How to handle prejudice residents?

[Maremma]

Can anyone help me understand the legalities of dealing with a prejudice resident? We have a resident in our facility that is very difficult to deal with all the way around. Mind you, he is a stroke victim and does not have dementia.

This man HATES colored people and more often than not all male aids and nurses too,with the exception of one colored male aid. ( strongly suspect the reasoning behind this is strictly due to the sheer size of this particular man. Can't see to many people even half out of their minds physically challenging this guy) He also as a hatred towards other male residents that have dementia and cannot be trusted near them either.

This of course creates all kinds of issues for everyone concerned. Examples. This patient was moved to three different halls already due to his "behaviors" against other residents. He was harassing a dementia patient that shared his room. He would constantly be screaming at him, swearing at him and calling him names. He threatened to strangle him with the call bell cord and was caught with it in his hand heading towards intended victim. (yanking it out of wall to use a weapon thankfully turned the call bell light on or it could have been WAY worse) THEN they finally decided it was okay to move this guy. We had been trying to get them to move him before this due to our growing concern for his room mate. They ignored us.

They already were well aware of his violent and abusive reaction to all colored people but decided it was a good idea to move him to the hall with the highest number of colored aids for second shift and a colored full time day shift nurse. They also thought it was a good idea to send the only colored second shift nurse down that hall on the regular girls days off. On those days that put a colored nurse, a colored aid and a white aid down that hall for the shift!

This guy would refuse to take meds from a colored nurse and God help any colored aid that would dare to even go to that end of the hall much less in his room! He would not eat if a colored aid took him his tray, if they managed to get it on the table in his room in the first place.SO if the only white aid was assigned to the dining room the colored girl would have to actually go to another hall and find a white girl to come all the way down there just to take is tray in the room to avoid a scene or worse violence) The colored nurse would either have to get the RN super to give meds or simply chart refused. The lies he keeps telling about everyone are downright scary. No one in their right mind is going to want to be anywhere near him without a witness. SO even for white people it is still scary to be near him.

The poor colored girl that would wind up left on the floor alone would suffer all kinds of abuse when she tried to give trays or answer call bells for anyone on that end of the hall when the white girl was shipped off to the DR. He would sit in his door way screaming all kinds of profanity, degrading racial comments, threats of physical harm to her.

He began heaping insults and abuse on other residents that had dementia and would wander down that end of the hall. One made the mistake of going into the room across the hall from him and he went after him screaming threats of violence and calling ugly names. I saw him heading towards the other patient and was able to run fast enough to prevent him carrying out the threat to beat the crap out of the poor confused guy. "No actual harm done", so again they do nothing about this lunatic. What if I weren't there to see it or fast enough to get between them? This type of crap was a daily ordeal with him reported every single time.

Then the fools decided it was a good idea to put a room mate in with him that required two assist. Umm okay? SO ONE white person in the entire hall is suppose to do that how? Yeah so the colored girl comes into the room not looking at nor saying one word to this man to try to help his room mate on the other side of his room. Well he began is raging and actually came after the colored girl (in his wheelchair)screaming that she is making an "a**" out of him", trying to ram into her with his wheelchair and punch her) White aid (me at the time) of course gets between them and yells for the colored girl to "get out! Go get help!" trying to distract him to prevent physical contact again coworker. Colored aid was forced to squeeze behind the head board of the other patients bed to get out of the room at all. room mates family comes in the door right at this moment no less and sees and hears the ordeal taking place. Family going to higher ups was the only thing that motivate them to intervene with this lunatic once again. They were terrified and who can blame them? This guy being in a wheelchair just gave him one more weapon to use to assault people with!

I personally was fed up with being a shield to all the other coworkers this guy would target.WHY he "liked me" and would not hit me even when I would intervene, only he and God knows.Still I was unable to reason with him and get him to change his behaviors once he would "get set off". I am not kidding when I say this but I swear the man was possessed! His face and eyes would change, he would growl like a wild animal and didn't care who saw or heard him then he would deny everything after he did it! After one particularly bad night with him I actually had nightmares about him. In my dream he was actually able to get out of the chair and was strangling me with the call bell cord for trying to stop him from beating up a dementia patient!

SO now he is in ANOTHER hall with "less colored aids" but still some but more males! UGH Really? Well he is just as abusive as ever.He sits in his door way hurling his venom at this poor colored girl relentlessly, making her cry daily and they just tell her "ignore him". REALLY? Just ignore him?

Is there or is there not anything we can do about this? There is a male float nurse that was subjected to his nasty verbal abuse and physically threatened. (apparently to this guy all male nurse's must be gay and incompetent and require castration which he is going to provide as soon as he finds a knife to do it with!) He made it very clear if that patient lays one hand on him he is calling the police. He said he left the office with the impression that the day he calls the police in on a patient is the last day he works there. He did say they did not come right out and say it like that but that was the "bottom line" of all their double talk.

Even the administrator going and talking to him telling him his behavior is inappropriate and cannot be tolerated has done nothing to change him nor has there been any consequence to him for continuing. I understand that we cannot "just abandon a patient" but there has to be something that can legally be done to deal with him. The day is coming when he is going to seriously hurt or kill another resident. Even if they don't care one iota about us staff they should be worried about that.

We had a Parkinson guy that was terribly inappropriate and constantly after any female staff that had to even be near him. He would say sexual comments touch them inappropriately etc. Again ignored by the facility. "Just tell him its inappropriate and you do not appreciate it" Yeah every single time you go anywhere near him to no avail anyway? Sexual harassment is sexual harassment and we should not have to be subjected to it just because it is a patient and not a coworker.

This guy was aloud to have Media movies that he would watch and staff would be forced to be subjected to if they had to go into his room to answer the bell or tend his room mate. (whom also was subjected to the sound even with the curtain pulled so he wouldn't have to see it. So they in essence were feeding this guys addiction because "he has rights". (but God forbid if a smoker came into the facility THEY had NO right to go outside and smoke where they would NOT be affecting anyone else.We are allowed to deny them that right)and we were ignoring his room mates rights by subjecting him to a room mate such as this.

He began "getting fresh" with some of the female residents and so then they decided they need to do "something" about this. He was no longer aloud out of his room without staff taking him and staying right with him. yeah like that stopped him! He was constantly sneaking out of his room and we would have to stop what we were doing to help anyone else and hunt him down and retrieve him!

So one night he snuck out of is room. (as he would sit and WATCH all the staff and had figured out that when they go into particular rooms they would not come right back out due to the level of care required). That was when he would take off. He went across the hall and began fondling a newer female patient. Indeed one that had her own phone and was not a dementia patient but he didn't know it! (I must admit that I did laugh when I was told how shocked he was at her response to his abuse. Good for her!) She promptly screamed rape at the top of her lungs and called the police as he tried to rush back out of her room!

That quick he is moved out to an all male facility somewhere! Really but we couldn't do that when he was sexually harassing the female staff for two straight years?

I don't understand why in a building supposedly full of critical thinkers it doesn't occur to the rest of them that abusive behaviors towards staff MUST be dealt with with a heavy hand. If for no other reason than because it WILL spill over to other patients eventually and land them a lawsuit.

What can the STAFF do to get administration to be more proactive with these type problems before they escalate to extremes like this? They just keep typing our hands and telling us it is part of the job. Take it or leave it kind of attitude. They seem unable to see past the end of their nose's around here.

[Asystole RN]

As a citizen of the United States you are protected under Federal, State and local law against assault and abuse, no matter the situation. As an employee you are protected under Federal, State, and local law against assault and abuse.

Your employer must have policies in place and make reasonable effort to protect their employees from harm. No one should ever physically or verbally assault you and it is in your right to seek help from law enforcement should anyone take illegal action against you. Should an employer refuse to protect their employee from harm then it is your duty to follow the chain of command, typically contact OSHA or your local labor board. As always, document everything that occurs, your attempts for resolution, and the outcomes.

That being said, as a nurse, your duty as the patient's advocate is to respect the culture, values, and beliefs of your patients. If they have a certain belief that conflicts with your own then you may seek outside conflict resolution, usually your chain of command. If you are unable to find a resolution then you must default to the patient's wishes. See the ANA's Code of Ethics for Nurses Provision 2.1.