Pornographic movies

[Mrs. M.]

I'm wondering if anyone else has dealt with this and what the outcome was. We have a 59 year old quad (quad x 33 years) who likes to watch Mediaographic movies. Since he cannot put the movies on himself, employees have to assist if he's going to watch. Some staff do not mind this at all, but others are outraged that we would allow these movies in a hospital. I have set up a plan so that nobody who is uncomfortable with the movies has to go in to assist him, and a stop sign must be placed on the door whenever he is viewing to alert housekeeping, dietary, etc from walking in on this. The problem is that he is lewd and disrespectful toward the nurses anyway, and some of them feel that the Mediaography is contributing to his attitude. They are probably right, truth be known, but the bottom line is that he is an adult and what he is doing is not illegal. He has no family, so having a relative assist isn't an option. Any advice here?

[agent66]

I don't work in long term care either, but agree with MOST of the posts above especially that of mjlrn, the facility is his home so he should be able to watch his movies in privacy. We are health care providers not there to be morality police, and this man who is still young in my opinion lives his ?absent? sexual life through these films. He is a quad so is he able to somehow read material of that nature himself ? Not likely, and I am pretty sure there would be no one to read it to him so although that would be a less offensive alternative , it is not likely possible. The best idea i have read so far is to put the film on for him, and put the sign up on the door alerting staff to his "business". If he is always lewd, I don't think taking his movies away is going to make him any better, just angrier and as many posters have mentioned already he is an adult not a child and should be respected as such. To me , the man has been a quad for 33 years , injured very young in life and although we may not all agree with his choice of coping, we have to at least respect it.

[Mrs. M.]

Ok gonna post my suggestion first (so you dont have to read my rant). He does not sound like a high quad, as he does not sound like he is on a vent. He should have some arm, wrist or even limited hand movement. Occupational therapy should be able to come up with a solution, see I dont know is functional level so my recommendations may not be accurate. Regardless, I would look into buying or having him buy a voice activated remote from Best Buy or Circuit City. As far as loading the movies, I would get his permission but take the labels off, mark them with a number or very very vague description and even consider putting a regular movie in the mix. So staff just loads an unmarked movie, he pushes play when they leave and stop before they come in.

You could even brag to the state saying look at how we use technology to promote independence. Then have him give a demonstration. This way you will impress the state and give your administrators heart attacks who likely harass you quite often. Ok that may not be a good idea :trout:

I think the biggest challenge you are facing is trying to convince the staff that this is ok. I dont think you will be able to do that. This is a moral/religious issue for them and they are grown adults. Healthcare professionals or any worker for that matter should not have to be subjected to Mediaography (if they choose not to).

Yes, I know it is his private "home." I am actually thinking about being a weekend supervisor at a local nursing home, so when a patient wants to smoke, leave their soap out of bags or put a tv near the ceiling I am going to let them. After all it is their home, is that not what the state inspectors say? (No I am not really going to let them but the hypocrisy KILLS me)

Thanks - those are some good suggestions. He is vent dependent and a high quad. He can actually only turn his head in one direction, and only about 45 degrees. The TV is turned so that the back of it is facing the door. The nurses who are supportive of his rights tell me that there is enough lead time on the disc that they can easily leave the room before the movie actually starts. Covering the jackets and numbering the movies would take away one more opportunity for people to be offended.

I'm afraid you are right though. What really bothers the staff is just that he is watching the movies, and everything else is just an excuse for not allowing him to do that. The hardest part of this is that I feel like a hypocrite - there is no way I would go into that room while the movie is playing unless it was an emergency. He's very gracious about that towards me - he'll say "Stop!" when he sees me near his room.

I think I will take CT Pixie's advice and try to separate the issues. If the staff will document the actual incidents where they feel he is being lewd, then I can deal with those incidents separately from the movie issue. I think that's where we are most vulnerable at this point.

[VivaLasViejas, ASN, RN]

Good thinking! Your resident's lewd behaviors and his right to watch Mediao movies are definitely separate issues, and should be handled as such.

When documenting behaviors, your staff should describe exactly what "lewd" consists of, but not use words such as "inappropriate" or "harassing"..........the state tends to jump all over us for using terms that convey any sort of moral judgment. They also don't accept blanket statements such as "Resident made lewd remarks to staff three times during evening shift"............documentation should include what was said and to whom, with exact quotes if possible. In addition, staff will want to document how they dealt with the behavior and the resident's response.

I'm passing this along because I've had to learn most of my LTC stuff the hard way: through trial and error and F-tags. :uhoh21: I would also suggest a consult with your local Adult Protective Services; if this resident is on Medicaid he probably has a case manager who should be involved in his care. I can tell you from my own experience that sometimes these people can be VERY helpful, and they are often the best ones to advise you how to handle these things as they get plenty of experience!

[Mrs. M.]

Great advice, thanks. I've been in nursing leadership for many, many years, but I'm only a year into my LTC experience. It's a whole new ballgame.

[CapeCodMermaid, RN]

Pixie-you may be 'just' a student, but your post was well thought out.

No matter where you work in this business, you're most likely going to run into a lewd, disrespectful patient. In the hospital you only have to deal with them for a few days. In LTC they could be a problem for years.

We can't legally use behavior mod in LTC and the resident's rights pretty much over rule everything else.

Have you thought about having his doctor talk to him? Man to man--if his doc IS a man. We had a young man (40's) at one place I worked in. He had urinary retention so we were supposed to straight cath him every shift. His mom was his guardian and she refused a suprapubic tube. I was new to the facility and didn't really know him. I gathered up the supplies and went into his room. Even before I started, he began making lewd comments. I told him I wouldn't tolerate that so he stopped. The next day he did it again but wouldn't stop. I told him I wasn't going to cath him if he continued being so disgustingly disrespectful. I called the doctor and told him that as long as the man was rude and lewd, I wouldn't straight cath him. The doc agreed. Then he took the next step and called the man's mother. He told her that the nurses shouldn't be subjected to this kind of behavior and if she couldn't get her son to stop he would have to have an sp tube. (I always liked that doc!!)

The point is, even though we shouldn't have to put up with that kind of behavior, sometimes we have no choice.

I wish the surveyors would make up their mind.....on one hand it's the residents' home, on the other hand they expect the food to be a certain temperature, the water to be a certain temp, meds to be given at a certain time. I don't know about all y'all but unless it's chicken I don't take the temp of my food before I eat it, the water is the temp it is, and I take my meds when I remember which is never the same time two days in a row!

[Havin' A Party!, ASN, RN]

From what I've been able to find online, the employer does have a legal obligation to protect the nurse from sexual harassment by patients...

Believe this is 100% correct.

[LydiaNN]

He could watch it anytime he wanted, for any amount of time. His private room was his "home" and he was a consenting adult so we could not put any limits on the type of movies he watched, the amout of time he watched them, or what time of day/night he could view them.

Thank you for making this point. It is his home. To the greatest extent possible, I think he should have the same rights he would have in his home. I realize that there are always going to be exceptions when your home is a facility, but IMHO, that just makes it more important to ensure he keeps as many of those rights as possible.

I also agree re: the Media not making him lewd and disrespectful. He is who he is. I do believe that staff have rights, too, and this behavior needs to be addressed, but not by rationing his access to movies as if he's a young child.

[bollweevil]

I would ask if he would like a chaplain to visit him sometime just to talk, since he doesn't have family. I would not put in the movies for him...he IS an adult but so are the hired help he has been lewd to. This is an example of entitlement...I'm entitled to view what I want. My feeling is if it isn't on the hospital TV channel, then you are out of luck. This may sound harsh, but a hospital is a controlled environment, we don't allow everybody everything...the diabetic doesn't get an ice cream sundae delivered from staff because" he is an adult and made an informed decision"...the smoker doesn't get to smoke in a smoke-free hospital/campus.

We use plastic utensils on the psych unit, no caffeine and no trash bags either, for safety of clients...and staff. Controlled environment.

This is too harsh because he is completely dependent, totally unable to do anything for himself. He is in his home and, as an adult, is entitled to watch what he wants. As long as someone is on duty who doesn't mind helping him and as long as he understands that he doesn't get to be rude to staff, he should be able to watch what he wants. I wonder what a lawyer would say.

The other people you mention - the diabetic, the smoker - these presumably can get up and walk away, go buy their own food, go out to smoke if they want to.

As for a chaplain - I will venture the guess that a chaplain is available maybe once or twice per week for about 30 minutes, if that. This patient is stuck in bed or w/c 24/7. That's a lot of hours to fill. Not that Media is the best way to fill them. But 33 years, my God! Can you even begin to imagine what he has been through? If ever there was a reason to further stem cell research, this is it. I hear what you're saying and would advocate some limits and even encourage the chaplain visits. But, since he's a total prisoner, I'd be much more lenient with him than with mobile, self-reliant patients.

How does his time get filled? Any visitors? Anyone to play a game with him? Does he have internet? Any pets visit? Local groups like churches, veterans, anyone? What a horrible way to live, IMHO. Has he made peace with it do you think or what? Does he take classes? Learn new things? So sad.

[psalm, RN]

Okay, this is his home...what if his tastes turn to kiddie Media?

What if he wants help taking illicit drugs? Or producing them?

What if he starts a criminal venture using a computer or whatever?

We still have to deal with the reality that we can't do anythingeverything we want just because we want to and have the ability to. Esp. when it is harassment to others.

[Noryn]

Okay, this is his home...what if his tastes turn to kiddie Media?

What if he wants help taking illicit drugs? Or producing them?

What if he starts a criminal venture using a computer or whatever?

We still have to deal with the reality that we can't do anythingeverything we want just because we want to and have the ability to. Esp. when it is harassment to others.

I think the big difference is legal vs illegal activities. Adult movies are legal. Child Media or illicit drugs are illegal thus would not be allowed.

[Mrs. M.]

This is too harsh because he is completely dependent, totally unable to do anything for himself. He is in his home and, as an adult, is entitled to watch what he wants. As long as someone is on duty who doesn't mind helping him and as long as he understands that he doesn't get to be rude to staff, he should be able to watch what he wants. I wonder what a lawyer would say.

The other people you mention - the diabetic, the smoker - these presumably can get up and walk away, go buy their own food, go out to smoke if they want to.

As for a chaplain - I will venture the guess that a chaplain is available maybe once or twice per week for about 30 minutes, if that. This patient is stuck in bed or w/c 24/7. That's a lot of hours to fill. Not that Media is the best way to fill them. But 33 years, my God! Can you even begin to imagine what he has been through? If ever there was a reason to further stem cell research, this is it. I hear what you're saying and would advocate some limits and even encourage the chaplain visits. But, since he's a total prisoner, I'd be much more lenient with him than with mobile, self-reliant patients.

How does his time get filled? Any visitors? Anyone to play a game with him? Does he have internet? Any pets visit? Local groups like churches, veterans, anyone? What a horrible way to live, IMHO. Has he made peace with it do you think or what? Does he take classes? Learn new things? So sad.

We have a chaplain who comes through to visit, of course. This resident chooses not to engage in discussions about spirituality. Our Activity Coordinator spends a lot of time with him. He likes trivia games - he's quite intelligent. He watches other movies in addition to the Mediaographic movies. He is learning Spanish using Rosetta Stone software. We have a facility pet that visits him, and some of our staff enjoy going in to talk with him. He is actually more content with his life than a lot of able-bodied people that I know. The only problem is with a few staff members who have major issues with the Mediaography. Even though I've made it clear that they don't have to be involved in putting the films on for him, it bothers them that it is allowed at our facility. Their most recent argument is that if an emergency were to occur in his room they would be exposed to the Mediaography.

He has never expressed any interest in child Mediaography. He likes women. A lot.

[CapeCodMermaid, RN]

LOL..if an emergency were to occur, I think they would be more involved with getting people out of the building safely and probably wouldn't have time to watch what was on his TV. I am totally anti smoking, but it's a legal activity and the residents can smoke out side if they want. I do not like to watch Mediaography but then again I don't like boxing or NASCAR. As long as it's a legal activity and he is not infringing on the rights of others who cares what he watches?