Infection control in the nursing home...

Nursing Students CNA/MA

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Hello, I am a Licensed Nurses Assistant (LNA). I work at a nursing home in NH. There's a huge problem there and I need advice.

We have a resident who's "care plan" allows for him to roll off his bed and onto the floor without having it deemed a "fall". Okay, so that's fine but what isn't fine in my eyes is this: He has a bowel movement and is rolling around in it. This seems inhumane to me. It's like he's a pig rolling in the mud. It's just wrong!!! But, this is his "care plan"? Wow! I am disgusted. What if his family shows up and he's naked (which he usually is) and he's in this condition? I would just cry if that were my family member. Plain common sense has me up at 3:30am, losing sleep over this situation and asking for some advice. I just can't get over it! Is this really okay? A woman stopped me in the hall and started telling me how she saw the resident in those conditions. She wasn't impressed to say the least. This is so bad. Isn't it abnormal to have a resident that uncontrollable in a nursing home anyway? The poor guy is around 60 years old. We have to run to him all the time...not complaining, just concerned that he isn't even in the right place for his condition. I feel he is being abused by the facility first off and secondly, we LNA's can't even get to him quick enough to be cleaning the messes. I had to feed this man while breathing in the smell of excrement. It was on the walls by his bed, on the bed rails, and on the mats to a smaller degree. I felt I couldn't even move in there. I wanted to throw up. Please tell me you all agree this is ridiculous and wrong. Should I call the board of nursing or something? Can I refuse to go in his room under those conditions?

Thanks for reading my rather long post. I will sleep better I hope since I am posting this.

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In the care plan I am sure it is in there not that it is ok for him to fall, and have BMs in his bed, but it is in his care plan so that everyone will be aware of these things happening with him. Do you all put a depend on him and he is getting himself naked and then having BMs in his bed? I would have someone talk to the family and explain to them about his behavior so that if they do come in and see him that way they know it is not because of neglect on the part of the LNAs, but just what he is doing. With this I would also be checking him often, and maybe see if you can put him on the toilet often enough to try to stop him from having BMs in his bed. Check the Care plan and see if there is around a consistant time he has his BMs and see if the LAs can bring him a few times to the toilet. I know you have many other people to take care of, but what would be better taking a few extra second to step in and just see how he is, and maybe see if he will toilet for you, or having BM all over and then you will be further behind taking care of the other residents. If he has got himself naked again try explaining that he needs to be clothed and put the depend back on him. Hopefully with good checking you can catch him before he has the BM on his bed.

I am concerned though about seeing BM everywhere in his room.. It Unfortunetly isn't a pleasent task at all, but the mess should be cleaned up properly. No one after the initial clean up should see or smell anything that was not cleaned up. It should be done properly. Even if it takes a few extra people to get it done. Hope it gets better hugs LNA/CNA work is never easy

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Hi, the problem is that he can not be toileted. He has involuntary movements, just like a fish out of water really. He can't controlled it. He can't stand up to be toileted. It's so out of control I don't see why the nurses don't tell the LNAs to do a proper cleaning. He is not on my list to do care for but I do feed him sometimes. That's when I found him like that. He is definitely not attended to promptly. it's just not right. Thanks for your response and concern. I appreciate it very much.

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They need to at the least make sure he has a depend on then. It doesn't seem right that they allow an incontient resident to be allowed to lay in bed without something on, and then not clean him up the way he should be. Yes I have to say if this continues you need to report this. This seems to me it could be neglect. I'm sorry I hope things can get better for him, and there will be a solution for this situation.

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Yes, they put a depend on him but he rips it off every time. Seems like there's nothing that can be done to solve the problem. If it continues, I must make a call and report this because otherwise this is the way things will be and that doesn't settle well with me.

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Have you guys tried putting it on backwards with hip protectors or underwear on over-top? Honestly we have one person who must have been a naked sleeper when he was younger because he takes off his pad every night, and nothing we do will keep it on, so I feel your pain, except he only pees the bed (whew)

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We can try that but I feel he will just pull it all off. Thanks again for all your help!

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Yeah the taking off of the depend is not the care givers fault it's simply a behavior issue, so that makes me feel better knowing the care givers at least are doing what they can there. I still suggest keeping an eye on him and keep trying to find something that will stop him from taking it off. You never know something might do the job. The BM must be taken care of better though. I can see no reason why there would be BM on the side rails of the bed and over the walls extra. So many health hazards for all, and I can not understand how any of the care givers would want to be exposed to it.

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Try scrub pants backwards over the depends. Also some conditions require meds that make have lave loose bm. Esp if he is a liver pt. Got the scrub pants idea from my cna

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Yes, it's a health hazard alright. The girls that have him on their list aren't doing a good job.....leaving the BM on things. There's a 19 year old LNA who is a lead on the floor and she was crying because she was so stressed out from this resident. I am not sure why they put such young people in leadership roles either but that's another story.

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I will have to mention the scrubs. This man doesn't have loose Bm's, he just plays with it.....takes his clothes off and it gets everywhere that way.

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We had a lady like that in a facility I used to work in. The nurses were aware of it, but had to keep documenting it until she got moved to a facility more appropriate for her needs. She was only there a few days. Most places I've worked that are LTC, the aides have barely enough time to take proper care of the ones they're responsible for, let alone an extra big BM mess 24/7. It sounds like something that the higher-ups need to deal with, possibly a social worker.

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