Silver_Rik, CNA 697 Views
Joined May 8, '17.
Silver_Rik is a Mental Health Aide, SRNA.
He has '1' year(s) of experience.
Posts: 32 (38% Liked)
A couple of stories from the other side. A coworker claimed she remembered my dad from the nursing home where she used to work. He had been a resident there for only three days three years previously, before being admitted to the hospital and then hospice.
Another time someone came into my office to rent apartment from me when I worked in property management. We started talking and it turned out she was one of the nurses at the facility where i'd had a colonoscopy.
A few weeks ago the patient I was taking care of for MedSurg clinical started asking questions about the psych hospital. We are part of the same network, and send patients there for medical treatment. I wondered if he had been one of our patients, because I couldn't figure out why he was asking me of all people. It turned out they were looking at transferring him to the traumatic brain injury long-term care unit at my work. Just out of the blue coincidence that he picked me to ask about the place.
I work in a psychiatric hospital. We have strict policy about outside interactions with former patients. We are not supposed to initiate any interaction or acknowledgement if we run across a former patient in public.
Now I'm the one taking my time to respond. Just really busy here with school etc.
- You have a cap of 3 PNA per unit with 20 max census. How do you handle 1:1's or 2:1's if you have them?
Now to your questions
1. There is no MHA (PNA) handoff at shift change. When the PNA doing Q15/Q30 checks is ready to hand off that responsibility they are supposed to physically transfer the check sheets - not just leave them at the nurses' station - and might give some updates on specific patients' whereabouts and behavior, but generally no.
2. We have MHA (PNA) leads but it's a supervisory (not sure if they have official supervisory authority) and support position with one per shift for the whole hospital. They split time between the shift coordinator's office and the units. They also respond to psych codes.
3. A PNA handoff with report at shift change sounds great; but you need one shift of PNAs out on the floor. You can't have your entire floor staff in the meeting room.
Does it make any sense to ask / offer to come back and work for them as a CRNA after you graduate?
Or, I know CRNA programs prohibit or strongly discourage working, but is it at all feasible to put in your last two months working over breaks?
I wouldn't think so at all. I loved the 'softball team' part. She didn't mention any names. I loved the video. I found her refreshing and real, not sarcastic. She's probably saved lives already and will continue to do so with her 'viral' video. Kudos to "Viral Nurse Katherine"!
Wonder if she's on AN?
It's like this "everywhere" not just healthcare. It's called salary compression, new people get hired in at more than you're making and compensation policies and manager bonus structures restrict how much increase existing employees can get.
My wife works in IT. She's a team lead with 11 years experience in her specify specialty and 6 at her current employer. New people with less experience who are always coming to her for help with their code are being hired in at $20K more than her. She could probably get that or more by going elsewhere; but likes the environment at her current work.
MHA (Mental Health Assistant, i.e. PNA) and SRNA (only required at my facility to work with geriatric and acquired brain injury pts, but it was a requirement for nursing school) at a state inpatient facility, adult 18+ only. Our typical shifts are 12's 7-7:30 (30 min lunch), though there are some 4's, 8's, and 16's. I've been on nights and just switched to days. I'm also an ADN student. Per unit census is up to 28 pts. Unit staffing on nights is typically 1-2 RNs, 1 LPN, 2-8+ MHAs (this depends on pt census, acuity, number of "closes" - i.e. LOS, 1:1, 2:1 - that to be covered.
7 PM we attend handoff report with the nurses. On most units they try to keep us engaged by passing out patient summaries so we can follow along, but some don't and kind of ignore us. Then we get our assignments for 7:30-11:30 - usually in 1 or 2 hour blocks. Assignments typically include: 15 min checks, taking vitals, charting vitals, close observations (1:1, 2:1, line of sight), passing snack, supervising visitation, transferring patients in from admissions, floor duty (cleaning, laundry, etc.), assisting with ADLs. There are some group activities on night shift but limited. Day shift of course has to take pts to group activities (therapy, occupational, music, computer lab, gym, library, etc.) As a male, I often sit 1:1 or 2:1 on high risk male pts for most of my shift plus maybe an hour or two of 15 min checks, taking vitals, preparing paperwork. As PRN/float without a home unit I probably dislike being assigned 15 min checks at the start of shift more than anything because I don't know the new patients. Similar situation with snack, since you need to know their dietary restrictions - especially fluids (volume limits and thickeners) and consistency.
At 11:30 we get our assignments for the rest of the shift 11:30-7:30. The assignment sheet is the primary form of structured communication. Usually the med nurse and another if we have enough nursing staff are in the med room to handle 8 PM med pass and follow-up, charge nurse is working in the conference room, and if we have another nurse they are in the conference room or chart room. They come out on the floor as needed to perform assessments, med administration, and other licensed tasks, plus help us - though how much they assist the aides depends on the nurse, unit, and staffing. If they need our help of course they tell us what they need - for example additional vital signs for medication admin.
I'm not sure if this helps you at all. Feel free to ask more specific questions, and I'll try to answer.
My grandmother worked during the War in a parachute factory. I've visited the location, it's an art gallery now. Airborne soldiers and air crews literally put their lives in her hands. Later in life, in the 1960's, she became an LPN and worked for over 20 years at the predecessor location to the same state mental health facility where I work now. She retired from nursing in the 80's and passed away just days after 9-11-2001
Between acceptance and starting the program.
I need to look at my program handbook to confirm; but I don't think we get tested again except for cause.
As a 50 year old nursing student and CNA with silver hair, in scrubs and maybe wearing a lab coat? All the time
Take a look at this article
Nurses stretched to 'breaking point' over pay, finds RCN survey | News | Nursing Times
We are not paid enough is my beef here, ma'am's and sir's.
My facility offers 4, 8, 12, and 16 hour shifts. I work mostly 12's with an 8 or 4 thrown in sometimes - usually if I'm covering for someone or have plans earlier in the evening and just work an 11-7.
The main shift changes are at 7 AM and 7 PM and I agree with something cited in another reply that it's probably less stressful on the pts to have most of the staff changeover only 2x a day.
Is it appropriate to ask feedback from the nurse who takes over on the patient? I think it's very likely that the patient will volunteer their reason(s) for wanting the change in communicating with the new nurse. If not the new nurse, they may vent to the UAPs (CNAs)
I agree with what others have said, it may just be that you are new. Your minimal communication style may enhance their sense of lack of experience and confidence. I get mistaken for an MD (50, silver hair) but if I hesitate or do a step out of order on a patient care procedure some patients can be merciless - and I'm dealing with patients who tend to not have much filter (psychiatric). Yours may be more discreet in expressing their concerns.
As far as being more open with your patients, you can show more empathy without prying.
I'm a Mental Health Aide at a state psych hospital, and a nursing (ADN) student. Several members of my family (biological and married/step) have or had mental diagnoses: major depression with suicidal ideation, bi-polar disorder, anxiety disorder, sleep disorders (symptom of the other issues?), and several ADD and/or Autism Spectrum. I have an adult step-daughter who may never be able to fully function in society or hold employment (Autistic, severe anxiety.)
I leave all that at home when I come to work. Other than mentioning that my dad (deceased) was bi-polar when I interviewed, and once having to take a call in the middle of shift report because a teen child was threatening harm, I've never discussed any of it with workmates. I think the fact that my patients may have the same diagnoses and associated struggles as members of my family helps me be more empathetic; but in a way dealing with it at work is almost like a break from dealing with it at home because there's not the emotional involvement.
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