Residents who pull their call light for the sake of it

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The nursing home where I am employed has several units for different purposes. We have a rehab unit for temporary patients who are healing from surgery--knee, hip, etc surgery. They are not sufferers of dementia or alzhiemers etc All of them are in their right mind.

This elderly lady in particular pulls her call light in very short periods of time, all night long almost during my entire shift--sometimes the moment you just walk out the door she pulls her call light again to ask you for something very trite. She always wants a bedpan to urinate. It's like she wants a bedpan for every drop of urine in her bladder. :angryfireNot to mention she wears a brief. There is never even that much urine in the bedpan. IMO the lady is being spiteful and trying to give CNAs a hard time.

If you don't answer her call light promptly, she will pretend that she is asleep and not answer you--about 1 1/2 minute later she pulls the call light again. She does this persistently. One night I did not get ANYTHING done at all.

From my experiences there is really nothing you can do about this, but answer the call light everytime. Which is really another disadvantage to being a CNA, there is not much support on our behalf when it comes to things like this mainly because we don't have a union.:o And it would be a bad idea to suggest or imply to a resident (especially the ones in their right mind) to not pull their call light so much, because they will tell their family and DON, and the CNA will be written up or terminated.

I wish there was something that could be done in cases like this.

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The nursing home where I am employed has several units for different purposes. We have a rehab unit for temporary patients who are healing from surgery--knee, hip, etc surgery. They are not sufferers of dementia or alzhiemers etc All of them are in their right mind.

This elderly lady in particular pulls her call light in very short periods of time, all night long almost during my entire shift--sometimes the moment you just walk out the door she pulls her call light again to ask you for something very trite. She always wants a bedpan to urinate. It's like she wants a bedpan for every drop of urine in her bladder. :angryfireNot to mention she wears a brief. There is never even that much urine in the bedpan. IMO the lady is being spiteful and trying to give CNAs a hard time.

If you don't answer her call light promptly, she will pretend that she is asleep and not answer you--about 1 1/2 minute later she pulls the call light again. She does this persistently. One night I did not get ANYTHING done at all.

From my experiences there is really nothing you can do about this, but answer the call light everytime. Which is really another disadvantage to being a CNA, there is not much support on our behalf when it comes to things like this mainly because we don't have a union.:o And it would be a bad idea to suggest or imply to a resident (especially the ones in their right mind) to not pull their call light so much, because they will tell their family and DON, and the CNA will be written up or terminated.

I wish there was something that could be done in cases like this.

If your nursing administrator was good, they would suggest to this resident that she is requiring a level of service that your nursing home just simply does not provide. The admin needs to find out why this lady requires so much help, for example does she really need this much help or is she just lonely? Maybe she just needs to have a family member visit her once in awhile during the day.

The admin could let the lady know that for an additional fee, the nursing home would gladly staff a CNA to be with her at all times, or she could go ahead and hire her own private CNA. Barring that, the administrator could suggest that family stay with this resident around the clock. The admin needs to set limits with this lady, and if she doesn't follow the rules, she either needs to be given notice or the family should be contacted.

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She's probably lonely. I don't think she is being spiteful to irrate the CNA or any f the staff. Perhaps when you leave the room you can tell her you will check on her as soon as you do XYZ. She might appreciate the thought and attention.

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Specializes in Cardiac x3 years, PACU x1 year.

It sounds mean, but it's the truth- sometimes lonely people are the worst. My job is to help deal with your medical problems (and those of 6 other people), keeping you company is not on my priority list. :icon_roll

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Specializes in DOU.

She may have a urinary tract infection... That could explain having to pee so often.

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I agree she may have a UTI. Definitely bring it to the nurse's attention. I would sit down with the nurse if possible (I know they're busy) and question if she's receiving antidepressants or if something traumatic has happened recently. Does she have a roommate? If she's used to constant company and she's alone in a room that may cause anxiety.

I had a pt like this this weekend on med surg. No joke, like clockwork, every 6 mins. I finally asked her why she kept hitting her light and was rude to staff. She didn't have an answer. She never said please, thank you, etc. She was always demanding and rude. I then asked her why she wasn't saying please and thank you. Her response? "It takes my breath away to say please and thank you." I told her if she could say that sentence then she could say thanks and please. It worked. I'm not mean and I cringe when I have to be blunt to pts (although I have no probs being blunt with others). But sometimes you have to demand respect and I think this may be one of these times. I am most definitely not saying you should be rude. Try sitting down with her for even 5 mins and get an idea of what her personality is like. Maybe she's scared that she may not recover completely. Is social services involved?

I sat down with this pt for a few mins to watch the pregame of the Super Bowl. Turns out she dislikes the Pats as much as I do. For the first time all weekend I saw her smile when I spoke of the game.

I would also remind her that she is in rehab and she can't continue this behavior at home. Does she have a husband or other family members that visit? Why not ask whoever will be taking her home about her behavior or check her H&P. Often times you will find what the pt's occupation was, family life, etc that will give you an idea of what she's about.

Another trick that I've found that works: remind her that every time you come into her room she's taking away time that you should be spending with others and that it's not fair to the other needy pt's that she take up all your time.

I know it's frustrating and infuriating. I'm an aide also. It's tough and can put you in a bad, depressive mood when you are dealing with these kinds of pts. If you haven't already you will develop a thick skin.

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Another reason for her constant urination can be contributed to a fear of becoming incontinent. In my experience, alot of older people get really upset if they wet the bed. I think it's that fear of losing control, not necessarily of the bladder or bowels, but that they are now dependent on others.

I'm not a nurse, but maybe one can attest to this, but I've found that after a foley is d/c'd a pt wants the bedpan/urinal very often because they lose that muscle ability. But don't take my word for it.

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Specializes in LTC, assisted living, med-surg, psych.

This is very true. And there are those people who literally can't go more than an hour or two without feeling they have to void.....a significant number of them elderly ladies who have borne many children!

To the OP: Please try to be patient with this resident. Yes, you must set some limits as to how much time you can spend with her, but if you anticipate her needs rather than wait for her to put her light on, ask her if there's anything else you can do for her before you leave, and come back when you say you will, this will help her learn to trust you and she may be able to wait longer before pushing the button. And if not, at least you'll know you're doing the very best you can for her while also caring for your other residents.:nurse:

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If your nursing administrator was good, they would suggest to this resident that she is requiring a level of service that your nursing home just simply does not provide. The admin needs to find out why this lady requires so much help, for example does she really need this much help or is she just lonely? Maybe she just needs to have a family member visit her once in awhile during the day.

The admin could let the lady know that for an additional fee, the nursing home would gladly staff a CNA to be with her at all times, or she could go ahead and hire her own private CNA. Barring that, the administrator could suggest that family stay with this resident around the clock. The admin needs to set limits with this lady, and if she doesn't follow the rules, she either needs to be given notice or the family should be contacted.

She could also be moved closer to where the action is. I know I would get antsy and anxious if I was closed off. Maybe move her closer to the nurses station? If she's up all night and her orders allow it, why not get her up in a chair and put her in the hall?

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This is very true. And there are those people who literally can't go more than an hour or two without feeling they have to void.....a significant number of them elderly ladies who have borne many children!

To the OP: Please try to be patient with this resident. Yes, you must set some limits as to how much time you can spend with her, but if you anticipate her needs rather than wait for her to put her light on, ask her if there's anything else you can do for her before you leave, and come back when you say you will, this will help her learn to trust you and she may be able to wait longer before pushing the button. And if not, at least you'll know you're doing the very best you can for her while also caring for your other residents.:nurse:

Excellent point.

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Specializes in ICU, Psych.

Many things could be the reason this resident has "to go" so often. All medical reasons should be investigated and ruled out before asuming that this resident just wants to be a pain. And please do not forget that any psychiatric or psychological disorder that this resident may have that would be the cause for frequent call bell ringing is also as real as a UTI !

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Specializes in L&D, medsurg,hospice,sub-acute.

Working in a similar situation, we deal with this problem in a number of ways--first--ask the patient what else she will need before you leave the romm, second, tell her that unless it is a lfe and death emergency, you will not be able to get back to her for 30-60 minutes--pick a time and gradually make it longer and longer--BECAUSE you have several people down the hall that need you--sometimes it is helpful to dramatize--somone in pain, someone dying, someone with difficulty breathing etc...third--we take turns going in to the patients that get us crazy---this is good for the staff and for the patient--it gives the staff the mental/emotional break we need, and when the patient sees that different people give her the same answer/ treatment, sometimes they let up a little...or have someone be curt/very brief and to the point with her--sometimes they call frequently because they like you (too much)---the physical issues are also true--possible UTI, possible psych isssues--have a psych consult for behavioral issues, sometimes they find interesting things with their labs.....also, I often pray before I go into they exasperating patients at their door--when really desperate--do it out loud, so they can hear you--Lord, please let me me calm when someone doesn't understand they are not the only person you have entrusted me with...etc....Good Luck and Blessings!!!

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