Pennsylvania Laws

[JBarger LPN]

I have a question on the law of most Pennsylvania nursing homes. The question is, Is their a law where their is a certain time frame as of the earliest you can start getting residents out of bed? I had heard that it is at 6 am. I don't really have a certain answer on that.We are in a heated debate between the 11-7 shift and the 7-3 shift. The 7-3 shift thinks we should get 2 residents up before we go home( 2 of their choosing) now this is a thirty bed floor and they only have to get 17 out of the thirty up. Now the 11-7 shift is composed of one CNA and one LPN who does rounds with the CNA. The 7-3 shift is composed of three CNA and an LPN. The LPN doesn't do primary care but the 11-7 shift does do two showers a night which then means that the 7-3 staff only has to do 15 residents. Now if my math is correct that is five to a CNA to get up. Now The arguement the 11-7 staff is complaining about is that to do the showers we would have to get the other residents up at between 5 and 5:30 in the am. In which from then until after breakfast they will not be toileted or be able to eat or drink anything because the kitchen has locked all the food behind a cage for the shift. Also The residents have not changed or the staff has not changed in over 6 months. If they did it fine 6 months ago then why is it a problem now. The only idea I can come up with is because the 11-7 staff on the upstairs of 50 beds has to get 12 people up. Their difference to us is they have 44 residents that need assistance to our twenty. They also have 2 CNAs and 1 LPN on the floor. If anyone can give me some more reasons for defending this problem please let me know.

John

[ktwlpn, LPN]

"Is their a law where their is a certain time frame as of the earliest you can start getting residents out of bed? I had heard that it is at 6 am"........................ I am not sure if it is a law but I have seen this become a problem in several facilities...Unless these residents are getting back to bed for a nap in the afternoon it is inhumane to get them up so early and have them sitting up until 7 or 8 pm...It looks like you have great pt. to -cna ratio-in my facility I have 2 cna's to 22 Alzheimer's residents and 5 to 60 on another floor(varied acuity but many a&o completely dependent folks)That is for day shift-on evenings that floor often has 4 cna's to get everyone to bed...Our shifts run from 6 am to 2 pm...I think that is too early...We do have acess to a pantry on my unit-I pass my meds along with coffee,juice,toast and cereal.The hot platters come much later because the dietary staff does not work the same hours as nursing...Anyway-I would fight the early riser idea tooth and nail-if you agree to get 2 up it will soon be 3 then 4...One call to the state by a pt or family member will put the kibosh on that plan...I have a problem on my unit now-my staff on evenings will start getting our residents ready for bed at 2:30 in the afternoon-I think that is a violation of their rights(they are walking around in their night clothes while visitors are coming in)-but they don't like to leave anyone up for nights-whom complain bitterly if everyone is not in bed when they come on....No way is everyone going to be happy-but the resident's comfort is the main focus-and that sometimes is disregarded....

[ June 13, 2001: Message edited by: ktwlpn ]

[Tim-GNP]

Sub-section 483.10 in the Federal Register [the section that deals with nursing home laws] makes provisions for resident's rights. If the resident wants to get up at 2 a.m. , the facility must honor the resident's request.

Here in the 'common-filth' of Pennsylvania; the DOH surveyors make sure that these preferences are listed in the plan of care, and that nursing assures that resident's requests are honored.

There was actually a deficiency sited at a nursing home that failed to identify this preference in a few residents, and were given a citation for it. Click this link, and it should [fingers crossed] take you to the description of the incident...

http://www.health.state.pa.us/facility/ltc-survey.asp?FACID=201302&PAGE=2&NAME=TAYLOR%20NSG#MID