Protecting Residents From Each Other
I know that sometimes I must sound like a broken record, but an incident in a Vermont nursing facility underscores why it is so important for nursing personnel to actively manage patient interactions. In Bennington, Vermont an 84-year-old woman suffering from dementia walked into the room of a 58-year-old man. The man was heard yelling, and when staff arrived they found the woman on the floor, bleeding. She passed away two days later, and the case was referred to the county prosecutor for action.
The prosecutor opted not to charge the man for assault or battery or manslaughter, finding that he was not competent to stand trial. The case is reported here. I would encourage readers to look at the article because the key take away is found not in the article itself, but in the comments. One person wrote: "They should charge someone at the facility. If I had a loved one there and this happend [sic] to them, I would want answers." Another wrote: "They get paid to watch and monitor the residents. Someone was apparently not doing their job."
I have written about the problem with the difference between perception and reality. If a nurse sits down for five minutes to chart at the nurse's station, that will be the time that a family member sees them and concludes they do nothing but sit at the desk and chart. The perception is that the nurses are supposed to be watching every patient all the time; the reality is that even if it were possible to do so, it would invade the resident's privacy. Without a 1 to 1 staffing ratio, it is impossible to guarantee complete protective oversight, and the oversight that is maintained is only as good as the number of people around to provide it.
This is the area that gets nursing facilities into trouble: having what is perceived to be too few people to do the job. The solution is not always to hire more people, but often simply to group residents with similar needs in such a way as to prevent a patient with dementia from wandering into the room of a patient with violent tendencies.
Where a facility fails to protect one resident from another, a viable claim of negligence often arises. These can usually be prevented. When they are not, sad stories like this arise.