Advice for CNA with unplease-able resident

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I've been a CNA for a few weeks and one resident gets under my skin so bad that I want to quit if they force me to work with her again. She's part of the biggest patient group on my unit (I don't know why they divide it unevenly but they do).

I felt so bad for her today because she had a fall. She transfers and toilets herself every couple of hours independently but for some reason an hour into my shift she fell between her bed and her chair. As we sat with her, took vitals and called transport for the hospital she said it was my fault for not checking on her. But I couldn't have done anything to prevent her fall even if I had said hello to her earlier since she doesn't call us for her toileting. This is what gets to me: she's incredibly demanding, down to how the trash bag sits in her trash can (even after I explain that I'm taking that trash out when I leave), and assumes the worst of us. If she doesn't see me for four hours (she's one of 16 in my group, hadn't rung her light, AND has a hired sitter who comes to our facility just for her) she told the nurse and other CNAs that I was gone!

When she came back after her fall she was so mean I couldn't handle it. She kept looking at her room and going "Damn. He really did nothing for six hours." I still don't know what I was supposed to have done. Make her bed? I didn't sit down for six hours. I was working with the other 15 residents.

I keep trying to be assertive. Or be sweet. I redirect her to what she wants so she'll stop vaguely complaining about every little thing. She pisses everyone off that I've seen so far, CNAs, nurses, admins, her sitter. They all seem to just avoid her whenever possible but at this point I'm afraid I'll be baited into a shouting match and I'm just not that kind of person. I'm just starting out so I don't know if I should request to be scheduled away from her. Other CNAs tell me not to let it get to me and the main strategy I see with her is to get in and get out fast. She expects you to hang around and listen and do a hundred tiny things and arrange everything to her schedule. She isn't confused, she's rich and entitled and doesn't listen to reason. Has anyone had a patient or resident like this?

How do I give her care without getting caught up in this fight? I really want to rise to this challenge but she says things that like, get to my core nerve. I'm trying so hard to be a good aide and I don't get it.

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Not trying to be unsupportive, but as a fellow CNA, if you think she's bad, you should work with a quad my facility has. VERY demanding. VERY bossy. Big black dude, like muscular. Even after 2 years of being paralyzed. He looks like OJ Simpson. It's pretty funny. Anyway, he's VERY mean. He cusses out everybody because nobody thinks like he does. He's all about common sense. As in, how you're supposed to do something when you're providing care to him. He cussed me out for not cutting his hair correctly. And was serious about it too. I'm a CNA, not a hair stylist or a certified barber hair cutter person thing. It's stupid af that my facility charges the residents for hair cuts. It costs like over $5,000 to stay there. They should get it for free.

Usually when a resident is worried about something that doesn't relate to what they want like transfering to bed or being changed, I block any intention of doing it for them. For example, you mentioned she gets anal about how her trash bag is placed. It's not hard to place a trash bag in the trash container. I'll show you an example of how I deal with a resident grossly observant.

Me: Hi, Mrs. Smith. How are you?
Smith: Good, I want to go back to bed.
Me: Ok, let's get you ready from your wheelchair next to your bed.
Smith: Hey, where's my purse?
Me: Over there on the night stand.
Smith: Put it on my side table.
Me: Mrs. Smith, you asked me to put you to bed. It's late. Why don't we worry about putting that on the table once we've got you in bed.
Smith: Fix that trash bag will you?
Me: No, I will not worry about that right now. We need to get you ready for bed. How about we change you since you're incontinent. Once I get that done, then I can be over there to adjust the trash bag since I can see it looks like it wasn't fully put in.

If they want something like being put to bed or changed, but their mind drifts somewhere else, with the exception of a quad, that's when I redirect them to what they originally wanted that's more important. We have other people we have to worry about as well. We'll get everything situated once the most important thing has been done. Changing residents briefs and putting them back to bed or getting them up are the most important. Not fiddling around with trash bags and whatever else nonesense. Nurses have never had a problem with me redirecting.

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The only thing you can do is to continuously be kind to your resident. You won't always get the easy to get along with residents. Sometimes you get the unpleasant ones but you still have to go in with a smile and do the best you can.

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Specializes in ER OR LTC Code Blue Trauma Dog.
On 6/15/2019 at 11:45 AM, daun47 said:

She expects you to hang around and listen and do a hundred tiny things and arrange everything to her schedule.

Realize this is symptomatic of another problem. It really has nothing at all to do with the way the trash bag is inside the can, or the way the flowers are arranged on the window sill or anything else for that matter.

You know what these people want? They want to know you care about them. Talk to them and treat them like a human being. They are not a "nursing assignment," they are a person just like you and me. ?

Don't just stand there smiling like a nurse robot in the room. They catch on to this and feel you aren't being genuine and sympathetic toward them. So despite the fact you can't stand them, try to get to know them anyways. At this point, what can it hurt right?

Ask them about the little things like their kids and things like that. Engage them on an interpersonal level and rather than rush out of the room as fast as you can, always say the little things like, "Is there anything else I can do for you before I leave to take care of my other patients?"

Soon you will find they de-escalate rather quickly. The next thing you will know, they will become the easiest patient you have. ...It really works.

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Specializes in Adult Primary Care.
22 minutes ago, Patient_Care_Asst said:

Realize this is symptomatic of another problem. It really has nothing at all to do with the way the trash bag is inside the can, or the way the flowers are arranged on the window sill or anything else for that matter.

You know what these people want? They want to know you care about them. Talk to them and treat them like a human being. They are not a "nursing assignment," they are a person just like you and me. ?

Don't just stand there smiling like a nurse robot in the room. They catch on to this and feel you aren't being genuine and sympathetic toward them. So despite the fact you can't stand them, try to get to know them anyways. At this point, what can it hurt right?

Ask them about the little things like their kids and things like that. Engage them on an interpersonal level and rather than rush out of the room as fast as you can, always say the little things like, "Is there anything else I can do for you before I leave to take care of my other patients?"

Soon you will find they de-escalate rather quickly. The next thing you will know, they will become the easiest patient you have. ...It really works.

Absolutely this!!!!!!

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Misery loves company. I know it's challenging, but I don't entertain their disrespect...you can't control their personalities, you can only control your own attitude. I smile, I'm polite, I explain what I'm there to do and move on to care for next resident. I show absolutely no negative emotion...I don't give them the satisfaction! As long as they aren't physically assaulting me...they can throw temper tantrums all they want. I find not reacting to their poor behavior...they eventually leave you alone. Sometimes you may also have to redirect residents in an assertive yet professional tone. I've had to remind residents in so many words that I had other residents to care for... unfortunately there is no VIP treatment & I have assignments I must complete...lol.

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