To never want to work on the nurse staff bank again!(59 Posts)
Im a healthcare assistant. Orginally on the staff bank, then on maternity wards and now back on the nurse bank before i start my training in occupational therapy in September.
I done a night on Tuesday and left so upset. I witnessed a HCA telling a patient with dementia who didnt sleep all night to be quiet because the other ladys in the bed wanted to sleep. The lovely lady kept apologising and then carried on shouting. The assistant stood by her bed and shh'd her and told her to shut up every time she started talking.
I also witnessed a nurse putting pills into another patients mouth when she refused to take them. This said patient was the one i was soley looking after all night. She could get aggressive and when i asked her if she wanted to get in to bed she shouted at me 'would you like to get into bed!' fair enough. I smiled and left her. The two other HCA's came over to me at 12pm and said can you get her into bed please. I explained and they proceeded to draw the curtains and try and lift her out of her chair and into bed. At which point she hit out at them (dont blame her) they were very rude tutting at her, put her back in her chair and stomped off after opening the curtains.
Its left me totally gobsmacked and i do not want to do another shift in the hospital. Its not the only ward i have witnessed this care on. Its so heartbreaking that patients are being treated like this, i am going to report it as i didnt once because i wasnt sure how to when i witnessed a HCA tell an elderly lady with dementia she would give her a black eye if she didnt go to sleep. The most shocking part is that all the staff on night heard her too and did not react. I think if they will do it infront of me a HCA they do not know how do they act when its just regular staff. AIBU to never want to return?
Well - I'm not totally sure what's wrong with the first example, although tone and body language matter of course.
Getting someone into bed/putting pills into their mouth again - depends.
Obviously the black eye example is horrible
I understand why you dont want to but otoh you could be the person who makes a difference by treating patients with respect and kindness.
Good on you for deciding to report it.
There is a huge amount wrong with our elderly wards. To be honest what you saw last night sounds like stressed staff trying to manage a night shift. There are still some wards that have quite a regimented attitude however on a shared ward you have to try and create an environment where people can sleep.
Was the patient you were meant to be specialling causing a disturbance to the other patients?
One of the reasons I left nursing was that for every devoted, caring and truly brilliant nurse there are countless nurses and care staff who shouldnt be allowed anywhere near vulnerable people. Ofcourse some situations are challenging and wards are grossly understaffed but some people really should not be in the profession.
What exactly are you going to report?
You were with one person on one shift. Try having 20plus, most with dementia and not implementing any order/routine. With staffing levels as they are and not enough private rooms it would not work.
Regarding medication , medication can be given covertly if it has been agreed and discussed in the mdt and care planned .
It's not easy.. I do the same job. With the first lass I'd have taken her through to a day room etc for a quiet cuppa or I'd have sat with her and talked very quietly. There's a lot to be said for single rooms where possible as this avoids that sort of scenario.
Second example.. If you're specialing someone it really should be done in a single room - specialing just means that they're bound to cause a disturbance (not intentionally) and it's so much easier to keep everyone calm and settled if the person needing specialed can be cared for alone in a separate room. I can understand if the ward doesn't have a private room or if they were all required for barrier patients but it wouldn't be typical to have to do this in a multi bed bay.
Putting pills in someone's mouth - I'm not sure of the legality, consent etc , probably if you have an adults with incapacity form you could do this legally and it wouldn't be wrong per se. I've given patients tablets crushed into yoghurt (etc). I always explain what I'm doing because I keep up a constant monologue anyway.
What you're saying does highlight the need for dementia trained staff though.
The HCA who threatened a patient with violence should not be allowed to continue working in a care environment - we all get stressed, angry, sore, tired etc but violence and threatening it is never acceptable.. however I suppose it's unlikely anything could be done now.
I can see what you mean, but it's really important that patients get some sleep in order to help them get better. There are also 2 odd other patients on the ward who could do with a sleep. So I think it's fine to encourage patients to get into bed and hopefully go to sleep. Threatening with a black eye is of course absolutely shocking and should never happen
Also if a patient doesn't sleep all night, they then tend to sleep all day instead, which compounds the problem. It'd be lovely if there were enough single rooms (although people can tend to feel lonely, isolated and scared of they're on their own in a strange room). It'd also be lovely if a hospital ward was a safe environment for vulnerable people to be wandering about in at night (but it isn't).
It's a very difficult job to do with usually too many patients and not enough staff. And always the risk of someone falling and breaking a hip or getting a head injury. So difficult for staff and patients alike. And so many people with dementia on the same ward, if where I work is anything to go by.
katemiddleton you don't see anything wrong with repeatedly telling a patient to 'shut up'?
Hmmmm, there are issues in communication and threatening someone with violence is completely unacceptable, but, trying to get someone to be quiet so others can sleep and making sure someone is taking medications (prior agreed etc) is fine, they may have been antibiotics which would treat infection which could have been worsening the confusion. Also, the issue with moving out of the chair could be for pressure area/continence care. Was the lady able to reason at all, did you explain why you wanted her to go back to bed? I would report the black eye threat and the 'shut-up' responses. Not acceptable, but the rest, all very subjective and context dependent.
I am very aware of staffing issues and have had many shifts on nursing wards looking after 12-14 patients and can understand it is very hard. But i always treat others how i would like my mother/father etc to be treated. I would not appreciate anyone telling my mum to 'shut up'
I am also all for being firm and although i was specialing the one lady i would go over to the other lady who had been shouting out and try to settle her down. She was very pleasant and i managed to persuade her to try and sleep as her grandsons would be visiting the next day and she wouldnt want to be asleep when the arrived. This managed to work for 20 minutes or so and then she would start again. The HCA also told her she was very naughty for keeping everyone awake!
As for the lady i was specialing she was really quiet and moving her out of her chair was not a case of pressure sure relief unfortunatley. I had earlier managed her to stand up so she had had pressure relief but she did not want to get into bed. It was a case of them dragging her out of her chair to get her into bed, which i had already tried (not dragging her. Trying to persaude her) and failed.
I didnt think of the fact there may be something in place about medication so thanks for pointing that out but the other incidents i found disgraceful. Another lady who did not have dementia and was in the bed next to the patient shouting out all night commented on how strict and rough she was.
How strict and rough the health care assistant was i mean not the lady in the bed next to her!
The op posted that the nurse asked her to be quiet and 'shut up' does depend massively on tone, it's not the politest but it's not TERRIBLE either.
I think you are being overly judgemental apart from the last example which of course is shocking and never acceptable. on night shifts recently I have had patients shouting out and keeping others awake and it isn't fair. I have quietly explained that other people are trying to sleep. Obviously someone with dementia may not chnage their behaviour but it doesn't hurt to ask !! I suspect there was a reason why the other staff wanted the lady to go into bed, perhaps she was at risk of falling if left in the chair all night, or at risk of getting a pressure sore, or was just safer in bed. I guess they will be the ones completeing the incident forms and taking the blame when something happens and not you.
I work on the bank as an HCA
Thankfully I haven't come across awful mistreatment of patients.
The threatening HCA should be sacked, obviously. As for the rest, you were there and if you believe they were treating patients poorly then obviously you have a duty to report it.
I try to stay away from the MFE wards to be honest. I do find them extra stressful and while I have had to special patients with dementia it isn't something that I think I'm suited to so I have to be very strict with making sure we swap every two hours like you legally should.
I think when you're a professional telling a patient to shut up is terrible actually. And likely to further wind up dementia patients who are shouting out because they are scared and confused.
I agree with you OP. But am sadly not surprised that many on here are defending this. Looking after people with dementia is hard work. But that does not excuse treating people badly and with no respect. And yes repeatedly telling someone to shut up, forcing pills into their mouth and physically forcing them into bed, is incredibly disrespectful.
And OP you are not being overly judgemental. You would have got a very different reaction if you had said that a carer was doing all this to an autistic teenager. But somehow when people become elderly and especially elderly people with dementia, lots of people stop seeing you as a full human being with the right to be respected.
You are being overly judgmental. They most likely wanted the lady to sleep for various reasons which I wont go into, sometimes you do things for the best of the client and leaving an elderly women up all night with dementia etc isn't the right thing to do.
The other things are wrong obviously, the name calling but it is an extremely stressful job. I am home carer so not in the same league and I cannot imagine having look after 10+ elderly people with dementia etc and your on a tight schedule, nightmare.
So physically forcing an elderly woman with dementia into bed is the right thing to do?
Since when has telling someone to shut up been the best way to get them to sleep. Would it be an acceptable thing to say to a child who wouldn't sleep? If not then why is it ok to be rude/aggressive to adults with dementia? They could have spoken gently and explained that it was night time and they needed to try and sleep. Tellinf someone to shut up is just likely to make people angry and make more noise!
Gentle pursuasion would be the right thing to do, forcing someone to do something against their will is never a good idea. There is no easy answer. Where I work we have a lot of confused patient's and they would be allowed to stay in a chair all night if they were more comfortable ( we do have posh recliner chairs though !). We also have good staff ratios which I understand a lot of places don't have.
Just to add - we also have patient's who wander/ try to climb into other patient's beds/ interfere with othe r patient's lockers and possessions. Allowing them to do this and upset other patient's is not acceptable and at some point you may have to try to physically stop them.
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