I'm not happy

Whispera, MSN, RN · Feb 5, 2009

It's never in a job description to be hit, scratched, or called dirty names. Since they are capable of understanding (right?) you can tell them how you feel in response to their actions, gently, and even ask them what's leading them to do such things. Continue to be kind and do their requests. I think you could run into SOME such patients in any environment, but if it's a general thing, you might want to work somewhere else. Not all places are generally icky--usually there are at least some lovely, wonderful patients, and a nurse gets some warm fuzzies and good feelings at working with them.

CoffeeRTC, BSN, RN · Feb 5, 2009

No, it sounds like they are out of control or have control issues. Treating nursing staff like servants shouldn't be tolerated. You are there to be a "nurse" not a maid. Yes, some of the stuff nurse, or CNAs do could fall under this category, but there are housekeepers, laundry and maintance for those type of tasks. The cnas should be assisting with the adls and making sure that the residents are participating at thier highest level. If they are making staff do things for them that they should or could do themselves..the IDT needs involved and careplanning needs to cover this and the limit setting.

The hitting, scratching and biting can occur with those with psyche or dementia dx but it is never acceptable to let this happen with others. Steps are taken to prevent or reduce these occurances and psych should be consulted.

I've worked in a place where it was a bit of an upper crust who thought Iwas there to "serve" Uh...no...I'm there to provide nursing service and TLC.

annaliza · Feb 5, 2009

providing care to those residents need more understanding and long patience. try to do this... first thing you will do when you come to your duty, you have to wear your smile, smile is like a virus it affects everybody, a patients that are not feeling well, it makes their day lighter.. or even makes them happy, if you see them like that, you will feel something... happiness inside you, cures for you and cures for your client..make ltc to tlc (tender, loving care) have a nice day!>>> :yeah: :lol2:

indiansfan · Feb 5, 2009

There is always "mean" people, whether it is staff or patients. The physical abuse should always be reported & I agree, never tolerated

StNeotser, ASN, RN · Feb 5, 2009

providing care to those residents need more understanding and long patience. try to do this... first thing you will do when you come to your duty, you have to wear your smile, smile is like a virus it affects everybody, a patients that are not feeling well, it makes their day lighter.. or even makes them happy, if you see them like that, you will feel something... happiness inside you, cures for you and cures for your client..make ltc to tlc (tender, loving care) have a nice day!>>>

and with regular patients and in a perfect world this would be valuable advice. however, i'm sure the original poster is already doing this. i've done this to some of the more difficult patients and all they've done is said "what are you grinning like a derranged fool for?"

to the op, you may get further if you go to the social worker v. going up the chain in nurse management. though we get regular inservices about how abuse, both physical and verbal is not part of our jobs, when we complain to nurse management they seem to think it is.

Sterling-RN · Feb 5, 2009

Keep in mind that many patience in a LTC facility can begin to feel abandoned or less valuable as an individual. I think some figure if they don't treat you like a nurse, and more as a servant, then they forget they are in a nursing home. Maybe I'm being overly melodramatic, but it occurs to me from time to time.

And nothing I've said above issues an EXCUSE for behavior you've mentioned. Although, I think the more we try to remember that we as nurses get paid to be there, get to go home, have the ability to control much more of our lives than our patients can...then the easier it is to be patient with them.

I have found the massive importance of supporting each other as nurses in these environments. Sometimes, we feel as if our management is against us, the residents are against us, our NA's are against us. Even though we know it isn't true, it's important to have a support system for each other in the work place. We aren't dealing with shipments, accounting, programming, etc. We are dealing with people, and our emotional wellness can be impacted greatly without someone to turn to now and then.

We all have a lot to carry on our shoulders. Remember to distinguish what you are there for from what you might be perceived to be there for by your clients, and be forgiving and gentle and kind after you've had a smoke. lol :smokin:

JB2007, ASN, RN · Feb 5, 2009

When I first started at the facility that I currently work at the residents on my hall thought that they could treat me like a servant. From all accounts from the staff that had worked there for years, the nurses that had work this hall had allowed the residents to act this way. When I first started I would run and fetch this and that until I was not getting my job done. Also, it was not like these residents could not do what they where asking me to do. One day I said enough is enough, I started telling the residents politly, but firmly you can do this your self or I will get someone to help you with that. It took a while, but most of the residents stopped being so demanding and started doing the things that they where able to do for themselves. I am never rude and all of my residents know that I am more than happy to do what I can for them, but I will not be ran ragged every moment of everyday. Good or bad I will not be a push over.

As far as the physical abuse that these A&O residents are inflicting on you that is wrong. Set up a meeting with the DON and SW as soon as possible. This kind of behavior is not acceptable whether these residents are rich or poor. You must respect yourself enough to not put up with that kind of behavior.

achot chavi · Feb 6, 2009

You are NOT their outlet and do not have to allow yourself to be abused. When presented with this behavior, I halt all care immediately, place the patient in a safe environment- like a well padded bed with side rails, I explain that "He/She is not allowed to hit/scratch/ bite/ kick/ pinch/spit/threaten/curse or whatever me. I have to leave the room now but I will be back to provide the necessary care. If the problematic behavior persists I will be unable to provide the care."

I document everything with as much detail as possible including quoting curses and threats. I advise my supervisor and ask all the staff to be consistent in this stance- I then return with another staff member and all care is done by 2 not 1 staff member until the patient understands and behaves better.

If you are consistent- the behavior will improve- you'll see.

If the patient is demented- then I would just skip to the part of having 2 staff members or more give the care together. One to hold the hands or feet etc.

I would also ask for a Psych consult. I would check for Pain and give pain meds at least a half hour before care, as that could make anybody act aggressively.

When the behavior improves, I would use positive reinforcement like a compliment or a special smile or something to show that this is better- never refer to the previous abusive behavior.

If all this fails, you can involve your DON, SW MD etc. Ask the patient before care if something is bothering her, or if she has any special requests, sometimes it is a simple as not liking the color of the dress you chose for her.

Document everything

Good Luck, Difficult patients can make us want to leave the field. Please know that all professions deal with similar problems.