Quit after a week!

[McArdle]

I am currently a CNA and am doing my prerequisites for the LPN program at my local community college. Although I live in IL (not far from the IN border), I have worked as a CNA in IN for the past 2 years. After getting tired of the drive and the traffic, I decided to start a new CNA job closer to home. I got a job at a LTC facility in their Alzheimers unit. Ive always worked with Alzheimers patients so I felt pretty comfortable with the position. Well, me and another cna were in a patients room getting her changed because her clothes were soaked with urine. This resident can be combative at times and very sweet at other times. She constantly calls out for her sister and is always trying to "rally" the other residents into making a "break for it!". Well, while we were getting her changed she flat out slapped the other CNA across her face. This CNA hauled off and slapped her across her face right back and yelled at her! She then proceeded to stomp on the stuffed animal that this resident always carries around with her (a unicorn). I felt this was totally inappropriate and uncalled for and just flat out WRONG! After all, this resident is in the alzheimers unit for a reason! I reported what I saw to my nurse manager (who is a LPN and about 24 years old). Nothing was done and I feel my nurse manager is more intrested in hooking up with the head of the maintenance dept than she is about the residents care. She is always on the phone with this guy and rarely comes out of her "office". When she does, its usually to give one of the residents a shot of Ativan so they dont bug her for the rest of the night.

Sorry for the negativity in this post but I am just very discouraged by this experience. I will never be that kind of nurse and if I do ever feel like this kind of behavior is okay I will get out of nursing pronto!

[chadash]

It is sort of, unfortunately, normal in dementia patients, and understandable with some of the psychiatric effects with organic brain problems. So, to respond as this girl did is just not to understand the disease. Of course, we should never slap back. If the patient is not demented, it is assault and needs to be dealt with, but not by being abusive to the patient.

Back to demented patients. Some times backing off and reapproaching the patient really helps, as you suggested. But sometimes you just need to do the job the kindest way you can, and take your knocks. You can become quite adept at ducking, swerving and other evasive manuevers. Remember, they just don't know what they are doing.

I wonder with a patient that is generally combative if they are getting the correct medications. There are some meds that see to help with this without being overly sedating. I would explore the options with the patients physcian.

[firstaiddave907]

Wow how sad that was. i agree wiht some of the other peopple about reporting it to an angency who handles this kind of thing.Residents can really try your patience at times, but hitting a patient back in retaliation or to "teach them a lesson" is just so wrong. I agree with you motorcyclemama

[Spritenurse1210, BSN, RN]

This CNA hauled off and slapped her across her face right back and yelled at her! She then proceeded to stomp on the stuffed animal that this resident always carries around with her (a unicorn). I felt this was totally inappropriate and uncalled for and just flat out WRONG!

:eek::eek::eek::eek::eek::eek::eek:

Definition of Assault and Battery:

"An assault upon a victim that is carried out by striking the victim, knocking the victim down, or otherwise doing violence to the victim."

You're absolutely right! This is abuse. The patient is not aware of what she was doing....even if she was, there is still no excuse for striking her. REPORT HER!!!!!! REPORT HER!!!!!! REPORT HER!!!!!! REPORT HER!!!!!! REPORT HER!!!!!! REPORT HER!!!!!! REPORT HER!!!!!! :angryfire :angryfire :angryfire :angryfire :angryfire :angryfire

[chadash]

This CNA hauled off and slapped her across her face right back and yelled at her! She then proceeded to stomp on the stuffed animal that this resident always carries around with her (a unicorn). I felt this was totally inappropriate and uncalled for and just flat out WRONG!

:eek::eek::eek::eek::eek::eek::eek:

Definition of Assault and Battery:

"An assault upon a victim that is carried out by striking the victim, knocking the victim down, or otherwise doing violence to the victim."

You're absolutely right! This is abuse. The patient is not aware of what she was doing....even if she was, there is still no excuse for striking her. REPORT HER!!!!!! REPORT HER!!!!!! REPORT HER!!!!!! REPORT HER!!!!!! REPORT HER!!!!!! REPORT HER!!!!!! REPORT HER!!!!!! :angryfire :angryfire :angryfire :angryfire :angryfire :angryfire

:yeahthat:

[momdebo, BSN, RN]

I understand your feeling, that's why I eventually became a nurse, thought I could have greater impact in just that kind of situation. You are always encouraged to follow chain of command and you can always then follow up with Joint Commision and especially Illinois or Indiana Department of Public Health. Never lose that special quality that makes you the patient advocate that you obviously are, you are speaking for those who are unable to speak for themselves.

[texas_lvn]

While I don't agree with what that CNA did, my question is: How can you also protect staff from being slapped or assaulted? Is this something that is routinely accepted.

I'm new to this whole LTC thing - last week I observed a resident slapping at, and swearing at two young ladies who were trying to get the resident to go with them so that they could change her wet clothes.

When I heard the ruckus, I asked the girls to just leave her be for the time being. They were being as kind and cajoling as they could be, but she just wasn't having it. I asked the resident to please not hit the staff, but I think it's a losing proposition.

How does everyone else handle these situations? If state had walked in at that moment and found her wet, I'm sure that they'd have had a fit!! But on the other hand, I don't feel that being punched should be part of the job.

DOCUMENT, DOCUMENT, DOCUMENT. It is sad that residents do sometimes hit, bite, pinch, and anything else you can imagine. It is usually part of their dementia process/problem. As long as you were to (or the nurse) document that the resident had on a wet shirt, and that she was being combative, you have CYA'd. There are also special classes that deal with this dementia process. Maybe you should talk to your DON and have her/him schedule a class. Good Luck!

Edited to add this: Make sure to go back after a few minutes and try again, and make sure you document the out come. If it happens alot, it needs to be careplanned.

[mtnmom]

you absolutely need to report this to the DON and to the state. By allowing such a barbaric, criminal act to go unheeded you will be allowing the same or worse to happen in the future.

you have the makings of a wonderful caregiver. I do not see negativity in your post but rather a reaction to something horrible that you witnessed. I am sorry that you had to witness it but perhaps you were placed there for a reason...to witness it and to act upon it....just something to think about.

anyway, hugs to you and good luck.

[banditrn]

DOCUMENT, DOCUMENT, DOCUMENT. It is sad that residents do sometimes hit, bite, pinch, and anything else you can imagine. It is usually part of their dementia process/problem. As long as you were to (or the nurse) document that the resident had on a wet shirt, and that she was being combative, you have CYA'd. There are also special classes that deal with this dementia process. Maybe you should talk to your DON and have her/him schedule a class. Good Luck!

Edited to add this: Make sure to go back after a few minutes and try again, and make sure you document the out come. If it happens alot, it needs to be careplanned.

Your advice makes sense. I've worked with a lot of dementia patients over the years, and learned to 'duck', but that's in a hospital setting where you aren't moving them from one area to another.

[ltcnurse1]

I am so sad to hear of the incident with the other CNA and resident. You did the correct thing by reporting it, but it definetly needs to be taken a bit further. These clients are left in our care to make good judgments for them and SAFETY is always first! This client is not in a safe environment at all. It hits close to me as my grandmother is an Alzheimers patient too. I too live in Indiana and attend college in Illinois (I am on the border too.) You most certainly did the right thing. I will keep this in my mind when we all have those rough days... I am sorry that you had this terrible experience, but I am glad you shared because if any of us "newbies" are in that situation too we will know what to do too...

Just remember we are the Patient Advocate!!! We are too look out for them and to take care of them! This makes me want to go do the best I can do.. Please keep us informed of how this turns out! Good luck with nursing.