Am I asking for too much - page 4
Before I start I want to make it known that I hate conflict, I hate being a bug. And I know that the Nurses and CNA's that work in LTC do not have it easy, and I know many of you are under staffed... Read More
Aug 9, '12 by IamBSN[FONT=arial, sans-serif]I've worked in LTC for the last 3 yrs. I've worked the rehab, long term care, and memory care units. I'm assuming your MIL came from a hospital setting to the facility you are referring to. In that setting, the patient to nurse ratio is about 1:3-6. I'm in a small facility and our ratio is 1:26. The CNA to resident ratio is 2:26. You said the spilled juice incident happened with service of the lunch tray. Generally, the rehab residents in our facility do not join the rest of the residents in the DR, but choose to eat in their rooms. This choice is generally made either due to mobility issues or because they find it distasteful to eat among residents who miss their mouths, can't speak in the normal fashion, have some abnormality that is not pleasant to the eye, etc. Its their choice, and we strive to honor their wishes. However, 1 of the 2 CNAs on the rehab unit is required to go to the DR to pass trays/feed. Its necessary for them to go because regardless of how distasteful the situation may be to the observer, those residents deserve to eat warm food just like the ones on the rehab unit, and their situation is permanent and steadily declining, Our goal is to make their final days as pleasant as possible. Generally, the residents on the rehab unit are capable of feeding themselves, generally have all their faculties, and can voice their wants/needs. The purpose of their stay is to rehab to home. I understand they are there for help/therapy until they can get there, but the purpose is for them to learn to do for themselves again. Its not The Hilton and although the CNAs are frequently treated like personal servants, they are not. During meal times, as I said, the ratio drops. However, the work load increases. Not only are they passing trays and assisting residents with meal time activities, they also perform a lot of other duties. Just because its meal time doesn't mean they don't have to assist with toileting, transfers, pulling people up in bed, logging meal consumptions, etc for those left on the unit. Additionally, the residents who do go to the DR are being returned to the unit and need put back to bed, toileted, cleaned up, etc. Every one keeps mentioning inadequate staffing issues, but did you stop to think how much your MILs stay would cost if there was "adequate staffing"? I'm sure she was covered by either Medicare/Medicaid/private insurance, but if this cost had to be supplemented out of pocket with what you might consider to be adequate staffing, your MIL probably would have been rehabing at home because only the very wealthy could afford the care. Honestly, I'm sure it was simply an oversight on the part of the CNA, but its also a matter of time management and sometimes, spilled juice just isn't the top of your list of priorities. Safety issues always come first, but that usually means protecting someone from a fall that would result in further injury and a longer stay, etc. As for the room conditions, I'm sure the facility was doing all they could to remedy the situation. I don't know where you are, but I'm in the midwest and we have had record heat/drought conditions most of the summer. Our AC just couldn't keep up with the demands placed on it. We were providing fans, placing wash basins full of ice behind the fans, etc to keep our residents comfortable. The conditions were never below the state's regulations, but we went over and above what the state requires. Try to cut the staff a break, and I sincerely hope the situation has improved for your MIL, but please keep this is mind while forming your opinions of the facility. Remind your MIL to use her call light for future situations and if you can, time your visits so you can be available to assist during meal times as these are by far the most hectic times for all concerned. Patience and respect for the caregivers will really go a long way to improve the situation.
Aug 11, '12 by mvm2, CNAWow I did not even know people were commenting on this yet. Wow people must still be under the impression that we chewed the facilities butt about all this. But we did no such thing. All we did was observe. just a little update. My mil has been there for a month now and we are moving her home on Tue. Everything went well for the most part untill she got an infection a week ago and the doctor at the facility ordered a med that she was allergic too. the nurses and the doctor did not notice it in her chart. (Which it was there.) There was an entire sheet of all her meds and allergies. it was the pharmacy that caught the mistake, so thankfully she did not get it, but my FIL was not pleased to know they did not double check that, and that she could have been given it. Again we are only concerened family members wanting to make sure our mother is taken care of
Aug 12, '12 by JZ_RNUsually nurses check before an antibiotic is given, I know I do. And I've had pharmacies call about orders another nurse put in for antibiotics, while I was not aware of a cross-allergy to that med from a different allergy the patient had, however, if it's the first time anything is given, I always cross-check any allergies and my meds. Any good nurse does. She didn't get the med, there was no problem. I'd like to see you try to keep up with all the meds of all those patients and all their allergies, smarty-pants.
Aug 12, '12 by Spidey's mom, ADN, BSN, RN GuideI'm surprised by the negativity towards the OP.
I like the advice about quietly talking to the CNA when you cleaned your mom-in-law up. When our family members are inpatients it can be hard to sit back and watch them be treated disrespectfully.
I don't think you've done anything wrong here. I hope it works out for you all taking mom-in-law home.
Aug 12, '12 by Silverdragon102, RN Admintime out guys,
OP came for support however we can't always comment on individual homes or facilities. I know how things are in LTC as I work LTC although in Canada and yes we are not there to serve and we are not there to cater for demanding clients and families but we all know it happens and people have high expectations. This doesn't mean we can throw around comments which are demeaning to client and family.
Closing this thread for a time out