is this abuse

Simplepleasures · Dec 7, 2006

You need to work in the trenches before you can truly have an opinion on this.
And remember, the nurses in the nursing homes are doing what most families don't want to do.

AMEN!

SuesquatchRN, BSN, RN · Dec 8, 2006

I have found, of all of my patients, that COPDers tend to be the most self-centered and demanding. We have one guy who will not comply with orders for bed rest, is constantly be checking his sats and heart rate, and falls asleep in his scooter using up the canister. Two weeks ago he awakens, realizes the O2 supply is out, and literally knocked me the he.. over with his scooter in his haste to get a new one. Even afterwards, when he was all hooked up again, it didn't occur to him to apologize for injuring me. Now, I understand that being unable to breathe has to be frightening as all get out. But if the resident referred to by the OP is anything like this guy it isn't any wonder.

We have another obese diabetic non-compliant COPDer who, while we were trying to get O2 onto her dying roommate, started whining and YELLING that she needed her Ultram and then complaining that we unplugged her radio to attach the roommate's O2 up. every time WE DID SOMETHING FOR THE ROOMMATE her needs would become urgent and she'd try to get us to drop the other's care to attend to her.

I have spoken harshly to both of these people. They may deserve respect, but so does everyone else in the facility.

nurse15dc · Dec 8, 2006

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Retired R.N. · Dec 8, 2006

Any of you nurses who are upset with what you call the "noncompliance" of patients with COPD need to review the effects of oxygen on brain function. No, these people do not always serve as role models of polite behavior. They are SICK! If they didn't need nursing care, they would be living at home where they could do whatever they wanted on their own schedule. Any time you attempt to discipline your problem patients with COPD they interpret it as punishment, and all you accomplish is to train them that to get any attention from you they have to demand it.

nurse15dc · Dec 8, 2006

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TheCommuter, BSN, RN · Dec 8, 2006

i am working in ltc facility resident was complaining sob no signs or symptoms was noted by charge nurse.she stated to resident that if you was having sob you would not be able to run your mouth ninety miles minute.

At this time, I do not believe any abuse occurred. There are many unanswered questions.

1. Many residents complain they are SOB, yet when you check their SAO2 it is 99 or 100 percent on room air.

2. Was the resident cyanotic or pale?

3. Was the resident demented?

4. Was the nurse's comment made in a joking, lighthearted context?

TheCommuter, BSN, RN · Dec 8, 2006

I can't even believe on that little information, people are prepared to call "abuse" or "neglect" and run to the Board to report this woman!

I agree with you. I do not like the thought of telling on another nurse and placing his/her livelihood in jeopardy. It is best to approach the nurse first, well before any phone call to the board of nursing. Give the nurse a chance to change the behavior.

SuesquatchRN, BSN, RN · Dec 8, 2006

Any of you nurses who are upset with what you call the "noncompliance" of patients with COPD need to review the effects of oxygen on brain function. No, these people do not always serve as role models of polite behavior. They are SICK! If they didn't need nursing care, they would be living at home where they could do whatever they wanted on their own schedule. Any time you attempt to discipline your problem patients with COPD they interpret it as punishment, and all you accomplish is to train them that to get any attention from you they have to demand it.

Oh, horse patoot. The residents I am talking about get plenty of attention and care. They are also nasty pieces of work. I have never attempted to "discipline" a resident. When one has 42 residents, all of whom are there because they are sick, one does not need someone whining that we didn't bring her her seventh glass of ice water in that shift, all of which are melting on her side table. Narcissism may be an illness but it's quite time-consuming.

Jo Dirt · Dec 9, 2006

it is written n the nurse practice act or the "laws and regulations of nursing practice" of every state in the us. -- we're mandated to report any violation of the nurse practice act that we witness another nurse commit. if we don't report the nurse, according to us nursing law, we then become just as liable as the nurse who violated the law.
if you go to your manager instead of filing a report with the board of nursing tne manager will make you "write it up" so that management can use it as ammunition against that nurse. this "you're mandated to report other nurses" mentality is drilled into all us nurses in nursing school. sad but that's the reality of how we have to practice.

i think this law was written with the assumption common sense would be used.

emotional_she · Dec 10, 2006

You need to work in the trenches before you can truly have an opinion on this.
And remember, the nurses in the nursing homes are doing what most families don't want to do.

I do agree with you wholeheartedly that the nurses are doing what family members dont want to do. However, I dont think I need to "work in the trenches" before having an opinion on the way people should be treated. I think that is common sense and probably something you dont learn in school or on the job. Even if the pt is CRAZY does that mean he or she should be talked to like a dog? I think its the nurses job to keep her sanity. The question comes down to this : would you want your family member to be treated that way? I wouldn't.

Paprikat · Dec 10, 2006

Wow, good topic!

We had a woman who had COPD, who would SCREAM for her puffers all the time. It was so hard to deal with, name calling, swearing, etc, and it seemed to worsen when families were around. We would do a chest assessment and SATS, and they would be in the high 90's. We had nurses who would say if you can scream like that, you can breathe. The ONE time she came out of her room and was quiet, I took one look at her and knew something was wrong. She truly could not breathe and was cyanotic, died in the hospital.

We have a lady now who does the same thing, screams and swears and hits so below the belt, saying I hope you DIE of emphysema, or to one nurse, I hope your little boy dies, etc. When she is sitting by the nurses station for HOURS doing this, all assessments are normal, it gets hard to keep it together. I guess I should also add, this lady has a Minimental of 30/30. Don't we deserve to be treated with respect?

emotional_she · Dec 10, 2006

You ABSOLUTELY deserve to be respected! I am not arguing that AT all. But just because some of the pts are jerks, does that mean the nurse should be too? I dont see anything wrong with saying " If you stopped screaming at me then maybe you could breathe better." But thats a little different then what the op described. I dont think I would report that nurse, or try to get her fired, I just wouldnt want her speaking to my family that way.