Failure to Maintain Resident Dignity and Respect During Pain and Help Requests
Penalty
Summary
The deficiency involves the facility’s failure to provide care that promoted and enhanced a resident’s dignity and sense of well-being. Resident #130, who had end stage renal disease, chronic pain syndrome, and was cognitively intact with a BIMS score of 14/15, was observed lying in bed with her call light on, crying out for help. An LPN at the medication cart outside the resident’s open door yelled to the resident that she would have to wait and then told the surveyor that the resident was a drug addict who would yell nonstop. The LPN was positioned close enough that the resident could hear this comment. As the resident continued to call out, the LPN loudly sighed each time and repeatedly told the resident she had to wait, while continuing to prepare medications. After preparing the medications, the LPN entered the resident’s room without knocking or identifying herself and asked, “What is wrong with you?” The resident was on her personal cell phone with 911, stating she was calling because nobody helped her while she yelled out, and she was noted to be tearful. The LPN yelled to the 911 operator that the resident was fine and did not need assistance, and the dispatcher ended the call. When the resident reported she was in pain, the LPN stated she had Tylenol for her, administered the medications, and left the room despite the resident stating she still needed help. The LPN did not assess the resident’s pain or offer non-pharmacological interventions and, after exiting, again referred to the resident as drug seeking and probably withdrawing, while continuing to ignore her ongoing calls for help. In a later interview, the resident reported feeling very frustrated, stated she had to yell to get help because staff ignored her, reported overhearing the LPN call her a drug addict, and said she often heard staff complain about her and felt they treated her like “ghetto trash.” The facility’s dignity policy stated residents would be treated with dignity and respect at all times.
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