Social Service Director and Housekeeping Supervisor's Ideas About Resident Rights...

[flashpoint]

We had our annual resident rights inservice last Friday. The comment was made that making the resident's wait for something that they want or need is a violation of those rights. I always understood that making them wait an unreasonable amount of time for no reason could be a violation, but they example that they presented is just off the wall! In their scenario...one resident wants their toenails to be trimmed because they hurt when she puts on her new shoes (she is diabetic, so only a nurse can do it and there is only one nurse in the building)...another resident is in respiratory distress and needs suctioning (again only one nurse in the building). So...is it a violation of the resident's rights to have to wait to have her toenails trimmed? Her foot pain is just as distressing to her as the other resident's inability to breathe. :icon_roll

I argued that life threats come before anything else...while someone else may be in extreme pain and they may feel like they are going to die, obvious life threats should always prevail. They argued that even though life threats are more important, the other resident's rights are still being violated and there could be grounds for legal or disciplinary action. I think the Social Service Director needs to repeat his training and the Housekeeping Supervisor needs to review the policy manual or something.

The day that my judgement is questioned for correcting a life threat rather than providing a simple comfort measure and the day that a Housekeeping Supervisor questions my nursing judgement is the day I will resign and go to work at Piggly Wiggly.

[Atheos]

Don'tcha just LOVE it when someone who's never set foot in a school of nursing tries to tell you how to do your job??:angryfire

Not to be contrary or anything but you realize that resident's right WASN'T invented by nurses.

In fact, for DECADES nurses were the MAJOR offenders until people cam along and told them how to do their job.

The OP would be better served by getting off the high horse and either making the other supervisor's feel good by verbally humoring them or better yet being a good employee by considering it and laying out respectfully to them why it won't work.

In any case, trying to 'put them in their place' is stupid because nurses have had to be put in their place as well...

Remember, the next time some of you get mad because someone wants to 'tell you how to do your job' that, the reason we have state inspections AND resident's rights is because of the way 'nurses and nursing staff' USED to do their jobs.

Heh. I'll go get my flame retardant suit.

[DusktilDawn]

Not to be contrary or anything but you realize that resident's right WASN'T invented by nurses.

In fact, for DECADES nurses were the MAJOR offenders until people cam along and told them how to do their job.

The OP would be better served by getting off the high horse and either making the other supervisor's feel good by verbally humoring them or better yet being a good employee by considering it and laying out respectfully to them why it won't work.

In any case, trying to 'put them in their place' is stupid because nurses have had to be put in their place as well...

Remember, the next time some of you get mad because someone wants to 'tell you how to do your job' that, the reason we have state inspections AND resident's rights is because of the way 'nurses and nursing staff' USED to do their jobs.

Heh. I'll go get my flame retardant suit.

I think you've missed the point of the OP. In fact the OP stated that their understanding was that making a resident wait an UNREASONABLE AMOUNT OF TIME FOR NO REASON for something was a violation. Her/his issue was the example provided during the inservice by SS Director and Housekeeping Supervisor that argued that making a resident wait to have toenails trimmed while the nurse is tied up with a resident in respiratory distress is a violation of resident's rights. They actually argued with the OP and stated that this could be grounds for legal or disciplinary action despite acknowledging that life threats come first. In essence they're saying nurses should be disciplined for not being able to be in two places at the same time. Rather disheartening for the nurses.

The sad part is that nurses have been disciplined over nonsense like this. Someone complained because they had to wait for a coke because the nurse was busy with a patient whose wound dehisced, or someone complained because they had to wait to have soup warmed up because the nurse was tending a post-op patient who was bleeding. Both of these examples have been posted here by other members and in both instances those nurses were reprimanded. It's gotten ridiculous. I really don't think you believe that nurses should be disciplined for dealing with an emergent situation first before things that are not.

Toenails, coke, and soup can wait. Respiratory distress, wound dehiscence, and hemorraging can't. Nurses understand this, unfortunately a lot of those that want to dictate how nurses do their job don't. That is the issue that responders on this thread are indignant about.

Another thing not really brought up on this thread is how other disciplines want to dictate to nurses on how to do their job in order to make THEIR job more easier or convenient at the ultimate expense of the patient. From housekeeping, dietary, PT/OT, RT, XR, Social workers, etc, etc, pretty much every department wants to dictate to nursing staff how to do their job. It usually involves them wanting nurses to do part of their job. It's not about any interest these departments have regarding patient's rights.

When hasn't patient advocacy been part of the cirriculum taught to nurses??? BTW patient advocacy groups didn't come along just to tell nurses how to do their job because nurses were the only ones violating patient rights. They came along to educate and inform ALL health practitioners that patient's HAD RIGHTS AND WERE ENTITLED TO THOSE RIGHTS. It's also amazing what state inspectors and hospital accreditors fail to see and continue to do nothing about that adversely affect patients and their rights.

BTW not intended to be flammable towards you Atheos, just my on the issue.

[achot chavi]

Do you work in the desert? Most people don't really need all that water all the time. A drink or two in the ladies' room is probably more than enough....but I digress.

I guess everyone is different, "a drink or two in the ladies room" (BTW I really don't think it is hygienic to drink in the ladies room, but I respect cultural differences and will try not to gawk when you do it) is not enough for me for the 8+ hour shift. Glad I dont work for you!!!

[CapeCodMermaid, RN]

My ladies' rooms are spotlessly clean and we have water coolers throughout the building.

[achot chavi]

EVEN SO!!! spotlessly clean or not I dont drink in the ladies room.

Do others?

[flashpoint]

I think you've missed the point of the OP. In fact the OP stated that their understanding was that making a resident wait an UNREASONABLE AMOUNT OF TIME FOR NO REASON for something was a violation. Her/his issue was the example provided during the inservice by SS Director and Housekeeping Supervisor that argued that making a resident wait to have toenails trimmed while the nurse is tied up with a resident in respiratory distress is a violation of resident's rights. They actually argued with the OP and stated that this could be grounds for legal or disciplinary action despite acknowledging that life threats come first. In essence they're saying nurses should be disciplined for not being able to be in two places at the same time. Rather disheartening for the nurses.

The sad part is that nurses have been disciplined over nonsense like this. Someone complained because they had to wait for a coke because the nurse was busy with a patient whose wound dehisced, or someone complained because they had to wait to have soup warmed up because the nurse was tending a post-op patient who was bleeding. Both of these examples have been posted here by other members and in both instances those nurses were reprimanded. It's gotten ridiculous. I really don't think you believe that nurses should be disciplined for dealing with an emergent situation first before things that are not.

Exactly...when we were having the discussion in the meeting, the SSD commented that if she got a complaint that I "made" a resdent wait a long time before I was "willing" to trim her nails and that if a complaint were filed, I would have to do some additional resident rights training and that I could risk suspension and being placed on a quality improvement plan. One of the other nurses commented that if she were called into the office and asked why she made the resident wait so long, when she responded, "Because I was suctioning someone else...but I trimmed her nails as soon as the other resident was stable," that the only response from the PTB should be, "OK...we just needed to ask because there was a complaint about it." The housekeeping supervisor kept going on and on about how unfair it is to make someone sit there having pain...I think she just doesn't get it. I personally wonder why the resident's nails were too long anyway...they are supposed to be trimmed (or at least checked) three times a week after their bath...that could be considered negelct, but simply expecting a resident to wait their turn should not.

I go to church with a guy who is on the state survey team...I think I'll ask him about this one...

[achot chavi]

When things get so other professions question the work of my nurses, i ask one nurse to write me a summary of what she does every 10-15 minutes, with that sheet in hand I shut everyone else up. Between sitting with an ice cream sunday and doing her toenails in different colors, my nurses are very busy, if not, they wouldn't be my nurses!!!

Unfortunately anything can be misconstrued or spun to look like abuse, we do have to be so careful!

[DusktilDawn]

Exactly...when we were having the discussion in the meeting, the SSD commented that if she got a complaint that I "made" a resdent wait a long time before I was "willing" to trim her nails and that if a complaint were filed, I would have to do some additional resident rights training and that I could risk suspension and being placed on a quality improvement plan. One of the other nurses commented that if she were called into the office and asked why she made the resident wait so long, when she responded, "Because I was suctioning someone else...but I trimmed her nails as soon as the other resident was stable," that the only response from the PTB should be, "OK...we just needed to ask because there was a complaint about it." The housekeeping supervisor kept going on and on about how unfair it is to make someone sit there having pain...I think she just doesn't get it. I personally wonder why the resident's nails were too long anyway...they are supposed to be trimmed (or at least checked) three times a week after their bath...that could be considered negelct, but simply expecting a resident to wait their turn should not.

I go to church with a guy who is on the state survey team...I think I'll ask him about this one...

Well, what I'd like to know is how unfair the housekeeping supervisor would think it is for someone in respiratory distress to die because the nurse is playing pedicurist? The sad part is you're right, she doesn't get it. But again why would anyone put on shoes that they know will cause them pain? The resident is only going to be uncomfortable through their own action. Their pain is avoidable. Makes me wonder if they actually expected the toenails to be done first since if the resident in respiratory distress died they couldn't complain. The ONLY solution in their scenario is to take care if the patient in respiratory distress, than deal with the toenails. You apologize for making the patient and explain that you had an emergent situation that had to be dealt with. If a resident is so self-absorbed that they cannot understand that and complains, the PTB SHOULD BACK UP THEIR STAFF.

The issue in their scenario isn't about the nurse "making" one wait before being "willing" to do a task, unfortunately they don't understand that either. Regardless of whether one has to wait because of an emergent situation, or whether one has to wait simply because the nurse can't do two tasks at the same time, it boils down to the fact that one person will have to wait. In essence, the SSD is THREATENING disciplinary action towards nurses for the inability to be able to be in two places at the same time. Regardless of whether the SSD has any authority to discipline nurses, I would view her remark as a threat, which constitutes workplace harassment.

I think you should discuss this "inservice" with your superior and outline your concerns. I think the SSD and Housekeeping supervisor need their own educational inservice on what truly violates a patients rights.

[systoly]

Do you work in the desert? Most people don't really need all that water all the time. A drink or two in the ladies' room is probably more than enough....but I digress.

I tried to do that at my facility, but they told me that was inappropriate behavior.

[systoly]

EVEN SO!!! spotlessly clean or not I dont drink in the ladies room.

Do others?

Not any more - they won't let me.