Residents of LTC who abuse the staff

roxxy3773, RN, APRN · Dec 16, 2010

Good luck!! It is often a daily part of nursing!

CoffeeRTC, BSN, RN · Dec 16, 2010

Because no one in the general public really wants to think about nursing homes. Srlsy...people think they are a place you house old people that are sick and getting ready to die. Everyones gets a picture of a dreary place with old people wandering around, moaning, looking disheveled or shrivelled up in bed. No one wants to accept that they could possible abuse or hurt the staff.

Large corporations don't want to properly address this issue either. The residents have rights, you know. (Non of the places I have worked in are like this)

Srlsy...good luck on this. Will you share your info with this group?

RNgrrl09 · Dec 16, 2010

Workplace Assaults on Nursing Assistants in US Nursing Homes: A Multilevel Analysis

Tak et al. Am J Public Health.2010; 100: 1938-1945

Assaultive Behavior in Alzheimer’s Disease: Identifying Immediate Antecedents During Bathing Journal of Gerontological Nursing Vol. 30 No. 9 September 2004

By Wilaipun Somboontanont, PhD, RN; Philip D. Sloane, MD, MPH; Frank J. Floyd, PhD; Diane Holditch-Davis, PhD, RN; Carol C. Hogue, PhD, RN; C. Madeline Mitchell, MURP

Searched google and found at least two articles. This problem exists across the board in nursing, it doesn't matter the specialty of nursing. There is currently an earlier post (today) about a nurse being assaulted on allnurses.com.

Nurses are on the frontline and are in danger of being subjected to violence, whether verbally or physically, daily by patients, patient's family, other nurses, doctors, you name it. JCAHO and ANA have initiatives to combat workplace violence. Nursing home violence may have a myriad of reasons- patient is demented, cna may have provoked patient in some way, failure to prepare the resident for whatever task the nurse was trying to perform and patient felt threatened...hundreds of reasons.

Best wishes with your research.

NurseLoveJoy88, ASN, RN · Dec 16, 2010

I work as a LPN in LTC. I have been hit, punched, spit on, had objects thrown at me, cursed at , threatned, and all the above. Was it written in my job description or anyone elses NO. With that said any health care professional with a little bit of common sense will know that we are at risk for being physically harmed by residents/patients. Good luck with trying to convince administrators but I don't see it happening. Instead of convincing them that it is not in the job description you should convince them to have quarterly inservices on how to deal with combative patients/residents.

Most of what I see is not residents harming staff out of spite but it is because they have some form of dementia or pyschological issue that they can't control at times.

My advice to any health care worker... if you don't want to risk being physically harmed than get out of the profession. Unfortanetly, this comes with the territory.

Once again good luck with your research.

casi, ASN, RN · Dec 16, 2010

I want to think there may have been an article in nursing 2009,2010 about staff abuse.

NurseLoveJoy88, ASN, RN · Dec 16, 2010

I work as a LPN in LTC. I have been hit, punched, spit on, had objects thrown at me, cursed at , threatned, and all the above. Was it written in my job description or anyone elses NO. With that said any health care professional with a little bit of common sense will know that we are at risk for being physically harmed by residents/patients. Good luck with trying to convince administrators but I don't see it happening. Instead of convincing them that it is not in the job description you should convince them to have quarterly inservices on how to deal with combative patients/residents.
Most of what I see is not residents harming staff out of spite but it is because they have some form of dementia or pyschological issue that they can't control at times.
My advice to any health care worker... if you don't want to risk being physically harmed then get out of the profession. Unfortanetly, this comes with the territory.
Once again good luck with your research.

To the grammer police... sorry for any errors.

Conqueror+, BSN, RN · Dec 16, 2010

I have worked LTC and actually had no problem with demented patients who thought I was trying to hurt them or women who thought they were about to be raped at shower time(how could I?) It was the awake, alert, and oriented patients who told you outright that "I can do what I want and if you do/say anything to me you'll be in big trouble".

taalyn_1, CNA · Dec 16, 2010

I work in a LTC facility and we have a few residents who do get combative, especially at shower or bed time. It is frustrating. The residents can not only hurt you, but hurt themselves in the process.

I have seen residents bite, pinch, punch, kick, cuss, scream and generally act way out of character. I have seen residents who are generally docile get very aggitated at shower time and act out in ways I never thought they would.

I think that sometimes it is their dementia that is kicking in and other times I think it may be the aide or nurse rushing through the process that sets them off and once that resident is in that state it can take a good while to calm them down enough to do what needs to be done. At least that has been my experience at my current job.

As someone else stated, you either deal with it the best you can or you change professions because it is going to happen sooner than later in most cases. The abuse of staff was not describedd in my job description or in any classes I have taken, but I have CNAs and Nurses in my family who did tell me about it before I started on this journey, so I was somewhat prepared. I think the schools and CNA classes should prepare newbies a little better for this as well as having inservices at the facility to discuss the best practices for dealing with staff abuse. I think the reason they don't is that they are already trying to cram so much info into such a small amount of time, and administrators seem to not want to acknowledge it at all.

Good luck in your research!

Ruby Vee, BSN · Dec 16, 2010

i work in icu. we have the same problem with demented, delerious or otherwise altered patients abusing the staff. and with competent patients abusing the staff because they're unhappy with the way their course is going. but i wish someone would study the perfectly competent visitors who choose to abuse staff to get their point across!

nerdtonurse?, BSN, RN · Dec 16, 2010

I'm with you, Ruby. If they acted in WalMart like they act with us, they'd get arrested and nobody'd care that pawpaw's in ICU for the 10th time this year because nobody gives him his meds....they'd still go to jail for their behavior. But because they're in a hospital, they know that there are NO consequences for abusing the staff.... :mad:

Start2 · Dec 16, 2010

As others have stated, this abuse, unfortunately, goes with the territory. :crying2: It would be wonderful if this never happened, but that is not the reality.

Patients often feel out of control with their situation and 'act out' in frustration. The staff most at danger of suffering abuse (physical or verbal) is the staff with the most daily contact. The LPN or RN directly overseeing the staff taking care of ADLs, as well as other portions of patient care, needs to investigate what happened and to intervene when necessary. He/she also needs to instruct the staff in ways to handle the patient to prevent future occurances. Sometimes giving mini-classes in patient/staff interactions is possible.

I know this is an ongoing problem that is not easily addressed. Good luck with your study.

:up: :redbeathe