Nursing home bending backwards for a certain resident?

[a_dee93]

I work at a nursing home. My floor is a combination of those who are there for long term care and those who are there just shortly for rehab. In total there are five units, each unit having three aides except for one, only having two because it is the independent floor. Anyways, we have this resident who, along with her family, are very difficult to deal with. She is an EZ lift resident but we were told during the night shift if she is persistent with wanting to have a BM, use the EZ stand to toilet her. I knew something was going to happen one week so I requested to not have her as my assignment on a Sunday. Monday night, I was off, they toileted her using the EZ stand for the first time in a while because she kept saying she needed to use the toilet and refused to go in her brief or use a bedpan. That Tuesday she was assigned to me and she is a morning get-up. The nurse told me not to get her up because she had a doctors visit at the hospital and that day shift would get her up. My shift ended at 7:00 but the daughter came in at 6:50 furious that her mother was not up yet. Supposedly at the doctors they claim she fractured her left shoulder and she says it's from the EZ stand. (Which we believe is false, she's fractured it before and the way she sits in her power chair along with other things that she does probably never helped heal it fully). Anyways, the daughters had a meltdown and now we HAVE to have four aides on our floor because two aides HAVE to go in the room. Two aides who used the EZ stand are not allowed in there and no male staff is allowed either. We HAVE to mark down in this journal every single time we go in the room, whether it's to empty trash or she pushed her call light. Even if she screams or is constantly pressing that light, we HAVE to drop whatever we are doing and go in there. I just don't understand how fair it is. We have 40 residents and yes, there are four aides, but come 4:30 when we begin getting people up for the day and finishing rounds, they still expect us to go in there. I've gotten in trouble because her light was on for five minutes while I was transferring an EZ lift resident and her roommate was in the bathroom. I can't leave them there by themselves or up in the air! It's so frustrating and so unfair to the other residents who deserve the same amount of care that we are putting into this woman. Any thoughts?

[auscultate]

TLDR This is not uncommon and will blow over after a few weeks, do your job to the best of your ability and bring any concerns (especially in regards to safe patient care) to the ADN or DN.

The long explanation

LTC is hard on both employees and patients, at advanced age their bones may be brittle due to osteoporosis especially females so many injuries can occur. Compound that with possible over medicating with pain medicines that can slow bowel movements and decreased sensation to pain makes is harder as well. Some things that you can do is get with your nurse and come up with a strategy on how to best care for that patient, also involve the patient as well to make sure that he/she understands what is happening. As long as the resident isnt confused most are understanding of whatever situation is occurring. You're doing a great job being concerned about the resident's bowel function, chronic constipation can be very bad for the elderly and can make them very sick. Do not put yourself or the resident at a safety risk though, so be sure to coordinate care with your nurse/adn/dn if needed. Family pay A LOT of money for their loved ones (in the thousands of dollars/month) to be in LTC, and they will question everything that is occurring to make sure that their loved one is in safe, capable hands.

[Missingyou, CNA]

There have been many times that we have had residents very much like the one you are talking about.

What usually happens is:

You do as you are directed and answer call light, document, have 2 aides present at all times in her room, etc, etc.

You end up not being able to care for the others as usual because this one person consumes so much of your (and others) time and energy.

The other residents/resident's family begin to notice that their care is lacking, they wait longer etc...and they begin to complain to supervisors.....The supervisors will either assign one on one to that inital resident or slowly start to have you back off on the demands.

The facility has to put every effort into keeping these family members happy and earning their trust because the family can always report to the state and the state can and will fine the facility.

Give it time. Do the best you can with what you have. Don't leave other residents if it is unsafe to do so to respond to that one particular resident. If your supervisor wants to know WHY you did or didn't do "such n such", or why the other residents are complaining, be honest and professional about your answer.