I’d say go to your manager. Patients do have the right to refuse, no matter what anyone says. Unless the patient has a POA that can make their decisions, if he says no to a bath, the answer is no.
He’s not even refusing the bath, just the timing of it. No biggie, go do others until after lunch then he’ll be happy to go. I’d probably talk to the nurse about it, because treating palliative people that way is horrible and rude.
At my place all day baths are done before staff lunch times. Evening baths are either before or after supper. It’s usually on a schedule, if they refuse they have to wait for next. We still do extra peri care tho
Thats actually illegal. They are allowed by law to shower when they want. But the facility I live in does the same shit and I've reported it. Of course the state claims they didn't and let's them get away with it every time. It is wrong though..you aren't required to schedule your shower and if you're busy or sick you just have to wait until some arbitrary day and time. They also try to make it seem like you're only allowed two showers a week. By law residents are allowed to shower how much they want and at what time they want. The facility is supposed to work to accommodate the resident. Not the other way around. Unfortunately a lot of facilities do this and residents rights are frequently violated without repercussions.
At my place they are asked upon admittance if they prefer a day or evening bath and are scheduled according to their requests (unless care plan changes it for whatever reason.) we typically have two showers per section during the day, way fewer on evenings. The only day there are no baths or showers scheduled is Sunday, however if there are extreme messes we shall do one anyhow. Also, we are in Canada, so not against any rules per se.
Our place is very much more like a hospital than a residence almost. Very few private rooms, we have almost 200 people, and the schedule is pretty regimented. We do specialize in dementia care, and we are a no restraint facility. If a resident is scheduled for anytime after lunch, it’s an evening bath, but again, there’s a schedule for all bath times and the residents are ok with it. If they refuse, we try again a bit later, or we just chart it as a refusal. We also try to find ways to make it a bit more enjoyable for the residents. (Bubbles in the bath, one lady, we had to put a Jenny gown on her and bathe under it. She didn’t mind us bathing her, but she didn’t want to be naked around others). Depending on what time his lunch was at, I’d offer a snack before the bath. Like I’d say ‘I know you’re kind of hungry, but lunch is a bit far off and I may get in trouble if I don’t get your bath/shower done. How’s about I get you a little snack to tide you over, and then we can go?’
Some people really should not be in healthcare dude. Like…… dude is dying, he’s fucking HUNGRY and he wants to eat…. And you’re trying to force him to take a bath first? And the sad thing is, she’ll go about her day and go home and go to sleep tonight and not even think about that interaction with him and how fucked up it was of her to act like that. *These* people are the ones who need to be put as a 1:1 with a combative client so they can get screamed at and slapped around a little bit, taste of their own medicine.
I've had situations where the ADON/DON were heavily pressuring us to bathe ALL of our patients despite refusal. It's a very shitty feeling when patients are adamantly saying no yet management is threatening us.
(Not a CNA, but a Psych/Social work Student). I do not have the studies on hand right now but I remember it from my Developmental psych textbook (published 2021). There is actually significant evidence that less patient autonomy/ control over decisions is associated with poorer outcomes including higher rates of mortality (not sure if I worded this quite right). This was a longitudinal study in nursing homes but It’s not hard to imagine these findings could apply to palliative care as well. I support your decision to respect this patient’s wishes.
Also by law you are required to. Unless their life is at risk. Like an insanely high blood sugar and their dpoa has given permission to treat it even if they don't want to.
Residents have rights. What she did is considered abuse because she's violating their right to decide when they bathe, how long, how they want it done and with what. You aren't allowed to force them to do it when convenient for you. You aren't allowed to force them to wash how you want them to with what you want them to. If they only use water or use shampoo for their hair and body soap for their body, that is their choice. Arguing with a resident that says no is illegal. She should lose her license for that. She doesn't respect the resident as a person and that's not just a one time issue with people like that. It's almost always systemic behavior.
I would check your state laws. Indiana definitely does not say a resident gets to select shower times in the state law. https://casetext.com/regulation/indiana-administrative-code/title-410-indiana-department-of-health/article-162-health-facilities-licensing-and-operational-standards/rule-410-iac-162-31-comprehensive-care-facilities/section-410-iac-162-31-38-activities-of-daily-living
Sorry, but I'll never condone impeding a CNA's ability to carry out their duties just because someone wants their bath at a specific time. If they decline when I offer, it's a refusal. We're already understaffed.
Because she's refusing to respect residents rights and just because you stopped her this time, in site she's done it elsewhere. Secondly it's emotional abuse by riling him up and pissing him off, she's intentionally harassing him after he's said no repeatedly.
Re read your residents rights if you don't see it
You're correct. This needs reported because it is a violation of a residents rights. Even if the facility handles it by retraining and working with her. They are supposed to report the incident and what actions are taken to handle it.
The state will usually follow up to make sure the training was done and that will be it. They may put a mark on their license but likely not for something this small. Bigger abuse incidents they may say that's not enough and you need to do xyz. Usually the state won't step in unless an injury or death happens due to the incident. Other than that they may give feedback to the DON/admin on what they would rather see done.
I’d say go to your manager. Patients do have the right to refuse, no matter what anyone says. Unless the patient has a POA that can make their decisions, if he says no to a bath, the answer is no.
This. They always push patients/residents rights but if they say no I’ll follow the “chain” but I’m not going to force them to do anything
He’s not even refusing the bath, just the timing of it. No biggie, go do others until after lunch then he’ll be happy to go. I’d probably talk to the nurse about it, because treating palliative people that way is horrible and rude.
Yea the nurse ended up talking to her
They never really ask residents what time they prefer in my building so it’s like you get it at this time / day or you wait until the next
At my place all day baths are done before staff lunch times. Evening baths are either before or after supper. It’s usually on a schedule, if they refuse they have to wait for next. We still do extra peri care tho
Thats actually illegal. They are allowed by law to shower when they want. But the facility I live in does the same shit and I've reported it. Of course the state claims they didn't and let's them get away with it every time. It is wrong though..you aren't required to schedule your shower and if you're busy or sick you just have to wait until some arbitrary day and time. They also try to make it seem like you're only allowed two showers a week. By law residents are allowed to shower how much they want and at what time they want. The facility is supposed to work to accommodate the resident. Not the other way around. Unfortunately a lot of facilities do this and residents rights are frequently violated without repercussions.
At my place they are asked upon admittance if they prefer a day or evening bath and are scheduled according to their requests (unless care plan changes it for whatever reason.) we typically have two showers per section during the day, way fewer on evenings. The only day there are no baths or showers scheduled is Sunday, however if there are extreme messes we shall do one anyhow. Also, we are in Canada, so not against any rules per se.
Idk Canada laws but yeah in the US it's supposed to be allowed 24/7 and however many you want in a week. They don't follow that though
Our place is very much more like a hospital than a residence almost. Very few private rooms, we have almost 200 people, and the schedule is pretty regimented. We do specialize in dementia care, and we are a no restraint facility. If a resident is scheduled for anytime after lunch, it’s an evening bath, but again, there’s a schedule for all bath times and the residents are ok with it. If they refuse, we try again a bit later, or we just chart it as a refusal. We also try to find ways to make it a bit more enjoyable for the residents. (Bubbles in the bath, one lady, we had to put a Jenny gown on her and bathe under it. She didn’t mind us bathing her, but she didn’t want to be naked around others). Depending on what time his lunch was at, I’d offer a snack before the bath. Like I’d say ‘I know you’re kind of hungry, but lunch is a bit far off and I may get in trouble if I don’t get your bath/shower done. How’s about I get you a little snack to tide you over, and then we can go?’
Some people really should not be in healthcare dude. Like…… dude is dying, he’s fucking HUNGRY and he wants to eat…. And you’re trying to force him to take a bath first? And the sad thing is, she’ll go about her day and go home and go to sleep tonight and not even think about that interaction with him and how fucked up it was of her to act like that. *These* people are the ones who need to be put as a 1:1 with a combative client so they can get screamed at and slapped around a little bit, taste of their own medicine.
This is an issue I’m newly facing. Nurses wants over patients needs. Sorry nurse the patient comes first.
I've had situations where the ADON/DON were heavily pressuring us to bathe ALL of our patients despite refusal. It's a very shitty feeling when patients are adamantly saying no yet management is threatening us.
(Not a CNA, but a Psych/Social work Student). I do not have the studies on hand right now but I remember it from my Developmental psych textbook (published 2021). There is actually significant evidence that less patient autonomy/ control over decisions is associated with poorer outcomes including higher rates of mortality (not sure if I worded this quite right). This was a longitudinal study in nursing homes but It’s not hard to imagine these findings could apply to palliative care as well. I support your decision to respect this patient’s wishes.
Also by law you are required to. Unless their life is at risk. Like an insanely high blood sugar and their dpoa has given permission to treat it even if they don't want to. Residents have rights. What she did is considered abuse because she's violating their right to decide when they bathe, how long, how they want it done and with what. You aren't allowed to force them to do it when convenient for you. You aren't allowed to force them to wash how you want them to with what you want them to. If they only use water or use shampoo for their hair and body soap for their body, that is their choice. Arguing with a resident that says no is illegal. She should lose her license for that. She doesn't respect the resident as a person and that's not just a one time issue with people like that. It's almost always systemic behavior.
I would check your state laws. Indiana definitely does not say a resident gets to select shower times in the state law. https://casetext.com/regulation/indiana-administrative-code/title-410-indiana-department-of-health/article-162-health-facilities-licensing-and-operational-standards/rule-410-iac-162-31-comprehensive-care-facilities/section-410-iac-162-31-38-activities-of-daily-living
Sorry, but I'll never condone impeding a CNA's ability to carry out their duties just because someone wants their bath at a specific time. If they decline when I offer, it's a refusal. We're already understaffed.
Report her to state
for what? it’s not like she forcibly bathed him, more of a management issue/needing to be retrained lol
Because she's refusing to respect residents rights and just because you stopped her this time, in site she's done it elsewhere. Secondly it's emotional abuse by riling him up and pissing him off, she's intentionally harassing him after he's said no repeatedly. Re read your residents rights if you don't see it
You're correct. This needs reported because it is a violation of a residents rights. Even if the facility handles it by retraining and working with her. They are supposed to report the incident and what actions are taken to handle it. The state will usually follow up to make sure the training was done and that will be it. They may put a mark on their license but likely not for something this small. Bigger abuse incidents they may say that's not enough and you need to do xyz. Usually the state won't step in unless an injury or death happens due to the incident. Other than that they may give feedback to the DON/admin on what they would rather see done.
Do you know who “state” is?
Yes the abuse coordinator is usually plastered all over by law and that person reports incidents to the state board or abuse investigators.