I just can't figure it out

[Professer589]

First things first, I'm not a cna or hha. I've worked in residential care for special needs individuals, and pediatric respite care for the last two years. I can change a trach, get feeding tubes, no problems with showering or toileting, vitals, meds, etc. I'm in school for nursing, but just finished general education, no actual nurse knowledge yet. I haven't taken any cna classes, because I'm going to school to be a nurse, so why would I need to take a cna class? Kicking myself now.

Anyway, I have absolutely no idea what I'm doing.

I took another job as a live in care giver for an elderly man on hospice. I told the company my skills and they know I'm not a cna. They literally just threw me into this house, didn't tell me anything about the patient. The info I got, I got from another girl who works with him.

I know how to do roll changing, but this guy I just can't roll change to save my life. He says his hip hurts if I turn him too far, and his frustration at being turned is very obvious. I can't get the brief on him correctly. Tonight I just put the brief under him. He's very sore and has been fighting a rash, so airing out won't hurt (according to the hospice nurse), but I feel bad that I'm only doing that because I can't get it on him right.

He keeps asking me when I'm leaving. He wants the other girl to come take care of him. I've been in the living room all day, just checking on him and doing the required things, because he only asks when I'm leaving.

I know not to take it personally, and well, he is dying. I know I'm not being a good caregiver by being on the living room most of the day. I've never worked with the elderly though. So I guess I'm half ranting, half asking for advice.

[angeloublue22, BSN, RN]

I'm really glad you want to do better. I know it's a frustrating situation. I have been there myself. I was an 18 yr old caregiver with 25 patients to myself with absolutely no medical experience and only 2 weeks training. We didn't have nurses, only a med passer. When I would get frustrated I would ask the shift before me or after how they do it. You should try asking the other gal to show you how she turns him and while you're at it, ask her what she does during her shifts. Don't be afraid to strike up a conversation with him. He is a person and he has a history. Ask him about it. It's okay to joke around and laugh with you patients too.

[Missingyou, CNA]

To turn him:

Put one leg over the other in the direction in which you are about to turn him. I personally think turning towards me is easier. Some think it's easier to roll away.

He will probably have a soaker pad or bed sheet under him. If not, it's helpful to you to place one under him. Just fold the sheet so it's under his shoulders down to at least his hips width wise and long enough so it hangs off the sides of the bed so you can grab it. You can grab hold of the soaker pad or folded bed sheet at his shoulder and hip and roll him towards you. Do what you need to do, then move the bed/walk around the other side and continue.

Have him help you as much as possible. Even if he only can move his shoulders in the direction you move him. Even the smallest effort helps you.

To put the brief on, it's all in the "tuck". Line up the brief with his backside and tuck it under his hip. the better the tuck, the easier it is to retrieve it once you roll him back. You may not even have to roll him the other way if you tuck it enough!

Watch your back and your body posture when moving him. Raise the bed, bend your knees, NOT at your waist! It will save you alot of pain in the future since it's often the little things that happen all the time that lead up to one big injury.

Change is hard for anyone, especially someone who is in his situation. Don't take it personally. He will get use to you. He will have a routine with you and he will probably eventually stop asking you to leave so the other girl will come in. It takes time.

btw, you will probably get paid more as a CNA and some states even reimburse you for your training once you start working in a nursing home or hospital. Not to mention the experience you get, the things you will learn working in these settings as a CNA will be valuable as a nurse. ...just sayin.

[annie.rn]

You've gotten excellent advice from "Missingyou". A couple things I can add:

* If it is possible, try to have the pt. medicated for pain 30 minutes before you need to turn him.

*See if the hospice nurse is willing to coordinate one of her visits w/ your shift. Let her know what you are struggling with and have her change him with you. She can give you pointers/critique while doing so.

*Save one of your changes for shift change w/ the other caregiver. You can do it together and he/she can give you pointers/critique.

******Probably most important***** Don't be afraid to talk to the patient. Tell him that since you are new to working with him you would like to know how he likes things to be done. Ask him what works best for him, what is the most comfortable, when he would prefer to be turned, etc. The pt. Is probably your best resource. I know you are probably afraid that asking questions will make you look incompetent but it won't if you come at it from the angle of wanting to do what is best for him.

Good luck to you! And good for you for wanting to improve.