Offensive?

[SydneyLynch]

I have worked as a CNA in home health for 2.5 years. I have recently completed my BSN and have passed the NCLEX, so I would say I'm a fairly competent aid.

I recently had an experience that has confused me and made me question what is and is not acceptable by the client when providing care in their home.

I am am working with a couple in a senior complex, who I would say is fairly normal with cleanliness. The first thing I do when I arrive to my shift is go into the kitchen and wash my hands. Today, the wife informed me that I must not have been told that she is the only one that goes in their kitchen. I was confused so I questioned what she meant by this, to which she informed me that I have germs and if I go in the kitchen then she'd get germs from me.

One thing I have learned working in home health is to be as respectful as possible as you are in someone's home, but I was actually offended by this request, now feel uncomfortable with wherever I go, and like I am not very highly thought of in this home. I am not sure if it is reasonable for me to feel offended. What do others think of this situation? Would you be offended or feel the same?

[I<3H2O, BSN, RN]

I have to first ask if it is possible that she has a psychiatric dx that would make this statement a little more palatable. If not, then I think I would have been offended too.

[SydneyLynch]

I have no information on her, as we are only providing cares to the husband.

I am not sure whether it would be appropriate for me to report to my company that I feel offended and uncomfortable.

[Carpediem1012, BSN, RN]

I know when the kids come home from school or have been out playing in the dirt, I ask them to wash up in the bathroom- and I'm not a particular germophobe. But if I am washing dishes, I want my towels clean. Maybe that's what she meant. As nurses we can carry a lot of germs.... Kind of a nosocomial thing in her house perhaps?

[caliotter3]

After several months of service in a home with no hint of a problem, the client made the same complaint, telling my supervisor that she didn't want the nurses going into her kitchen. In this case, there is obviously some kind of undisclosed problem with this person's behavior. It is only common sense that such a preference should have been mentioned to the involved nurses on day one or day two, not 'thunk up' months later as a way to make life difficult for the 'help'. The passive aggressive move of complaining to the supervisor without ever saying anything to the offenders, also points to either some kind of personal problem or an overwhelming sense of one's self importance. If a client speaks up in the beginning or when it occurs to them along the way, I don't necessarily get offended enough to leave the case right then and there. But that tactic of complaining after several weeks or months because you have developed an agenda does not fly with me. If they want a nurse off the case, they should act in an adult manner and tell the agency so. Unfortunately, this happens often enough for long term nurses to develop their own way of dealing with it. Call it strike one and put up your guard.

[caliotter3]

If you are different from the client, such as a different ethnicity, that complaint could also be a thinly disguised personal insult because she does not really want you to provide the services. Clients know that they can not say that they don't want certain people because of discrimination, so they will find something to be disgruntled about. Judging by your expressed feelings, I would say that you may be uncomfortable enough to sense that you are not truly welcome there. If the agency has alternate work, I would consider asking for a change of assignment if it bothers you enough.

[MrChicagoRN, RN]

I had one home where the wife objected to me using the kitchen sink, because that's where they "wash the (store bought, raw) chicken."

I have no idea if she felt I was contaminating the sink, or the sink was contaminating me, and then hubby. She had other peculiarities too.

just use the bathroom sink, or a hand sanitizer, and forget about it.

[mindofmidwifery, ADN]

I don't think you should take it personal. Old people say the darnedest things. But yeah, I agree with that if you're anything but white, she may have purposely said that, and I can see why you would be offended. I worked at an answering service before and this old man was calling a home health agency and I happened to be the person he spoke to and took a message for, but anyway he said that he didn't want his nurse to come back again because she "didn't know" how to cook. "All she cooks is African food." It was ridiculous. Hopefully you take from that story not to be too offended, it's your job and if she's crazy then so be it. Don't let her get in the way of doing your job.

[mindofmidwifery, ADN]

Or maybe she just has OCD.

[toomuchbaloney]

Do not fall into the trap of thinking that every stupid thing that a patient or family member says is personally about you. While some comments may be, the vast majority are not about you, they are about whatever is going on in that person's head. Taking things personally, in general, is going to make you more unhappy than it will make you happy.

Take note of her preference. Put a note in the EMR that staff should not wash hands in the kitchen sink. Wash your hands in the bathroom sink. Provide your care with a smile and a professional attitude. Leave.

If her behavior becomes hostile and a change of staff is needed let your management team know.

[SydneyLynch]

Thank you for all the responses!

Like I said, I've been doing home health for a few years now and have definitely learned how to adapt to peoples needs and wants. I've learned to respect the person in their home, and not take things personally. I always wear clean scrubs and shower at least once a day, I am clean and appear clean. This is one of those rare moments that I was taken aback and felt offended afterwards.

Im the same race as this couple, so I don't think it's a race thing. I do think it's a "having help in the house" thing though. She is very resistant to having help in the home because she believes her husband does not need it, I highly disagree, but working as an aid I would never say that. I feel as if it's a disrespect for the work of an aid, but I will always respect her wish. They are moving soon, so I don't plan on being pulled from the shifts.

Im glad to hear though that my feelings are justified and I will be sure to inform my manager that this is an issue so future aids are aware from day 1.

[caliotter3]

No matter what the underlying cause of a client's behavior, it is wise for the caregiver to be on top of the situation. The smart caregivers will move from case to case of their own volition and using their own timing. This way they avoid the eventual stigma with the agency when the clients complain to get a "change of face". Let your gut be your guide.