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My Dad moved into an Assisted Living in June. The morning LPN who administers the morning meds is not friendly to my dad. He drinks instant coffee in his room in the morning. This morning he wasn’t feeling well and asked his morning LPN if she could make him a cup of coffee. She told him that NO, he wasn’t in that part of Assisted Living. I’ve heard her speak harshly to him on several occasions when she didn’t know I was in the hallway. She also lied to him and told him that he couldn’t have a migraine headache medication until 5 pm that day (it was morning when he asked). The order was written for the pill to be given PRN. I’ve already had 1 meeting with the administrator and things have not improved. They won’t let cameras, but I would love to be able to see what goes on when I’m not there. I think this woman just doesn’t like my dad. What else can I do?

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Withholding meds IS abusive.
It is big power trip for some med-administrators. I've seen this happen in every AL facility I've worked in...there is always at least one sick individual passing meds who gets off on the power. It is sick, and wrong, and needs to be reported as high up the chain as necessary to make it stop.
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BurntCaregiver Jul 2023
@tiredsister

I was the medication supervisor in a high-end AL and I know what you say can be true.
No one under me dared step out of line on my watch because they knew what the consequences would be if I caught them. There was also no hiding in the residents' apartments until the shift is up either (this is common in AL's for aides who do not want to give a shower or change a diaper).
I expected the aide staff to behave well and to maintain a good work ethic. I will not tolerate laziness.
In turn, I would not tolerate nor did I expect any of the aide staff to tolerate abusive behavior from residents. The aides were not expected to interfere in any of the residents' personal matters. If some resident was feuding and fighting with another, it was not for me or the aides to settle it. We would never take sides or listen to any petty squabbles and complaints. I did not expect them to socialize with the residents, listen to complaining, or allow a resident to "lash out" at them because they are bored or want someone to fight with.
I know what you're saying is true though, and it's up to the supervisors and administrators to run a tight ship and make sure they know what every aide, nurse, and staff member is doing all the time.
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OK...you might want to try this...
If dad can have Alexa in his room you can "drop in" and listen in on conversations.
So if you know that the LPN is going to be in his room at 7 AM you can be listening in.
This would give you more of an idea what the conversations are.
You can't see what is going on but you can hear.
*As I was googling this I did come across info (did not watch it though) on how to turn Echo into a security camera...just a thought
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For starters, it's not the LPN's job to be friendly or to make coffee. It's her job to administer the medications. There's no reason to complain to her superiors about that. Although, there's nothing wrong with doing someone a favor once in a while.
I can't tell you how many times I'd bring a resident a snack if they weren't feeling well, chance a pull-up, or give a shower to help put the aides. Technically, it wasn't my job because I was the supervior, but if everyone was busy and it had to get done, I'm not too proud to work.
These days many, many nurses in such a situation are.

What you do have reason to complain about is if she is lying about orders on when to give medications. Also the speaking harshly. What did she say? You say you've personally heard her on several occasions. So that behavior can't be overlooked as someone having a bad day or being overtaxed with work and doesn't have time for petty nonsense that is very common with elderly folks.

I would talk to her personally and her supervisor. Personally, I'd reconsider leaving your father in a facility that does not allow cameras in his personal space if him and his family want them.
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Breezy23 Jul 2023
I am a nurse myself and if it "isn't my job" attitude prevails the patient or here the resident suffers, and no patient should be lied to or spoken harshly to. The LPN could say " I can't get you coffee right now but let me get someone to get it for you" or she could do it anyway. Part of being a nurse is to be kind, friendly, caring, trustworthy, but most of all professional and this LPN doesn't sound like that at all. I hope the OP gets somewhere with administration, her father shouldn't be made to feel this way.
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Ask for another meeting with the administration and her/his boss.

Tell them that you require a different LPN be assigned to your father.

This is abusive behavior.
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anonymous1732518 Jul 2023
All well and good if they're not understaffed.
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Any chance you can ask AL admin to give your dad another LPN? Be frank. Explain the current LPN is mean to your dad.

You won’t change that person’s mean streak. It’ll come out in various forms. Don’t wait around to discover how she behaves when you don’t watch. You have a bad feeling, that feeling is right.
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AlvaDeer Jul 2023
Would be very rare to have two nurses on duty same shift for ALF.
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An LPN is not an aide. Her job at that moment was to do med passes. Med passes need to be completed within a certain time. Because then comes around meds that have to be given before or after lunch. She may not have that couple of minutes that it takes to get him a cup of coffee. When she meant he was not in that part of the AL, they must have different areas depending on the care residents get. Your Dads care must be such that he is pretty independent so capable of doing for himself. He is not paying to be waited on, sort of thing. His migraine pill? If that is as needed and it was on the cart, he should have been given it. Otherwise she could have said "I will get it as soon as I am done Med pass". There needs to be an RN in charge. The LPN answers to the RN. I would talk to the RN, tell her what you said here but...ask if she could please find out what the problem is with her and Dad. If a med is "when needed" then Dad should get it when needed. If no RN, I would question why an LPN is in charge. Most States require RNs be in ALs.
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I’m sorry but if she made coffee for all the residents, she wouldn’t be able to dispense meds to everyone.

All of the rest of it, I can understand your pov. When you have another meeting, I would leave the coffee bit out.
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BurntCaregiver Jul 2023
@southernwave

Sometimes you can make a person a cup of coffee. If you can't, then you can ask an aide or some other employee to do it.
No one has to be nasty about it though, but some people are and that does not have to be tolerated for one minute.
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So the morning medication LPN is a grumpy witch, but I'm not seeing anything abusive in what you have told us. LPN's don't make coffee, that's not their role. No doubt she could have told him to use the call button to summon someone lower down the hierarchy but she snarked instead - every part of our lives include encounters with people like this and we learn to deal with it.

As for the mistake in medication - that is something that needs to be addressed, and focusing on the LPN's professional competence will get you farther than complaints about her difficult personality.

returning to add that this is based on the assumption that someone living in AL is a competent adult with minimal physical limitations, treating anyone with cognitive or physical needs limiting their self care in this way would indeed be abusive
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It sounds to me that she is being professional about her job duties. She has a set job description that she follows. Some nurses are pretty stern in their duties and this is from life long experience of dealing with patients that have been unruly and troublesome or from family yelling and screaming at her for whatever reason or the other.

I'm sorry this happened to your dad. If she yells and screams at her patients that is one thing. If it is just a simple no, its a simple no. At least she did give an explanation that he is not in that particular unit and left it at that. Her main objective was to get the meds passed by a certain time. You could have gone to the nurse's station and requested to get his medication for his migraines.

I don't think she has a personal vendetta against your dad.
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MACinCT Jul 2023
When I worked in a large hospital every employee was part of customer service. While not in my job description I should obtain that denture cup. If something was out of my scope of practice then my response was that I would notify someone else. No was not an option. I recommend to keep a log of all instances and speak to her manager
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Some workers in assisted living facilities bring to work their own frustrations, anger, and jealousy from their personal lives. They resent serving others. Making vulnerable residents miserable gives them an easy power trip that they can't get elsewhere. Management is at fault for hiring and retaining an employee who is mismatched for the position.

Are there other substandard employees there that are being tolerated by management? If yes, this is a hopeless situation and you should move.

Start documenting your concerns in emails to the administrator even though you're not getting relief. You will need it if it escalates to a complaint to the ombudsman or to the owners.
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