[nursespike]

It was very similar at this facility when I first started out..the pager drove me NUTS! It was an expectation of staff that when there was a call out...tag, youre it...after the pager "broke" it was never replaced and the staff got educated on how to use the phone and the call list to help find replacements or actually problem solve before calling me or the DON. Now they call for clinical issues mostly, which I dont mind. We are accepting more and more high acuity patients..you guessed it...with the same staffing "challenges" (pts with TPN, Hickmans w/ antibiotics...throw in some behavioral issues..and voila!)...I dont think there is a such thing as "long term care" anymore. Management isnt bad, you have to have limits and I always remember what it was like working on the floor, and treat others with respect- no matter what their position. Anyways...I think we have digressed...lol...there is no such thing as a "restraint free" facility

[imisscoco]

Originally Posted by nursespike

It was very similar at this facility when I first started out..the pager drove me NUTS! It was an expectation of staff that when there was a call out...tag, youre it...after the pager "broke" it was never replaced and the staff got educated on how to use the phone and the call list to help find replacements or actually problem solve before calling me or the DON. Now they call for clinical issues mostly, which I dont mind. We are accepting more and more high acuity patients..you guessed it...with the same staffing "challenges" (pts with TPN, Hickmans w/ antibiotics...throw in some behavioral issues..and voila!)...I dont think there is a such thing as "long term care" anymore. Management isnt bad, you have to have limits and I always remember what it was like working on the floor, and treat others with respect- no matter what their position. Anyways...I think we have digressed...lol...there is no such thing as a "restraint free" facility

Sorry to everyone for the off topic public post but Nursespike, you just sent me a private email and I can't locate it!

[achot chavi]

Originally Posted by imisscoco

I love it. They always say "walk in another man's shoes". I totally agree about the 4 letter words vs a hip fracture. I hope someone explained that to the family that complained.

I tried, I even tried explaining that he is one of our better aides and has a special needs child at home etc. The family was just overstuffed with self-righteousness. I couldnt calm them down so I had to apologize profusely and we sent the CNA on a two day (paid) vacation to clear his head

[imisscoco]

Originally Posted by achot chavi

I tried, I even tried explaining that he is one of our better aides and has a special needs child at home etc. The family was just overstuffed with self-righteousness. I couldnt calm them down so I had to apologize profusely and we sent the CNA on a two day (paid) vacation to clear his head

We had a great aide who had been at the facility for 10 years. He was toileting a patient who had been restrained in a straightback chair. He left him for one minute unattended to get a change of clothes (in the same room). The patient fell off the toilet, hit his head, ended up with a subdural hematoma, consequently died. This patient was end stage dementia for a very long time. No excuse for leaving him unattended. Anyway, the family made a huge stink and the aide was fired, even though it was his first offense in 10 years. Even though he was wrong, it was really sad. I know he never would have done it again and I felt badly that the administration didn't stand behind him, even though he made a fatal error.

[achot chavi]

You see thats why we end up over-restraining!! Nobody wants mistakes- doctors, lawyers, politicians are all allowed to make a mistake, after all they are only human! But G-d Forbid we show our human side and make a mistake or error in judgement- its the end of the world!!!
People fall, even when they are restrained the patient sometimes succeeds in loosening the restraint and slipping out.
Seriously, I am very sorry for the patient who fell and the aide who lost his job. No matter how careful we try to be this could happen at home or with a private 1:1 nurses aide!
I hope the aide got a letter of recommendation and has since found emplyment

[snowfreeze]

Stroke patients and dementia patients are difficult to work with. Keeping them safe is also difficult as they always seem to be diligent at injuring themselves. Documentation of the behaviors and physical handicaps allows us to use devices for comfort.