When residents get attached

[Lexi256]

Hello everyone,

I work in a long term care facility with a variety of residents with differing levels of care needs. Some are completely dependent upon the CNA staff while others can pretty much handle themselves with very minimal assistance from us. Part of the role of a CNA is to encourage independence where residents can do things for themselves, however when I started the job I was willing to wipe any butt that needed it, so I ended up helping some of our more capable people with simple tasks. Some of my coworkers have told me that I am spoiling the residents so that they expect too much out of us. Many of the residents have told me that I am their favorite aide because I help them out with things that other aides would not help them with. The residents have told me that I will be a good nurse someday because of how kindly I treat them.

That being the case many of the residents have become attached to me. I've had several of them ask me to sit with them in their room and watch movies with them or have a meal with them. Some of the nurses have told me that the residents ask where I am on my days off. One resident in particular tried to get hissy with me last week because I had "left her alone" in her room after I had cleaned up after she had had a diarrhea episode all over her be and then helping her to wipe up in the bathroom. And this is one of our more independent residents.

When she asked me where I had been I told her I was tending to the other residents but I don't see why I should have to explain anything. These people don't seem to understand that I'm at work. They seem to want to be friends and I guess there's a fine line between being their CNA and being their friend.

I guess what I'm asking is how do I draw the line with my residents? What did some of you do in situations like this?

Thanks for your input. I appreciate it.

[doodlebuttRN]

It can be difficult, and it was for me. I had very similar interactions with patients when I as a CNA and early in my nursing career. You have to set boundaries and stick with them. It is about a million times easier to set boundaries initially than it is to try and explain to a resident why you can no longer (insert activity here) even though you did yesterday/last week/last month. I know that it feels good to get that type of response and appreciation from your residents, especially certain ones. But if you are not facilitating independence for them, you are not doing them, you, or your colleagues any favors. You have to stick to your guns, in your words and your actions though. "Mrs. Needy, you are on the toilet now, and I will be back to check on you in (reasonable time frame)." And follow through with it. Be clear, concise, and do not over-explain. If you offer too many details, it gives an opportunity for her to argue the point.

There are also some very manipulative residents who will run you ragged if you let them. But i think you will find that if you maintain the same boundaries for all of your patients, it will be a lot less physically and emotionally trying for you. For me, it took time, practice, and a bit of confidence. Good luck

[missmollie, ADN, BSN, RN]

Reminding them that you are at work will help. When resident x asks you to watch a movie with them, just state "You know I would love that, but I have all these other residents I have to go visit and help. Would you like to go to the common room?"

This accomplishes a few things. It addresses their need for companionship by offering an alternative where they can socialize with other residents, it lets them know that you are working, but it also shows that you care. Don't offer the common room if you don't have time to get them into a wheelchair or assist them there. If they ask you this before you provide care and they are a total, ask what their favorite (topic) is while providing care and allow them to talk about it.

If you get a few out to the common area, you can always go say hi to all of them when you have a chance. 2 birds, one stone type mentality.

Thanks for all you do as a CNA! It is definitely not an easy job, but can be fulfilling.

[amoLucia]

Word of advice - be wary of pts who become too attached as they can VERY QUICKLY un-attach themselves when they choose.

And they can be very fickle. Like "you're the best-est CNA here" and then they tell that to the next CNA while they rag on you as being "mean" or "not caring".

There's a fine line between 'being friendly' and 'being a friend'. It takes some practice to differentiate between the two.

And I will be honest - in all my years, there were just a few pts I really did care for a bit more than some others. I knew there was a fine line I was approaching, but my actions were never over the top.

[Lexi256]

Hey there, and thanks for "thanks". I'm greatful to work in a place where the nurses appreciate the CNAs and they thank us on a regular basis. So thank you back. It's RNs like you who make us feel appreciated and respected on the job.

I have tried both your suggestions at some point in time. I usually tell them "it would be very nice to see a movie with you but I am still at work" and then I usually ask them if I can get them a drink or a snack. I'll even talk to them a bit if I have time.

Really the facility I work in is very small so I'm not totally overwhelmed with residents to take care of, but of course I cannot allow myself to stay caught up in one residents' room while call bells ring outside.

I think getting social groups together is a great idea, however that depends on how well the residents get alone with each other. Right now some of our units have more social drama than a high school cafeteria.