Confrontation with a Visitor

[Jo Dirt]

It was a quiet Sunday afternoon and I walked into a 97 year old woman's room and saw a strange man sitting on her bed. She was laying supine and he was sitting next to her with his body over hers and intimately rubbing her arm. It didn't look right to me. At one point he leaned over and looked like he was going to kiss her.

I went to the nurse's station and asked the CNA if he was a relative. She said he wasn't, he was from "a church."

I said, he's in there getting too touchy-feely with Mrs. J and she said he had his hand on her leg when she saw him and agreed, he gave her the creeps.

I went into her room and asked if he was a relative and he said no, he was a friend. I said this whole scene is totally inappropriate, totally inappropriate, you need to get off that bed and get your hands off this patient!!! He was pushy an unapologetic and said everyone knows who he is and his wife is visiting down the hall, everyone knows him, the family knows he comes to see her and wants him to touch her and kiss her and let her know she is loved.

It made me sick.

He left and came back with his wife who wanted to know what my problem was and I told her. So, she went and sat on the bed and held this woman's hand (nothing like how her husband was touching the patient). Then the husband said I made him really upset and I shot back that I was pretty upset myself. I said you can't tell me you wouldn't want me to do the same thing if it was your mother and I thought she was being touched inappropriately! He just gave me this defiant look as if he didn't have a clue what I meant.

Him and his wife left and didn't say another word to me.

I wrote a long letter to the DON and plan to call tomorrow. This has me really upset. Just because these people go to church does not make them virtuous. In fact, they were both very arrogant and pushy. Several people told me they are very strange and they do not trust them. Still, I am apparently the only one to call Mr. Pervo on his behavior. My instinct that what he was doing was so strong I was ready to be as fierce as I needed to be to get the point across to him that I wasn't about to tolerate him fondling a 97-year-old woman suffering from dementia.

What should I do about this next time? It looked like an act of sexual assault to me (at the very best it was terribly disrespectful to the patient) and I felt like I should intervene THEN, not stand out in the hall and whisper about it to someone else. I believe if he cared anything about Mrs. J he would have understood her caregiver stepping in to ensure her safety, but he wasn't concerned about that at all. Then again, if he really cared about Mrs. J I can't believe he would have been touching her in such a demeaning way. It was really gross.

[feralnostalgia]

how awful. It sounds like you did the right thing...if there's ever any doubt it's better to be protective. and so what if he's from her church, that sure hasn't stopped other abuse cases from happening...

[Koyaanisqatsi-RN]

It was a mistake by getting into an argument with the visitor the way you did.

However, it was definitely a good move to write the DON. I hope you also documented the entire situation and informed the charge nurse.

[caliotter3]

Speak with the DON and/or administrator and see if they will agree to limits on this person and his wife, preferably that they stay out of the facility. If they are restricted from the facility, then you can call the police and have them removed. I've been in facilities where people have been restricted before, so I think it can be done.

[Straydandelion]

It was a mistake by getting into an argument with the patient the way you did.

However, it was definitely a good move to write the DON. I hope you also documented the entire situation and informed the charge nurse.

I don't see where the OP got in any arguement with the patient, just the visitor. IMO that is part of being a patient advocate. It is up to the patient and family to decide visitors, but appropriate and inappropriate action on their part would be up to the nurse if family not around.. what was the patient's reaction? Perhaps inform the family also and let them know what happened?

[dishes, BSN, RN]

Jo Dirt

Sounds like a very uncomfortable situation, you did the right thing. Your patient cannot speak for herself and you were protecting her.

Did you get the name and contact information of the visitor? Someone at your facility, preferably the team, need to clarify with the patient's family if they have given this visitor and his wife permission to touch their mother. If so, the permission should be put in writing and added to the patients careplan.

Dishes

[Koyaanisqatsi-RN]

I don't see where the OP got in any arguement with the patient, just the visitor.

Oops, of course I meant the visitor, not patient.

But saying stuff like this

this whole scene is totally inappropriate, totally inappropriate, you need to get off that bed and get your hands off this patient!!!

Is guaranteed to elevate and escalate a situation. There's no reason to take that tone with anyone unless someone's life is literally in danger. There are more effective ways to manage a situation.

[caliotter3]

It also wouldn't hurt to inform the resident's doctor if you feel that she was upset by the situation. A doctor can certainly intervene in such matters. Get him/her involved.

[SuesquatchRN, BSN, RN]

I think you did good. And I'd have told him much less nicely than you did, Jo.

[Koyaanisqatsi-RN]

I think you did good. And I'd have told him much less nicely than you did, Jo.

You really believe the words she used were the best way to handle it? Or you would have used harsher words? Oh my.

Never in my life have I ever seen tactics like that do anything except escalate situations and make things worse. And trust me, I can get my way pretty persuasively, but yelling at people and accusing them seems to yield sub-par results at best. Again unless someone's life is at stake right now this very instant, I think there is almost always a better way to handle a given situation.

I would have asked the patient if he needed something, if there was a particular reason he was so close and acting that way. If he says no and continues to do what he is doing, I'd ask him to stop as it isn't appropriate. If he continues then I call my charge nurse and security. Simple. In fact I have dealt with a situation eerily close to this one in the last few weeks and that's exactly how I did it. Much less mess than would have been otherwise.

[chicookie, BSN, RN]

I am sorry to disagree with you ooottafvgvah but sometimes especially in that situation that the visitor was already being aggressive, you can't just sit back and be all Suzy Sunshine. Some times certain words are needed to prevent a situation from escalating because alot of times vistors/pts/ pt family will see you as a door mat and will try to get above your head and you have to show authority.

Plus we also have to take into account the tone in which she said it. It can have different meaning depending on how the OP said it. She could have been very nice about it or she could have been mean about it. She didn't say she yelled at him.

Also not everyone has the gift you do. Not everyone is able to hold back their emotions and do things the way you do. You are lucky and that is a good trait. I know that if it were me, I would have said "Sir, get off the bed. Unless you are a relative you shouldn't be touching her like that. I don't care about what religion you or who knows you. Don't touch my patient like that."

I don't hold back though. My two cents.

[november17, ASN, RN]

This may have elevated and escalated the situation but I would have told the guy to leave. Holy crap!! You're there for the patient, to hell with how that guy felt.