What are the nurse's rights regarding difficult family members? - page 4

Well this post will be half advice seeking and half venting, I suppose I need both. I was a fortunate new grad, and started my first job as a LTC/Rehab nurse the end of August, less than a month after passing my NCLEX-RN. It was... Read More

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    Do NOT do 1:1 with these type of family members....always have another staff member around. could be come a he said- she said thing.

    I second the going up the chain of command...maybe this ADON is brushing this under the rug?
    BostonTerrierLoverRN likes this.

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    Learn this now - you are nobody punching bag. A person has no more right to assault you than they do a bank teller or a butcher. Yes, there are times we deal with confused patients and may get injured - that is one thing - but an alert and oriented, albeit angry person whether it's a patient, family member or whomever has no right to put their hands on you. It wouldn't be tolerated in any other industry and we need to stop tolerating it in ours.
    morte likes this.
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    Is the patient supposed to be discharged home with this family member? Some possible red flags are: threatening speech, becoming vocally beligerent when aggravated, acting out physically against staff, making unreasonable demands, invading another's personal space, throwing, hitting or pushing objects in the environment. Abuse by family caregivers can and does happen- it would be a tragedy for a patient to be discharged home into the hands of an abuser.

    Who Are the Abusers?
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    Quote from country mom
    Is the patient supposed to be discharged home with this family member? Some possible red flags are: threatening speech, becoming vocally beligerent when aggravated, acting out physically against staff, making unreasonable demands, invading another's personal space, throwing, hitting or pushing objects in the environment. Abuse by family caregivers can and does happen- it would be a tragedy for a patient to be discharged home into the hands of an abuser.

    Who Are the Abusers?
    Excellent point! Report dtr as an abuser of her mother! That might solve the whole mess. I love it, sorry I didn't think of it. Do NOT tell ANYONE, ANYONE, ANYWHERE, ANYWHERE that you reported, if you do report.
    Last edit by Kooky Korky on Dec 10, '12
    morte likes this.
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    There needs to be an adminstrative meeting with all disciplines to create some sort of plan to deal with this family member and her behavior. Then it is up to the administrators to direct you all on specific ways to deal with her, and a safety plan put in place. If this family member is not a POA, and Mom can speak for herself, then she is a guest in your facility, and can be placed on a no tresspass order. Which is exactly what needs to happen should the family member not adhere to the rules of the facility. Social work needs to speak with her, to come up with a plan everyone can deal with. Weekly family meetings,in addition to a plan for family member to write everything down and charge will meet with her ONCE daily to address any issues. Set perimeters on when she can come and see her mother, and otherwise, when she can call to speak directly to her. And she needs to be told that in fact should she be verbally or physically agressive with staff that she will deal with the police. I am not sure why adminstration is dealing with this, however, should your direct supervisors not be amendable to a plan for safety and effective communication, then I would most certainly bring this higher in the chain of command, right to the corporate aspect of the facility. In most nursing homes, there's an omsbudsmun, and state agencies--I would certainly make use of them as well. There's difficult family members, then there's people who are members of a resident's family who are threatening and dangerous. I am curious if Elder Services is involved in this case, as if a daughter is that out of control, I would fear for the resident's safety should this be a short term stay. Additionally, I would speak with your case manager and social work regarding reporting to elder services should the resident go home, as perhaps this resident needs a court appointed guardian if the daughter is incapacitated to the point of physical agression in trying to make a point. You have a resident to protect and ethically and appropriately deal with via your nursing license. I would not put it on the line for a dangerous individual who has no business taking care of her mother in any aspect until she can get herself under control--if that is even possible.
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    Oh, and report to OSHA. Do that TODAY. There needs to be an alternate level of supervision if your current administration will tolerate assault of staff. And if your facility accepts state or federal insurance (Medicare) I would call the compliance hotline. And your parent corporation probably has a complaince hotline as well. Look it up. If you lose your job over this, then I would contact an attorney. Otherwise, this will put some plans in place outside of the facility itself to keep you all safe. Another thought I had is that most local police departments have officers specific to elders. You need to start a paper trail with this officer. I use all of this "drastic" measure interventions, as you are charge in the facility when some of this stuff happens, so you are responsible. If another family member of another resident has seen all this behavior, you never know who has already made reports to agencies and the police. CYA.


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