questions and vent

  1. I have a question and need to vent a little.

    How many aides do you have per hall in your LTC? (please put number of pts also.)

    How do you change your pts that are far too heavy? The LTC i work at does not have such a thing as a NO LIFT POLICY .....I wish we did....

    OK...I only work night shifts every other weekend. This was my first weekends. Friday night, I had a hall with 50 pt...one of them is on hospice..6 with caths...and 5 on feeding tubes....one or two dying. Well, we have four halls and usually four aides at night. Well I went and made sure that all of my people was dry and then found out we was short on a hall so I had to go and start on it. Finished it all but two people and the girl came in (think she planned it..ha ha) So that was my first dry round..we have to do three. Well I passed out ice gave my ensure to four people, stocked my cart, and stocked bathrooms with gloves etc.. Started on my second round and finished..did books, and did last round. Well I have a few heavy pts....which no one wants to help you but wants you to help them. Well when i was doing my books I asked a girl..I said do you know these people by room number? because that is the way that the book is set up..it is not set up my name. She said no I just go through and write what it said the night before and guess..i was like ok...well i looked and the names of the pts was on the bottom of the page. Well I could not remember who had a BM or not. So last night..Saturday night/sunday morning..I made a BM list and put it in the hall so that when I changed someone I could write it down and remember what it was a be for sure. Well, to me this is a good idea and the ther aides and the LPNs and the RN is making fun, but hey it makes me correct and makes their job better. Well we have only three aides there on SATURDAY/SUNDAY morning and so we have to split one hall and I asked who was going to do the books for that hall..they said well we are not going to do it someone else can catch it up. I was like fine I will do it because the regular is not here and she does not know what happened. Then I don't know who had a BM that they changed, so I told the Charge Nurse and she got on to the other two aides and they denied it and said that if they change someone with a BM on a split then they chart it. LIARS.. They don't want to help me change anyone. I think that we should all have a homebase..one hall, then we should go and we should all three or four go and change every person on hall 1 and then go to 2 and 3 and 4. Then we should go and do our ice and stock on our own halls and when you do have a person with a bm put it on a piece of paper in the hall labeled BM and put your name beside it then let the person who has that hall chart it and add that BM list to the book and if any questions then your name is beside the list and a question could be asked to them..that way everyone gets helped and everyone does not get the hard halls, but to them this is a bad idea. To me it gets done faster.

    I am so ill.
    I am going to bed..nite
    •  
  2. 15 Comments

  3. by   mattsmom81
    I'm not a LTC nurse so I can't speak specifically to your comments. I have worked with people who don't like to help with heavy patients and I just learned to change their linens myself unless they're fighting me. Of course, if they fight, or if you have to boost or lift one needs help then. Some nurses and CNA's just don't like teaming up, but don't risk your back lifting alone...not worth it!!

    Sounds like a lot of work ...meds and treratments on 50 patients....and suspect your aides aren't helping the situation. (seems a chronic problem in LTC) Have you asked your director for direction? Maybe some disciplinary action is needed to get others to do their jobs correctly.

    Good luck, maybe some LTC nurses will respond who have some good ideas for you to feel better about your job and give you some options.
  4. by   Bookie
    I remember having up to 60 residents, with 2 nurses and 4 aides. Our aides liked to team up. Don't make enemies but also don't let the lazy ones cause you to hurt yourself or get by without charting. Do you enjoy your job? Do you plan to stay in it? I worked 1 night as an aide in a nursing home and quit. Night shift is brutal and the aide work was brutal. My dad told me quit and I took his advice and never regretted it.
  5. by   ktwlpn
    Originally posted by GAstudent
    I have a question and need to vent a little.

    How many aides do you have per hall in your LTC? (please put number of pts also.)

    How do you change your pts that are far too heavy? The LTC i work at does not have such a thing as a NO LIFT POLICY .....I wish we did....

    OK...I only work night shifts every other weekend. This was my first weekends. Friday night, I had a hall with 50 pt...one of them is on hospice..6 with caths...and 5 on feeding tubes....one or two dying. Well, we have four halls and usually four aides at night. Well I went and made sure that all of my people was dry and then found out we was short on a hall so I had to go and start on it. Finished it all but two people and the girl came in (think she planned it..ha ha) So that was my first dry round..we have to do three. Well I passed out ice gave my ensure to four people, stocked my cart, and stocked bathrooms with gloves etc.. Started on my second round and finished..did books, and did last round. Well I have a few heavy pts....which no one wants to help you but wants you to help them. Well when i was doing my books I asked a girl..I said do you know these people by room number? because that is the way that the book is set up..it is not set up my name. She said no I just go through and write what it said the night before and guess..i was like ok...well i looked and the names of the pts was on the bottom of the page. Well I could not remember who had a BM or not. So last night..Saturday night/sunday morning..I made a BM list and put it in the hall so that when I changed someone I could write it down and remember what it was a be for sure. Well, to me this is a good idea and the ther aides and the LPNs and the RN is making fun, but hey it makes me correct and makes their job better. Well we have only three aides there on SATURDAY/SUNDAY morning and so we have to split one hall and I asked who was going to do the books for that hall..they said well we are not going to do it someone else can catch it up. I was like fine I will do it because the regular is not here and she does not know what happened. Then I don't know who had a BM that they changed, so I told the Charge Nurse and she got on to the other two aides and they denied it and said that if they change someone with a BM on a split then they chart it. LIARS.. They don't want to help me change anyone. I think that we should all have a homebase..one hall, then we should go and we should all three or four go and change every person on hall 1 and then go to 2 and 3 and 4. Then we should go and do our ice and stock on our own halls and when you do have a person with a bm put it on a piece of paper in the hall labeled BM and put your name beside it then let the person who has that hall chart it and add that BM list to the book and if any questions then your name is beside the list and a question could be asked to them..that way everyone gets helped and everyone does not get the hard halls, but to them this is a bad idea. To me it gets done faster.

    I am so ill.
    I am going to bed..nite
    Sorry you had such a crappy night....In my experience both as an aide and an LPN -the aides aLways worked in pairs-to protect themselves and the residents..On my 44 bed secure unit we generally have 2 to 4 aides on nights-most of our folks are ambulatory-many need to be assisted to the b/r on rounds-only a few needs to be turned and cleaned in bed routinely....I would never try to do rounds on heavy resdients alone-you could be jeopardizing your health and saftey and that of the resident....Also-as far as your BM record= the charge nurse really needs to handle this-keep your own list in your pocket through the shift-that's great.Constipation can cause many problems in the elderly-they can get darn sick.And it is a sentinel event.It's no fun to remove a rectal impaction-for the nurse or the resident..I bet the other aides are a bit envious of you because you are going to school-maybe that is why you are not getting the help you need.It is not fair to you or the residents....2 choices-stay and try to change things or move on ..Good luck
  6. by   Disablednurse
    GAstudent, I am glad that you really care about your patients and want to fill out the book correctly. That is one problem (filling out the book by what is on the previous night) that is always seen in LTC and it is really good to see someone who really cares. Talk to your nurse or charge nurse about the problems you encounter. Never try to turn someone who is too heavy for you, I hurt my back and now cannot work any more as a nurse. Be careful.
  7. by   GAstudent
    No I do not plan to quit. I love my job. I love kid and old folks (they seem to go hand-in-hand) i have talked to the nurse and she is like well that is something that you all have to discuss. I was like ok well what if they wont listen. There is a lady who plays in her BM everynight so they said to cut her nails (makes no sense how that will stop it.) well i cut her nails and the other aide said did you cut them enough. i was like yes and she looked at them and said no they need to be shorter ..i said no that hurts when you get them to short and so the other aide cut them more and the pt said that it hurt..i was so mad. I just don't know what to do. Last night i had to stock my cart and my hall (second shift left nothing and linen everywhere) so i cleaned it up and stocked then i had to do the other hall because no one would do it and i was not leaving it that way for first shift.
  8. by   Kimburly
    I used to be the evening supervisor at a 150 bed LTC. We had 3 floors of 50 pts each, but one of the floors was broken into 2 units of 25 each, half of the floor was a behavioral closed unit. The floor with the most dependent pts had 6 aides on evenings and I believe 5 on nights. The floor with the most independent people had 3 on evenings and 2 on nights. If my aide staff was short I would pitch in and do HS care. I wasn't as fast as the aides but even getting a few pts done helped them out. Also iif one aide was done earlier they were expected to help the others. And on nights they would send an aide from one floor that was done faster to another to help. Good aide work requires teamwork.
    You should talk to your charge nurse, then your supervisor, then your director if you feel the practice is unsafe (which it sounds like it is). Lifting by yourself can be harmful to you AND to your pt. You can harm their joints, cause skin tears or drop them. And yes a great focus is on BMs in LTC. Many elderly get constipated and sometimes the consequences are deadly.
    If you can't get this resolved then look for other work. You may end your nursing career before it ever really starts if you hurt yourself.
    Good Luck.
  9. by   rebel_red
    Hi GAstudent.

    We are spoiled in our facility. Each hall holds 18 residents. 1 aide per hallway on nocs. Fresh linen carts for each shift. (Though we frequently raid 3-11 carts for extra washcloths, pads and blankets.) Oftimes we have 2 aides per hallway. Right now our census is changing. I currently have 11 residents to care for during my shift. Sometimes we will be one aide "short" so I have 15 patients....still a walk in the park. We also give bed baths and dress a specific amount of residents in the morning. We are also very good about helping each other turning heavier residents and giving an extra hand with those who can be combative.

    I hear your frustrations. I get so annoyed with my coworkers when they complain about our staffing. I think I have died and gone to heaven. I would prolly drop dead if I had to do 3 rounds on 50 residents.

    Anyhow what I am trying to express, rather poorly.....Is it was the same for me when I started. At first no one was willing to help. They made fun of me for being "slow" and "persnickity". My supervisor was really supportive. She told me it was fine to start early, to take my time and that she was the same way as a cna. It has gotten much better over the 8 months. When my coworkers realized I was serious and this wasn't some student lark they lightened up. There were a few blowouts at the desk with the staff bully. And quite a bit of me nailbiting because my coworkers would sleep.....(our house sup has since put an end to that.)

    So I hear what you are saying. I hope it gets better for you. And anytime you want to vent feel free to! Personally I would quail at being responsible for so many folks. Sounds to me though like you are willing to stick it out. Wish I had some great advice for you! All I can say is I am willing to listen and lend my support.

    Take care of yourself
    Tres
  10. by   seewhiterabbit
    Just remember that your hard work and effort will pay off! It is great that you came up with your own way of trying to keep track of the BM, and it is horrible and childish that the other aides and Rn's made fun of you for that. That kind of behavior on their part is just ridiculous. Try really hard not to get down in the dumps, and don't get bitter. Just keep doing your best like you have and take pride in what a wonderful nurse you are!
  11. by   FutureRNMichael
    I work in Assisted Living which is much more lax than a nursing home but nonetheless...

    I am working through dealing with some jealous co workers as well.. Really irks me. Most of them are upset because I plan on going to school an being a RN. Meanwhile, they have all been working at the same place with poor pay for 4-5 years doing exactly what I am doing after a month and with much less passion.

    They get really pissy if I dont answer their call lights when each person is assigned a section, in their own section while they just sit and chat it up.

    Im still young(18) and have not really learned to deal with this type of people very well but I feel like it should turn out OK.

    I cannot wait to get CNA cert. so I can go work in a hospital with real proffesionals. Certaintly couldn't be more unproffesional than some I work with.

    The worst part is, it makes it somewhat diffcult dealing with them instead of focusing 100% on my work. It is hard to understand why some people are like this!?! Why can't they focus on themselves and their work??
  12. by   GAstudent
    futurernmichael..i am in the same boat..since i am in school for my rn they are all pissy and some say they are going to go back. i love my work but hate the co workers. i wish i also worked with more professional people who worked and not talked about everyone else..
  13. by   CoffeeRTC
    Okay. 50 residents sounds like too many...Is this staffing ratio legal in your state? We have 48 res with 2 CNAs and one RN on 11-7s. I've been in your place befor..... A nursing student and an aid.. no one would help or teach me anything..my back hurt soooo bad.... Keep up the good work, accurate records on BMs are sooooo important! Who wants an enema when the really don't need one? Just remember if it wasn't documented it wasn't done and NEVER falsify documentation....
  14. by   LauraF, RN
    The facility I left had 90 residents for 3 aides on the night shift. The medicare residents had their own aide(about 20) and the other aides were to cover the rest of the building. Usually there were two aides over by the medicare area which was adjacent to the regular pay residents. Then the other aide had about 40 on two halls herself. What generally happened when it was time for rounds the LPN would help the single aide on those to halls, and the other two would work the other two halls. If the two aides got done before the aide and the LPN they would come help. Everyone luckly worked together.

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