One of the most important aspects of the Nursing Assistant's job is ensuring the safety and well-being of those entrusted to our care. Aside from staffing shortages, no other topic is covered so extensively in the media, and for good reason. The public SHOULD become outraged over abusive and neglectful behavior on the part of staff towards patients. As caregivers, it is our duty not only to prevent abusive situations in the first place, but also to report any incident, no matter how seemingly insignificant, to our supervisor immediately.
In most facilities, a 'chain of command' is followed. If you witness innapropriate behavior towards a patient by a fellow CNA, report to the charge nurse. If the behavior originated from your charge nurse, report to her supervisor or the Director of Nurses.
If you have followed the chain of command and reported the incident to the appropriate supervisors and still feel the incident has not been adressed properly, there is a patient abuse hotline number posted in every facility. It is our right and duty to call (anonymously, if desired) to ensure the incident does not go unnoticed.
There are different types of abuse, but all should be reported. Among these are physical, sexual, verbal, emotional/mental and neglect; which is failing to provide care for or act in the best interest of the patient.
I have given examples of each below. This list is not exhaustive, by any means. If you question whether an incident you've witnessed falls under the category of abuse, do not hesistate to discuss your concerns with your supervisor.
Physical Abuse
Examples: Kicking, slapping, punching, squeezing, pinching, poking, pushing, roughness, force-feeding (ie: forcing food into mouth, holding mouth open or closed, holding nose to force swallowing, in some cases; syringe feeds ); Physical restraints, if not ordered by a doctor and/or if the restraints are improperly utilized and/or not released at least every 2 hours
Mental/Emotional Abuse
Examples: *Threatening the patient in any way-ie: physical threats, threats to withold food or care. *Purposefully neglecting patient, or refusing to tend to needs whether the need is unspoken such as the need for incontinent care, or spoken such as an ignored request for a sweater. These are both neglectful actions.* Restraining patient in any way, against wishes, without a doctor's order. This includes, but is not limited to, isolation, physical restraints and chemical restraints. *Saying hurtful things: ie, 'Mind games', for example; if spouse of patient has passed away and due to patient's dementia the family requests that their loved one not be told about the death to protect their well-being, it could be considered malicious to 'break the news'--depending on the circumstances. *Not taking steps to alleviate patient's fears--for example, willfully neglecting to close the curtains at night in the bedroom of a resident who fears reflections on the windows. (some demented patients will view their reflections as an intruder.)
Sexual Abuse
Examples: Any act of inappropriate touching, fondling, or handling of the patient with or without consent. As caregivers, it is never permissable or acceptable to become involved sexually and intimately with the patients who are entrusted to our care, and legal action can be taken against a person accused of this conduct. Sexual misconduct performed by two consenting adults is a blatant violation of patient/caregiver ethics. Sexual misconduct against an unwilling person constitues harassment at best and possibly rape depending on the circumstances.
Verbal Abuse
Examples: Swearing at a patient; telling a patient to shut up; name calling; speaking in a demeaning voice; racial or ethnic slurs; verbal threats; public chastisement/humiliation; public disregard for privacy and dignity.
