I'm in SERIOUS need of advice, please. I started a nursing home supervisor job in the summer of 2017 and, even though I've been a charge nurse in my 22+ year career, this supervisory role is new for me. I have a more laissez faire type management style and I'm working on becoming more respectable as a manager. I can only do so much, it feels like, though. I have a dual role in my job and I'm a wound care nurse at my facility as well.
The LPNs are supposed to do weekly skin assessments on their assigned group of residents and that doesn't always happen. Months ago, I let everyone know that corrective actions would start happening if they didn't do them and print them out for me to review... it didn't seem to matter. I still get 2 out of 3 or 3 out of 3 in a 5-week review period. So, for those who I notice only do their assessments sporadically, I've done corrective actions. One nurse has pushed me to do 2 on her within the last 4 months. She has a HORRIBLE attitude anyway... So, fine. NOW I'm having issues with the nurses not doing their dressing changes-- they sign them off to be done but don't actually change the dressings. I had to write up 4 people for this last week. All of them had excuses and said they "meant to do them but forgot" or "the computer changed the entry from an "N" for "not done" to" their initials accidentally. Do you believe that??? Insert *eye roll* here. So I'll have to keep a check on this very closely from now on. I can't believe they don't understand the seriousness of this neglect. Because that's exactly what it is... !!!
My main dilemma and why I'm posting for advice is in regards to my CNAs and the fact that I can't get them to consistently use heel protectors, float heels, turn people off their backs and use pillows (that's so BASIC!!!!) and I've even implemented the use of disposable foam wedges to turn our residents with actual wounds on their backsides OFF of their bottoms. I can't get them to use them consistently. Some units are good about it and some just like to keep them on the resident's chair, on the floor or lying beside them in the bed but not actually UNDER them where it's actually doing the person any GOOD.
There are 3 shifts and I'm only there for 10 hours a day, 4 days a week. I've asked for the help of unit managers and for other supervisors but they also have their own jobs that they are trying to juggle. The DON said that it's the LPNs responsibility, as well as the CNA's, to make sure the resident is being cared for properly. I understand that... but how the heck do I drive home the seriousness and that there are consequences to their not doing what they are supposed to do? I don't even think they would care if I wrote them up to the point where it was a final warning. I don't even think HR would let someone get fired over not using a foam wedge. But then it's MY responsibility. I'm just at a loss and need advice from someone who is maybe going through something like this or who has gone through this in the past. What have YOU done??? What works to make people 1) CARE and 2) do what you ask of them?????
I organize the inservices for the CNAs every month and even when the inservice isn't about pressure ulcers, I still mention this as being super important. YES, we have agency CNAs and LPNs as fill ins but they aren't always the problem.
It's our own staff as well.
Thank you so much!