Horrified at what I have seen go on in this nursing home

fastwalkslowtalk · Nov 14, 2012

If it was abuse then it definitely needs to be reported.
Some of the descriptions are a little vague. Putting dirty socks back in the clothes drawer? Are you calling them "dirty" because you saw someone take them off a resident's feet and put them into a drawer? Just because they were wearing them (while lying in bed and making no contact with the floor) doesn't make them dirty. I dunno about that one.
I also know (from experience) that what might seem like "rough" to a new student who has never done the work of moving patients may just be someone who is comfortable in moving patients around and no longer handles them like a fragile feather like we all do as students.
If you do report then you might want to have some more descriptive, specific examples of what you witnessed.

Without being there to personally observe and stand as a witness to the events described by the OP, I am going to have to play the devils advocate here. Just for the record, I do not and will not condone abuse performed by any of my staff, but to the inexperienced, untrained eye, what you may construe as abuse may actually not be. If every single healthcare professional was turned in on abuse charges, I doubt that there would be many left in the field today. The truth is, there is not a single healthcare provider who has done everything they are supposed to all of the time. Even RN's and Physicians make mistakes that could be career killers. Blatant disregard for a patients safely in the form of negligence/neglect is a very serious issue but things do happen. From my experience, staff to patient ratio's, time constraints, staffing issues, training or lack thereof, level of experience, resident points on service plans, wages, hours worked and overtime, personal life problems are all factors that contribute to the level of care we provide. You may want to revisit the scenarios you spoke of and determine if what you observed was a clear cut case of elder abuse.

For example:

Dirty Socks: The truth is, many residents do not have adequate clothing provided to them by family members. Laundry is often only done on a weekly basis and is only washed as needed if clearly soiled.

Speaking Rough to Residents: Some residents have behaviors that require staff to be more direct and firm with in order to gain cooperation or else the resident will become more difficult. They may have hard hearing or difficulty processing verbal "commands" because of disease processes. This may be done as an effort to effectively communicate with this particular resident.

Banging legs while transferring: There are going to be times in your career when you are going to have a resident that is going to be a hard transfer, despite doing your best within your capabilities to provide good technique.

Dropping Residents on the bed: Without seeing it firsthand I really can not offer a determination here.

In my opinion, the facility should be allowed to determine whether or not these stated concerns of yours are issues that could be addressed through staff training or handled within the facilities disciplinary process. Your eyes are you own and I encourage you to make the right decision. If what you observed feels like abuse to you, then by all means make your report as stipulated by the Law as a mandatory reporter. On the flip side of the coin though, keep in mind that there may be circumstances where in your career that you may find yourself in the same scenarios.

funtimes · Nov 14, 2012

The truth is, there is not a single healthcare provider who has done everything they are supposed to all of the time.

This is a good point. Often you have CNA students that come from another line of work where everything goes by the book all the time, or whose main life experience is school. Healthcare isnt like that at all. In some cases doing things like that would actually be detrimental, or youd fall so far behind on your work that patient care suffers. Sometimes you have to prioritize and just worry about the important things, rather than whether the socks you just put back in a drawer should be washed because the patient had them on their feet in bed a short time. To a student who is watching this might seem horrible, but of course the student doesnt also have ten other residents that need to be taken care of and 2 call lights going off, and is meeting a resident for the first time that you know better than your own family because youve taken care of them for a few years and know all their quirks and habits.

I see a similiar thing in EMS all the time as well. You learn the way things are supposed to be done. In reality when you are on a call, they are almost NEVER done exactly like they are taught in a book. The situation is too fluid and changing and unpredictable, and there are too many different variables. Ive actually seen a student tell a Paramedic who had been doing the job for over a decade(and is now a physicians assistant) that he was doing things wrong. They just dont know enough to know any better.

tenn_bsnstudent · Nov 17, 2012

Let me just say I worked in a nursing home for 2 years before getting a job at the hospital. It was horrid. For me, it wasn't only how the residents were treated (by some nurses and techs, not all were bad). And I reported a LOT. Any time I reported something to my unit manager, ADON, or DON, they said they would investigate it but nothing was ever done. There were even several times that state would come and investigate it but nothing ever came out of it. At least at my facility, the supervisors generally didn't care about the well being of the residents. They claimed they did but their actions showed otherwise. I have seen nurses and techs make up vital signs, a nurse throw medicine away without offering it to the resident, a tech put a towel over a combative residents head in the shower, a tech charting dinner before the trays came out and never offered some people food. All of which I reported and very little action happened. The lat situation the tech was fired but told they would still give her a good reference. Sorry, that should be falsifying documents and neglect/abuse. But facilities don't care, they want to keep their money and keep things quiet.