Harassment at work, patient to staff - page 3

I am a nurse in LTC and have had to deal with abuse (verbal, emotional) harassment from a patient for quite awhile now. Management knows this is going on as they have been informed repeatedley and there is documentation to... Read More

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    Wow, such open hostility! I hate to see the facility you work in!!

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    Our LTC facility sends people out to psych facilities if they continue to be a problem. We had one lady that was constantly telling the Director of Nursing & Administrator that all of the workers were doing things that we weren't. She was counseled several times & finally sent out. What a relief to have her gone!
    lindarn likes this.
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    Quote from merrywhiterose
    Our LTC facility sends people out to psych facilities if they continue to be a problem.
    And how does that help those that have advanced senile or alz. type dementia...who don't know that what they are doing is wrong, and oftentimes are unable to actually stop or modify the behavior?

    The patient that the OP is referring to has a brain injury and ST memory loss. Is the verbal assault that he does right? No, however, I doubt that shipping him to psych facility is actually going to do the patient any good.

    It seems to me that the behavior is a manifestation of frustration on the patient's part. Why not find reasonable solutions to try to control and minimize the frustration and behavior? Seek out resources that are able to help with the problems associated with brain injuries and develop the care plan accordingly. If all else fails, a referral to a facility that has experience in treating and caring for patients with brain injuries would be appropriate and might be beneficial to the patient.
    Last edit by ClearBlueOctoberSky on Feb 29, '12 : Reason: correction of terms
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    I am a recent lvn grad and i am currently working at an assisted living facility for a month now. Out of the 1 month, i've only worked for 7 days because i am only on call. Out of the 7 days, meds have been thrown to my face, verbally abuse, and been hit twice. Every time i'm about to go to work i feel like having a panic attack. I am terrified of the resident and the work. I have about 60 residents all with dementia ranging from moderate-severe. I know you're not supposed to take it personally but it is affecting me both physically and mentally. I totally feel your pain. I want to quit so bad. I even spoke to my nursing director about giving my 2 week notice, but she said just hang on. Other places are more difficult. I don't know what to do i never expected nursing to be like this.
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    I am sorry to hear you are having such a hard time of it. Alas, patients have all the rights. Nurses and aides and techs do NOT. Some hospitals post such things as "We are a 'no violence hospital' which means respect is expected"...or something along those lines. I work in a psych hospital and we are subjected daily to verbal abuse by the patients, at times by coworkers, at times by management. There is NO recourse. There HAVE been a few (VERY FEW) severe abuse cases(staff members nearly beaten to death by patients) have resulted in the patients being sent to prison. Generally, in our facility, we are expected to "expect the abuse and put up with it" or quit and in this economy there are too few jobs out there to warrant resigning.
    lindarn likes this.
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    i don't have any answers for you ...i have been there and management did not take me seriously either, they said i was taking it personally. I had other nurses administer their meds with the same abuse and they said they would never return to that room because they could, she wasn't their true assignment. Management did nothing. I left that place after 3 months and moved closer to home so not sure how it ended up...but just know it happens and it is frustrating that we have no true outlet....i did document everything (and this patient was alert and oriented and a previous nurse!!!!! i know how hard it can be, i came home in tears because no one backed me and helped me deal with the abuse....you are not alone though and I hope you can maintain your strength and get through the day!
    lindarn likes this.
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    Quote from srimer
    I'm not quite sure if you've been educated enough to be able to handle "abuse" in LTC. Most residents are no longer able to control their behaviors, and "verbal abuse" just comes with the territory with dementia / Alzheimer's. Ask your Administrator for an in-service before you go off the deep end. Most of us who have years of experience have learned to smile with the behaviors and realize that that particular person could be a loved one someday, and do we want them medicated just so staff can "deal" with them? I say "no" and so would most state agencies. Keep your chin up and have some humor (it really helps). Or, you may want to consider a career change.

    Good luck!
    Not sure I can agree with you on this one, dear. Mostly when I read this, I get the image of some nursing administrator who's concerned only about the bottom dollar of that "client" instead of the wellbeing of staff members. While I don't agree in unnecessary medication, I DO believe in the safety of myself and the staff members I work with. It is TOTALLY unappropriate to simply simper and smile and wave butterflies and hope everything is alright simply so we "don't have to medicate dear daddy". The very idea that healthcare professionals would write such a thing does not sit well with me. Please read the OP notes a little closer. This situation goes beyond trying to redirect a patient with a cup of tea! God forbid...that the OP need to have a career change simply because of an OUT OF CONTROL patient. This is NOT the OP's problem, but the clients. Good Lord!!

    To the OP...you have my sympathy. This situation sounds totally out of control. Document, document, document. Chart behaviors, and wording. Do this consistantly, and fill out incident reports also. If patient ever physically touches you, involve the police. Asault is asault, no matter what your administration may tell you.
    lindarn and Nurse Leigh like this.
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    Moved to Nurse Colleague/Patient Relations for more discussion.
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    The resident has a brain injury and short term memory loss and I donít think youíre going to be successful in reducing this behaviour without specific interventions. What has been tried so far?

    Could you leave the meds until he or she comes up to you demanding them and saying you forgot? Then you can say Ďoh, perhaps I did forget, let me checkí and make a bit of a production of looking through everything before coming up with the meds and saying Ďgosh, sorry, here they are!í The aim is to reduce the behaviour, it doesnít matter if the resident thinks you would otherwise forget or deliberately not give them or steal them or whatever it is they think. Maybe the satisfaction of believing they are right would actually be a good thing for them. It sounds like the behaviour is escalating, maybe thatís because they feel that no-one is listening to them. Not saying for a second thatís the way it is, just saying itís probably the way the resident sees the situation.

    I wonder if he /she had a specific routine for medications prior to admission? Maybe they were always taken with breakfast or after breakfast or after cleaning teeth or at 9.30am on the dot or straight after getting dressed or any of million other things. If so, can you can you change your routine to accommodate that?

    Distraction by another staff member, as mentioned by another poster, might work too. ĎCome on, Iíll make you a coffee and then Iíll go back and ask about the medications for you, weíll get it sorted outí. Sort of good cop/bad cop thing. Perhaps the staff member who takes the resident to another area for coffee or whatever could then go back to the resident and say 'I've sorted it out for you, she'll be here with your medications in five minutes' and then in five minutes you go and give the medications. Time consuming but perhaps a possibility.

    You say it happens to other staff too but itís worse with you Ė have you asked the staff who have the least problems what they do, or observed the way they give the medications, to see if thereís anything you could change about your approach?

    Is there any family and if so do they have any suggestions? If they havenít seen this and donít believe itís happening, try and get them on your side. Same for medical staff, if they havenít seen it, itís going to be hard for them to believe how bad it is. Incident reports are needed because of what is happening to you, but they generally (at least where I work) donít focus too much on what may have triggered the abuse and this is where behaviour charting is needed too. Looking for a trigger for the abuse is NOT saying you are doing anything wrong, it's just acknowledging that there may be something going on that is making this worse and looking to see if you can find what thing is and then modifying the situation so that thing is avoided.

    You may not be able to eliminate this behaviour completely, probably the most you can hope for is to minimise it. If everyone together is able to come up with something itíll no doubt be time consuming but that has to be better than whatís happening now.
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    Closing per OP request

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