CNA assignments in LTC?

The nurse working the hall decides which CNA has which residents.

On my alzheimers unit there are basically two halls. one cna gets the front hall while the other gets the back hall. on the other halls outside my unit the nurse assigns the aids to each section of their hall like one to the front section, one to the middle, and one to the back section.

on my unit my 2 full time cna's get the same residents. if someone who does not usually work back there comes to work they may or may not get the same residents. it depends on which one of my full time cna's are working that day. they get first choice basically.

if we are short staffed an aide can volunteer to be switched but only if they have enough people on their hall. ultimately it is up to the supervisor. Floaters do not get extra pay. If you are assigned to float then you have to float.

yes, each cna has a soiled linen and trash barrel.

We have Senior CNA's that make out the assignments, the assignments are not always by room #'s but by the acuety of the resident. Most of the units rotate assignments although some prefer to keep the same one. And yes we do have to float to other units, usualy we ask if anyone wants to volunteer and if not we have a float list and everyone has to float except the Senior CNA's.

Our particular nursing station has about 75 residents worked by 6 CNAs (if they all show up). At the beginning of the shift they see the one of the charge nurses for their daily assignment, which is already prepared on a xeroxed piece of paper.

I worked as an aide and I like the way this particular LTC functioned. The assignments starts with the daily schedule posted. Under the wing was the nurse, than the CNA's by numbers. Each of those numbers represents a list at the wing, and the schedule breaks, and other assignments like call light duty during meal time.

Let me give you an example of this 3-11 schedule.

1st floor would consist of two units, 64 residents (32 to one unit), 2 nurses and 6 aides. On the daily schedule we would have Wing one: #1...CNA....#2..........#3......... wing two:#4......#5......#6..........

So when they clock in they would see what # their name is on which represents the list assignment.

First break # 1 and #4 , 15 minutes later # 2 and #5 go on break, 15 minutes later # 3 and # 6 go on break. by the time it's #3 and #6 it's already a 30 minute break they should be relieved by #1 and #4.

Looking at the list assignments, we may have 2 rooms and both resident assigned. The reason we have the rest in different rooms is because it's better to have two different aides go into the room verses one it gives a second set of eyes to a neat room.

So, when we're short staff 1 CNA, it would be 2 and 2, and a float (5 CNA's)
Two of the strongest CNA that can connect and work as a team work together. We have a float list which consist of 5 residents from one side (wing 1) and 5 residents on wing 2 (same floor) We ususally give the resident who are considered more needy or time consumers to the float list. Sounds like a horrible list but it's not because you have to think about the other two who have about 27 residents to worry about. By giving the float list the time consuming resident enables the two other staff members to focus on the unit and the remaining residents.

If we're short staff with two call outs which leaves 4 CNA's to 64 residents which does happen....we staff 2 and 2, again the two CNA's that can work together. And there is no list they decide amongst themselve who they do, it works provided with encouragement that they work as a team. And if they're knowned as individuals who don't work together then it's one CNA per hallway which is 16 residents.

As for who creates these assignments, we create them by room #'s and bed(a or b). Empty bed? lucky for that aide, new admission it's already on the list. We're able to do it like that because the census is always full with a waiting list. But one thing about working short is that nobody is allowed to sit and chart until ALL CNA's are done providing HS care because everybody's list is different, one may have an easier and the other may have it hard. If for whatever reason a list becomes difficult or overwhelming, then adjustment is made by the charge nurse with the CNA's input because only they know by heart of what is reasonable, just like a nurse would know what unit is difficult to work as a nurse....

My recent job as a nursing supervisor, I tried to add this but it couldn't be done, staff CNA's were under paid, so we were under staff to begin with. Agency Staffing hired on a daily basis, census was never full. It was constant adjustments.

As for rotating staff members, we usually keep our full time employee's on a certain list but probably once a week or maybe even twice we rotate the list, and for the most part keep them in a certain unit.

A CNA makes out the assignments because the nurses don't usually care, and we rotate assignments, so it's not usually an issue.

If another floor is short, yes someone floats. There's a float list. If you refuse to float, you clock out. We staff according to resident needs and not staff preference. We work for the facility, not the unit.

We have trash and laundry carts down the hall in the CNA station. So we get to cart them all down there.

We've got really good teamwork, so if one person's assignment is particularly difficult, the others just help out. It's the standard, and is expected.