Offensive Nursing Behavior

Specialties Geriatric

Published

Specializes in LTC, Dementia/Alzheimer's.

Hello all!

I work on a Dementia/Alzheimer's unit in a LTC facility. Most of the nursing staff is friendly and patient with the confused residents, but one nurse in particular is neither. She is an older nurse, been at this facility for a long time. She's gruff, rude, and can be downright mean!

She completely goes against all of the therapeutic and respectful treatment guidelines that go with geriatric dementia patients. She argues with the confused residents about trivial things and attempts to forcefully bring them "back to reality" (which isn't going to happen...). This upsets the residents, frustrates her, and she then makes snotty comments.

On one occasion, during dinner, a resident was having trouble communicating due to forgetting words. Res: "I want some.. uhh.. some.. some.. You know!" and pointed in a general direction. Nurse: "No. I don't know. What do you want? You'll have to tell me. You'll never get what you want if you can't spit it out." and walked off.

Another occasion. A resident was nonsensically rambling, but directing the conversation towards the nurse. The nurse started to walk away. The res said angrily "Well, aren't you listening to me?" The nurse said "No. I'm not. I can't understand a thing you say," and kept walking.

She frequently refers to a resident as "orifice," (the resident's name is somewhat similar) when she knows very well what the resident's name really is.

She's told a resident he was a "jackass."

A resident was having trouble eating meals, however ate the occasional sweets her daughter brought. This nurse told the daughter to "stop bringing that crap" so the resident would eat her meals.

She often tells the residents "I don't care what you want." pertaining to a variety of different things like where to sit in the dining room, when to go to bed, regarding taking meds and cares, etc.

Much more, but that's all I can think of at the moment..

Many nurses have reported her behaviors and each time she is "counseled," but the behavior continues.. What would you do in this situation?

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Specializes in psych, addictions, hospice, education.

It seems she believes she can do whatever she wants and there will be no consequences to her. If she is verbally abusing the residents, I'd be wondering if she's physically abusing them too when she is doing things away from the eyes of others.

Most of the following is just rhetorical. You don't need to answer here. I'm just tickling your brain with my unending questions:

Does she interact with staff appropriately or is she the same with peers as she is with residents? Why do you think she's still there? What personal reasons might she have? What reasons might management have? Does she have good skills other than a lack of interpersonal caring? Is there no one else who wants her job? Is she nice to management and they don't see her in action with residents?

Have you talked with her about what you see her doing? Is she aware which behaviors are inappropriate? I know it's hard to believe she could be unaware, but truly, if a person is raised with such behavior all around, she can come to think it's as it is, and not a negative thing.

Is she generally unhappy/angry? What's going on in her home??

What kind of counseling has she had? How do you know she's had it? Were there any changes immediately after it?

Her behavior can't continue. Something has to be done. It is right to report her. If the direct boss doesn't do anything, then the boss's boss needs to be informed. Residents' family members need to report her too. The state can be informed and they DO investigate such charges.

Be aware that if you report, you'll have to have evidence that can't be seen as gossip or opinion. Charging someone with abuse (and what you wrote does seem like emotional abuse to me) is a big thing.

Her behavior makes for a hostile environment. Other residents see it and feel intimidated as well as the ones to whom she directs her behavior.

Expect some backwash to hit you. Maybe you and some others you work with can go to the boss together?

If I was the manager, I'd want to know what this person is doing to the residents. Maybe the manager doesn't see her behavior due to being not there, being not aware, or being not there and aware when it happens. As a manager, I'd be watching her like a hawk. If she's been counseled the number of times the facility's policy requires, I'd be following up with a long train of paperwork about the situation, and if she didn't improve, I'd be telling her to find another job. This sort of thing can close a LTC facility.

Be brave. Applause for caring enough to write about this, here. I hope you do more...

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Specializes in LTC.

id report her again...again....and again...everytime she treats a resident like that. imo it sounds like abuse.

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Specializes in Mental Health, Medical Research, Periop.

I use to work with someone like this, and it was a unionized place. Many complained about her attitude and how she talked to patients, but nothing happened. I transferred off that floor, but guess what? She was promoted to supervisor! Can you believe that? Geez! Sorry I hijacked your thread, but just wanted to say, I know how you feel.

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By your own definition, during your employment you have numerous times observed abusive behavior towards elderly patients by a nurse. If you have knowledge or have observed abuse of the elderly, you are mandated by law to report it. If the administration has only counseled the nurse, that issue will be investigated also. When you report to APS, you will need to provide information and specifics of what happened, who was a witness, and other specifics would be very helpful. Elder abuse is not just physical, it is mental, sexual, financial, etc.

We had a similar incident at a Silvarado assisted living facility in Calabassas, Los Angeles Co, CA. The caretakers were not only verbally but physcially abusing the residents. While there was complaints and accusations about the problem, the administration took no action.

There was a group of 4-6 male & female careakers who took part in the planned and coordinated abuse, which went on for a year or more. Yesterday the newspaper reported that one of the male caretakers, who was in his 20s, was convicted of torture as well as other serious charges (no mention of his cohorts). He will be in prision from 6 to 30 years; with the prision overpopulation, he could be out in 3-15 years.

The group was crafty and chose residents who could were incapable of communicating the abuse, although families complained of bruises, and other behavior of their seniors that would indicate abuse. The facility is still in business, but I have no idea what happened to the administration.

BTW in the APS report, you can request that your name and other identifying information be kept confidential. This means that the employer or the alleged abuser would not know who made the complaint.

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Specializes in school nursing, ortho, trauma.

Geez - sounds like SHE'S the jackass....may the world treat her as kindly as she's treated others.

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She obviously hates her job. She's unhappy and moody. I think when she has problems at home, she takes it off on her patients who have nothing to do with it. YOu should continue reporting her untill she gets fired.

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Specializes in LTC, assisted living, med-surg, psych.

Document, document, document.........what you hear her say, what you see her do, how the residents respond. Write down dates, times, location---all of it. And if the DON or the administrator don't do anything about it, report it to your state board of nursing! This is clearly abuse and as such is prohibited by law, not to mention the BON and general common sense. Can you imagine a family member's reaction to hearing their mom or dad referred to in anger as a "jackass" or "orifice"? Worse still, can you imagine your OWN reaction if your mom or dad was in that nursing home and she talked to them like that?

You're on the right track. Keep up the good work---this woman is a bully and must be stopped from practicing her brand of "nursing" on vulnerable frail elderly people. :flmngmd:

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Specializes in ER/ MEDICAL ICU / CCU/OB-GYN /CORRECTION.

I would not have the time of day analyzing her behavior or problems and really would not care about her issues.

I would call the state abuse hotline or write a letter to the state. Someone has to defend the residents.

As a mandated reporter it is my obligation and since the institution is not bringing this to immediate resolve action needs to be taken.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

If I have exhausted all venues, and HR still does nothing, I would file and elder abuse and ask to remain anonymous or I'd file a complaint with the board.

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Specializes in Hospice / Psych / RNAC.

Are you actually filling out incident reports when this type of behavior is occurring? That's what needs to be done for documentation reasons for an investigation for outside sources since no one inside will do anything.

You do an incident report and management cannot tear it up. Next time she verbally abuses someone write her up.

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Specializes in Ambulatory Care, Case Manager.

I think it will take one or several of the resident's family members to complain to the supervisor in order for this nurse to get fired. I personally would not want her to be taking care of my loved ones. I want my loved ones to be treated with respect and not as if they were treated like criminals. The residents are away from their family, the least they want is to feel "unwanted".

If none of the staff reports this, one of the resident's family will and will have all of you involved as nobody did anything to stop this demeaning behavior. This is considered elder abuse.

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