Failure to Identify and Prevent Verbal Abuse by Nursing Staff
Penalty
Summary
The deficiency involves the facility’s failure to identify and respond appropriately to an incident of verbal abuse involving Resident 5. The facility’s abuse policy defined verbal abuse as conduct that causes or has the potential to cause humiliation, intimidation, fear, shame, agitation, or degradation, and required staff to remain in control of their behavior, act professionally, and avoid retaliation. Resident 5, who had diagnoses including kidney and urinary disorders, hypertension, and bipolar II disorder, and who had intact cognition and required set up/clean up assistance for ADLs, reported that shortly after admission there were events that should not have happened and that one nurse made inappropriate remarks and would not leave the room when the resident requested another nurse. On the date of the incident, Resident 5 reported that they approached a registered nurse (Staff G) about a leaking catheter and felt that Staff G was not listening and that they were uncomfortable with Staff G providing care, so they requested a different nurse. Later, while Resident 5 was in their room, Staff G entered and stated they needed to know what the resident’s problem was with them and continued to argue with the resident. Resident 5 explained they had urinated on the dining room floor, felt embarrassed, and needed help, but Staff G responded that this was a nursing assistant issue and maintained they had done nothing wrong. Resident 5 repeatedly told Staff G they were uncomfortable talking with them and asked them multiple times to leave the room, but Staff G refused, telling the resident they needed to settle down and that they would not leave until the resident did so. Resident 5 continued to insist that Staff G leave, including telling them to get out of the room. A witness statement from another RN (Staff F) corroborated that Resident 5 had requested a different nurse due to discomfort with Staff G, and that Staff G insisted on knowing why and then entered the resident’s room. Staff F overheard Resident 5 speaking in a frantic tone about the embarrassment from the catheter leaking in the dining room and heard Staff G state that the catheter issue was a nursing assistant problem. Staff F observed Resident 5 repeatedly ask Staff G to leave and Staff G refuse, stating they would not leave until the resident settled down, until Staff F intervened and told Staff G to leave. After the incident, Resident 5 reported a headache and inquired about their last blood pressure medication dose. Facility leadership later acknowledged that Resident 5 did not want Staff G in their room, that Staff G had gone back into the room despite this, that the resident was not protected from further contact with Staff G, and that the incident constituted verbal abuse due to the confrontation and failure to honor the resident’s requests.
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