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Losing patience with residents.

Posted

How do you deal with residents who test your limits? I've only been a nurse one month and I feel like I want to scream seeing certain residents tread up the hall to the nurses station because I know exactly what they are coming there for. They are the ones with all the behavioral issues that the DON and Administrator refuse to have sent out for evaluation. The pain pill seekers. The attention seekers. The confused residents who are yelling because they are convinced something has been stolen. (I'm a little less impatient with them, because they really just are lost and helpless.) I just feel like I'm at a breaking point and have only just begun my nursing career. Any advice besides starting a yoga class to deal with stress? Lol

Edited by Sbrewster

casi, ASN, RN

Specializes in LTC. Has 3 years experience.

You really can't send them out for eval. Basically the hospital will see it as a dump and send them right back. Push to have them evaluated by in-house psych maybe. Honestly LTC is full of these kind of patients. Sometimes you need to hide from them.

We send all psych/behavioral res to a local mental health facility and they observe and adjust their meds before sending them back. I don't think we have in house psych.

casi, ASN, RN

Specializes in LTC. Has 3 years experience.

What you are describing above really isn't what needs mental health hospitalization. Every place I've worked only sends the really violent patients out for adjustments and then tries to keep everyone else in house for medication adjustments. You take a LTC patient out of their environment and they aren't going to do well at all. Just like your facility has dental, hearing, eye doctor, and podiatry that comes into facility they should probably have a psychologist that comes in as well who can evaluate psych problems and the need for further psychotropic intervention.

One thing to keep in mind however, in LTC we tend to avoid psychotropics like the plague. Just because the patient is driving you crazy, doesn't mean that they need to be medicated.

I'm sorry I forgot I had edited my post earlier and it didn't say half the things I wanted it to. I had several examples of things residents were doing but edited it all out because after re reading it sounded really specific to each resident and I was afraid it could possibly flag a hipaa thing. So the things I re typed in are definitely not psych worthy, no. My post before I edited it mentioned people throwing their walkers and coffee cups for not being able to drink coffee at 2:00am, constantly hollering HELP all hours of the day and night for no reason and a few others that I felt were a little too specific (like if someone happened to read this and knew them they would know who I was talking about). But I see what you're saying. My post doesn't make as sense without all the major problem residents in it. Lol

loriangel14, RN

Specializes in Acute Care, Rehab, Palliative.

Patience, patience, patience.They usually can't help it and they depend on you for care. I just take deep breath and keep smiling. if it was your parent/family member you would want their caregivers to be patient and kind. I love my old folks but it's not for everyone.

Edited by loriangel14

psychgeribuff

Specializes in Geriatric Psychiatry. Has 3 years experience.

First off hugs because it is difficult to deal with patient that are combative/confused/ and med seeking behavior. What you are in need of is empathy, the ability to be in their shoes. And this is made so difficult with the time constraint put on you in ltc. I took a workshop a few years ago that placed me in the shoes of someone with cognitive dysfunction. Glasses I couldnt see well out of, corn in my shoes, head phones with distracting noise on it. Then I was sent to complete a task....it was impossible. Imagine being somewhere you dont recognize and have someone pull your pants down every two hours. So just take a deep breath and always remember that they are behaving this way because of a disease process. Mabe look into further education on geriatric care or dementia and goodluck with the rest of your career!!!

Edited by psychgeribuff
spelling

brattygrl

Specializes in Peds critical care. Has 15 years experience.

Hey, as an adult, in my own home, I'd be ****** off too if someone told me I couldn't have a cup of coffee just because it's 2am. I'm just sayin. Think about it from their point of view once in a while.

Brattygirl it's not like I wouldn't give him some if I could. The kitchen is locked up and they don't let us have a key. They just leave snacks outside on a cart for the residents. :( I feel for him, but there's nothing I can do and there are better ways of dealing with anger than throwing childish fits.

Pangea Reunited, ASN, RN

Has 6 years experience.

If that's your real picture and you want to vent about your residents, you should change it ...just friendly advice :)

You keep in mind that you are in THEIR home and tread accordingly. Be compassionate and assertive too. A little empathy and creative problem solving goes a long way ie: getting or suggesting that the resident who likes coffee at 2am, instant coffee (there are even decaffeinated kinds). Don't be so quick to judge their coping mechanisms, but DO be firm with your own boundaries and set a good example.

ktwlpn, LPN, RN

Specializes in Med Surg, Homecare, Hospice.

You can not personalize their behaviors. These people have dementia. You can not reason with one who has a broken "reason-er". Dementia care is not for everyone. If you don't have the patience and passion to care for them you need to work on a another unit.

Can you make the guy a cup of instant coffee? Nurse coffee?

Imagine how you would feel if your wallet, purse, cell phone was stolen? This is their reality.

Do a search on here, we have a great thread with a ton of tips on redirecting dementia residents.

Plan your med pass around giving those PRN's.If they are taking them at the same time every day someone needs to call the doc and get an order so you can avoid all of the PRN documentation and interventions and crap.