How do I deal with this patient's family members?

[morango576]

I am a CNA in FL and would like you nurses opinion on this matter, if you will.

I have been with this Home Health Agency since December, and have had this particular patient for 5 months now. She has Dementia, but mostly independent requiring supervision on a variety of tasks and activities.

We get along REALLY well. She likes me a lot and always tells me "thanks for making my day so bright" everytime I leave her house. I also like her a lot. We have fun together...

Anyway, she lives with her son who is bound to a wheelchair because of a car accident yrs ago. He does mostly everything for himself. At first he didn't bother us at all. But lately he's got into a crazy mood (I think he's jealous of us having too much fun :angryfire), and he's doing everything he can to either slow down my tasks or prevent me from doing it. The other day he said I could not wash her clothes, and she had wet her bed really bed. I stuck R (Refused) on my Daily chart for that day (laundry). Then another day he told me to go easy on the paper towels (he doesn't just say it.. he YELLS at me). Then I started using one of my patient's hand towel as a bib, instead of "wasting" his paper towels. He comes around her and SNATCHES the towel out of her chest... to which my patient turned to me in a desperate face... I told him to leave the towel where it was. He turns to me and yells "WHY?". I told him he had told me to not use the paper towels, he said "for this you can use". I said "I prefer using the towel because it shields it better all the way down to her legs"... because she makes a big mess especially on cereal days! Anyway, another day he came around the table, where my patient was sitting and eating lunch and I was sitting on the chair right next to her, he whams her against the table, trying to push her chair closer to the table (it wasn't that far away)... she screamed in terror! The only thing that came out of my mouth was "OH GOSH!". I could NOT believe what he had done. The way he treats his mom. The way he gets in between us.

Well, I told his sister -- my patient's younger daughter who lives 6 houses away on the same street -- all about this, that her brother is being an old fart, he tells me not to feed her this or that (things that she usually eats but now somehow he forbids her!), and the sister told me "please don't call your agency and tell these things, because if you do, I will have to drop your agency". I had told her I was unhappy with the conditions I was having now, all of a sudden her brother puts on a mood and creates a big problem for us. The one who pays for it is my patient and I'm very concerned. I'm there to do my job, whatever is on my aide Assignment sheet by my RN supervisor, I'm following it to the letter. I'm never late, I never miss work, I take my work very seriously, I enjoy what I do and excuse me -- but I do a DAMN good job! I'm proud of it! But at the same time I don't know how to deal with this old fart that is unhappy about life and is jealous that his mom and I are enjoying the time we have together... we walk, we watch TV, we play games together, we read, we laugh and tell jokes... I don't know why a family member could have a reason for a complaint about this! Anyway, I need the hours too as I am going to start nursing school now in May, and to be honest... I'm not ready to quit my job just yet, because like I said, I'm enjoying it very much. But I don't know how long I can stand this situation with the family members. I don't want to get in their business... the sister keeps telling me that her brother because of the accident, blahblahblah, that I have to have patience with him... I told her "I don't have to have anything for him... he's not my patient... I just want him to leave me alone so I can do my job properly"! Am I asking too much????

Tomorrow I have to go there again in the morning, and after that I'm going to my agency to drop paperwork for the week... but I am very tempted to tell the supervisor there about these things. But at the same time I'm afraid I won't have this patient anymore. I like her and I think she deserves the care I'm giving her. And I count on these weekly hours... I don't know if I can get another patient like her again.

What do you nurses think of my dilemma???? Should I put up with this problem or what?

Thanks a lot for reading... sorry it was too long!

[caliotter3]

One of the reasons it is important to keep records for yourself is that employers have been known to cause documentation to "disappear". If the office copy of documentation has "disappeared", your copy of your side of the story is evidence that you did indeed report as required.

[Atheos]

Indeed.

Courts are not likely to take your spoken account seriously.

If you have detailed and dated written notes the courts WILL take that seriously. Especially as time passes because there is no loss of memory or possible error in your story.

[muffin7]

Morango,

You are not crazy. Don't let anyone make you feel this way.

No one can make you feel anyway that you don't want to feel.

You are just doing your job. Now, it has come to this, and you are not returning to this job. If anything happens to the patient you have your documentation. Continue to be strong for yourself, if not for yourself, please advocate for your patient

As far as asking for help in the breakroom...you did what you should have done...You were relying on others RNs, etc (as we all do when we are learning) to inform you.

[morango576]

oh... I see.

Like I said, I'm new in all this. Learning.

You just made me think of something. At the bottom of my daily chart, there is a blank spot there that asks if there is any change in client's condition. One time, I guess my 2nd or 3rd week at the agency, I wrote down that my cliet was very confused one day and that I talked to my RN supervisor over the phone to inform her. I got chewed out by the office manager because I wrote it down on the daily chart, although it specifically said to if any changes. I asked why. The manager said "The RN doesn't want anything written in there. If you need to report something, you can call her and talk to her directly". Thought it was weird... how is she really going to remember what I told her? And, if somethign comes up in the future, how can I prove that this issue was addressed to them?

See... now I understood where you are going with this. It's a good point I had not thought about.

[morango576]

Atheos has scared me now. Oh gosh. I feel like a fool for not writing my own stuff down.

[caliotter3]

Now don't panic. Just start going back in time and write down what you can remember. And be scrupulous about notes to yourself from here on out. This is a good learning experience for you. And don't take any poop from those people tomorrow. You are doing the right thing by removing yourself from the case. Maybe, because you talked to that other lady, something will finally get done for the poor client. You probably did good without even knowing it! At least we can hope so, for the client's sake!

[Atheos]

Atheos has scared me now. Oh gosh. I feel like a fool for not writing my own stuff down.

Didn't mean to scare you.

Just something I learned in my 6th week of being a CNA...

The facility/organization/employer WILL try to sell you out. The only thing that saved me is that about 12 different CNAs on different shifts told the same story and named the same nurses.

The best advice a state inspector told me was document EVERYTHING.

You are your only protection.

I'd still call APS if I were you. You WON'T get in trouble and they most likely WILL go out and investigate both the family AND the HH agency. You will find that APS people are generally very nice. I've seen them go after abusers like wild dogs seeing meat but I've never seen them go after someone that reported something. Even later.

Plus, in your state you may be mandated by law to report it and if you don't you could possibly get in trouble.

In my state not reporting can result in jail and/or fines + loss of license.

Better to report and them not investigate than the alternative.

[muffin7]

So from this point on...... document not only what you said, but also the response, and who you spoke to, etc.

Relax and try to think... look at a calendar to help you document.

I am not saying that anything, but you never know what will come of this mess ...but you will have your own records if needed. Be sure to write down the date, time and who you spoke to (from your office) and of course the conversation...

Hang in there!

[morango576]

I definitely will.

I am more exhausted of this whole thing than anything else. I know tomorrow I will have to speak with either this lady "supervisor over everyone", or my office manager. Either tomorrow or Friday. All I wanted is for her to stop pushing me and now she's probably going to chew me out for not going tomorrow, blahblahblah...

Many things are going through my mind right now...

I'm so tired.

[caliotter3]

And the admonition to you about noting in your daily note that you informed the RN supervisor about a change of condition-----hogwash. You were correct in what you did. Never do otherwise. That is your job to write that down in that space. If they want more detail, like things you would say differently from the patient chart copy; you write that down in what is called a "communication note" or an "incident report". If you were not calling your supervisor and documenting changes in condition on your daily note, you would be hanging yourself out to dry. Unfortunately, you might find it easier to sleep at night with an employer who takes documentation and patient/employee safety more seriously. Good luck.

[morango576]

will have to go to bed and try calming down...

I'm just thinking how well my patient and I got along and how much I helped her, I'm sure I did. She always appreciated me.

Maybe if I keep thinking of this positive aspect of the situation, I can cope better.

Thanks to you all, you've been great!!! will let you guys know what happens tomorrow

[muffin7]

Hi Morango,

I hadn't seen Atheos reply until right now.

Don't be nervous. You have been reporting what has happened about your patient to your supervisor, etc. As a precautionary, you will be reporting to an agency (whatever it is to protect your patient) tomorrow. You have nothing to be worried about. You will be reporting bruises to them and you will think back to anything else that you can at this time. Your patient is ok at the moment and you want her to stay that way.