NM nurse to be 3,905 Views
Joined: Sep 22, '08;
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I think explaining to him you're a student might not be a help. In his mind, he's independent and if he thinks they sent someone to 'practice on him', that might make things worse.
I use a lot of the techniques the other posters have written about. One that I've had a lot of success with is to join them in their world, wherever that might be.
I had one guy who would NOT go to sleep, in his mind he was working and there was trouble with the train. So I figured out I could tell him the bell rang, shift is over. He gave me enough detail I could fudge knowing about his job. If he thought everyone was ok and safe, then he could relax.
One other night, this same guy was SURE he was fishing and had fallen out of the boat. And they were going to leave him like that. He was going on and on about his wet clothes. Turns out his brief was indeed wet. So I changed him, talking about how now he had dry clothes and look the dock shops were closed, it must be quitting time. Now you're dry and clean and we can do the rest tomorrow. And you know what, he agreed and calmed right down
Joining them in their world has helped me a lot with agitated, confused residents. I do watch to make sure they aren't agitated and going to slug me, then I wait them out a bit or for the drug to kick in and go back. But most times, you can calm them down if you play along.
Ya'll are making the math way harder than you need to But yes, 53 right is passing.
I've seen a few of those. I let my nurse know first. And I also have no problem telling him his behavior is not appropriate. If it is a new behavior for him, like Coffeemate says, your nurse might want to investigate a new illness or psych issue.
Also something that I've experienced this week... have any of his meds changed recently? I ask that because unknown to me, a lady I'm familiar with seemed to me to go completely off her rocker last week. She is one I don't work with often (on a different hall), so I didn't know her psych meds had been changed. With very dramatic and from what I saw, not very good results. Might this be a problem with your guy?
Psych or med issues aside, most folks who are fairly with it still understand acceptable behavior. And if it's allowed (or hopefull isn't being encouraged), he may just get carried away. I have on many occassions, told someone their behavior was out of line and they were aware enough to correct themselves.
You guys have enough bed pads to use a CLEAN one to roll up the dirty linen? I wish I could be that extravagant I have 30 people (probably 25 or so incontinent) at night and I'm lucky if we get 5-6 pads each from the last laundry run. You get REAL good at knowing who the heavy wetters are so you can change them before you have to change the bed. Sometimes this means every hour for those folks but it's more of a pain to change the bed 3 times.
I will admit that briefs, pads if that's dirty too, do go on the floor at times. With the dirty side, wipes all rolled up inside. If you do it right, when you roll the whole thing together, you can use the off-side tape ends to hold the dirty one in a bundle. No mess, no fuss. If we have can liners (which is rarely these days), the bundles go in that before the barrel. But if you've wrapped it all in a neat ball, there really isn't much smell anyway.
At night I start at one end of the hall and take both my cans with me from room to room. I can hang a bag for collecting water pitchers on the dirty linen cart and not make a separate trip for those. What I've done a few times is get one of the bigger wheelchairs and put a towel down and load it up with all my 'extras' for the night... gowns, pads (if there are any), bottom sheets, washcloths for get ups, a package of wipes and a periwash bottle. Then I drag that chair with me down the halls and don't have to run for stuff all the time.
So do you all notice this??? It always seem that when I find someone with a big messy BM, there are NO wipes or spray anywhere in that room?! And to go running to the storage room risks a bigger mess because that resident will now paint with the mess, now that they know it's there. So I keep a full package on my cart ALL the time. I don't know how many times that's saved me a bed change!
I think you just rewrote my first ever post here I went home crying every day for a few weeks. But I stuck it out and now almost two years later, I am a good aide. It was definitely worth doing. I'm also in a nursing program (finished my first term today actually) and I can tell you, it was such an advantage to do this job! If I had to learn basic patient care AND nursing skills together, it would have been much harder. I hope you get through this while ok. Ask for more orientation, there's nothing wrong with that at all! If you need an ear, I'm only a PM away
At my hospital, fortunately before I worked there, they once had a bariatric woman who was 500+ pounds. She was extremely needy and yet abusive at the same time. When they rolled her, she deliberately pushed back against them. Several staff suffered career-ending back injuries thanks to her. EMTs from the ambulance service often had to come up and assist with turning and repositioning. She was continent of bowel and bladder, but deliberately went in the bed. One minute she would be swearing and hitting, and the next she would be sobbing and begging the CNAs to stay with her.
See there's a reason that the only words of Spanish I know are the really bad ones I had one 100 year old lady who didn't talk at all. Except to swear at whoever or whatever (sometimes the artwork) for anything. She was the one that I learned the safety (mine) maneuver of flipping her gown up over her arms when she needed changing. It's not a restraint, it lasts only the time it takes to change her, which is considerably less when you are not ducking and everyone is safer. Doesn't do much for the vocabulary lesson though
The flipped up gown has saved me bruises many a time. What really isn't fun is the ones you don't know are kickers who suprise you with a rockette move!
I will add alert stroke patients who can not speak. They know exactly what they are doing and why and have been some of the meanest I've had to deal with. And honestly I can't say that I blame them but we've have a few that go above and beyond general frustration. One would roll up behind others in the dining room and pinch the h#ll out of them for no reason! She beat up a nursing student right before she was asked to leave. We didn't know she could transfer herself until she got a CNA cornered in her room and wouldn't let her out. Granted the aide wasn't bright enough to block her with the bathroom door and just go out that way, but still, that resident was a trip!
sorry, was having trouble posting and put this up to test. It was giving me a wierd admin error message but it's working now. Never mind
You will pick up most of your skills after school. You will get the basics and how to do things safely in class. As you've seen, what they teach in school and what is in the real world often differ greatly. But not always in bad ways.
I haven't worked in a hospital but I can tell you there are rewarding parts of LTC, even while the admin does its level best to make it hard for us. The thing I like about long term as opposed to the rehab section is getting to make a relationship with my residents. You get attached to them and know how they like things. I find that the ones no one gets along with tend to be my favorites somehow. The pay isn't the best but if you intend to use this as a career step in the medical field, the experience can't be beat. You will see good aides and not so good, same for nurses. I look at it as how to's and how NOT to's
You will learn things like how to change someone or the basics of dressing and transfers. But you won't get competent at those until you do it day in and day out for awhile. It's totally different the first time you have to dress a stroke patient, as opposed to an able bodied classmate playing 'stroke'. If you get good at picking out the good aides and making friends with them, life will be easier. As you've seen here, there does seem to be a universal hazing thing with new aides. I've talked about this at work and the consensus seems to be that so many come and go and don't bother to work when they're there. Once you pass muster, so to speak, and people know you're serious about staying on, not just floating by, life will get easier for you. It won't be easy to start with and you will go home hating it, I can almost promise you that. BUT I can also say it doesn't stay that way. If you can get through the learning process on the job, you'll be fine
Good luck in your class!
Fran, you sound EXACTLY like me Right down to the shy. When I started this, it was a total act on my part to get through my day while I learned the PT skills I needed. Now I get compliments on being friendly and having a nice way with PTs I don't go for much socializing/goofing off. I'm much better now but when I started, I was SOOOO slow. I knew it and know it frustrated some of the other staff. But it was a learning process. I've seen staff fired for many reasons, slow is not one of them.
Yes you don't want to be so meticulous that you don't get anything else done but speed will come with time. For now, do the best you can, ask questions as you need to. And don't be afraid to take time and do it right You'll get there. Good luck!
Ouch, sorry to hear that! This is another one of those situations where policy/class and the real world don't quite coincide with each other. Policy at my facility is that NO one is left alone in the toilet. That's the stated policy and if there is an incident, you are at fault.
What happens in reality is that you have to use your judgement. On the skilled hall at night, it's me vs 30 residents. Many of whom are continent (mostly) and mobile enough to get there with help. This is where the dilema comes in. WIth that many, they often want to go at the same time. And there are always those who get tired of waiting and just take themselves. If you stay with every one of them, start to finish, you won't get them all. Some will fall because they tried on their own, you won't get any of the incontinent residents changed, you will spend your night watching people pee. That's the stated policy.
What really happens is you have to use your judgement. With a new resident, I always go and stay either with them or just outside the door, the first time I take them. Once you know them a little bit, you have an idea of what they are like. If it's one I have to stay close to, I plan it so I can do a brief change of a neighboring room (they share a bathroom) or get out someone's clothes for morning. Reality is you WON"T be able to stay with every single bathroom trip.
Management knows this but turn a blind eye *UNLESS* something happens, then it is your fault. This seems to be an unfortunate reality of the job. During the day, you won't have as many residents but it can still get crazy if they all toilet. So you have to learn your residents (I know you are in clinicals, this is a skill you will acquire ) and know who you can trust to wait for you to come back.
Good luck with clinicals. You will be a pro in no time
NM CNA, reading through your posts tonight, I have to wonder why you do this job. Your posts are pretty negative for the most part. Maybe you're just burned out? Not all places are bad. Maybe you have found one that is and lord knows where I am is not perfect by far but I would be working at McDonalds for the same money if I disliked this so much.
Right, CT! The admin was even in the dining room at the feeder tables! I didn't even think he knew where it was. Fortunately I'm on nights and all I heard were tales but damn, who knew the admin crew even knew how to pass trays!
I'm discussing hours with my job right now. I tried to do full time work and school. I thought I'd be one of the exceptions that can make that work. But I can't. I tried from January til now and I'm not doing nearly as well as I want in class. I'm passing but that's not enough of a margin for me. I'm also used to doing very well but I'd be happy with a solid B, not lowish C range. And I feel really bad when people at work compare me to those who have families etc, work AND school. But it's not the same. For me, I can't do it. I don't have back up support, it's just me and if I crash, that's huge for me. I know everyone has their own road and I really thought I could do it. Admitting I can't now is admitting defeat, to some extent and I'm not happy about that
I may have just quit my job just now but I can't tell yet. I told them I can do Sat/Sun 6p-6a starting now but she wanted two weeks from now. I know it's late notice and I do apologize for that but in the next two weeks, some REALLY important stuff happens. She said no, you have to do weekdays (I'm sat-tues graveyard now) and my reply was then I will have to quit.
So there's my line in the sand. We'll see how it turns out.
Common where I am too. I didn't see this one but a nurse got taken down by the admin, in front of everyone a few weeks ago. And he pulled all the staff to the nurses station (CNAs, nurses, probably housekeeping) and pointed out "THAT nurse!" you all make sure THAT NURSE is doing her job! Yeah, big time professionality here too.
Good luck in your search, Kohala! I went PRN yesterday too. But for school reasons. I'm not looking entirely yet but may if the 2 days a week is not tolerable. Trouble is I'm really fond of some of my residents and it's hard to leave them. I didn't expect that to be an issue.
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