So I work for a home health agency and I've been doing this for a few weeks. I see two clients, 9-1 and 1:15-4. One is hoarder, keeps her house dark at all times, kitchen infested with ants, dolls everywhere, trash is emptied on the daily. She is a nice lady when she's in a good mood. My second client, a lady that I have only met with twice. She's particular about how she wants things done and her house is nice and tidy. We got along pretty well, I thought. She told me I was going to make a good nurse one day and that I was patient. Today, I arrived 2 minutes early to my second client's house. It was my second time meeting with her. I called her to tell her I arrived, like I did on the first day. She was mad that I was late, I explained to her that I had a client before her and am given 15 minutes for commute. She kept on fussing over it, saying that no one had told her anything, even though I did tell her on the first day that I see a lady before her... She was agitated that I called her instead of knock on the door. "Normal people knock on the door. Why would anyone call when they can knock on the door?" "Okay," I said, "Next time I will knock on the door." "Well go on, knock on the door." "You mean, right now, as we are on the phone?"
Seriously?
She gave me attitude as she let me in. Went on and on about how other people knock. I became annoyed very fast. I started in the bathroom and worked my way to the kitchen. I remember her husband telling me that's what their CNA of 4 years would do. They had a routine. Her kitchen is brightly lit up with natural lighting. She insisted I turned the light on so I can see what I was doing. I said it was alright and I would prefer to have the light off. She flipped the switch on. I told her again I could see just fine and flipped it off. She flips it back on. Okay, whatever. She watches me mop and sweep from the other room, the whole time. After I finish I go into the backyard to dump the water, hose the mop, set it out to dry, took the bucket bath in. She said I needed to mop the bathroom. Annoyed that she didn't say a word as she watched do all of that, I asked her if I could just clean the floor with a rag with a cleaning agent. She said she would like it mopped and that it has always been mopped and that she told me from day one it needed to be done. Which I honestly don't recall. I was flustered. I told her I will next time, and that I need to get started on other things. She says nothing for a while, sits down, and says, "I don't know how you're gonna make it." I ignore it and go to the bathroom to set up for her bath. She got mad that I didn't take the trash out first thing before I did anything. Like I said, she is particular about things. The whole time I was there, she kept on fussing and complaining about how I don't do anything right, I don't understand or speak english, I'm the worst CNA she's ever had, etc. Okay, lady. I am not a child, I am a good worker, and I am fast. I have a bad temper sometimes and I try to keep cool when I'm at work, but when she was speaking to me like that, the whole entire time I was there, I had to give her a piece of my mind, too. But I was not mean. I would just said she didn't need to talk to me like that and I was here to help her, she just needs to explain things once instead of going on and on about things (like knocking on the door), and that she didn't need to be mean to me. She said she wasn't mean and everyone loves her, because she is a good Christian. Okay.. After a while, it became kind of humorous that she would follow me around and insult me. I would just agree with her and say "Yeah, I'm the worst CNA ever. You got really unlucky there." "Yep, I don't know how to speak english." "I'll never make it in life." She tells me to be quiet and that if I were her kid she'd beat the **** out of me. This whole time I'm just cleaning. I ignore her again. She tells me she doesn't want me there. She called the agency to complain about me while I was in the same room, told them I didn't know anything, I don't do anything, I'm the worst, etc. I go into the guest room and start cleaning there. Off of the phone now, she says more stuff about not wanting me there, complaining about me, to me, some more. I step into another room and called the agency myself and told them she really didn't want me there, and they said it was okay for me to go. I use her telephone to clock out and she's yelling at me telling me to get off of her phone. That entire hour was a nightmare.
I came home and was never more happy to be greeted by my awesome, loving corgi. Maybe I should just look into working with animals, I thought.
I'm not sure what to think right now. I know I will have to deal with some pretty difficult people. Other than being a smart aleck as I was being insulted, I don't know how I could have handled the situation differently. I really don't. I can't just take all of her insults as I am on my knees scrubbing her toilet. I understand that clients will get annoyed and impatient with CNA's they haven't worked with before. Before I started working as a CNA I knew there would be times where I would be discouraged from pursuing a career in nursing. But I wanted to get my experience for nursing school. So far I just feel like a maid. I wanted to avoid LTC because of the running around, not having time to do stuff for patients, and the lack of interaction with them, and just the drama with co-workers. I know nursing is a difficult job, but in a different way. What I really want to do is neonatal or peds. I'm really hoping that along the way I don't get more and more discouraged from my goal. I'm not sure if I have a question, or really know what to do, or how to feel right now. I guess I'm just ranting.
I consider myself an all around nurse. I have worked in many areas of nursing and prefer certain areas in the field. I did work rather successfully as a home health pediatric nurse for many years as a part time (at one time or another it was full time). I have to say that there are many difficult clients out there. I will tell you what a client's mother once told me. She said "I learned the lesson the hard way. I got rid of many good nurses on the way to finding the "perfect nurse." A nurse that acted and thought exactly how I thought. Guess what, she/he doesn't exist, because we still can't fix my baby. Then I encountered the unfit to be nurses because after all the hassle I put those poor people through, the good ones didn't want to come back. So I hope you are good and we get along because I am now counting on you to help with ____ care. I need you so much." I stayed for 7 years on that case and we became good friends. With me, her child looked to me as a second mom. The 23 weeker that wasn't supposed to live (or ever get her trach out and never wean from the ventilator) just graduated from college... ohh and that was without a trach or any support whatsoever. During my care, she learned to crawl, walk etc. She learned to eat, getting rid of the tube feeds fairly early. She sprinted off the vent and learned to speak with the valve on her trach. Then came the day that the trach was removed permanently and closed. The whole thing mom was trying to find out before is that she was actually trying to find out what kind of person we are. That no matter how bad things get, you are always on their side. If you can take her at her worst and still come back, it means you truly care. I am not saying that if this person truly does not like you or that she doesn't want you there, that you should go back. I am saying that it just may be her (albeit dysfunctional) way of testing your character.
Wow...Yeah, that's a horror story. You definitely handled that better than I would have. Are you a housekeeper or CNA? Sounds like she needed a maid. Do all Home Health CNAs clean houses? Hmmm, I'm glad I started in a hospital... Good luck with your career.
Did I mis-read? Wasn't this an elderly patient? In CNA school we were taught many important things. We learned about dementia, alzheimer's disease, depression... all things that can cause a person to behave this way. Sometimes people can go many years undiagnosed even when being cared for by professionals. Even if none of these are an issue, I always try to put myself in the patient's shoes. I am a fiercely independent person. It is a struggle of mine to allow people to help me with personal things, even my husband. I can get touchy if he does the laundry for me one day. I have to work on that, and have been. Obviously, he loves me and is trying to help, but I really like doing those things myself. Not only is it relaxing, but it gives me a personal sense of accomplishment. I like doing it. Now fast forward 50, 60 or maybe 70 years... suddenly I am no longer capable of doing these things that I once took so much pride in doing... I am no longer able to be "useful" by my own definition of the word... this could be devastating.
Now, I am not saying that we should be doormats, by any means. But the way I see it? These people are not just "unhappy" and mean. They come closer to death every single day. Some of them are unable to handle this in a totally stable manner. Hell, most of us (not all) freak out when we start seeing lines around our eyes or grey in our hair... forget about being unable to drive a car any longer, or mop a floor bc our bodies are beginning to fail. Understanding. That is crucial to this field. Period.
I was grabbed by the throat and lifted off the floor and slammed into a wall by a very large patient once. This was an alzheimer's patient. He was usually very gentle and docile. However, after using the toilet, I had to clean him up... usually not a problem. But this one time he flipped out bc he didn't understand what was going on all of a sudden. All he knew was some little girl was sticking her hand on his bare butt. So he reacted as many being assaulted would do... Was I scared? Hell yes! I kicked the wall and screeched. Help came and from then on, peri care was only done as a team just incase. Was I angry? No. Not. One. Bit. Why? Understanding. Compassion. And.. sense of humor. A few weeks later I watched a charge nurse get kicked across a room by a 100+ very frail man on a toilet bc he didn't want her in there while he used the toilet... she was squating in front of him trying to talk to him soothingly and he just launched her. A few minutes later we were in the office laughing (with this nurse) about how she just got drop kicked by an old man. :) This man was one of my favorite patients.
This isn't about being walked on. It is about being understanding and compassionate. We are not going to teach these people anything new about their outlook on life or their attitudes. That isn't our job anyway.
You will have to deal with people like this and if you do become a nurse. You will cleaning their gross bodily fluids up and they will try to smack you and tell you you're a terrible person (and much worse). It's good you are seeing what you will be dealing with now, before you have invested time and money into becoming a nurse.
It is not okay to be rude back to the patient, or to lose your temper. You have to learn to separate your emotions from the job you are hired to do. If you can't do that, then you probably need to investigate other professions.
Difficult clients, family members or co -workers can be found in all lines of work. I interview the person I have the conflict with I ask (open-ended questions) what are their likes, dislikes to gain insight as to how to approach them for resolution. I keep a journal when working with all families or individuals I am providing a service for (CYA Cover your assets) esp dealing with fickle persons. If you find the person offends verbally, tell them using "I". .. For example, you can say : I notice that you seem upset about me being here. I notice that it bothers you when I touch your belongings. Or I heard ( I both respect and acknowledge that this is your home) you say that you are unhappy with the way that I clean. How would you prefer for the cleaning and organizing to be done? Also I recommend that if this clients concerns are out of you area of expertise, communication with your supervisor is key.
I'm confused. Are you a nursing assistant or a house keeper?
Aside from that, if you've agreed to do these types of tasks as a CNA, then it's unreasonable to do things the way you would do them. Elderly people are most often extremely particular and as a hired hand, you'll have to do it the way they want, unfortunately.
Other than that, if you feel she is being abusive, I'd set limits immediately with someone like that. I don't care who you are, nobody deserves to be treated like they are inferior and I'm not afraid to lose my job over it. That's the nature of abuse tactics, when you are desperate, abusers will pick up on that and use it to their advantage.
If you take away nothing else from my post, please always remember this:
They need you more than you need them. There will ALWAYS be job opportunities for CNAs. Loyalty is a great quality, but don't ever allow anyone to abuse you. Do not compromise.
When I was in nursing school I had a job that was similar to that and I had a mean old lady. She was so evil that I ended up crying (I didn't have any experience and was trying my hardest with her and she was so mean). She ended up saying how sorry she was for being mean and awful but I ran out of that house. I told the agency how rude she was too. Honestly LTC is a great place for a CNA to learn patient care and time management. I worked as a CNA in LTC for almost a year while in school. If you can, give it a shot. Yes, it is a lot of work but you learn a ton.
I am in the same situation as you, I have worked for home health for around 5 years. It does take patience, in this case a lot, and a strong sense of self identity.
Several factors come to mind upon reading your story. One, does the woman have a disease process? Such as dementia. If so, I know it is very frustrating, but all of her lashing out could be because of the disease. It helps if you try to remember it isn't the person that is lashing out, it is the disease. I know it is very hard to take insults with a stiff upper lip. Or it could be she has always been this way.
I am reminded of a situation similar to yours. I was caring for a lady that I called her "queen Elizabeth" in my head. She had to have everything her way or she would start with the insults. I couldn't make a bed right, fold towels right, cook a meal, or drive right. How I got along with her is I learned to listen. For example, when I came in asking how she was doing, how did you sleep? Things of that nature. Since I seemed to take an interest in her well being she eventually backed off, a little, and let me do my work. Also when I was so frustrated with her insults that I wanted to bang my head on the wall I would just hum a tune in my head of a song I like. It is important to remember that what she is saying are just words, they have no meaning. Her insults I mean.
Also it does help to put yourself in that persons shoes too. It must be hard to let go of a lot of control you once had and to let strangers into your house daily. I wouldn't like that, would you?
Above all, keep your supervisor aware of the situation. Chances are this lady is like that with every new person and your supervisor already knows. People can be strange. Good luck.
It sounds like you're the one giving the attitude.
I've had similar experiences with patients. However, it is not okay to be rude to them by being a smart orifice. You gotta think to yourself; Is this a battle I really wanna fight? It's a patient particular about her home being cleaned. Big whoop. Not worth potentially losing your job over it.
In these situations, I just say "Okay" to what they say (as long as it's not a patient safety issue). She wants the light on? Okay. I'll leave the light on. I understand you could see just fine, but who cares? She wants it on! It didn't affect your ability to do your work. She wants the bathroom mopped? "Okay, I'll be sure to mop it before I toss the water".
You're going to come across many a difficult patient as an RN- those who swear and spit, throw their s*it at you, make nasty comments to get a reaction out of you, give you attitude. Part of the job is learning to manage your responses and reactions to them. You want to work as a peds nurse? Guess what? Peds come with difficult family members, or those that think they know more than you, or those that truly do know more than you because that's their chronically ill child in the bed that they know how to care for. That temper that you speak of will not be helpful.
Control that temper of yours when "people are being rude to you." You can't afford to lose it on a patient/patient's family as an RN.
If you really don't want to do home health, then look for a CNA job in obstetrics to get some experience.
Just my two cents.
I also totally disagree with the post above.
We take so much abuse as nurses.
I have a repeat, chronic pt who is so mean and abusive- and mgmt defends her. Quite honestly, pretty much all of us at my job wish she would drop dead.
It's pretty sad when a person is so nasty that it causes their caregivers to despise them.
And I do not buy the most tiresome excuse others make for them- "It's their disease making them act like that...they've been through so much.." What a bunch of bs.
Elderly people are particular. So what I do with a new client is sit down and go vet what they want done. Then write it down so we both understand the plan. This way there's no complaining about routine. For example if laundry is to be done. I put it first on the list so I have time to complete it before I leave. Then move on. Bath? Cleaning etc. if a Clievt follows me around I splu say this is what is on the schedule and keep moving. You don't have to put up with rude remarks etc. if you run into problems advise the agency of what is happening. Sure. Adjustments will need to be made. But no one should have to be bullied or insulted. Once a pushy client knows she can get to you she will push you more and more. Good luck.
I have a repeat, chronic pt who is so mean and abusive- and mgmt defends her. Quite honestly, pretty much all of us at my job wish she would drop dead.
It's pretty sad when a person is so nasty that it causes their caregivers to despise them.
And I do not buy the most tiresome excuse others make for them- "It's their disease making them act like that...they've been through so much.." What a bunch of bs.
I find this response sad. Very sad. I hope you end your days with perfect grace and not a hint of dementia, otherwise you will likely encounter this same attitude from your caregivers.
Maybe I'm alone on this, but I found the part where, when OP told pt she was just trying to help and pt did not need to be mean, pt stated that everyone loves her because she is a good Christian.
I think some people enjoy being rude and intimidating and try to excuse/deny their abhorrent behavior by saying they are oh so wonderfully Christian.
Cleary not the case, and I've known so many people, both religious and not, who couldn't be truly mean to save their life - they treat others with a graciousness I would like to achieve someday.
Sadly this woman doesn't seem to care how her actions affect those around her
explorereb96, ADN, BSN
145 Posts
I consider myself an all around nurse. I have worked in many areas of nursing and prefer certain areas in the field. I did work rather successfully as a home health pediatric nurse for many years as a part time (at one time or another it was full time). I have to say that there are many difficult clients out there. I will tell you what a client's mother once told me. She said "I learned the lesson the hard way. I got rid of many good nurses on the way to finding the "perfect nurse." A nurse that acted and thought exactly how I thought. Guess what, she/he doesn't exist, because we still can't fix my baby. Then I encountered the unfit to be nurses because after all the hassle I put those poor people through, the good ones didn't want to come back. So I hope you are good and we get along because I am now counting on you to help with ____ care. I need you so much." I stayed for 7 years on that case and we became good friends. With me, her child looked to me as a second mom. The 23 weeker that wasn't supposed to live (or ever get her trach out and never wean from the ventilator) just graduated from college... ohh and that was without a trach or any support whatsoever. During my care, she learned to crawl, walk etc. She learned to eat, getting rid of the tube feeds fairly early. She sprinted off the vent and learned to speak with the valve on her trach. Then came the day that the trach was removed permanently and closed. The whole thing mom was trying to find out before is that she was actually trying to find out what kind of person we are. That no matter how bad things get, you are always on their side. If you can take her at her worst and still come back, it means you truly care. I am not saying that if this person truly does not like you or that she doesn't want you there, that you should go back. I am saying that it just may be her (albeit dysfunctional) way of testing your character.