How much abuse from patients do you take???

Fiona59 · Oct 19, 2004

Long Term Care appears to be like that across Canada. When it is publicly funded the government has this weird idea that all the patients are sweet, helpful little old ladies, without dementia.

Care Managers always take the families side. Even had one who told us to sign for the meds and if the resident wants them left at the bedside do as ur told.

Why do u think they will hire anyone for those jobs-- its because staff with morals and ethics wont take them.

Been there, done it, and wont go back. But then I was told to "work on my people skills". Families don't like being told the truth. Even when Mum or Dad was an abusive alcoholic at home, they see a saint in the facility.

LydiaGreen · Oct 20, 2004

Long Term Care appears to be like that across Canada. When it is publicly funded the government has this weird idea that all the patients are sweet, helpful little old ladies, without dementia. Care Managers always take the families side. Even had one who told us to sign for the meds and if the resident wants them left at the bedside do as ur told. Why do u think they will hire anyone for those jobs-- its because staff with morals and ethics wont take them.
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On the contrary, government run long term care homes that I have visited in Ontario are the best I've seen (can NOT say the same for the private ones - all they care about is the all mightly buck). Government run long term care facilities in Ontario now require PSW certification (same as CNA) and this now takes a year of school (used to be six weeks, I think). PSW's do not pass meds, only RPNs or RNs do. I don't know if it's the same in all of the government run LTCs in Ontario, but the two that I have been to do not permit abuse by anyone (residents or staff). If a resident is being abusive (verbally or physically), they are moved to their room. The rationale on this is that the resident is paying for their room, not the right to be abusive to staff or other residents in the common areas. The other residents are not paying for the honour of witnessing or being on the receiving end of abuse. If a particular resident remains abusive despite all interventions by the staff and the resident's doctor and family, there is the option of bringing in an expert in dealing with geriatric behavioural issues. He assesses the resident; not just present behaviour but past behaviour as well, family relationships, relationships with staff, etc. He's really good at pin-pointing the issue that is triggering the abusive behaviour and finding simple resolutions. Sometimes, there is nothing to be done - the expert opinion will be that the person is miserable because that is their basic personality and always has been. LOL. But, most of the time, he is able to find ways that the abusive behaviour can minimized with, if not eliminated entirely.

Worthy · Oct 20, 2004

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On the contrary, government run long term care homes that I have visited in Ontario are the best I've seen (can NOT say the same for the private ones - all they care about is the all mightly buck). Government run long term care facilities in Ontario now require PSW certification (same as CNA) and this now takes a year of school (used to be six weeks, I think). PSW's do not pass meds, only RPNs or RNs do. I don't know if it's the same in all of the government run LTCs in Ontario, but the two that I have been to do not permit abuse by anyone (residents or staff). If a resident is being abusive (verbally or physically), they are moved to their room. .

Thanks LydiaGreen.

I might emphasize that the facility in question is NOT Long Term Care as LydiaGreen mentions (LTC is my morning job, and while not perfect, I feel more protected there and there are stringent standards regarding abuse in either direction).

PSW certification in Ontario is now four months. It used to be six weeks, it is now four months, and they are working on getting it to be a year. I know, I just graduated from the PSW program last April (did that at the SAME TIME as nursing school! whew).

The place I am speaking of is an "Assisted Living" facility, and therefore is EXEMPT from the Health Practice Act i.e. PSW's cannot pass meds..but here they can, because it is legally a "home environment". Believe me, when the VON RN's come in, I love to see their jaw drop when they hear this. I mean, I have a 22 year old History major handing out liquid Morphine today - she only knows "it's a pain killer".

The turnover rate in staff is astounding. I ran into another girl today who graduated with me from PSW, and she was clutching a batch of "cards" she had made at home for the families. She works on the Dementia ward, and she snorted at me and said "what do I say? Your loved one has become incontinent and is very quickly moving towards death???" She was kidding, of course, but you get the picture.

I am going in to my other job tomorrow and asking if I could get more hours. I just wanted to confirm I wasn't being weak, and that I couldn't hack it!

Thanks everyone.

Worthy · Oct 20, 2004

residents spread out over THREE floors! - that's insane!).

Just had to respond to this. Yes, three floors! I've have two residents on the first, ten on the second, four on the third. There are staircases and very slow elevators. Many employees take the stairs to each floor. After working a morning at the LTC facility, I don't have the energy to run up the stairs. I take the elevators, and use the time to catch my breath. A fellow employee the other day called me Lazy for not taking the stairs!!

It was all I could do not to strangle her. Geez.

Fiona59 · Oct 20, 2004

Lydia, I'm glad that in Ontario its a perfect world.

I worked for one of the best LTC providers in Alberta. Publicly funded. Whenever a staff member was abused verbally or physically the first thing out of a Care Manager's mouth was "what did u do to provoke the resident". The resident and their family was always right. Sure, I'll give a diabetic with BGM of 22.4 a cookie because she wants one and her family want her to have it just before meals, sure, I'll leave ur methadone at ur bedside so u can take it later. It's called customer service and the customer is always right.

I've been hit and scratched and told its part of their condition/dementia. The wanderers are the worst, no locked unit beds available, so deal with it.

I will never work LTC again.

boulergirl, CNA · Oct 21, 2004

Hi Worthy,

I would RUN, not walk, from that assisted-living home. Although I've been scratched, pinched, hit, screamed at, cussed out, kicked and almost bitten by residents, my experiences are NOTHING compared to the nightmare you describe. And then the mgmt. expects you to write cards to family members on your FREE time? :angryfire

Move on, my friend. (Keep the day job, though! Sounds like a good one.)

LydiaGreen · Oct 22, 2004

Lydia, I'm glad that in Ontario its a perfect world.

No, Fiona, in Ontario it is not a perfect world. I am sorry that your experience in LTC was not a positive one. Two of my classmates LOVE working LTC in the facility I have described and would not return to hospital nursing for anything. I personally do not like LTC but not because of any abuse (verbal or physical) that I ever suffered from a resident. It's just not my cup of tea.

Perhaps I should clarify that my experiences with LTC have been limited to a smaller, rural portion of Ontario where the nearest city is a four hour drive and there are towns approximately an hour and a half away in each direction with government run LTC facilities. There is ONE private LTC facility in the entire district. Perhaps government LTCs all across Ontario aren't that wonderful. Perhaps only the ones in smaller towns (less than 10,000 people) are decent enough to treat their employees as human beings. I hope that isn't true.

But, why are there patients with dementia in an assisted living facility? The assisted living facilities in my area may have residents who develop dementia while living there and may continue to live there while waiting for LTC placement, but I have never heard of a "dementia wing" in an assisted living facility. Residents with dementia require a level of care that isn't "assistance" but full-time care! Maybe things are just simpler in my little corner of the world, maybe we're twenty years "behind" the way things are in the big cities.

Fiona59 · Oct 22, 2004

LTC is a very tricky area to work. Families feel guilty about using it. Residents often resent being there, paying any of their monthly account, and either take it out on their families or caregiver or often both.

Families don't like to admit their parents have Dementia. Many seem worried that they will inherit it. Ergo, they like to keep Mum/Dad in as normal a setting as they can for as long as they can.

Dementia units have long waiting lists. Its hard on the facility that has someone that needs placing STAT and its hard on their fellow residents. Had one husband in visiting his wife the other month. We weren't equipped with wanderguard and had a big time wanderer on the unit. Finally got him settled, along came the hubby and decided to take him for walk and started the whole process over again for everyone. Then the husband started on the staff "people like him shouldn't be here". "How am I supposed to know he's not normal?" Whatever normal is in a geriatric setting?

Management just kept telling us to lock the doors, because wanderguard wasn't in this years budget. So, families were upset because they had to ring for admission to the unit. "I don't want my parent on a locked unit, they dont need to be on one" Quite right, but management are all finished by 4pm and leave the staff to handle it until morning.

boulergirl, CNA · Oct 22, 2004

But, why are there patients with dementia in an assisted living facility? The assisted living facilities in my area may have residents who develop dementia while living there and may continue to live there while waiting for LTC placement, but I have never heard of a "dementia wing" in an assisted living facility. Residents with dementia require a level of care that isn't "assistance" but full-time care!

At the assisted-living facility where I work, we have "Life Guidance"--it's a fancy name for the dementia wing. And, yes, there are people there that shouldn't be. I've had to work with residents who are VERY combative, residents who can't feed themselves or walk, and residents who have very complex health problems beyond our level of training. Right now we are without a nurse, so the marketing director keeps taking in residents and putting them on the assisted-living wing without having been properly evaluated. I know they need the $$$, but this doesn't help the residents or us, especially if a resident with dementia leaves the building and wanders toward the street. BTW, there are a number of ALF's in Georgia with a "secured wing", so my situation isn't uncommon.

Trauma-tizedRN · Oct 31, 2004

Years ago I worked at a hospital that was REALLY into customer satisfaction ratings (aren't they all....LOL)

I was caring for this awwwwful woman with CHF. A well-known frequent flyer....and dreaded by all. Somehow, I had not had the pleasure of being her nurse....until...the day..it happened. My number was up.

I walked in on eggshells...waiting for the axe to fall....this woman had violent tendencies and a scream like a a banshee. Hmmmm. All was well. Pleasant and converstaional. Weird.

By noon, nothing but the same. I was beginning to fool myself into thinking she had decided to spare one nurse on the unit and it was going to be me. Then her light went off. I walked down the hall and entered the room, just in time to be hit in the chest with a flying lunch tray and it's contents. "I'm not gonna eat this SH** fou f*****g Bit**!!! and on and on.... Next she wanted the charge nurse....whom I gladly sent in. She told the charge that I hadn't given her any meds and refused to give her insulin because I was trying to kill her. (Had all her meds) I walked in and said I heard it all....now tell the charge nurse here the truth. Mega ballastic then. She said she was leaving the f'ing hospital and going accross town to another (we knew that our hospital was the last in town that would admit her still) So I said, let me grab your suitcase for ya. I had had it. Charge gets sup to intervene.

Well, next thing I know....I am called to manager's office for a sit down with supervisor who questioned me on the patients complaints. And proceeded to rip me a new one because I had "upset" the patient. I wrote the supervisor up. This place was a concentration camp for nurses. Perfectly acceptable for the docs to scream and belittle you anytime, anywhere. I was out of there within the next month or two. Wanted to quit nursing after that hospital adventure.