Several years ago I was the charge nurse on night shift in LTC. I had one resident who was an elderly gentleman who had dementia, did not speak English but did understand English, and had a diagnosis of enlarged prostate and possibly prostate cancer, though due to no diagnostic investigation I only could speculate this. This particular resident was very challenging due to his need/desire to void was a constant, making him a very high risk for fall for he would try to ambulate independently to the toilet constantly. On this particular night he was very unsettled and agitated making it impossible for me to leave him alone in his room. He was yelling and calling out, and I was unable to calm him so I made the decision to transfer him to a Geri chair ( we used them at that time, but do not anymore), put a warm blanket on him and took him on rounds with us so I could keep a close eye on him and see if he would settle. It worked and he settled a bit. I spoke to him between rooms, and encouraged him to try to rest. He stopped yelling out and we were able to get rounds done. Then I kept him close to the nursing station while I was sitting there. My critical thinking and decision enabled my resident to be more comfortable and allowed him some much needed rest. Unfortunately for me, my manager at the time did not think my decision to make my resident more comfortable while we were doing rounds was the appropriate decision and she “wrote me up”. I did speak to my manager and stood my ground with my rationale that my decision was for the betterment and comfort of this resident in that moment, and I would make the same decision again. I will finish this story by sharing that at that time in my career, I was a fairly new nurse, but I had been advocating for this resident for months between my management team and his physician for better pain management, but the physician finally agreed to order an indwelling catheter that afforded him some comfort, but no medication for his pain. It was not too long after that evening that he went palliative. I was with him when he passed.
This experience has stayed with me and has made me a more fierce advocate for all my resident’s.