coping with difficult pt in LTC

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I've been trying to cope with a residents difficult behaviors and am scared I will jeopardize my license because of her actions. She is pill seeking and requests prns frequently despite reminders she needs to wait. She often rings call bell for very minor things and I feel as though she is just attention seeking. Although that is stressful considering I have 60 other residents to care for, I am worried that she removes her nasal prongs then c/o SOB! After stabilizing her she will cry and beg me to stay with her but I just can't. I spend so much time answering her call bells but I need to tend to the other residents. The fact that she intentionally causes her SOB whenever she feels like she needs attention is stressing me out. I can't be with her 24/7..but I also can't let her o2 drop and not be there. She's her own poa and refuses to transfer to hospital when satting low although she says she feels like she'll die when it drops. Any advice pls!

dishes, BSN, RN

3,950 Posts

How does labeling a patient as 'difficult' enhance effective communication skills with the patient and the team?

Have you discussed your safety concerns with the patient and listened carefully to their response? Have you discussed the safety concerns with the team? What is the team's response?

theRPN2b

147 Posts

Specializes in Medicine.

Speak to the DON and make her aware about this issue.

Silverdragon102, BSN

1 Article; 39,477 Posts

Specializes in Medical and general practice now LTC.

Have you discussed this with other team members? Have you tried meeting with her as well as other team members to see what the real issue is?

dishes, BSN, RN

3,950 Posts

@pumpkinspice Have you experienced having nasal prongs in your nose and tubing wrapped around your chin and ears? Were you hyper-aware of the prongs? or were you able to ignore them and rest comfortably? I have experienced O2 via nasal prongs and found it difficult to distract myself from the unpleasant sensation in my nose and on the top of my ears. I can see how the discomfort of the prongs may cause some people to unintentionally remove the prongs while they are asleep.

morte, LPN, LVN

7,015 Posts

@pumpkinspice Have you experienced having nasal prongs in your nose and tubing wrapped around your chin and ears? Were you hyper-aware of the prongs? or were you able to ignore them and rest comfortably? I have experienced O2 via nasal prongs and found it difficult to distract myself from the unpleasant sensation in my nose and on the top of my ears. I can see how the discomfort of the prongs may cause some people to unintentionally remove the prongs while they are asleep.

that does not appear to be what is happening here. it appears to be an intentional act of not wanting to be alone.

Specializes in LTC and Pediatrics.

She sounds like the kind of resident who just needs a few more minutes of you time. I know that you have many other things to do. Yet, I have found that if I can spend a few extra minutes with the "needy" resident, it goes along ways towards her contentment. Sometimes they just need to know that someone cares and those few extra minutes helps.

pumpkinspice

21 Posts

I think you're right. Thanks:)

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