Obsessive resident/Please help.

TheMoonisMyLantern, ADN, LPN, RN · Feb 20, 2019

Tough situation, I'm sorry you're going through this. When patients become inappropriate it is vital to set firm boundaries, state to the resident the behavior is inappropriate and reaffirm that you are there to serve in a professional capacity only. If she persists it is important to end the conversation, "I'm sorry but I can't continue this conversation if you continue to say these things."

You also need to involve social work, your manager, and the physician. More than likely if she's not currently seeing a psychiatrist or therapist she's going to need to see one and her behaviors need to be careplanned for. Your manager and the social worker need to have a conversation with her regarding her behavior.

Ideally I would suggest not working with this resident for a while until everything subsides, however this may not be possible in the long term care setting. Whatever you do, do NOT be alone with her, always have a witness when you are with her in order to protect yourself from allegations.

Unfortunately with her somatic symptoms it can be difficult because with geriatrics because their health is generally poor or fragile, objectively assess and address her symptoms however do NOT faun over her or coddle her as this will feed into her behavior. These somatic complaints need to be careplanned for as well, ideally with behavior guidelines set by the psychiatrist.

I really wish you luck with this, I'm afraid there may be no quick or easy fix but I do hope it improves with time. Bottom line is Protect yourself and document everything!!

ruby_jane, BSN, RN · Feb 20, 2019

3 hours ago, TheMoonisMyLantern said:
Ideally I would suggest not working with this resident for a while until everything subsides, however this may not be possible in the long term care setting. Whatever you do, do NOT be alone with her, always have a witness when you are with her in order to protect yourself from allegations.
I really wish you luck with this, I'm afraid there may be no quick or easy fix but I do hope it improves with time. Bottom line is Protect yourself and document everything!!

Yes, and yes. Hang in there.

NJEN · Feb 21, 2019

Thanks for the replies. I appreciative the help and will try your recommendations. ?

guest1048932 · Feb 21, 2019

First, you need to tell the resident that her behavior is inappropriate. If she is making inappropriate comments or saying things that make you uncomfortable, tell her to stop as soon as she does it. Tell her it's inappropriate and that it is making you uncomfortable. Whether she is cognitively intact or not, you need to say this and then redirect her. Don't say you're too busy, she'll make a reason for you to see her. The next time she makes up an illness, express concern for her need to pretend to be sick, and say that if it happens again, you will have no choice but to notify the doctor and have her assessed. Also do a little detective work: is it only you that she has these behaviors with, or has this been increasing with all staff?

Second, document the behaviors, your actions, and her response. She may seek you out because you make her feel safe, or you remind her of someone. The illnesses she's making up may have to do with her feeling like something is wrong, but she's not sure what. She may need some reassurance frequently, so try saying, "You're fine. I have to check on a few other people but I'll be back once I'm finished, ok?" Her behavior may be repetitive, but try redirecting her and reassuring her. You need to document her behaviors so that other nurses and staff are aware. This will also help you see what works to mitigate her behavior. Her care plan may need an update to deal with conditions, such as loneliness or boredom, that may be influencing her behavior.

Third, get your director and other nurses on board and make a plan that will be implemented to handle this resident's behavior. You may need a physician, geriatric psych, or behavior support to come in an assess her.

Be professional, but firm. When in doubt, look to your director of nursing or director of care for guidance. At the very least, make your supervisor aware of the issue you have.

TriciaJ, RN · Feb 21, 2019

Please make sure your manager and coworkers know this is happening. People tend to believe the first story they hear. If the resident starts telling tales about you and this is the first they're hearing any of it, then it looks bad for you.

I agree with previous posters: her inappropriate behaviours need to be addressed in her care plan. It would be ideal if you didn't have to work with her at all for the next few months. Otherwise, when she makes inappropriate requests, don't fob her off with excuses. This just gives her something to make end runs around. Level with her that her behaviour is inappropriate and her request will not be met. Wishing you the best.

NJEN · Mar 1, 2019

Thanks ? these are great information and suggestions. I tried some of these suggestions yesterday and it seems to be working. She's now attaching herself to another young male nurse. ? But I'll continue to do my job and once it's done I'm out of her room.

Davey Do · Mar 1, 2019

On 2/20/2019 at 4:06 AM, NJEN said:
the faking illnesses are getting worse recently
How do I handle this behaviour? Any help would be much appreciated.

You've received some excellent advice from the other members, NJEN, and I could add nothing to their suggestions, except...

In the problem-solving process, brainstorming is a step whereby we consider different options. Any and all options are considered, no matter how ludicrous, because, after all, a ludicrous idea might just spark an idea that could lead to the very best option.

If this individual's ability are "getting worse recently", perhaps she requires feedback from others on the matter as well:

2096180473_fakeillness.png.db5333700a4c6ed80e5e2d14b980c206.png

TheMoonisMyLantern, ADN, LPN, RN · Mar 1, 2019

6 hours ago, Davey Do said:
You've received some excellent advice from the other members, NJEN, and I could add nothing to their suggestions, except...
In the problem-solving process, brainstorming is a step whereby we consider different options. Any and all options are considered, no matter how ludicrous, because, after all, a ludicrous idea might just spark an idea that could lead to the very best option.
If this individual's ability are "getting worse recently", perhaps she requires feedback from others on the matter as well:

This cartoon sums up how I feel whenever I witness seizure like activity, I've become too jaded from the many pseudoseizures I've seen over the years haha

Jedrnurse, BSN, RN · Mar 1, 2019

When in doubt, make sure you're in her will... ?

CharleeFoxtrot, BSN, RN · Mar 2, 2019

On 2/20/2019 at 5:06 AM, NJEN said:
Hi all,
I'm a newly graduated nurse with 10 months work experience and could use some advice. I currently work in aged care and there's a resident who is in love/obsessed with me. ?
She tries to find me when I work on different floors and expresses very weird feelings towards me. If I tell her I'm busy and can't talk. She pretends to be sick to seek attention from me. I have tried to give her time to talk chit chat with me but this seems not good enough for her. With 36 residents to care for I don't have the luxury to give her the time to talk and deal with fake illnesses. So I just deal with fake illness now but she will get agitated because I can't stand around and talk with her.
This has been happening for months as well but the faking illnesses are getting worse recently. I was okay with it at first but now its starting to get out of control and annoy me.
How do I handle this behaviour? Any help would be much appreciated. Thanks.

Just a thought, have you reported this behavior to her doctor? Has she had a neuropsych work up or evaluation lately? The worsening could have an organic component in addition to the psycho social aspect.