shared with DON & she was also present). The resident apologizes to me and says he misses being my friend. Asks me to forgive him for past mistakes. I respond to him (in front of DON & his son) that what he said and did was very personal to me and that it would just have to be a one day at a time thing..take it day by day until hurt feelings are resolved. Son tells resident..that is more than you deserve Dad.

Fast forward to today..one of the nurses comes to me & reports that this resident spent most of the weekend telling some of the aides that "I got her in trouble once and now I've got a great plan to set her up and get her in trouble again. This time she is sure to get fired". I am a well liked "boss" and the nurses and aides luckily "have my back". They come report what he says & openly go above my head to tell the E.D. what is being said to try and prevent further damage.

The powers that be say they are going to ask him to seek alternative placement, but there has been no real commitment on their part to see this thru. In my opinion this man is 1. hurting my reputation with other residents 2. Jeopardizing my livelyhood and could potentially put jeopardize my license.

He is playing a game and seems to get a kick out of it and unfortunately he is winning. Help me understand how to protect myself!

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Specializes in LTC, Magt, family practice, legal nsg.

i would start a log of your whereabouts when you are out on the floor. avoid interactions with this resident without anyone present. request that your DON have a meeting with family to indicate what was said. BTW, you can also file a grievance/complaint. remember that process goes both ways, not just for residents and if there is one, management has to get back to you with a resolution.

goodluck!

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Specializes in LTC, Hospice, Case Management.
i would start a log of your whereabouts when you are out on the floor. avoid interactions with this resident without anyone present. request that your DON have a meeting with family to indicate what was said. BTW, you can also file a grievance/complaint. remember that process goes both ways, not just for residents and if there is one, management has to get back to you with a resolution.

goodluck!

I see you indicate experience with legal nursing. Exactly who do I file a grievance with. This has turned into complete on the job harassment and refuse to let this guy put my license in jeopardy. The higher ups are giving lip service to making him go away...but I've yet to see a 30 day notice given. I should add that I am about the third/fourth employee that he has gotten suspended within the past year - every complaint investigated, everyone found completely unfounded. I'm just the most recent unfortunate target and I think he finds it most amusing that I am the ADON. I personally think he enjoys the game & is now finding it a challenge to see if he can get a boss fired. The higher ups say "they have my back" but we all know how when push comes to shove that things can sometimes really back fire on the innocent guy.

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Specializes in LTC, Magt, family practice, legal nsg.

grievance or complaint form - usually we think this form is only for residents, but this system is for everyone. this will start the ball rolling. you can also place a complaint with your HR department, so that information is on record. if you have a compliance department, i would suggest to start calling and you can either provide an anonymous report or not. every nursing home is required to have a compliance department. i would also suggest that you recommend having a psychologist see the resident to see what kind of fixation he/she has. if there are no prior records of what has been done with previous employees, it will be tough to prove your case later as your best defense is the record of what have happened in the past and chronology of the incidences. suggesting a meeting with the family, with resident present and getting the threat on the record will be helpful to you. consider this as a form of abuse (threatening verbal abuse) and remember, abuse goes both ways and must be investigated. it can also be from resident to staff.

goodluck!

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Specializes in MDS/Office.

OMG this is horrible!! I think you need a good Attorney NOW!! Just because someone lives in a nursing home, does NOT give them the right to make false accusations. False allegations = Lawsuit. Sound too harsh? Not when your License is on the line because of this jerk. Keep us updated. :rolleyes:

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Specializes in Gerontology, Med surg, Home Health.

OKAY, so not every nursing home has a compliance department.

Here are my suggestions and believe me, I have a building full of these kinds of residents:

1. Tell him in no uncertain terms that you are not friends, nor will you ever be due to the nature of the caregiver/resident relationship.

2. Do not approach him.

3. If he wishes to speak to you, always, always have a witness.

4. Call your ombudsman and let him/her know what is going on. I am very proactive when it comes to residents like these and chat with my ombudsman almost weekly.

5. Document everything you say to him.

Sorry to the person who suggested she file a complaint. There is no one to file a complaint with! This is the business we are in.

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OKAY, so not every nursing home has a compliance department.

Here are my suggestions and believe me, I have a building full of these kinds of residents:

1. Tell him in no uncertain terms that you are not friends, nor will you ever be due to the nature of the caregiver/resident relationship.

2. Do not approach him.

3. If he wishes to speak to you, always, always have a witness.

4. Call your ombudsman and let him/her know what is going on. I am very proactive when it comes to residents like these and chat with my ombudsman almost weekly.

5. Document everything you say to him.

Sorry to the person who suggested she file a complaint. There is no one to file a complaint with! This is the business we are in.

Agree. There is no complaint form or person for this in most LTCs. If you are a chain or corp owned then yes, there are probably people you can go to. Ombudsman work for everyone...get them involved.

Sounds like this person has a history already. Cry wolf how many times??

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Just remember to keep a copy of whatever you submit to higher ups. It goes without saying document, document, document. I would also go along with contacting the Ombudsman in this situation. I would also careplan the behavior as well and check with his MD to see if a psyc consult is needed. Even though management says that they support you, repeated complaints whether founded or not could cause you to appear as a liability to their reputation.

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Specializes in LTC, Memory loss, PDN.

This resident needs to be transferred to a psychiatric hospital/clinic. The behavior is psychotic and if untreated will harm him in the long run. Not only might his level of functioning decline, but if this continues, it may progress to the level of self injury to lend support to the fabricated stories. All staff contact, not just yours, must involve two staff members. This patient is highly manipulative. All communication needs to be strictly professional. If he says he wants to be friends, tell him you're here to provide professional care, but he is welcome to have his outside friends visit. Again, he's not out to get you, he's suffering from psychosis and needs to be evaluated and treated.

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Specializes in LTC, Hospice, Case Management.

Thanks all for your support. We did send him to inpatient psych a couple weeks back. He tells everyone that this was my fault as well and it has just increased his anger even more. He claims the psych Dr. there read him a 10 page letter that I had written full of lies to get him in there.

On the upside though, I had yesterday off. I have heard that he physically attacked the DON yesterday - purposely ran her down from behind with his w/c and screaming at her for no apparent reason. Remember, this guy is alert and oriented - knows everyone in the facility by name and their job titles. He knew she was the DON...did not "go after" the first staff in his way.

Systole - you are absolutely right about him potentially causing himself self harm as he told the aides he planned to wait until I was nearby, act like he was about to fall knowing I would come help and then when I got next to him to help, he would fall and tell everyone I pushed him. This is well documented now.

217Shana - Thankfully I had careplanned his manipulative behavior months ago as well as a tendency to unreasonably target particular staff members. It was partly this careplan that helped save my own butt during the surveyor investigations.

Again, Thanks everyone. I have dealt with psych patients for years but this one is vicious. I am hopeful that plans are now in motion for discharge since he is now after the DON and the ADON!

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Specializes in LTC, Memory loss, PDN.

Nascar nurse,

I'm sorry to hear that the patient's condition has worsened, but I'm sure glad you're no longer the primary target. What a relieve. You deserve a week off, not just one day.

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Specializes in ortho, hospice volunteer, psych,.

hugs! hugs! and still more hugs!

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