Affection to residents and still professional?

  1. First and foremost I'd like to say, I really do love my residents! But I often wonder, what is considered professional and what is not, where do we draw the line? I give hugs often when one of them is feeling down, a pat on the shoulder/back/arm (can you imagine the kids you raised just dropping you off one day and only visiting for 15 min once a week-month?!). I try to say goodnight to everyone when they get "tucked in"/with HS meds (3-11 shift), and honestly sometimes even finding myself saying things like "if we didn't love you we wouldn't need to do this" (safety issues, IVs, medications etc.). Hoping I'm not alone here, but def curious where you all consider that magic line is drawn. And I don't mean a DOH/state survey line, I mean a warm comfortable home-like atmosphere while still being a professional nurse - line?
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    About Rach823RN

    Joined: Apr '12; Posts: 6; Likes: 2
    RN; from US
    Specialty: 3+ year(s) of experience in LTC, Veterans SNF


  3. by   psu_213
    In my mind, a comforting pat on the back is ok. I find a hug to be over the line. When I was a CNA, I knew another aide who would give residents a kiss on the cheek after she did HS care. In her mind, she was only doing it to be comforting, however I though it was really inappropriate (and kinda yucky).

    I am now a nurse in an ER, and I realize we have a much different relationship with our pts (whom we say for a few hours at most) then the relationship a LTC nurse has with the residents of the facility. However, we just got a PG survey comment: "It is never OK for a nurse to call a patient 'hon'!!!!! SOOOO disrespectful!!!!" (yes, the caps and the punctuation did come from the person writing the comment). Again, not the same as in LTC, but it does make you realize that some people do not appreciate well meaning attempts to make them feel comfortable.
  4. by   Naturess
    Hey there,

    This is something I've also been struggling with lately. I'm a hugger. I let residents take my arm, kiss my hand, and tell me I'm loved. That's why I'm in the field. I'm told I'm the best by residents and families because I don't just monitor numbers and side effects but mind and spirit, too. Nursing homes aren't great places, but if I can bring a little sunshine with the medpass- I'm making the world a better place.

    On the other hand, sometimes "being there" for the residents takes it's toll. They can become overly dependent on caring staff to coddle them when they need to learn to buck up a little. I actually had a mini-mental breakdown last night when I had worked a double (Rehab unit 1st shift, 30 residents on my regular ltc unit Pm shift) I don't normally do Pms so I didn't have the flow memorized.

    Yesterday sucked absolutely (seems to be the whole 210 bed facility lately). There was a readmit at 5pm, accompanied by her 2 very sweet but very anxious daughters, she had constant emesis upon arrival until I left at 2am, she had a new stage II pressure ulcer on her coccyx, open area to abdominal fold, and irregular pulse, hypotension, and orders would not be finished for her until 8 pm. The NP wrote a bunch new orders for 8 people at 3pm, causing pharmacy to keep stealing my MARS and have me sign for new meds, pulling cartriges etc (all during the 1700 medpass) a lady who arrived 2 days ago is actively dying but fairly comfortable, another just arrived a week ago and is confused and ****** off and risking a fall with her behaviors, another was readmitted 1 day ago and c/o burning, his shower check revealed a host of scratches to be documented, another shower check revealed a new stage I/II pressure to rectal area, another lady started coughing with blood while family present, an obese lady who fx her arm 2 weeks ago is on the light q 15 minutes c/o pain (crying "I want to die) but no interventions (ice, perc, fentanyl patch, repo, 1:1) will work and she is barely eating now- her daughter is extremely anxious.

    Yes I had flights of suicidal ideation that night/day. I eventually went in at 1030 put a patch on my favorite resident Fred, and started to just break down. It felt SO cathartic to just tell someone "I can't do this. I'm stretched so thin, there's too much work for one person to do safely, I don't even feel like a human sometimes." He said, "Honey, you'll get through this." He had tears in his eyes as he listened to my story. And reached out for me like a real Grandpa would and hugged me. It was such a genuine feeling that someone cared about how bad of a day I had. Cared that I was hurting. Just 5 minutes made me feel so much better, let me blow off steam and feel like a human for a second. I also think Fred felt good having the opportunity to talk with me- a sense of purpose if you will.

    I don't know if I can do this my whole life (i'm one year into the nursing career). I think I'd like to be my own boss someday, run some kind of business. I love the elderly and know that they need better care than they get in this cold-hearted god-forsaken healthcare industrial complex.
    Last edit by Naturess on Apr 12, '12
  5. by   nicenurselpn
    I work with kids with severe handicaps and I will give them hugs. One of the kids is always asking for hugs and "head noogies". For most of the kids, there is little to no family involvement. I am part mom, part nurse and part friend to them.

  6. by   Kittypower123
    As a general rule, I don't offer hugs to residents. I will, however, accept hugs (side hugs if it's a man - never has been though) or offer a hug to a resident who is upset (usually it's a side hug or a reaching over the walker hug). Considering how few hugs these folks get, it doesn't seem right to "forbid" hugging - just be careful about how and when you hug. If it's someone I'm not comfortable with hugging, I will maybe pat their shoulder or place a hand on their hand/arm to let them know I care.
  7. by   nursetiffany.
    i love my residents. they are my family.
  8. by   orthonurse55
    I have worked in LTC and I don't find anything wrong with the appropriate hug, pat on the shoulder or occasional kiss on the cheek. You get to know your residents and who you can do that with "safely". Those little old ladies love a little peck on the cheek when you give them their hs meds. To some of them, we are their only family. Let's give them a reason to give us those beautiful toothless smiles.
  9. by   CapeCodMermaid
    I accept hugs gladly but do not offer them unless asked. really crossed the line when you told a patient about your troubles. No matter how bad your day/night is, YOU can go home at the end of the day. You burdened him with YOUR problems when he has plenty of his own. It was unprofessional.
  10. by   NamasteNurse
    As a floor nurse on an Alzeheimer's unit, I hug all the time. Kisses too. As some of you said, we are the only family many of these people have. Imagine being in a wheelchair most of every day, all of the days are exactly the same and the only time you get human touch is getting your butt wiped. I'd go 'crazy' too. These are people we are working with, not residents or patients---HUMAN PEOPLE. We NEED physical attention to live. I've seen so many resident's decline so quickly once their families lose interest, it breaks my heart. I am their nurse AND their family. I am professional. I insist they take their meds, eat, drink, walk, stretch, and get PPD's. I also hug, pat, kiss and love them.

    I would NEVER burden them with my personal or professional problems. Of course, none of my resident's could even begin to understand all that, but NO, it's not ok to bring them bad news of any kind. Bring them your joys, good weather, a new baby, your mom is coming to visit. But bad news, NEVER. It's not good for healing.
  11. by   winnowill
    I give little pats on the back and an occasional hug when there is a resident that is upset over a death in the family or just plain depressed because they want to go home. I smile, joke with certain ones that like it. Every resident is an individual that has their own individual needs.

    Edited for spelling