We’ve all been assigned to cranky, demanding rude residents/patients. You know them: Mean, belittling people who have elevated themselves above all others in level of need. Not just pillow fluffers, these residents demand strict attention to minute details not because the attention is necessary but because the resident believes they are entitled to it. Resident families can be just as hard to work with. I’m not sure who is worse: The demanding resident or the demanding family member. Regardless, here are 7 tips on working effectively with the Mrs. Cranky’s of the world:
1) CHECK IN
Check on the demanding resident 1st thing: Once you know you’re assigned to Mrs. Cranky, go to her room and check with her right away. Let her know you’re her aide.
2) DISCUSS PLANS and ADJUST WORK FLOW
Ask her if she has any special requests for today: Perhaps she wants her bath later in the morning; or she isn’t feeling well and would like to skip breakfast. Or maybe she has guests coming and would like to wear the hard-to-don red dress. By asking her what her plans are for the day, you are giving her a real say in how her day will go. Based upon her feedback, schedule your workflow to accommodate Mrs. Cranky’s needs. This does not mean you neglect your other residents.
3) SHARE YOUR WORKFLOW PLAN
It is perfectly acceptable to let Mrs. Cranky know that your other assigned residents have the same needs as she does. Make it clear that you are responsible to others and that you cannot cut back on time they need. You can say all this in a polite, professional and caring manner. Even further, I would let Mrs. Cranky know the order in which you will tend to her care. Give APPROXIMATE time frames. By doing this, you are alerting her that you hold your other residents’ needs just as high as hers.
4) ANTICIPATE NEEDS
Unless she is your first resident, check in with Mrs. cranky every so often. Anticipate her needs. Use your knowledge of her demands as a tool: If you know she usually rings the bell at 10am for bathroom use, be one step ahead of her and show up in her room at 9:55am to see if she needs the toilet…
5) TALK!
When performing actual cares for Mrs. Cranky, listen to her if she speaks. If she is rude or insulting you, let her know that this offends you! Tell her that her words hurt your feelings. By doing this, you put her on notice that you won’t stand for rude remarks and the like. Try to find some common interests to talk about- this shows her that you do have a genuine interest in her. Ask her about pictures she has; ask her where she has traveled in her life; ask her questions about HER LIFE in en effort to show your curiosity. If she answers your questions positively, GOOD! Keep aiming for this positive energy. If she continues to gripe and complain, remain quiet. Don’t ignore her, but ignore the negativity.
6) ASK POINTED QUESTIONS
If Mrs. Cranky seems upset or angry, while doing her care, ask her if something is bothering or upsetting her. Sometimes people are uptight or nervous about things and take it out on the nearest person. If she expresses sadness let her know she can speak with you about those things and offer to pass on her concerns to others as needed. Let her know she can trust you. If she is angry at her family, offer to speak with the nurse to see about a family meeting. If she is mad at other staff, listen but don’t give any feedback. Give her attention for her positive words and say little about her negative words.
7) FOLLOW UP! OFTEN!
During the shift,after her care is completed, check in with Mrs. Cranky. Again, ANTICIPATE her needs! When you take a break, let her know. By doing this you are letting her know you care about her. At the end of the day, if appropriate, check in with Mrs. Cranky one last time. Ask her if she needs anything. Ask her how she thinks her day went- and what could be done to make it better. When we ask people to help us with planning schedules and work flows, it’s amazing how much feedback we get! It’s always appropriate to say goodbye and other polite remarks.
One of the most important parts of dealing with difficult patients/residents/clients is to be able to communicate effectively with them. Usually, if you keep them informed of exactly what’s going on, the plan of care and so on then problems are far more easily avoided.
Working now as a qualified RGN I see so many people practising poor communication in their daily work and it leads to problems down the line.
The majority of the points in the above article are all encompassed and enhanced by quality, effective verbal and non-verbal communication.
In my experiences it is communication that makes or breaks a nursing unit. If you have a nurse who is rude or demanding, the aides don’t hear her. Same with residents. Those who constantly complain are catered to and they never learn that they are not the only resident who needs care. Tallk about the squeaky wheel getting greased- no where does this happen more than in nursing homes. Band aid after band aid is applied but the wound never heals because the cause is never corrected. Rude residents, and their families, are cited by many aides I know as a reason for quitting their jobs. At 9, 10/hr- who wants to be verbally abused like this?
I’ve gotten a couple emails from people who say I am promoting “Kissing the butts of residents” in this article. Hardly my intention! Instead, I am suggesting that aides work with the demanding residents to let them know, the aide is, indeed, in charge of her assignment. Kim you are right- it’s one of the reasons we see such turnover. We get what we pay for. No one wants to be nor will tolerate being verbally (and physically) abused at work…in no other profession is it acceptable either. I don’t know what the answer for that is- we can’t change the diagnoses of our patients/residents. What we can do is change how we work with them.
Thank you for the comment, Ben. I agree: Communication is KEY to just about everything we do in this work!
Changing the work flow sounds easy. But sometimes it is not. Do I leave Mr. Jones all poopy in order to go tend to Mrs. Cranky’s pillow fluffing moments? I say not. Mrs. Cranky needs to anticipate that other residents have needs greater than her own. To back me up, the charge nurses need to support the CNA’s in this area, 100% of the time. The day that happens, will be the day the Mrs. Cranky’s of the world (as you like to say) will become less demanding and crude and rude.
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