Oh my Goodness! Question about first day

Nursing Students CNA/MA

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Hello everyone,

I just finished my first shift in a locked Alzheimers ward and have some questions. First a little background. I went to school and completed a CNA class about a year ago. I haven't taken the exam yet but finally decided to start working as a CNA about two weeks ago. I am new to this area so I don't know anything about the facility I am working for now. During my interview, which was a joke, I was told the aide to resident ratio is 19 to one. I must have looked pretty shocked because they reassured me that there are only two total care residents in the whole facility and most residents do a lot for themselves. Next I asked about training and was told I would orient on all halls and both shifts I would be working before I would start working on my own. Okay, now to the point. I oriented last Friday for eight hours with an aide who never worked my hall. I get a call Wednesday morning telling me I am all set in the schedule and they need me to start working my normal shift starting Thursday evening. I explained to the aide that does the scheduling I had not completed all the orientation yet and her response was, "our census is extremely low right now and we're scheduling three aides so you'll have all the help in the world." I started my shift and my first duty was to pass snacks. This was concerning to me because I know some residents have special diets, need thickened drinks etc. So I asked is there a list of who has special dietary requirements and they all looked at me like I was nuts and started rattling off a list of who can have what. Which would have been fine if I had known anybody's name. Then, it turns out that I have 15 residents to take care of and I have no clue what I am supposed to be doing with any of them or who any of them are. So I start asking questions which are halfway answered or not answered at all. There are three residents who are supposed to have two aides whenever they need anything done, because of being combative. Nobody would help. Thankfully they were fine. The night went on and things only got worse. So after this long winded vent my questions:

1) Is it normal to only orient brand new aides for one shift and then set them loose on these poor unsuspecting residents?

2) Is it normal for facilities to be less then honest when describing what level of care residents need?

3) Is it normal for residents to be covered in bruises? (This really bugged me and it seemed every resident I got ready for bed had some bruising on their arms and bodies)

4) Is it normal for residents to be put to bed in dirty clothes and with dirty faces, bottoms etc. ?

I'm not sure if maybe I am too naive and this happens regularly. The whole night I was so worried I was going to forget some crucial step and hurt somebody. Is every place like this?

Sorry for the long winded post. Thank you for any advice you have.

Anne

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I don't work in a Nursing Home but I think you deserve a proper orientation. From what I understand alot of places lie to you to get you on board. As for the bruises, if you suspect abuse report it!!! No people should not be put to bed in dirty clothes with dirty faces. But from what I have heard nursing homes are so under staffed sometimes you just have to do the best you can. When I was in Nursing school I worked at Nursing homes through an agency and I was always horrified by what I saw there. I saw alot of lazy people who did as little as possible for the patients. If you care then right there you are better for these patients then probally most of the staff there. Good Luck and I hope you hang in there, sounds like these old people need someone who cares

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Specializes in ICU, ER, Hemodialysis.

1) Is it normal to only orient brand new aides for one shift and then set them loose on these poor unsuspecting residents?

2) Is it normal for facilities to be less then honest when describing what level of care residents need?

3) Is it normal for residents to be covered in bruises? (This really bugged me and it seemed every resident I got ready for bed had some bruising on their arms and bodies)

4) Is it normal for residents to be put to bed in dirty clothes and with dirty faces, bottoms etc. ?

I'm not sure if maybe I am too naive and this happens regularly. The whole night I was so worried I was going to forget some crucial step and hurt somebody. Is every place like this?

Sorry for the long winded post. Thank you for any advice you have.

Anne

1) No, you should receive a proper orientation. As a cna, I'd say 2-4 wks, at least. Being a cna is a HUGE responsibility, and proper training is a requirement. I would suggest you talk to the person that told you that you would receive a proper orientation. I would NOT work in such an important role without feeling that I was prepared.

2) I'm not sure of your question. Are they being less than honest to you about the residents level of care? If so, I wouldn't say that is normal, but as a cna, you should get report from the nurse. Ask him/her what is the resident's level of care needed.

3) It is normal for the elderly to have bruises on their arms and legs due to the fact that many are on anticoagulants. As far as their bodies, that one I'm not too sure about. If you have any concerns of abuse, as I assume is why you asked this question, then you should report it. It is better to report something and it end up being nothing then the other way around, IMHO.

4) I don't really care if it is "normal" or not. If residents are being put to bed dirty then I'd say that is abuse and should be reported. Of course, you could bring all your concerns to the DON first to give him/her a chance to change things around there. He/she may be unaware of what is going on!!

Only you can decide if you want to stay with such a facility or not, but I'd suggest that you get a proper orientation and bring your concerns to the DON. I would rather be told, "I don't think you are right for this facility" than to work while looking the other way!!! I wish you all the best and hope everything works out for you.

Sincereley,

Jay

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Thank you both very much for taking the time to answer my questions. I spoke with the DON, who seems like a nice lady, but she wasn't able/willing to authorize a longer orientation. So that coupled with my other concerns made me decide to move on and keep looking for a facility that I can feel comfortable working in. Have a good weekend. Thanks again.

Anne

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Specializes in ICU, ER, Hemodialysis.

Good luck with your new job search!!!

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