Patient claims of Abuse

Silverlight2010 · Apr 27, 2012

I'm afraid I don't have much to offer on this subject but am trying to figure out how rude= abuse. Might have to provide a little more clarification on this.

SweetPEI · Apr 27, 2012

Whoa slow down. You might want to revisit what you learned about patient abuse and also learn your facility's policy relating to abuse. In this case the patient complained to you about the attitude of the cna. You could have a: brought it to the cna's attention b: asked the patient to go into more detail so that you could possibly "fix"the issue, c: hopefully you get the point...etc. You just can't jump off the wagon and think abuse because of that complaint. Many a times patients can degrade the reputation of a staff member when they don't get what they want. Of course there are times when there complaints are valid. You should have inquired the content of what the Cna said or did. Were they sexually inappropriate, did they threaten to harm, DID they actually harm them, were they verbally abusive, etc. These would be prospective actions of abuse. If the answer is no, then maybe let it go but pull the cna to the side and let her know that her behavior is deemed rude by a patient. if multiple complaints occur about the same CNA then perhaps it would be time to call a meeting. As the nurse, if you are charge, perhaps think about assigning that patient to a different CNA. Everyone does not always work well together and that includes patients and staff

helpme, · Apr 27, 2012

When i asked the patient what happened, she just said the CNA was rude to her. She even told me not to talk to the CNA anymore about what she told me.

But now, she’s claiming i told her i will do something about it. That she was crying when she was talking to me. That the CNA dropped the word “********”. and that she was “verbally abused”. She reported this all to the shift after me. She never told me that the CNA told her ******** or she was verbally abused.

helpme, · Apr 27, 2012

When i asked the patient what happened, she just said the CNA was rude to her. She even told me not to talk to the CNA anymore about what she told me.

But now, she’s claiming i told her i will do something about it. That she was crying when she was talking to me. That the CNA dropped the word “bullpoop”. and that she was “verbally abused”. She reported this all to the shift after me. She never told me that the CNA told her such or she was verbally abused.

SweetPEI · Apr 27, 2012

If you feel like this should be followed up why don't you just ask your supervisor what the protocol is in this case. They are professionally wrong for cursing. More if she said that to the patient intentionally then that's a problem. However, that's a long battle you will put yourself in trying to prove. My advice: bring it to the cna's attention and let her know you will report her to the supervisor if she continues to use profanity in the presence of patients.

Silverlight2010 · Apr 27, 2012

But now, she’s claiming i told her i will do something about it. That she was crying when she was talking to me. That the CNA dropped the word “bullpoop”. and that she was “verbally abused”. She reported this all to the shift after me. She never told me that the CNA told her such or she was verbally abused.

Any documentation from day the, incident in question? Anything you wrote in your nursing notes or patient chart? Getting the impression from your post that what she is stating now, "was crying, you would do something about it etc..." isn't what happened when you first spoke to her.

Hard to say what your policy/procedure is where you are but in a similar situation I might have made an entry in my notes, keeping it very objective. Pt reported that CNA ******was "rude to me". When asked for clarification, pt would not provide any additional information and declined offer of writer/RN to speak with CNA****** regarding this incident. Pt stated "I don't want you to talk to them about it" and made some further note about the patients behaviour during the time you were talking, calm, quiet, shouting, crying (or not). Direct quotes can be good. Document any actions you took as a result.

Depending on the situation, I might approach the charge nurse (give them a "heads up" on a potential situation) and the unit manager (if more serious) and fill out an incident report (if incident report worthy). I would definately pass it on to the next shift, pt complaining about CNA being rude, wouldn't provide details, was calm, but didn't want us to talk to the CNA.

Good objective documentation is really important. Sometimes complaints are founded, and as SweetPEI said sometimes patients make accusations against staff because they didn't get something they wanted. Maybe they just don't like the person, maybe they're confused. Who knows. Do you have a mentor or someone you trust at work you can talk this over with, get some guidance from?

Esme12, ASN, BSN, RN · Apr 27, 2012

When i asked the patient what happened, she just said the CNA was rude to her. She even told me not to talk to the CNA anymore about what she told me.
But now, she's claiming i told her i will do something about it. That she was crying when she was talking to me. That the CNA dropped the word "bullpoop". and that she was "verbally abused". She reported this all to the shift after me. She never told me that the CNA told her such or she was verbally abused.

We do not offer legal advice here at AN. However, Using profanity is not abuse in and of itself. How did you document the incident, if at all? Did you write up the CNA for unprofessional behavior? I would report the incident to your superior and let them deal with the CNA's inappropriate behavior. I personally don't believe this falls under mandated reporting of elder abuse but it is an indicator of unprofessional behavior of the CNA and they need to be held accountable.

JDougRN, BSN, RN · Apr 27, 2012

HUmmm. A resident complained to you about a CNA being rude, but refused to go into much detail. Then, if I'm reading it correctly, this same resident insisted that YOU said things you didn't, including that you "Promised to do something about it?"

Something is rotten there

Sounds to me as if you have encountered a not so unusual specimen- called Elderius Manipulativatious. Commonly found in nursing homes and hospitals. Can be confused, or just down-right mean. Common behaviors include "Twisting" what one staff member said or did, and "reporting" them to another staff member. Seriously, while I understand elder/resident abuse is nothing to joke about, just because someone has reached their 70's or beyond, doesn't make them sweet, wonderful, cookie baking Nanas. There are miserable, manipulative, and downright nasty people of all ages. I'm assuming from the tone of your message that you are a fairly new nurse? Please be aware, that sometimes residents who have been in the system for a while can be a lot more "with it" than they pretend to be. It's a slippery slope we walk, because we have to take issues of abuse towards our patients and residents seriously, but you also have to understand you are dealing with a fellow health care worker's job and reputation.

I have a fellow nurse/friend- someone who literally will do anything they can for a patient- take care of a 60'ish man who was well known to us. This man was pretty miserable, noncompliant, and fairly nasty to the nursing staff at times. He got mad at my friend for some silly thing- I think it was refusing him ice cream with his sugars in the 500's- Reported to his family the next day that this nurse had put him in his weelchair and LOCKED HIM IN A CLOSET ALL NIGHT! The family flipped, and reported it to management. There was a big huge investigation. Only trouble was......there were no closets on this floor, and he couldn't describe this closet that he had been locked away in for several hours. It didn't matter that all of us were working on the same floor with her at the time, and he was a 2 person assist. No closet existed, nor could the pt. explain why he didn't yell for help (Trust me, he had NO issues yelling down the hall at 3 am for something, trust me EVERYONE on the floor heard him) This pt. didn't care that his lies could have gotten her fired or lost her her nursing license.

My point is, if you are in a position to potentially cause this much trouble for someone, you better make darn sure it's valid. How would YOU feel if a patient lied about you, and tried to get you in trouble? I don't know if your resident lied, but the fact that she said that YOU promised you would do something about it.....I'd be very careful if I were you. I've had pt.s that I insisted that another staff member go in with me whenever dealing with them, so I'd have a witness. Sad, but true.

sockov, ADN, ASN, BSN, CNA, LVN · Apr 27, 2012

you should write up the patient for being manipulative to staff and causing disruptive behavior!

nguyency77, CNA · Apr 27, 2012

Hi. I'm a CNA and if I may, I would like to share my humble opinion with you. First of all, I think a good nurse does NOT jump to conclusions or make assumptions about the situation. You need to understand what happened before you go crying to management about elder abuse that may/may not have really happened. A good nurse is objective.

I'm tired of people thinking that we CNAs are all abusive, uneducated morons who are bitter because we get paid so little. I'm standing up for those of us that do a lot of dirty work for some of you nurses, yet only get mistrusted and patronized in return. Don't get me wrong; I have a profound respect for the nurses I work with. But I don't like that all you're concerned about is your own butt, and not the safety of the patient or resident. The first priority is that the resident wasn't actually hurt, and that no abuse took place.

You need to understand that not all elderly patients, like JDougRN stated, are cookie-baking grandmas. There are many of them who are lonely and need love. If they don't get the love they need, then they seek the next best thing-- attention. You cannot be gullible when it comes to serious issues like this. Investigate first, assume later.

Silverlight2010 · Apr 27, 2012

I still stand behind good, objective documentation.

I also stand behind reporting complaints or situations to one degree or another.

It does no one any good if I fail to report a problem and suddenly the patient or their family is up in arms because Nana was mistreated, abused, or what have you by the CNA, LPN, RN, cleaner, whoever yesterday or last week. If I document it, even just a short entry in my nursing progress notes, then I have something that can be referred back to if/when a little problem becomes a big mess. It can protect everybody, including the CNA in the OPs original post. Managers can look back and see that the original complaint was "rude", not swearing, verbally abusive, pushing, threatening, stealing, hitting....They would also see that I talked to the person the complaint was about, and documented their response because even if the patient didn't want me to talk to the person being accused, that's not going to happen. I want to hear from both sides. What if the patient's version of rude (that she didn't want to provide details on) was the CNA told her she had to wait for something?

Giving the charge RN, and the team at change of shift a heads up keeps everyone in the loop when as happed with the OP, the story was different for the next set of listening ears. It's not throwing anyone under the bus either. It's FYI, so if they get called on to deal with it they don't have to try and figure out what the story is.