How do I Handle Trifling Calls?

[TheLazyCNA]

Hello, allnurses, I am a new CNA with 4 months experience and I would like your advice on a new resident I'm taking care of. He will call every 5 minutes, no joke, for the most paltry things I've ever seen. He might need me to reposition his call light because he can't reach it (how did he call me then?); he might need me to reposition his blanket an inch to the left even though he is already covered; maybe he wants me to change the AC temp to 71 degrees from 72 only to call me again 3 minutes later saying he needs it at 70 degrees instead; etc, etc. Then one day he wants to "sleep" next to the nurses station so he can call out my name every single time he see's me walk by, the dude doesn't even care if I need to use the restroom since he needs attention NOW.

I was told to visit him more often, every 30 minutes but that's not enough for this guy. Nothing is EVER PERFECT ENOUGH and I feel like finding a new career if I have to put up with this worm for the next couple of months!! I understand he is "paying" me 9 bucks an hour but so are the other 17 patients, they deserve my attention too. Some CNAs told me to be "firm" with him but when the Nurse supervisor see's me doing that then he starts ******** bricks and caves in to the resident's demand because the resident might say I'm being rude. "Just give him what he wants!"

What would you all do if you were in my spot? Thanks!

[missmollie, ADN, BSN, RN]

It's tough. Part of me can understand, especially if he is incapacitated in any manner. But you do have 18 other residents you need to take care of.

If you can, work with another CNA as a team. Go in the room together, get his needs taken care of, and let him know that you are starting a round and that you will be back in half an hour to check on him. Now he has the knowledge that you have to round on all your patients and that you will be back. This might help him feel like he's being taken care of, and that you care. One thing though; you have to be back at the exact time you promised.

Please remember that some people are very lonely. He may have other CNA's who just ignore him during their shift, making you seem like an angel. Making a promise and keeping to it may be enough to build some trust with this person and ease his mind about being forgotten.

Hope everything works out!

[hookyarnandblanket]

I've dealt with many like this, both in LTC and in the hospital. Do you have whiteboards in the resident rooms? Perhaps writing on the whiteboard what time you will be back could help. We've had to do that with patients because they ring for a pain pill or to know when lunch will be served. Some of these people, too, have been catered to by family and come into this setting expecting the same thing. Don't let him dominate your time or it could reflect back on you.

[TheCommuter, BSN, RN]

Go in the room together, get his needs taken care of, and let him know that you are starting a round and that you will be back in half an hour to check on him. Now he has the knowledge that you have to round on all your patients and that you will be back.

Q30 minute rounds in the LTCF/nursing home setting are unrealistic and unattainable. Even in acute care hospital settings, staff is only expected to round once per hour.

[TheLazyCNA]

Thank you all very much for the helpful and inspiring words! I'm lucky right now because the man left during another shift. The last time I saw him he asked one of the aides, "can you grab that for me?" The aide asks, "that? Grab what?" He then reaches over for the TV remote, "that." "It's already in your hand sir." We were certain now that he is a manipulator. I just lol'd and went home. Thank goodness.

[missmollie, ADN, BSN, RN]

Q30 minute rounds in the LTCF/nursing home setting are unrealistic and unattainable. Even in acute care hospital settings, staff is only expected to round once per hour.

Not rounding every half an hour, but just giving him a time and checking on him. She is not getting anything accomplished if he is hitting his call light every 5 minutes. It's about building trust with him. However, since the OP's last post he does sound like a manipulator, which it's time to get the nurse involved and explain how him doing things for himself is part of his rehabilitation.

[neuron]

Residents who do that I say 'I'll be back to check on you in a little while, ok?' That seems to keep them calm. I always check on my residents so I was not just saying that. With the frequency of him turning on his light, you may have to let the nurse know you have already checked on him and that you have to check on your other pts.

I had this resident that yelled my name all day when I wasn't there, and admin, DON, ADON all would hear him in the front. Every day he did this and bothered other residents. He started yelling my name and the other residents started calling my name. I guess that's what happens when you care and are patient with your residents.

[ComeTogether, LPN]

On one hand, I feel for you, because I've had patients like this. Sometimes there is just NOTHING you can do for them. They just crave attention, from anyone, for any reason, 24/7. My first thought is, he needs to be busy. I'd try to find him something to do, a puzzle, a game, a coloring book - anything to occupy his mind. Even a movie or another old lonely person would work, because he does sound lonely.....

On the other hand, you just can't feed into it. You have to find ways of dealing with difficult patients that don't involve you crossing (or nearly crossing) any lines. This man should not be able to bother you so much that you refer to him a a 'worm'. I also think that you need to switch off with another CNA. Thats what needs to happen with difficult to please patients, sometimes you just need a night off from it.

I've had a few patients over the years that I just didn't "click" with. Sometimes it happens, and when it did, I would switch with someone.

[OCNRN63, RN]

Thank you all very much for the helpful and inspiring words! I'm lucky right now because the man left during another shift. The last time I saw him he asked one of the aides, "can you grab that for me?" The aide asks, "that? Grab what?" He then reaches over for the TV remote, "that." "It's already in your hand sir." We were certain now that he is a manipulator. I just lol'd and went home. Thank goodness.

That almost sounds like something someone who had a stroke or some type of brain injury would do.

​You need to learn how to deal with difficult people better. You may not always have the option to "LOL and go home."

[RubyRabbit, BSN, RN]

I've had a handful of patients who behaved exactly the same way, if not worse. Unfortunately you will learn that you have to figure out a strategy for this situation instead of hoping it'll go away soon. It might, but somebody else will come along soon enough. Handling different scenarios will make you an experienced and capable CNA.

Every patient is a little different, but what I typically do is:

Once I have observed the behavior and am confident that the pt IS calling out unnecessarily, I cease to tolerate it any longer. Yes, continue to be nice. Be professional, caring, and meet his needs. You can do all of these things without encouraging him to keep acting that way.

I sit down and have an open talk about how the facility operates (nurse to pt ratio, how many other patients need your help). I use a gentle tone. I found that pretty much all patients are surprisingly understanding. I make sure that the pt will still ask for help when he really does need it, though.

If that doesn't work and he continues to demand for little things, start a system. Promise him that you will check on him at least once every thirty minutes (or however often you are able to). Tell him to comprise a list of things that he needs so that when you check on him next, he can tell you everything at one time. Double check again that he will still call for emergencies. Use a friendly tone so that he will want to cooperate with this and help make your day easier. (Maybe it gives patients a sense of purpose when they need it the most.. I've found that most patients really enjoy this if they know that it helps you.)

Also, you will learn little tricks as you continue working. You can never be openly rude or cold, but you don't have to be his servant, either. We are professional nurse assistants.. Not maids or waitresses or family members! For example, I had a patient who constantly called and called to ask for juice. It was not out of thirst, he often didn't drink it and he behaved in many other narcissistic ways. At one point, I told him that I cared for his wellbeing and that although fruit juice is healthy, it still contains a lot of natural sugars. I suggested that he try water for the next drink, and then he can get a juice later. He couldn't object... But trust me he stopped calling.

Another trick is to watch how you say certain things. For example, if he asks for the remote and it's clearly within his reach, instead of grumbling "it's right there, you can get it", say something like "where is the remote... Hey! It's right there next to you silly!" lightly laugh, tell him you'll come back later, then just walk off. The patients can't complain, but they still know they can't play their usual games with you.

[RubyRabbit, BSN, RN]

CNA work is hard. Especially when it gets busy and you're on your eleventh hour smelling of bodily fluids and some of your own sweat, patients like these are almost too much. I understand that and I also think it may be hard for some RNs to understand if they aren't required to respond to every call light, all the time. They also get compensated much more for their work. However, don't forget to always remind yourself of the other perspective. Put yourself in your patient's position. Try to understand why. Get to know them as people; ask them to share anecdotes or something that's important to them. Even the most difficult patient is relatable if you offer the time. Imagine if he/she were your mom/dad. He/she IS somebody's loved parent, or brother, or sister, or aunt or uncle, etc. You get the opportunity to witness them at their worst and ugliest state... You get the privilege to take care of them through that.

[OCNRN63, RN]

CNA work is hard. Especially when it gets busy and you're on your eleventh hour smelling of bodily fluids and some of your own sweat, patients like these are almost too much. I understand that and I also think it may be hard for some RNs to understand if they aren't required to respond to every call light, all the time. They also get compensated much more for their work. However, don't forget to always remind yourself of the other perspective. Put yourself in your patient's position. Try to understand why. Get to know them as people; ask them to share anecdotes or something that's important to them. Even the most difficult patient is relatable if you offer the time. Imagine if he/she were your mom/dad. He/she IS somebody's loved parent, or brother, or sister, or aunt or uncle, etc. You get the opportunity to witness them at their worst and ugliest state... You get the privilege to take care of them through that.

We get compensated more because we have more responsibility. A lot more.

[RubyRabbit, BSN, RN]

I know that, and was not saying RNs shouldn't be paid more. I was simply trying to sympathize with OP's struggle because some people have called her cold, uncompassionate, etc. I wanted to point out that RNs may have a different perspective, reasonably so, but that she is not a cold person because of that.

I was merely saying that RNs do get paid more and so they might have a higher tolerance for this kind of behavior. Yes RNs have more responsibility, but that does not mean RNs work harder than CNAs or CNAs work harder than RNs. I would say that depends on the individuals and the facility. In the same way, I know many RNs feel that they do a large portion of the grunt work but doctors get paid much more because they have more responsibility. It can be frustrating sometimes. Not that we don't love our jobs, but CNAs get barely above minimum wage and we all have things we need to pay for.

If you read my entire post, you'll see that I just wanted to relate to OP and yet remind her the importance of patient care. Was not trying to attack RNs.