Resident rights

Career Columnist / Author · Jun 17, 2017

I have been a cna since september. We have recrntly had some issues regarding cnas being banned from certain rooms by reisent in the right mind. We recently had a meeting that was particularly about how the residents are not aloud to ban cnas. My question is, is that true. I havent been banned but my a couple of my co workers have been banned from multple rooms. I work 3rd shift so if gets frustrating. I have been under the impression that residents have there ow rights and they are aloud to refuse care. And telling them they cant do that is a form of abuse if im not mistaken. Is there anyone that can clarify that for me.
Thank you in advance.

This is a facility specific decision (meaning a business decision), not an outside regulator or law. Residents are allowed to ban caregivers if the facility lets them. Many facilities choose to cater to the requests.

It seems it can be a problem if it gets out of hand, or if there becomes a culture of residents picking their caregivers.

brownbook · Jun 17, 2017

Nurse Beth is correct.

A RN, or manager, or case worker, should be notifying the doctor and or family of what the resident is refusing to allow the staff to do.

I appreciate your concern. You sound like a good CNA.

MunoRN, RN · Jun 20, 2017

I am apparently understanding your question differently than the previous posters, if the patient has not been legally declared incompetent and is refusing all care from specific caregivers, and those caregivers provide care anyway then they are breaking the law. No facility policy or other rules override these laws. Facilities are not required to provide other caregivers to provide care to the patient just because a resident refuses certain caregivers, but no, you definitely can't ignore that refusal of care unless the ability to make that decision has been legally taken away from the resident.

Sleejones · Jun 21, 2017

The particular residents that are refusing care from certain caregivers are not legally declared incompetent. They are "in there right mind". And thats what i was thinking. To me i look as it as if i dont want someone in my house, and they come in anyway that is trespassing. If im not wrong. I would thing thatd be the same for them. But like i said ive only been a cna since september and when my superiors had told us otherwise recently it just didnt sit right with me.

dream'n, BSN, RN · Jun 21, 2017

error

jdub6 · Oct 11, 2017

The right to refuse care for any reason at all is a right for all competant patients. However there generally is no corresponding right to demand care. Just as one can refuse Tylenol but not demand Dilaudid instead, one can refuse care from the aides on duty but has no right to demand that a specific staff person change assignments.

It would behoove you to learn your facilitys policy regarding residents who demand a specific caregiver when that person is assigned other tasks (wanting a shower from the med nurse). A facility might choose to direct their staff to do everything possible to accomadate these requests but this can be tricky (for example if 80% of residents want a female aide but only 20% of aides are female it is generally illegal in the US to fire the men due to gender-so the facility can hire extra women or inform these residents that refusing care from certain staff is refusing care period.)

At some point residents who refuse care from many staff or demand a few specific staff pose a problem- accommodating them would require other residents waiting or missing out on care. Many facilities offer such individuals a choice between hiring their own private caregivers or maybe moving to a different facility.

In my experience facilities that go too far to accomadate such things often do so for money (the resident is private pay) and are not good places to work. I left a facility where a private pay dementia resident reached the point where she needed a locked memory care unit but her son didn't want to pay for it. The DON insisted she be in 1:1 at all times but didn't increase staffing. This meant ratios for everyone else went from 1:20 to about 1:35. Ridiculous. This resident needed a higher level of care and the family should not have been allowed to demand it be provided at that type of facility-it should have been hire a sitter or move out.