I'm a CNA and have worked in a great ALF for the past couple months. I love my job. However, we have a very difficult resident, I'll call her Louise. Louise comes from BIG money and is used to having maids around. She treats all of the CNA's as her maids. When you go in to help her get ready (keep in mind she can do just about anything herself) she snaps orders at you, and never says please or thank you. The other day I was almost in tears because she was being so demeaning towards me.
Just to give you an idea, she makes you "fluff" her pillows, the other day she screamed at me because I didn't place her pillows at an angle after I fluffed them for her. (She makes everyone do this, not just me even though I'm new.) After that happened she made a snide remark to me, saying "Wow I guess you are new huh? I guess I'll do it myself since you obviously don't know what you're doing." The worst part is, she literally barks orders at you and NEVER says please or thank you. She literally treats you like you're scum. I mean, I've dealt with difficult residents but she tops the cake. I heard that when you give her showers, she makes you wash her arm, then dry. Wash again, then dry. Wash again, then dry. This goes on about 8 times, keep in mind for one arm. This is why she demands that you bring in about 10 towels. THANK GOD that she gets her showers in the evenings, and I'm on days- So hopefully I'll never have to shower her! I forgot to add that she's in a wheelchair. She's capable of walking, but doesn't want to. I think she likes having everyone push her around. She also goes to the bathroom and does everything else herself, but we have to come in and dress her??? Grrr.
I'm just wondering how you would deal with this situation?? I'm a very softspoken person and tend to not speak up when something's bothering me, but it's getting to the point where I don't even want to go into her room. I know I shouldn't let her bother me but she does!
It would be great if you could talk to your DON about having a group meeting with all of the CNAs and making an updated plan of care that specifies how each person will care for this resident. Consistency is the key. If all the CNAs set firm limits on her behavior she will have to comply (or move to a new ALF!).
Exactly. Limit setting only works if everyone is on the same page. Refusing to rewash an arm, addressing rudeness, making clear what tasks are hers and which are yours: everything needs to be listed on a plan, give a copy to her and her family. If everyone has the same expectations, she's got no room to manipulate staff. She may still be nasty, but you can point to the care plan on the wall, which puts the onus on the facility and not you personally.
Have a nurse go over part of the care plan with you regarding what amount of assistance you are to provide. You provide the care that is directed and if she requests more than what is outlined you calmly explain to her that your goal is for her to be independent. Try to get her to focus on being independent. If she can dress herself safely, then she need do just that. If she can fluff her pillows then she needs to do it, "how that will strengthen your arms Louise." If none of this helps, then a care plan meeting is in order, as well as social services speaking with her about the way she speaks to the staff. Always be kind to her...and always report to your nurse what she is saying and how she is treating you.
Had one like this as a patient once... I set the limits in another way though.. whenever it was time for maid service, I'd very sweetly say "I've got vitals to do right now, then blood sugars.. I'll be back when I get these done because as you know, these are things that need to be done on a time schedule and I can't be late with them"... then I'd high tail it out the door and do whatever needed to be done. It worked too...
JBudd, MSN
3,836 Posts
Exactly. Limit setting only works if everyone is on the same page. Refusing to rewash an arm, addressing rudeness, making clear what tasks are hers and which are yours: everything needs to be listed on a plan, give a copy to her and her family. If everyone has the same expectations, she's got no room to manipulate staff. She may still be nasty, but you can point to the care plan on the wall, which puts the onus on the facility and not you personally.