Ornery resident

nightmare, RN · Aug 24, 2008

Thread moved to Geriatric and LTC for more input.

nightmare, RN · Aug 24, 2008

This perhaps needs to be handled by your DON .If you try to talk to him he will just complain that you are harassing him and you will get into trouble.Take your concerns to the nursing staff and see what they say.

birdgardner · Aug 24, 2008

Are you in charge?

The residents need care and help with ADL. You give that help and care. Does that make you in charge, the boss?

It doesn't sound like you take care of this patient at all. Ignore his comments and yelling. You're not likely to change him now, and no one is going to be influenced by him and think worse of you.

If you do attempt to straighten him out, you will be overstepping your boundaries, and you just might find yourself in a whole mess of trouble.

twister431 · Aug 24, 2008

Are you in charge?
The residents need care and help with ADL. You give that help and care. Does that make you in charge, the boss?
It doesn't sound like you take care of this patient at all. Ignore his comments and yelling. You're not likely to change him now, and no one is going to be influenced by him and think worse of you.
If you do attempt to straighten him out, you will be overstepping your boundaries, and you just might find yourself in a whole mess of trouble.

You are absolutley correct, I'm not the boss. I do have some interaction with this resident cath care and such (he does not mind that). I do not want to say anything at all but it is causing a strain on my co workers and I do not deserve to be treated that way. With the feedback I'm getting it sounds like I'll just send this one up the ladder. thanks.

Crystal2dish · Aug 24, 2008

Hello, I have a slight problem with one of my residents at a ltc facility. This resident is very,very rude. He thinks guy aides or nurses are all gay. He will not allow cares done by male staff, This is okay we make exceptions for the lady residents who are not comfortable with male staff. With that said this guy yells at me when I walk by his room saying get the hell away from here and comments like this. I'm not sure how I should handle this situation. I'm thinking him and I need to have a talk but I do not want to overstep my boundaries. Somehow I need this resident to know who is in charge and do it in a very political, but stern and firm way. Any Ideas?

If dementia is involved, there is a different process to deal with the resident's behavior than if the resident is lucid. Examples of dealing with the dementia may include positioning the resident so he may not see out the door (but still have a view out the window) or approaching him with a partner. The resident may have some very real fears that will not dissipate with a confrontational discussion. If the resident is lucid, then the SW and NM may discuss the appropriateness of his targeting male caregivers and disturbing other residents by yelling out. Whatever route is chosen to deal with the resident, it will need to be a team effort with proper protocols followed and documented. Residents are considered to be vulnerable adults and as such have specific rights.

Then I must comment on your statement " I need this resident to know who is in charge..." as a possible reveal as to why he may be targeting you. You are an employee. You may be in charge of some things, but perhaps you have not yet grasped the limitations of your dominance. The resident cannot up and leave. He has to live there. Perhaps it is not the resident who needs an attitude adjustment? Rudeness is a somewhat subjective description of behavior. Perhaps the resident knows more than he is given credit for and is expressing his fear (?) of you the only way he can.

So definitely involve others, to include the nurse manager and social worker, in working to improve this situation for everyone. :nurse:

pumpkin92356 · Aug 30, 2008

Has this resident been diagnosed as having some form of dementia or is he depressed. Is he physically abusive or just making verbal remarks towards staff. If he is only verbally abusive most facilities will tell you to have other staff assist him if he doesnt want you. He unfortunately has the right to tell you not to go near him if he so chooses. Document, document his behavior so you will have something to show the doctor and maybe some type of medication can help him with his rude and aggressive behavior. But all I can say in my experience as an aide for many years is Grin and move on as there are always some patients that arent going to like you and some other staff member will just have to attend to his needs in your place. And most of all don't take his behavior as personal towards you he is what appears to me to be trying to retake control over his life now that he is in a nursing home he probably feels that this is the only way in which he can draw attention to himself. I don't know if this will work but you could try and talk to him and ask him (when he seems to be in a good mood at the time) if there is something you could do for him that would help him and you take care of him. Let him feel that it is all up to him and he might feel that sense of control that he is trying to get back. Because he is in my opinion a classic case of "Resident demanding Control". Good Luck you are going to need it. If this resident feels like you are trying to rule him then this could be the root of the problem. Try a more passive approach letting him feel he is the boss.

Pumpkin92356:D

TheCommuter, BSN, RN · Sep 3, 2008

When we get patients such as the one described above, we simply arrange for them to have female direct caregivers (CNAs and licensed nurses) only. If he feels all male caregivers are homosexual, it is best to keep male employees far away from him. His viewpoints have been shaped and cemented over many years, and nobody can change them in the year 2008.

achot chavi · Sep 7, 2008

Try Behavior Modification.

I would sit down with him- ignore the curses- tell him that we don't talk this way in our facility and we cant take care of him as long as he is cursing or abusing the staff in any way.

Tell him that he is important to you, and you all want to help him in any way possible but not at the expense of being abused.

Be specific as to what behavior you find objectionable, Tell him that you will leave the room if his behavior persists and come back as soon as he can be calm and cooperative,

continue that you will try to give gentle care with privacy and dignity, you will take into account his personal requests, you will answer his call bell in an efficient manner but you need his cooperation.

Then be consistent. Praise good behavior-smile and give an encouraging word (like "its real nice to be with you on days like this")

Ignore him when he is abusive, if he is unsafe to himself and or others- ask for a mild restraint. like a lapboard or guardrails.

In time you will see better behavior- I've done it and it works!!!

You need the whole staff in on this as well- or it wont work

Good Luck- and yes- you are not the "BOSS" - but you run things on your unit!!