Behaviors and Call Lights! Help!

[carolbear]

I just started a new position as a Staff Development Nurse. Talking and working closely with the CNA's and Nurses, I have found a common thread to poor morale. It's the one patient on the unit who is not demented but has behavioral problems. We all know the one.....the one who puts on the call light 15 minutes after the CNA or Nurse has met all the resident's needs.....and continues this behavior, often with the resident yelling at the poor CNA who has eight other resident's she must attend to. This is also a survey nightmare. You have your DON's and Administrators telling you that you have to answer the call lights within three minutes. What a horrible nightmare. To top it off the resident has been assessed to death! Nothing physical, nothing environmental AND the resident refuses mental health!! It is just the way they have been all their life. How does one deal with this type of resident and their demanding family members? Can't force psych on the resident who refuses, nor can you make them see mental health? Does anyone out there have sucessful experience with this kind of patient?

[UKRNinUSA, RN]

I joke with my ER pts as I hand them the call light, that they should use the bell if they need to get hold of me but please be advised that there is a $100 charge added to the bill each time you use it. If only..............

[squeakykitty]

I had a lady that was a supervised assist to the bathroom. She could walk, but needed someone there. She wouldn't use her call light!! I kept walking by her room, and kept seeing her tubing under the door, because she was walking in there by herself. Once, I saw her stand up and take a couple of steps and her alarm didn't go off because it was still stuck to the magnet, and the whole thing was dangling from her shirttail.

Please use your light! Life is too short to spend any part of it with a broken hip!

[TrudyRN]

I just started a new position as a Staff Development Nurse. Talking and working closely with the CNA's and Nurses, I have found a common thread to poor morale. It's the one patient on the unit who is not demented but has behavioral problems. We all know the one.....the one who puts on the call light 15 minutes after the CNA or Nurse has met all the resident's needs.....and continues this behavior, often with the resident yelling at the poor CNA who has eight other resident's she must attend to. This is also a survey nightmare. You have your DON's and Administrators telling you that you have to answer the call lights within three minutes. What a horrible nightmare. To top it off the resident has been assessed to death! Nothing physical, nothing environmental AND the resident refuses mental health!! It is just the way they have been all their life. How does one deal with this type of resident and their demanding family members? Can't force psych on the resident who refuses, nor can you make them see mental health? Does anyone out there have sucessful experience with this kind of patient?

Suggest the family get a part-time sitter/companion for this patient.

Are you absolutely sure there is no physical problem?

[TrudyRN]

Carol,

I know EXACTLY what you are talking about. I read your post and had to look at your name and location because I also have that resident. I am one of the CNA's that get the short end of the stick when it comes to one particular resident. She is only 48 years old, and honestly the meanest, rudest, most miserable person I have ever met, seen, or heard about. Her parents are her POA and she is completely sane. Her parents tell her that she needs to treat us with respect, and they have been called a million times about her behavior. She is 4'11" and 375 lbs. She cannot walk, but she sure can order everyone around, threaten to call state every other breath, and SCREAM at the top of her lungs every single day, evening, and night. She has hit us, threw things at us, and she verbally abuses her roommates. She refuses her diet that could save her life, she refuses psych, she refuses just friendly conversation unless it is about food. I have worked with her for 3 years, and last week I snapped. I just couldn't take it anymore. I told our DSD that I can no longer be assigned to her. Other aides are just as frustrated with the woman but they do nothing about it. After 3 years of charting behaviors every day and pleading with our DON, ADON, and administrator, there is still nothing being done. I don't understand how a company can allow one person to run off their help and literally abuse us like this. I asked why we accepted her in the first place and the reply was that cencus was low. That is just ridiculous. They say that they can't "kick her out" either. They know how terrible she treats us all but still nothing can be done? There's got to be something!!??

You need to press charges when she physically assaults and batters you. Do it. Do it now. She apparently understands nothing less. And your boss has no right to stop you from prosecuting her. Do it now.

[TrudyRN]

I had one who was putting on the light continually.........she was using it as ummmm, a sex aide............ ........

:trout: :rotfl: :chuckle :roll :barf01: :smackingf :icon_roll :cheers: :icon_redface:

[Simplepleasures]

Yup, when all else fails:bugeyes: , humor is all that's left. Or maybe a couple of cold ones after work.:biere:

[jetscreamer101]

I had one who was putting on the light continually.........she was using it as ummmm, a sex aide............ ........

eeewwww

[shoreh2000]

i second that. what a smart nurse!!!

[LoveMyBugs, BSN, CNA, RN]

Where I work there are a couple of these. One lady is on her lights every 5min, last week was my first night with her, and she would call me in because there was a wrinkle in her top sheet, or her call light was 1/4 of an inch to low from where she wants it, that there was two too may ice cups in her cup..... If she wasnt on her light she would just yell at me, whenever she saw me walking by. I went and sat in her room and talked to her for about 5min and she left me alone for about 30 before she was on her light again, she is just really starved for attention. I had another one, who was similar, and what I was able to get her to agree to was, I promised that I would be in her room every 30 min and I would meet all her needs then, and that I had 12 other people that I was taking care of and if she was on her light before the 30 min I wouldnt be able to be in her room right away, and she agreed and it worked.

[Patti 2nd gen RN]

Nikki - that's horrible!! Our administrator has talked to a couple of them who have been really awful, and told them that if they don't shape up, they'll be asked to leave. Don't know if she can really follow thru on that or not.

Ours did--and does--Thank God--we work as a team and the first sign of anything they can be sent to the hospital for they are out--and listed as a 'do not re-admit'--Some of them take more paper work,and time, but we tell them if the family can't afford a private sitter, or can't sit with her, she needs more than we can provide, and she's outta here!!!

[Patti 2nd gen RN]

I tell them--there are this many staff to this many patient tonight--if you call, a reasonable time period is 10-15 minutes--the oriented ones are usually shocked at how few night shift staff there are, and things work better then

[shoreh2000]

as an ex-don and an ex-surveyor your dministrators practice is unacceptable .

what needs to be done is that staff (especially the idt members) need to address the residents behavior. if you transfer the resident and don't take them back because they exceeded their 7 day bedhold and if the resident wants to come back and you still have empty beds, you can get cited.

the problem is administrators and don's do not screen the resident prior to admission. they need to make sure they have enough trained staff to take care of the that particular resident.

according to the federal and state regulations, if you accept and admit a resident to your facility, you better be able to take care of them.