Is this neglect?

[mikasa]

Hello, I'm new on this site! I'm a nursing student in my junior year of a BSN nursing program. I work as a CNA and have noticed things that my co worker has been doing specifically to one patient. This patient is in hospice so she is pretty much comfort care and does not need to get out of bed if she doesn't want to. My co worker, let's name her Jess, has not been getting her up for breakfast or lunch every time she works. This patient is so skinny, like a skeleton. She doesnt talk and is VERY easy to dress, take to the toilet etc. She is a kind patient and probably does not know what is going on. She can also walk.

Since she is hospice, I guess I can understand how it is ok to leave her in bed. Jess would always say she doesn't want to get up which is ridiculous because this patient cannot speak so how would she know? When I have this patient I always get her up because she will eat and drink. Jess also does not change her depends until the end of her 8 hour shift. This patient is supposed to be changed q 2 hrs.

The employees during the next shift has even confronted her about how she does not change her residents. There is one resident that I guess she never takes to the bathroom. Since she was confronted about it she has been taking her residents.

I really think she is lazy and tries to act like she cares for the residents. What can be done? Or is this a big issue? Thanks

[lovenotwar14]

Yes this is neglect. Would you want someone treating your loved one that way? Report her!

[SwansonRN]

I think you probably already know the answer to this question. My question is why don't you change her or get her out of bed if you know this is going on? If this is indeed happening and not just unit gossip then you're responsible for doing something about it.

[mikasa]

Sometimes we would just get her up. Just recently I have and she did not say a word to me about it. Other co workers have also dressed her and Jess's mood would turn cold as if we were doing something wrong when we were just trying to help. When we get her up, she does not change her q 2 hrs either. It's like she's just lazy and would rather have her in bed than care for her. Sometimes we do not have time since we have our residents to worry about. I think one of my co workers is thinking about reporting her. Thanks for the comments, I will do something.

[HappyWife77, BSN, RN]

Tell the DON/DNS or ADN. You are an advocate for your patients too.

[tokebi]

Since she is hospice, I guess I can understand how it is ok to leave her in bed.

No no no. The only reason you wouldn't get comfort-care patients up would be if it caused pain. Simply being on hospice does not mean it is okay to stop all the care. At my work, comfort-care-only patients are considered higher acuity.

Your co-worker either does not understand what hospice/comfort-care is, or plain lazy, as you said. It is unacceptable that she would leave pt in soiled diaper for entire 8 hr shift. Your DON must step in. If you don't see any action from management, remind them it is a pressure ulcer waiting to happen. The idea of in-house pressure ulcer development should get their attention quick. If they still don't do anything about it, I would report.

This kind of thing should not happen. This is exactly why general public feels reluctant and fearful about hospice. Shame on us for letting such fear reality.

[Alnitak7]

The patients have to be changed every two hours even if no one wants to do it. I think you could tell if a non-verbal patient wants to be up by watching them.

This is not customary and is not how they usually handle problem employees, but you and the others should try to figure out why Jess is "lazy." Is she really just tired? Is there something she could do to help her get more energy that does not involve being written up?

[mikasa]

I honestly think she is getting lazy. When you first meet her she seems very kind and very happy girl but she suffers from depression. Through working with her more I've noticed she is very sensitive and has become lazy. I feel like it's all an act, like she doesn't actually care for her residents. I've also caught her lying. I think I will confront her first about the issue but I'm nervous because of how she will react. Don't get me wrong, I like her as a person and I just don't want her to hate me. I know it sounds really stupid. But you guys are right. I wouldn't want my grandma to be treated this way.

and this is a pressure ulcer issue because she does not get turned or reposition but the resident can slightly move on her own since like I said she can walk, she's just very fragile. And thank you for defining hospice for me. You guys have opened my eyes how big of a problem this is.

[rn360_]

There is NO time in a patients stay where it is ok not to change him/her, or get him/her up if it helps with eating ect. Staying in bed and staying wet will cause decubiti in no time! This is NOT acceptable and you need to let your superiors know!

[ckm2]

please objectively report this immediately reporting the actions non actions but don't report what you feel like she is lazy that is subjective. Also remember we are not only accountable for what we do but equally or more importantantly what we dont do.

[motherof3sons]

Anyone that is in our facility comfort care or hospice needs to have meals and fluids offered to them. This is neglect. It needs to be reported to your charge nurse and if nothing is done to your DON. When you have knowledge of neglect and do nothing then you can be held accountable for it too.

[mikasa]

I thought I should update you guys. I was talking to my co worker and he already reported her. She will be talked to tomorrow. Thanks for comments guys, I was really struggling with this.