Am I doing the wrong thing?

Nursing Students CNA/MA

Published

Specializes in Geriatrics.

This is making me kind of angry. I just got a call from my supervisor stating that the family members are complaining because the clients are going through too many briefs and they are having to replace them too quickly. She is telling me not to change a client's brief from now on unless they have feces or are super soaking wet. She tells me that otherwise, they are going to start taking count of how many briefs are used during a shift. Am I the only one who feels like there's something really wrong with this?

I will be honest here, I do change a person's brief even if they are only a "little" wet. I am trying to prevent odors, skin breakdown, etc. from occurring. And I *really* do not feel like I am doing the wrong thing by doing this. Whenever I relieve other shifts, I often find the clients in a soaking wet and/or soiled brief and they stink to high heaven. I never complained or said anything about it because I'm not that type of person, I don't like causing trouble. A lot of the clients have skin breakdown and one even has a gaping pressure sore and has had one for months now, and even though I have no way to prove this, I highly suspect that this is because other shifts aren't changing them as they should. This really bothers me because I can't help but to feel as if I'm being penalized for doing the right thing. I go into work every day, I give everything my 110%, I try to always do the right thing, I pick up extra shifts constantly even when I'm completely exhausted and run-down, just because I want to be there for my residents, and yet it still seems like it's not good enough. They have to pick on me for some little thing, like, going through too many briefs during a shift. It's ridiculous.

Let them count the stupid briefs.

It will only prove that you're taking care of your residents.

Unbelievable.

What a load of rubbish.

Truly shocking! That is a terrible way to cut costs. It will be interesting to see what the families say when there is serious skin breakdown. They will blame you too! UGH...

I say keep changing them and chart it. At least you are covering your backside. Might want to polish up your resume too - sounds like a crazy place to work.

The state ombudsman might be interested in this new "policy".

Good luck!

Brook

Specializes in Long term care.

If you actually do what they are asking you to do, you will be the first person they blame when family complains that they found them in a soaking brief! ....it WILL happen eventually!

Keep taking care of the residents the way you have been. I agree, let them count briefs!!!!

Specializes in Med Surg/Ortho.

If they need to be changed, change them! You are doing the right thing. I would also speak up about finding clients in soaking wet and dirty briefs from other shifts. AND document it. They are the ones doing the wrong thing, and it is hurting the residents. I understand you don't want to cause trouble, but you need to advocate for your patient.

Gotta admit, this is a new one on me. Yes, family members will complain that you are using "too many" of their precious supplies, but they will also waste not a second in complaining that you are leaving Grandpa sitting in wet pants.

You will be "wrong" in either case, so the thing to do is to err on the side of human decency and keep Grandpa clean and dry. Let them count the stupid briefs, and when it is pointed out that the other CNAs use half as many as you do, you can calmly tell them that yes, you've certainly noticed that when you come on, Grandpa is definitely VERY wet and VERY smelly and VERY unhappy, and YOUR job is to change that situation, pronto.

I think I'd love to have one of the family explain to me, in precise terms, exactly HOW wet Grandpa should be before having the urine-soiled item removed from his skin? Perhaps you can ask them how long THEY would be willing to sit in urine-soiled items before being changed?

No, you are not wrong. The facility is. Surely there are better ways to cut costs other than jeopardizing the patients' skin. Who is this policy really hurting in the long run? Clearly the patients! :no:

No way are you doing the wrong thing! The same thing happened to me. My resident was running low on briefs so we called the family to state that he needed more and they complained that he is going through them too fast and hes going to start counting AND he thought we were using them on other residents. It made me SO angry because you cant predict how much a person is going to go to the bathroom in one day ESPECIALLY if they are on Miralax!! Im just in shock that you were told to leave your resident soaking wet because that is technically considered neglect. I will never understand. Hope everything works out for you :)

This is making me kind of angry. I just got a call from my supervisor stating that the family members are complaining because the clients are going through too many briefs and they are having to replace them too quickly. She is telling me not to change a client's brief from now on unless they have feces or are super soaking wet. She tells me that otherwise they are going to start taking count of how many briefs are used during a shift. Am I the only one who feels like there's something really wrong with this? I will be honest here, I do change a person's brief even if they are only a "little" wet. I am trying to prevent odors, skin breakdown, etc. from occurring. And I *really* do not feel like I am doing the wrong thing by doing this. Whenever I relieve other shifts, I often find the clients in a soaking wet and/or soiled brief and they stink to high heaven. I never complained or said anything about it because I'm not that type of person, I don't like causing trouble. A lot of the clients have skin breakdown and one even has a gaping pressure sore and has had one for months now, and even though I have no way to prove this, I highly suspect that this is because other shifts aren't changing them as they should. This really bothers me because I can't help but to feel as if I'm being penalized for doing the right thing. I go into work every day, I give everything my 110%, I try to always do the right thing, I pick up extra shifts constantly even when I'm completely exhausted and run-down, just because I want to be there for my residents, and yet it still seems like it's not good enough. They have to pick on me for some little thing, like, going through too many briefs during a shift. It's ridiculous.[/quote']

As a nurse in a LTC facility, I can tell you that you are 100% in the RIGHT, hon. preventing skin breakdown that leads to impossible to heal pressure ulcers is waaaaay high on my list of priorities. A dear lady in my facility just died from sepsis linked to a pressure ulcer, and the skin breakdown that led to that pressure ulcer could have been prevented had she been changed more frequently. There are other factors, of course...a persons nutrition and hydration level for instance.

You stand your ground...

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