What would YOU have done

Nurses General Nursing

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I have a question for you nurses or CNA's for that matter. Say a quadriplegic person whom cannot talk, (but does have a voice and can cry out) is crying out because he's uncomfortable. A nurse (I really do not even want to call her that) gets tired of his yelling out and says he is disturbing other patients, closes his door and removes his call light for the whole night. The only way this person is able to work the call light is by tapping it with his head. So if you had witnessed this, would you have gone about your work or would you have said something?

Specializes in LTC,Hospice/palliative care,acute care.

One of the big problems he'll face is he is still trying to control something (anything) around him that he can. Often in health care it's difficult to stick to a rigid schedule-other things happen and they have to take precedence. It's a shame when a staff member looses a resident's trust by saying they'll be back in a certain number of minutes and then for whatever reason are not able to do so. Sadly when you live in LTC you do not have 1 to 1 care and you have to learn to wait and understand that someone else may have a more pressing need. It's not easy. You mentioned that he does not like being turned -he can be medicated for pain before hand. He needs to be turned regularly. It's another example of him trying to maintain some control. He very well may have rung that bell for help constantly and been repositioned 10 times to no avail. His reasoning may be faulty but that is NO excuse for the staff's actions. He is angry and depressed and will likely benefit from a psychiatric consult. He is going to need help dealing with his new reality. You can make sure he gets that consult.Give him the emotional support he needs. Help him learn to be patient and co-operative because it's in his best interests.Make sure he is getting something for pain.Make sure that occupational therapy is involved-they can offer adaptive equipment in and out of bed to help him be comfortable. You and the rest of the family speak for him now but you also have to learn to set limits with him and that's hard. Work with the staff-not against them. Touch base with his social worker for support ,too....It's an awful thing that has happened to him but it will take HIS HARD WORK to get back to the life he had before.Feeling sorry for him won't help him .A resident his age with his problems is very challenging-alot of the staff are his age so it's tough on them ,too. Good Luck-keep us updated.

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Thanks for all of your replies! This patient (which is my uncle) had a stroke almost six months ago and it has left him in this state. He has been in a nursing home since the beginning of Nov. but was taken to a hospital last week so see if he can be weaned off his air. He should be staying at this facility for aup to 40 days. Now when he was at the LTC, he was never really repositioned, because he likes to lay on his back. However, my aunt and I give him his bed bath so of course we are keeping an eye on skin breakdown and bedsores. Being that this is a hospital, he was told that he would have to be repositioned every couple of hours and he complied. I guess Sunday night when they repositioned him, it hurt him and he cried out. So she took his call light and shut the door. This nurse is currently being investigated and is NOT allowed to go into my uncle's room again. I am just wondering whey no one spoke up to her? The family feels the whole unit should be under investigation since no one spoke up. I mean his room is only 3 doors down the nurses station so everyone had to hear him. He was so exhausted on Monday from not being able to sleep the night before. That really breaks my heart! Sure he can be a pain and be demanding! LOL!! However, the truth is, it was her job to deal with it and help him. He is only 45 and trying to adapt to this way of life.

I am going to play devil's advocate here. If no one spoke up how did YOU hear of it? Your Uncle can not verbalize, so it was not his complaint. Just trying to get the picture here.

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Specializes in Med-Surg Nursing.

I agree with KTWLPN's post. I know I try to abide by what I tell the patient as in saying I'll be back in X amt of minutes...sometimes though, that doesn't happen. Another pt may be having a medical crisis that trumps a breathing treatment, or maybe a doctor came in to round on another one of my patients.

Unfortunately, your uncle will need to be turned q 2 hrs for the rest of his life so as not to get bedsores which can and do kill people from infections that can develop from them. I believe that this is what caused Christopher Reeve's death and I took care of a quadriplegic patient who also had many hospital admissions for infected pressure ulcers(bedsores) and he finally succumbed to the infection that overwhelmed his body. The LTC facility that DID NOT turn him at all is mind boggling as well.

He should probably be administered pain medication around the clock so as not to be in pain from being turned and repositioned. I've also had quadriplegic patients who for whatever reason just CANNOT get comfortable and I've spent the last 15-20 minutes trying to reposition them to the best of my ability. It's frustrating for both the patient AND me so I understand how that nurse might've lost her cool...not acceptable but understandable.

And like Steelydanfan asked since you claim no one spoke up, who told YOU this happened as your uncle is unable to speak or write.

Taking away the call bell is abuse. Yes that nurse should've been reported and I'm glad to hear that she/he was.

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last week i had a young (early 30s) guy ringing his call light for 1)ice 2)another drink 3) salt 4) honey mustard 5) a rag to wipe his face 6) for me to look at his butt that was itching (no joke) and this was AFTER i went "above and beyond" my call of duty to go downstairs and get him food from the cafeteria (after hours) TWICE. i do NOT have to do that btw.

i went so far ask to kid with him and ask him for a tip - but i would never dream of taking even HIS call light away. that is dangerous and disgusting.

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I am going to play devil's advocate here. If no one spoke up how did YOU hear of it? Your Uncle can not verbalize, so it was not his complaint. Just trying to get the picture here.

Even though my uncle cannot speak in full sentences, he can say words. They performed a tracheotomy back in Sept and if you place a speaking valve over his hole, he can say a few words. When he is too tired to try and talk, he uses a letter board. We have been communicating like this since Nov. A co worker actually told us about what had happened. I don't know if she was working that night or not, but she told us what happened and she said that this nurse was not allowed back in his room.

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I agree with KTWLPN's post. I know I try to abide by what I tell the patient as in saying I'll be back in X amt of minutes...sometimes though, that doesn't happen. Another pt may be having a medical crisis that trumps a breathing treatment, or maybe a doctor came in to round on another one of my patients.

Unfortunately, your uncle will need to be turned q 2 hrs for the rest of his life so as not to get bedsores which can and do kill people from infections that can develop from them. I believe that this is what caused Christopher Reeve's death and I took care of a quadriplegic patient who also had many hospital admissions for infected pressure ulcers(bedsores) and he finally succumbed to the infection that overwhelmed his body. The LTC facility that DID NOT turn him at all is mind boggling as well.

He should probably be administered pain medication around the clock so as not to be in pain from being turned and repositioned. I've also had quadriplegic patients who for whatever reason just CANNOT get comfortable and I've spent the last 15-20 minutes trying to reposition them to the best of my ability. It's frustrating for both the patient AND me so I understand how that nurse might've lost her cool...not acceptable but understandable.

And like Steelydanfan asked since you claim no one spoke up, who told YOU this happened as your uncle is unable to speak or write.

Taking away the call bell is abuse. Yes that nurse should've been reported and I'm glad to hear that she/he was.

I think the reason that he was so uncomfortable is because he is not use to being turned. Needless to say, he is not returning to that particular LTC facility. We found out later that they have been closed several times and opened up under new names.

Trust me, it gets just as frustrating on the family as well...I will not lie about that, but it is not acceptable if he is in pain.

Now that I am thinking about it, someone might have reported it being that a coworker is the one whom told us and then my uncle told the charge nurse the next day. This particular nurse even walked into his room one day last week and told him that she did not have time to play board games. Luckily a family member heard her and told her that it was his line of communication. The nurse knew that as there is a huge sign telling how to work it. :rolleyes:

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