One of My Residents wont speak to me (Long term care)

[lilaclover]

So just wanted to get some opinions on this situation:

I work in long tern care and have one Resident who is completely cognitive and is usually always joking and talking with me when I come by to do the evening med pass. Yesterday when I can by he was very very quiet. He just took his meds and said nothing to me, wouldn't even look at me. I asked him if everything was ok since he wasn't being his normal self. ( I was thinking maybe he was sick, or something had happened) He then tells me "Well you are not a very good nurse if you don't know whats wrong with me" I told him " I am sorry but I really don't know whats wrong, you will have to tell me" Still thinking I had missed something since apparently now I am a "bad nurse". So finally he comes out with it. He says " I didn't appreciate what you did last night". I was still clueless as to what he was referring to. Then he tells me it was because I asked him to leave another Res's room the other night. The situation was this: I got a call from my care aide that one of the other Residents had fell on the floor in their bathroom (off the toilet) and hit his head on the floor. So I came flying into the room with my vitals kit and dressing supplies. This man was entering the bathroom of the Res who was on the floor. I asked him to please leave and that I would see him later. He wouldn't move so I told him " I am sorry but this is an emergency and you are really going to have to leave" He then left and I dealt with the poor guy on the floor and I never really thought about it again. Until I came on the next day and this guy won't speak to me. He told me I a terrible nurse for doing this and that he is not talking to me again. He won't even let me check his blood sugars. I apologized to him and told him I am very sorry if it came across rude but that in emergency situations we can not have other Residents coming in the room and that the Res on the floor also needed his privacy. He tells me "well maybe you should start thinking more about other people" I told him I am very sorry but in that situation I am thinking about the poor gentleman on the floor, and it would be the same if it was him. But nope he wouldn't accept any of that. He still won't talk to me 3 days later and won't even look at me..... I don't know what I did wrong.... Was it so terrible what I did?? What should I do now?????

[FLArn]

If the resident who fell had a poor outcome and this gentleman is aware of it, he may be depressed or scared that the same could happen to him and is projecting his feelings onto you. I would continue to approach him as you usually do; give him a few more days to get back to normal. If that does not happen, then a psych referral may be needed. Try not to take it personally, the resident;s reactions rarely have anything to do with us.

[Katie5]

Kill him with love, keep doing all the right things you're doing. Quit apologising to him- you've done enough of that. Give him space but not too much that you ignore him. He'll come around.No kidding:)

[TheCommuter, BSN, RN]

I would switch patients, if this is possible. For example, I would let another nurse care for this resident while you care for one of his/her other diabetic residents.

In addition, I wouldn't allow this situation to consume too much of your time or mental effort. It appears as if this gentleman is alert, oriented, and has more than enough cognitive function to understand your repeated explanations. Move on to the other residents who actually want your care. Don't feel guilty.

[lilaclover]

Just wanted to add that the gentleman that fell on the floor ended up being ok, just with a couple skin tears...

[SuesquatchRN, BSN, RN]

You're assuming that because this resident is A&Ox3 that he does not have any cognitive deficits. Wrong. He sounds very child-like, and is, like a child, sulking. Let him sulk. He'll come around again. And for now, have someone else get his finger stick.

[lilaclover]

Good Point SueSquanch

[leslie :-D]

You're assuming that because this resident is A&Ox3 that he does not have any cognitive deficits. Wrong. He sounds very child-like, and is, like a child, sulking. Let him sulk. He'll come around again. And for now, have someone else get his finger stick.

sue, you're such a pro.

serious.

op, clearly what sue said.

i'll bet he really has enjoyed your presence up until the emergency, and it threw him off when you had to use that 'stern' voice.

he is likely thinking "i thought we were friends"...just how a 9yo would respond...

as sue said.:redpinkhe

should there be a next time, maybe going to his room after the emergency, reassuring him that you're not yelling at him, would do much to appease him.

i personally do this when i've been 'abrupt'.:)

leslie

[mlk1217]

I agree, he'll come around. If not it's his own care that he is holding out on. DOCUMENT daily on this pt and inform your charge of the issues.

[Misslady113]

Oh my dear nurse. It's NOT that serious.:chuckle I had a resident who did the exact same thing. We used to joke around and laugh and he always told me I was one of the nicest people he ever met. Then one day I went to take his weight, and he had a fit and would not talk to me at all. He even called me a B***h. I was a little surprised by his reaction, but not totally devestated. I tried to keep talking to him like things were normal, but that didn't work. It just made things worse. Then I remembered what I learned in my class, "Sometimes silence is the best form of communication". So I would just go into his room, perform care, and leave with just a hello, explanation of what I was going to do, and a goodbye.

Try not to take it personal. Each person is different, comes from different backgrounds, reacts differently to things, etc. My particular resident was bipolar, so I didn't think it really had to much to do with me. One thing I have learned in this field is that no matter how nice you try to be, there will ALWAYS be someone who doesn't like you for whatever reason they see fit. Some of these people are in bad moments in their lives and it just takes one thing to make them feel bad and take it out on you.

So it's not your fault, and he will probably be alright in time. If not then it's not really your loss, more his, because he lost a good nurse, and they are hard to find. And because of that reason, he will probably come around. Be patient with him, and just be polite without being too friendly and he will probably miss you and get over himself. Good luck.:heartbeat

P.S: My resident was over it in about two weeks and now I'm back to being one of the nicest people he has ever met.

[chelynn]

I would like to add that it is all in the approach. Sounds like you were a little panicked when you came in the room and I'm sure that projected in your voice or actions to res. Just remember to keeo your cool and approach resident calmly. Also as the others have said dont stress about it so much.