How to best work with demanding residents?

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Specializes in RCAC Nurse Manager.

Hello, do any nurses out there have recommendations on how to best serve demanding residents in long term care? I work in assisted living and have a resident who experiences what he perceives as health "crisis" on a daily basis. Every morning, following breakfast, this resident will either call for nurse assist or simply show up at the nursing office door. One can be certain that I spend about an hour or more on his needs each day; that's quite a bit for assisted living. He is impatient and becomes upset if I am not immediately available to him. Each day, he arrives with a new concern. These concerns range from "look at my toe, does it look bigger than the other one" type concerns to "I think I have a mass in my throat". Generally speaking, I just stop what I'm doing and tend to this resident to avoid his verbal outrage. I know this is not the best way to approach this matter and would appreciate any advice on how to best work with this type personality.

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Specializes in Dialysis.
BirdieBird said:

Hello, do any nurses out there have recommendations on how to best serve demanding residents in long term care? I work in assisted living and have a resident who experiences what he perceives as health "crisis" on a daily basis. Every morning, following breakfast, this resident will either call for nurse assist or simply show up at the nursing office door. One can be certain that I spend about an hour or more on his needs each day; that's quite a bit for assisted living. He is impatient and becomes upset if I am not immediately available to him. Each day, he arrives with a new concern. These concerns range from "look at my toe, does it look bigger than the other one" type concerns to "I think I have a mass in my throat". Generally speaking, I just stop what I'm doing and tend to this resident to avoid his verbal outrage. I know this is not the best way to approach this matter and would appreciate any advice on how to best work with this type personality.

Most ALs charge for extra services. If your facility does so, then start adding charges for nursing services, let him know that the charges will be added. Also, let his POA know, as well as his social worker, as there may be something else going on 

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If the person wants their money's worth or has anxieties about problems being monitored or caught early type of situation. I will take additional vital sets like every 4 hours, take a BP reading on both arms, and or have them do a daily weight, maybe an orthostatic set on a schedule. That way they feel better without me losing a lot of time while making them feel like they do not have to make demands to get the care they feel they need. 

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Specializes in Geriatrics.

Sounds like some underlying SMI. 

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Specializes in Critical Care.
BirdieBird said:

Hello, do any nurses out there have recommendations on how to best serve demanding residents in long term care? I work in assisted living and have a resident who experiences what he perceives as health "crisis" on a daily basis. Every morning, following breakfast, this resident will either call for nurse assist or simply show up at the nursing office door. One can be certain that I spend about an hour or more on his needs each day; that's quite a bit for assisted living. He is impatient and becomes upset if I am not immediately available to him. Each day, he arrives with a new concern. These concerns range from "look at my toe, does it look bigger than the other one" type concerns to "I think I have a mass in my throat". Generally speaking, I just stop what I'm doing and tend to this resident to avoid his verbal outrage. I know this is not the best way to approach this matter and would appreciate any advice on how to best work with this type personality.

Sounds like this human has some personal issues that should be dealt with by a professional... 

With this sort of personality, I don't let them take up my time and waste time that could be spent in patient care. I'll make up excuses to leave that scenario. To participate is only enabling him. Put a time limit on it. Don't be afraid to push back in a tactful way - and don't fall for any trickiness. You're there to care for patients, not tend to his... whatever he has going on. 

If it is truly that bad: keep a personal log of these incidents with dates and times. Present them to your boss and express your concerns. What helps me best is writing an email to myself. That way it's time stamped. Keep those logs as objective as possible. 

Harder said than done... who cares if he has a verbal outrage? In fact, if you sense one coming on, get to a public space where there are other witnesses who can advocate for you. If you feel like you are being bullied, that is another reason to bring this to someone's attention. 

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Specializes in Dialysis.
Red Shirt 6 said:

If the person wants their money's worth or has anxieties about problems being monitored or caught early type of situation. I will take additional vital sets like every 4 hours, take a BP reading on both arms, and or have them do a daily weight, maybe an orthostatic set on a schedule. That way they feel better without me losing a lot of time while making them feel like they do not have to make demands to get the care they feel they need. 

In Assisted Living, that's usually not an option. If they need thst level of care, they need to be seen acutely or reside in LTC

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Specializes in long trm care.

Get another job! Stop putting up with that bull crap! And tell the guy to see his doctor!

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