New CNA having trouble with difficult patients

mindofmidwifery, ADN · Oct 18, 2015

I used to be so anxious knowing I had to deal with notoriously difficult residents! What calmed me down was getting to know them better and the things I can do to sort of alter their behaviors. I worked noc shift, handling two halls by myself, for about four months. It took me about a week and a half to get completely comfortable with nocs but I worked evening shift at the same nursing home for 6 mos before that. Some of the nicest residents during the day turn into evil spawns at night ðŸ˜“ toughening up definitely helped as well.

Missingyou, CNA · Oct 18, 2015

Learning about their disease will do wonders. Read whatever you can online starting at alz.org. It's amazing how understanding an illness will help you cope when they become combative. It will change how you see things and how you see them.

Sometimes all it takes is to wait it out a few minutes. If you're trying to change their brief/dirty bedding and they are combative, it may take leaving them be for 5-10 minutes. Their moods can change that quickly and you may get more cooperation.

It's all in your tone of voice too. Use a soothing tone of voice and always be respectful. If someone is crawling out of bed. Saying "Fred! Get back in bed, your going to fall!" will only meet with frustration and likely a few good swings of the fist from the resident. Remember, they see you as a "kid" (no matter how old you are)and who are you to tell them what to do!!! If they're getting out of bed at 2am, then get them up. Toilet them, see if they go back to bed, if not, don't argue. Let them stay up....it's not like they have to get up and go to work the next morning!!!!

One lady I took care of would ALWAYS scream, punch etc when trying to get her washed and in bed for the night.

I discovered that she loved nice new things, so every night I greeted her like she was an old friend I hadn't seen in years...then I told her I brought her a new nightie and "let me help you try it on and get comfortable"!! She would be delighted and cooperative. Every night it was the same routine...and the same "hospital gowns" but, to her it was all new. Very rarely did I get a refusal...and when I did, I waited 20 minutes or so and started again until it worked. :)

Another gentleman would beat on me for trying to change him in bed. I knew his wife was the apple of his eye, So I sat him up on the edge of the bed and asked him how he met his wife. He'd tell me the same story (it was an awesome story :) !)over and over every night, completely distracted while I washed him up.

Meet them where ever they are. Step into their world. Get creative with how you respond to them!

You've only been there a month. You're still getting to know the residents and they are still getting to know you.

BBboy · Oct 23, 2015

You have to learn how to work differently with each and every individual resident you come into contact with. Eventually over time you'll get more comfortable with your role and skills and will gain confidence. You also need to build up a tough skin but that will come with exprience

Momof8CNA · Oct 24, 2015

Learning about their disease will do wonders. Read whatever you can online starting at alz.org. It's amazing how understanding an illness will help you cope when they become combative. It will change how you see things and how you see them.
Sometimes all it takes is to wait it out a few minutes. If you're trying to change their brief/dirty bedding and they are combative, it may take leaving them be for 5-10 minutes. Their moods can change that quickly and you may get more cooperation.
It's all in your tone of voice too. Use a soothing tone of voice and always be respectful. If someone is crawling out of bed. Saying "Fred! Get back in bed, your going to fall!" will only meet with frustration and likely a few good swings of the fist from the resident. Remember, they see you as a "kid" (no matter how old you are)and who are you to tell them what to do!!! If they're getting out of bed at 2am, then get them up. Toilet them, see if they go back to bed, if not, don't argue. Let them stay up....it's not like they have to get up and go to work the next morning!!!!
One lady I took care of would ALWAYS scream, punch etc when trying to get her washed and in bed for the night.
I discovered that she loved nice new things, so every night I greeted her like she was an old friend I hadn't seen in years...then I told her I brought her a new nightie and "let me help you try it on and get comfortable"!! She would be delighted and cooperative. Every night it was the same routine...and the same "hospital gowns" but, to her it was all new. Very rarely did I get a refusal...and when I did, I waited 20 minutes or so and started again until it worked. :)
Another gentleman would beat on me for trying to change him in bed. I knew his wife was the apple of his eye, So I sat him up on the edge of the bed and asked him how he met his wife. He'd tell me the same story (it was an awesome story :) !)over and over every night, completely distracted while I washed him up.
Meet them where ever they are. Step into their world. Get creative with how you respond to them!
You've only been there a month. You're still getting to know the residents and they are still getting to know you.

this is awesome advice! years ago, i was a live in caretaker for alzheimers patients, and these are the same strategies i used. if they insist that its 1940 and you are their neighbor, so be it, then! when you meet them on their "turf", they will be much more cooperative. i just try a "friends" approach..i act like we are best friends, and im simply helping them.its much less threatening, and they seem to react better towards my suggestions. aside from that, get your own personal routine going! right down a list of what you need to get done, and just try to work with that. i was so confused when i first started, until i made a list of what i had to do, and when i had to have it done by, and it made a huge difference.

fifiandclea · Nov 25, 2015

Been a CNA for almost a year now. Started off January of '15 and have been PRN at a rehab ever since. I am still not used to the whole idea as an aid. I work at least 4 nights a month because of school. I don't like begin an aid but that is just me. It's mostly because of the 12 hr shift and working nights. I say that you ask the nurses to help you with the difficult patients. If they are flat out confused and not cooperating you well her hurt if you deal with them yourself. GET HELP. Always ask and don't worry what they think because it's going to be on you if someone -even yourself- gets hurt. Don't feel bad about dreading this job, to be honest I think this is one of the most underaperciated and stressful jobs. You will get used to it in time and find out if the dread goes away or if this job is just not of you. GOOOD LUCK!!