Family members that run the facility!

[wefdm21]

What's up with this! I have a psychotic resident on my hall who is now in her 5th nursing home, which happens to be the last chance for her because there are no more facilities that will take her. Well anyway, mental illness must run in the family because the son is just as crazy as the mother. He's known for going around sexually harrassing the nurses and threatening peoples jobs. What is unfortunate is that he is good friends with the executive director. Just recently this resident has accused a nurse of ripping out her J-tube and scrubbing around it with a wire brush. She's not all here, and they know it, but the son comes in, believes what she says, and eggs her on. He is constantly telling her that something is wrong with her and she is now being sent out to the ER on a daily basis. Last night she threatened to report me because I would not send her back out after she had just returned from the hospital 4 hours earlier. She also had an appoint to go the next morning. I had to send her roomate out because she was truely sick, but this resident got so jealous that the roomate was leaving that she had a fit. It's really sad because just to have a normal day this resident has to be given every prn psych med that she has on a routine basis. But I'm feeling like I don't want to work in LTC anymore because of this and other reasons. The facility feels like they have to give into any request this family has not matter how weird and believe any story they come up with not matter how insane. They recently had the day shift nurse suspended for a week, and I fear that my job is on the line everytime I'm around them. There is nothing that anyone is doing wrong, but we have to take time away from our other residents in more serious condition to go around and get statements from everyone to cover our behinds. It's a really sick situation. This is just my vent for today. :angryfire:madface::angryfire:madface:

[nurseangel47]

Every LTC facility has those types of families, unfortunately. I would ask to be reassigned to another area of the facility if that is a possibility. Otherwise, just document, document, document, and CYA.

I remember families like this in the LTC facilities I've worked in before. It does divert attention away from others who may need it more and I feel for your situation. Don't let it drive you away from long term care, tho'. We need LTC nurses in the trenches fighting the good fight, so to speak.

Don't give up. Maybe tuning out some of the whining will help? I don't know. It's not easy when the family is in your face constantly, I realize that. Good luck.

[BBFRN, BSN, PhD]

Maybe you could set up a meeting with your higher-ups, care planner, etc. to discuss setting boundaries with this patient and her son. Express that it's not financially good for the company to keep sending this patient out on a regular basis- maybe that'll perk up their ears. I would then bring up how they are bringing down staff morale- which may lead to staff quitting- also not financially good for the company.

[prowlingMA]

I would collect all of your documentation and let the higher up managers see it. Document every word the patient and son say/do.

Or call you local appointed Ombudsman (sp?) They can really help in sticky situations like this.

And remember you are not alone. At one LTC I worked at we had family change their wishes by the minute. " Mom needs changed, mom is tired so don't touch her" in the same sentence. Accused me of breaking a piece of furniture she watched her mother break. And was constantly freaking her mother out ,saying she looked sick, needed to be at the Dr.'s, ....

Just remember "The NUT doesn't fall far from the tree"

And use the PRN as much as is needed, that is what they are there for.

[CHATSDALE]

been there at different kind of facilities, acute, ltc etc

some families don't really believe all the bs, sometimes the pt is an angel and the family is the pits[esp in pedi], sometimes their all crazy as a bezzi bug, point is sometimes you jump from frying pan into fire

i wish i could tell you something more hopeful but if ptb are taken in and have suspended another nurse for a week i would follow others advise and get out you don't need a thing like this in your folder

[Calgon-take.me.away]

besides being sure to CYA,,,take another nurse in with you each and every tiime that you go into that room. It was sound like a big inconvenience, but that way she can not accuse you of something. You have a witness to all that is said and done in that room.

In each LTC you will have these type of patients. Kill em with kindness sometiimes works also. It is all about control. We tell them when to sleep, when to eat, when to go to the bathroom when to get up, and when to go to sleep. This is the only way some of them can have any control over any part of their lives is trying to control you.

And of course document, document and document. Keep your daily notes, communicate with others. Hope this helps

[nursenikki928]

i also have this problem where i work and i am sure everyone else does. some of these patients and their families think they are at the hilton and not a skilled nursing home. hang in there and definatly document everything. everytime you give a prn make sure your documentation supports the use of the medication. all the documentation can be a hassle but is worth it in the end.

[snowfreeze, BSN, RN]

Document, document, document. CYA with witnesses. Set limits on time spent in room with patient, put a sheet inside room to document who is there and when and for how long. (you may also verbalize who you are and the time you are writing down) Set limit at 15 mins, meet needs then leave, will return in 1 or 2 hours and will meet important needs for 15 mins. Have the administrator and the DON establish these rules along with the primary physician and/or medical director. This is long term care, not acute care or sub-acute care. The son should be given guidelines on what is acute enough to send to the hospital. Stick to the guidelines/rules, have all the staff oriented to this and to be kind when in the room but strict about following the rules. Remind the patient and family of the rules everytime you enter the room.." I am here for 15 minutes, please let me know your needs that are most important for me to assist you with, I will not be back to help you for 1 or 2 hours." This takes a few days and everyones cooperation but it does work, even with the worse offenders. Good luck and keep up the good work.

[RN BSN 2009]

yup.. kill them with kindness

[roxyblueyes]

I think this latest epidemic of families going from caring for resident to overbearing crazed zealots is a result of the commercialized legal Media ad Bug. You know the one that starts - Do you have a loved one in a nursing home ------- and ends call 1 800 law suit. If the legal system is so concerned for these old folk why aren't they using thier position to create reform instead of lining thier pocket with the families money. Documentation is crucial as a vaccine to this bug. Although if there wasn't somemuch CYA to do maybe we could focus on care.

[AbsoluteRN]

Iceyspots,

How does your DON and Administrator approach this situation? When we have families this unreasonable the entire IDT has a conference with the family to discuss the issues; luckily our DON and Admin are on our side. There have been times where we said, maybe we are unable to meet your needs.. .other times we have flat out said, it is not fair to the other families and residents and suggested they provide a sitter... this usually helps them see the light. The other side of the coin is pinpointing why this res. is so needy, is her behavior a negative s/e to meds... some pts come back from acute care on multiple meds out of the same class and that can cause increased confusion and agitation. The important thing is that the staff be together on the concern before bringing the family to discuss it. Good luck.

[oramar]

Well anyway, mental illness must run in the family because the son is just as crazy as the mother. He's known for going around sexually harrassing the nurses and threatening peoples jobs. What is unfortunate is that he is good friends with the executive director. :angryfire:madface::angryfire:madface:

It is so odd that these nutty patients and their nutty families always seem to have friends in high places. This reinforces my belief that about half the people in health care managment have a few loose screws themselves. It is unfortunate fact of life that we all have to deal with people in clinical situtation that we would not give the time of day to in the non professional world. If these people were my neighbors or relatives I would not speak to them, look at them or answer the phone if I saw their names on caller ID. However business is business and we have to do what we have to do. You have my sympathy and best wishes but I don't know what to tell you to do about the situation because it is the same everywhere. Except for the sexual harrassment which I don't think you should have to put up with. To bad there is not a way you could document it with like a hidden camera or something.