Latest Likes For MedChica

Latest Likes For MedChica

MedChica, CNA, LPN 8,698 Views

Joined May 18, '10 - from 'Tampa'. MedChica is a I float everywhere.. She has '3.5' year(s) of experience and specializes in 'Psych, LTC/SNF, Rehab, Corrections'. Posts: 578 (52% Liked) Likes: 1,020

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  • Jul 1

    I don't see how you'd be doing this alone. You're not in that facility all by yourself.
    When the facility alarms go off, everyone (CNA, Nurse, Housekeeping, Maintenance, etc...)should be making a beeline for the exits to recapture the pt.
    Yes, running. You can't work psych in cute Koi clogs, I'm sorry.

    Someone should already be on the phone with the A/DON. Yes, you must FOLLOW the pt and coerce them back. Call the daughter on your cell if that helps. If not, call the police and state the cause. Get a cop out there. You cannot lose your pt.
    We've pulled residents off city buses. It can be done.
    Is the neighborhood attentive? If you've got watchful homeowners nearby, they WILL alert you to a resident trying to escape.

    Your pt doesn't seem all that aggressive. How exactly are you 'distracting' the pt? Why not give them something to do?
    Reality orientation doesn't work when someone's mind is completely broken. It could actually create aggression.
    Sometimes, you've gotta run with the delusions. I don't mind talking to residents for hours on end. Psych pts are funny. Characters. They're hilarious. I let them follow me around, too. It doesn't bother me. I'd rather them follow me around, a bug in my ear, than trying to break out. The discussion will be weird but fun.
    "How do I get to giant eagle?"
    I'd say something like, "I dunno. What's a giant eagle?"

    Interesting dialogue will be had. If it's a destination (like, where they used to live before coming there. Home), lead the convo off on a tangent.

    -- "How do I get out of here?"
    Give them direction. Just don't provide the right ones. I just keep sending them to dead ends. They'll just walk to the other end, get distracted, come back around 30 minutes later and ask again. Good exercise.

    Do they have friends in the facility? Sometimes, I put two talkative pts together and let them yack the other's ear off. If you eavesdrop, the discussion will be utter gibberish but they like it. Everyone needs to socialize.

    -- "I'm trying to get home."
    "Where do you live?" Then, redirect the discussion to something more interesting.
    "Why?"
    "It's dark outside/too much traffic, papa. Stay here with us until the traffic thins out/tonight and you can leave tomorrow."

    I used to have a resident who wandered (sundown) and tried to elope every other day. He either had to pick up a car or go to work or was looking for an item for work or was waiting on a vehicle to pick him, etc...
    -- "Papa, the car is in the shop. It won't be ready until tomorrow. Just wait here with us."
    -- "Papa, you don't work today. It's --" ...nighttime/Saturday/Sunday/the weekend/the holiday, etc... " You're off. Why do you want to work on ____? You should be resting. I wish I was off. "
    -- "Papa, it's night time. Why do you want to be running around at night - it's dangerous? Let's wait to leave until tomorrow when you can see? They'll pick you up tomorrow.
    -- "Well, you should eat before you leave. You're gonna get hungry. C'mon - they're making --"
    -- "...you can wait here for the night. We have a room for you with a tv in it and everything else. You don't have to pay for it or anything. Stay with us and leave tomorrow."

    It's okay to phrase statements in an asking tone but you don't redirect a pt with questions. That gives them opportunity to shoot down whatever you're offering which shuts the dialogue down. "Is that something you'd like to do?" ; "Are you hungry?"
    Ask questions when you're probing for info. You don't redirect a pt with a question.
    You suggest. You make statements.
    "Let's do --"

    Food helps. I used to settle a pt with pudding every time he made a run for the exit. Talked him down; then, "I have some chocolate pudding...?"

    EDIT:
    I never worked ALF. I was just geripsych. So, pardon my confusion.

  • Jun 15

    - Make sure the cart is stocked BEFORE you start. Rule #1.

    - Make sure you've got mixed thicken liquid. It's a pain in the booty to have to stop and hunt down powder.

    - Make sure you've got ensure and formula on the cart.

    - Disoriented/Sundowning/Dementia pts? Go with the fantasy. Don't get frustrated with exit seekers. Be creative in your redirecting. "Let's wait for breakfast. Then you can go to work after you eat." ; "It's dark outside and everyone's asleep. Let's wait until sunup." ; "We've got a nice room for you over here with a tv in it. All paid for and everything. Let's come this way so I can show you where it is. They'll bring your breakfast to you."

    - I like to manually flush but, in the world of auto-flush buttons, there's no excuse to not have well hydrated PEG pt's.

    - During report, figure out your blood sugars and your crush/whole people. Also, make note of who needs BP/P and O2 Sat.

    - Leapfrogging with the CNA helps create a buffer for the pt who likes to talk about everything under the sun.

    - Get in the habit of using paper towels when you deal with PEGs.

    - Give PRNs with the med pass if you know the pt will request it.

    - When you pop a narc flip the card backwards & return it to its spot. When it's time to review the count, just go to the narcs that are flipped backwards. I never sign as I pop narcs. Slows me down. I pop and flip. When I've finished everything? I open the cart, search for flipped narc cards & refer to my notes to record the times of admin.

    - Keep gloves in your 'clean' pocket.

    - Skin tears happen. Keep some TAO & island/bandaids on the med cart or in your 'dirty' pocket.

    - Temporal thermometers are quicker.

    - Use pulse oximeter for pulse.

    - Keep your wrist cuff and pulse oximeter within reach. Steth, too, but it can stay on the side of the cart if yours has a carrier. At one facility, we're told to record manually. No one does. I certainly won't get on here and lie as if I do.
    Whatever. You're not going to be doing manuals for routine BID/TID vitals unless the numbers are out of range or change of status. Other than that, you'll have to take more scheduled BP/Ps than you will listen for bowel and lung sounds.

    - Recognize a potential situation and head it off:
    a. Skim through the blood sugars. 0630 b/s (recorded at 0400, most likely, and it's a lazy nurse so they don't think to give the pt anything to maintain glucose levels) of 70. It's 0700. Think you should go look over the pt or recheck the blood sugar? B/S of 210 recorded at 2445. 0200 B/S recorded @ 97. S/S begins at 200 so they didn't rec'v much insulin. Think they're dropping to quickly? Think you might want to keep an eye on them? Think a little glucatrol...or OJ or a shake or sandwhich and milk might help?
    b. Alarm going off? Answer it. You can keep a lot of people off the floor that way.
    c. Family member that you've never met comes in & everyone's talking about how they're such a huge pain in the booty. Don't duck and dodge them. Remain cheerful and available. You've gotta make a good first impression or they'll sit and nitpick and create problems for you the entire shift. I've seen it. With "problem" visitors, being proactive always works for me. That family member may not be what others say they are anyway. Could've had a bad day. Could've dealt with rude nurses/aides. You never know. I
    d. Fall risk/wandering/elopement with combative tendencies on 1x1 presently seeking an exit to "go to work" dragging the CNA up all over the facility. Potentially combative pt looking especially volatile this morning with raised voice and pressured speech and all the distracting/redirecting in the world isn't working. As soon as you get on the cart pop those PRNS. Ativan, Geodon, xanax, apap, etc....
    Anyway, behaviors escalate with time. Redirection doesn't always help.
    Medicate "now" and you won't have a situation to contend with "later".
    Medicate "now" and you don't have to scrape them off the floor "later".
    It's about keeping them calm and safe...and uninjured (and out of handcuffs for assaulting staff)...and in their home. Too many incidences and they'll eventually be put out of the facility. If yours is one of the few geripsych places available, where will they end up? Jail, maybe.
    No joke. This happened to a former pt of mine. The facility didn't 'put him out'. His stupid ass daughter took him away from us and put this 63 year old low-impulse control having occassionally psychotic man (who couldn't even watch the news at times because it gave him homicidal ideas. Seriously. He came to me contemplating murder/assault of another because of something happening on tv. Had to talk him down,buy him a soda and pop some ativan.) in an ALF. Well, he set it ablaze one night according to the local news. Now, he's in jail.
    The aides and nurses where I worked were just like, "Well, what the hell was he doing in an ALF in the first place?"
    Of course, he should be taken to task for breaking the law and endangering lives. He just doesn't belong in jail. He's (mentally) ill and, literally, "knows not" what he does, at times.

    - Don't memorize unless you're writing every order.

    This is what I call 'thin line' corner cutting that is typically done in real world:
    - Start medpass earlier. Hit the PEGs and trachs early.
    - Lots of bolus feeds/PEGs and you're running late? Push it. Same goes for combative (MR, disoriented) pt's on PEGs. Push it. Clamp the tube, draw up two syringes of water and push them through. They're fed, medicated, hydrated & the line is patent. Win-Win for the shift. I wouldn't let an Ax0x1 or disoriented and deluded pt lay in filth or refuse to bathe so I won't have them refusing anti-HTNs, ABTs, anti-anxiety and psych meds. If they have a psych dx, you already know that redirecting has it's limits & continuous refusals of important meds only hurts the pt in the longrun.
    - Med noncompliance. They're AXOx2 or manic/schizo/disoriented and getting loopier by the day? Crush up important meds (throw in any ordered sedatives), add a bit of water. Put in microwave for 5-10 sec. Mix in coffee, juice or shake and serve.
    - Always add crushed meds to HOT food and salads with creamy dressing.
    - Throw the albuterol in the nebulizers. The pt will get to them. Just remind them.
    - I'll check PEG placement once a shift. Good enough.
    - A/Ox3 to 4 residents may be happy to have you place their meds at the bed side. Especially, if they don't like to be awakened or bothered. Just check to ensure that they've taken them. Warning: Don't leave meds unattended in the room.
    - Do 0630 accuchecks at 0400. Just don't give the insulin unless longacting. You don't want them crashing out on morning shift.
    - Pass creams/groin/abd fold powders to the aides. Just be aware that these are medications and technically a CNA can't administer. Do I use them to administer, anyway? Heck, yeah. They can throw on nystatin when they're changing them.
    - Jevity 1.2 (for instance) out for continuous feed? Crack open some cans and pour it in the bag. No one has time to be doing bolus feeds on 6 residents.
    - Heavy number of PEGs/Bolus w/hordes of meds BID/TID/QID? I will give every OTC (and once a day med) that I can on the first feeding/administration. You really can't bypass most OTCs. They need their iron and vit d. They need their protonix, lactulose & pro/uri stat. They need their eye-drops. They need their neb txts. Gotta give it.
    - Sometimes, benadryl helps...

  • Jun 5

    Quote from Rntr
    Employers have a right to ask for a certain dress code and this includes hair, tattoes, inappropriate or overdone jewelry, perfume (totally out of place in the workplace). To ask you to show up on time and not abuse the "sick" benefit... there could be more and this should all be in a policy. It's upfront, not hidden and.....

    You have a right to not work there.

    I personally am glad there are certain standards that apply to everyone. Get over it and quit making such noise out of nothing.
    We're talking about judging someone for something that CANNOT be controlled. It's a problem when you tell a group of people that what is natural about them is wrong -- that they should change a natural feature to fit.
    No, they shouldn't be told to 'get over it'.
    They don't have the problem. You do.

    ...but this isn't an issue that affects you so, of course, you'd be all obtuse and "dismissive" about it. Who cares, right?

    Ugh. Does this site have an "ignore" feature?

  • Jun 5

    Is this a troll thread or something?

    I have an armpit length kinky/curly fro. I rec'v compliments from everyone.
    Even I didn't - I doubledog dare anyone to look me in my eyeballs and call it 'unprofessional' -- suggesting that I "do something about it".

    No. Braids, dreds, sisterlocks, fro's, etc... are not fads. They're black hair styles. It's deeply cultural.
    As for my curls -- this is how my hair naturally grows from my frickin' scalp. Hell, yeah - it's BIG! LOL I don't need to 'do something' about it. OUR hair doesn't need to be 'fixed'.
    I'm not going to alter the very structure of my hair shaft to fit some idiot interviewer's WARPED beauty ideal.
    Should I change my skin color,too? Maybe, get the fat sucked out of my lips...or butt ( could be lucrative considering all of these 'boxy'-looking pancake *expletive* females getting butt augmentation these days). LOL
    I've enough to spare!

  • Apr 14

    Honestly, you're supposed to do count whenever you take the cart. Is the RN not counting with you? That's a problem.

    Corrections is odd. Where I work, some used to flip the cards upside down. The supv found out because another whined to her about it and blamed the new staff. I came in once and the supv gave me a talking to about it. I was like: ??? "I just got here. The cart is always 'like that when I get here'. I dont flip cards." Most of us came from the nursing home. Flipping cards upside down isnt a bad habit learned ... from the nursing home.

    Your supervisor is completely useless, by the way. I never ran across so many lazy mini managers until I did that specialty.

  • Apr 4

    Quote from roser13
    Nursing school only teaches a fraction of the necessary knowledge. Experience teaches the rest.

    Practicing nursing under an administrator with no on the ground experience is most nurses' nightmares.
    Requoted for emphasis. Thank you, madame.

  • Apr 1

    Attaching the '-shame' suffix to everything. I never hear it in person. Only online. It just makes me hostile.

    'Bully'.

    What's a 'sontimeter'? (centimeter)

    Coochie. When I did xray(ivp), had a little girl who kept referring to her vagina as her coochie. "Mommy - my coochie!" ; "Mommy, my coochie hurts." Eww. She just kept saying it.. When I have 'workmares', this is what I dream of.

    "Dude -- !" My coworker taught me that this is a question, exclamation and a response. I used to think it was funny. Now. I found myself using it all the time

    "...and I was all -" ; "...and she was like -" ; "...and we were all like --" I have a coworker who talks like this. Cracks me up. Now, I talk like this, too!

    "Super"...because nothing is just cute. It is SUPER cute. Awesome can't just be awesome. It must be SUPER awesome. One of my coworkers talks like this. Often. I like the feelgood motive behind it. I mean, have you ever had someone call you 'super awesome'? I have.
    I was like, "Yes!" *pumps fist*

    "Moist" is only gross sounding because people drop their pitch and enunciate every vowel and consonant. MmmmoooiiiiSSSSSST. See? That's just gross.

    When elders use the word 'pet' for fondle or canoodling with a partner. It's like using the word "having relations" instead of "having sex". I tend to use the latter often, though. It just less dirty and more proper to say that someone's 'havin' r'lations'.

    Canoodling.

    "Lou-wheeze-e-an-uh". (Lousianna) I never heard it pronounced that way (uh, correctly? Lol) until I encountered nonsoutherners and floridians. Screw Webster! I don't care what the vowels dictate. It's "Lou's'anna". .or "Louey'sanna" (slur it!). It's "N'awlins:...or "Na'orlins". It's "tEx-is", not "Tec-sis".

    I actually didnt screw up orient and orientate until I became a nurse.

  • Apr 1

    Attaching the '-shame' suffix to everything. I never hear it in person. Only online. It just makes me hostile.

    'Bully'.

    What's a 'sontimeter'? (centimeter)

    Coochie. When I did xray(ivp), had a little girl who kept referring to her vagina as her coochie. "Mommy - my coochie!" ; "Mommy, my coochie hurts." Eww. She just kept saying it.. When I have 'workmares', this is what I dream of.

    "Dude -- !" My coworker taught me that this is a question, exclamation and a response. I used to think it was funny. Now. I found myself using it all the time

    "...and I was all -" ; "...and she was like -" ; "...and we were all like --" I have a coworker who talks like this. Cracks me up. Now, I talk like this, too!

    "Super"...because nothing is just cute. It is SUPER cute. Awesome can't just be awesome. It must be SUPER awesome. One of my coworkers talks like this. Often. I like the feelgood motive behind it. I mean, have you ever had someone call you 'super awesome'? I have.
    I was like, "Yes!" *pumps fist*

    "Moist" is only gross sounding because people drop their pitch and enunciate every vowel and consonant. MmmmoooiiiiSSSSSST. See? That's just gross.

    When elders use the word 'pet' for fondle or canoodling with a partner. It's like using the word "having relations" instead of "having sex". I tend to use the latter often, though. It just less dirty and more proper to say that someone's 'havin' r'lations'.

    Canoodling.

    "Lou-wheeze-e-an-uh". (Lousianna) I never heard it pronounced that way (uh, correctly? Lol) until I encountered nonsoutherners and floridians. Screw Webster! I don't care what the vowels dictate. It's "Lou's'anna". .or "Louey'sanna" (slur it!). It's "N'awlins:...or "Na'orlins". It's "tEx-is", not "Tec-sis".

    I actually didnt screw up orient and orientate until I became a nurse.

  • Mar 31

    Attaching the '-shame' suffix to everything. I never hear it in person. Only online. It just makes me hostile.

    'Bully'.

    What's a 'sontimeter'? (centimeter)

    Coochie. When I did xray(ivp), had a little girl who kept referring to her vagina as her coochie. "Mommy - my coochie!" ; "Mommy, my coochie hurts." Eww. She just kept saying it.. When I have 'workmares', this is what I dream of.

    "Dude -- !" My coworker taught me that this is a question, exclamation and a response. I used to think it was funny. Now. I found myself using it all the time

    "...and I was all -" ; "...and she was like -" ; "...and we were all like --" I have a coworker who talks like this. Cracks me up. Now, I talk like this, too!

    "Super"...because nothing is just cute. It is SUPER cute. Awesome can't just be awesome. It must be SUPER awesome. One of my coworkers talks like this. Often. I like the feelgood motive behind it. I mean, have you ever had someone call you 'super awesome'? I have.
    I was like, "Yes!" *pumps fist*

    "Moist" is only gross sounding because people drop their pitch and enunciate every vowel and consonant. MmmmoooiiiiSSSSSST. See? That's just gross.

    When elders use the word 'pet' for fondle or canoodling with a partner. It's like using the word "having relations" instead of "having sex". I tend to use the latter often, though. It just less dirty and more proper to say that someone's 'havin' r'lations'.

    Canoodling.

    "Lou-wheeze-e-an-uh". (Lousianna) I never heard it pronounced that way (uh, correctly? Lol) until I encountered nonsoutherners and floridians. Screw Webster! I don't care what the vowels dictate. It's "Lou's'anna". .or "Louey'sanna" (slur it!). It's "N'awlins:...or "Na'orlins". It's "tEx-is", not "Tec-sis".

    I actually didnt screw up orient and orientate until I became a nurse.

  • Mar 31

    A bonus plan for 'the heart of the nursing home'.
    Yeah, because the rest of us run around, miss breaks, work off the clock, leave late and do nurse aide AND nursing tasks due to shortstaffing because we... don't care? The heart of the facility typically stands at the clockout machine 5 to 10 minutes before shift ends. Our aides work hard but let's be real, here.

    I don't need a slap on the back but everyone busts ass in the nursing home sweatshop. Nursing, housekeeping, dietary and maintenance. It's not one group more than the other.

    "Perhaps we could find a way to evaluate and track ---" Uh, uh. I dont like the sound of this already. I, for one, am not keeping track of or documenting *expletive*! If you pay them and support them? They will come and stay.
    If you want to give money, offer more money per hour. The end.
    The fact that you offer gimmicks instead of actual benefits is telling. I wont even pretend to be shocked. Frankly, I dont know how youd track anything but you guys are going to have to handle it on your own. No one on the floor has time to be doing corporate 'busy work'.

    Ive found a very nice facility. Well staffed. Pays very well. Training is great and the only reason why it runs so efficiently, Im convinced, is because the CEO is a NURSE.

  • Mar 31

    Didnt you just create a thread about this same issue?

    Seems like you work 3-11? If the vanc was to be hung, why didnt the two shifts before you do it? I dont understand that.

    Anyway, so, okay, - you did call lab which was good. The supv wasnt aware of that so you likely didnt document your correspondence with lab... which was bad. (Lol. Document these things, op).
    You didn't hang the vanc, though, because it was 'too late' -- what does that even mean, OP? (lol) What is 'too late' when the pt was supposed to recv ABT two days ago? What are you people waiting for - sepsis? (lol)
    But, you think this is about the lab not sending timely faxes? And you're all offended that the supv called you "on your day off" about the giant boo-boo you made? "She yelled at me -- !"
    Well, you know what, OP? Jesus would've had to 'take the wheel' from me, too. (lol) This is the second thread from and every correction is met with a rebuttal. "...but, they didnt -"
    "...but, but, but --" Jesus...take the wheel! That's your pt. That is your pts life youre dealing with. This is serious business.

    No one wants to see you fail, OP. But, no one wants our pts harmed, too. If you need help, if you have questions, just ask. Just...ask, honey. For one thing, Im sure you told nightshift about the vanc situation in report. So... unless theyre new too, I cant believe that nightshift wouldnt correct you on the spot. If they did, and I'm almost certain they did, you shouldve hung ABT before you left.

    You shouldn't have quit. Youre just gonna run into the same issues at your new place. Waltzing around with gloves on, not assessing/documenting injury, leaving keys all over, wasting narcs on your own, etc.... That's you on the floor. You're told to not pass in the dining hall. You do it anyway. You hang ABT whenever you feel like it. God forbid that someone RIGHTFULLY and sternly correct you or youll swear up and down that youre being bullied.
    "Aint nobody got time for alluh dat!" , OP.

    You only had 20 pts. 1 ABT, Im assuming. Handful of accuchecks -- that's nothing. Seems like a decent place, to me, because that's a cake assignment. Youre so new, you dont even how good you have it! I work at a few facilities. You dont even want to know how many pts per nurse there are or how many accuchecks/crappy PEGs that are forever clogged/bolus/iso/IV pts exist in the bunch. You shouldnt have quit.

    Some Tips?
    -- At your next job? Request more days of orientation and stay away from 3-11. It's the hardest shift in most places Ive worked, imo, because they do everything mornings does PLUS The admissions, the phone, the visitors, the sundowning, a heavy 5p med pass, and MINUS the support. It's too much for a new nurse. Most new nurses that Ive seen just dont last on that shift. They crash and burn. 7 t 3 or 11 t 7 is best. For you, Id recommend 11 t 7 while pulling am shifts throughout the week BECAUSE you wont learn everything you need to know on nightshift (or weekends) because you dont have to do whats commonly done on mornings. 7 t 3, allows for a more wellrounded skillset. In my opinion.

    - Get in the habit of writing things down. I take report with a notepad. Everyone gives report differently. Even if I only recv info on 2 rooms, I write a list of room/bed numbers and I jot down things as they happen during your shift. Every prn given with times, every accucheck, every O2sat/temp/bp taken, etc....

    - When you accept your pt assignment, you need to know: Your diabetics. Your bolus/pegs. Who is crushed/whole. Who is ABT. Who fell/had seizures. Your PRNs. Your hospice pts. Of course check folks with status changes first.

    - I dont chart until the end.

    - Youre new. Youre going to be slow. Its okay. Start earlier if you must.

    - Always check your people at the start of the shift. It doesnt always occur to new nurses to do this. Im flexible but I do prefer bedside reporting.

    - Make sure the carts ready for next shift. Even if youre running behind, you shld be ready to surrender keys at the appointed time. I finish my medpass, check narc count, clean/restock the cart...sit down and chart. If I'm behind and reliefs coming in 10-20 minutes, I stop and make sure that the count is good so that they can start their work.
    You want to keep things timely. "I have to see the TAR/MAR to --" No, Im using it. Fill in holes when Im done or fill them in tomorrow. Get off the cart and get outta the way. (lol) The other shift has work to do. You work around them, not the other way around. Im projecting a bit, I'll admit. To be clear, Im not talking about being 5 minutes late. More like a whole hour. One of my workplaces, two nurses who repeat offenders. LPN and an RN. The LPN, I followed. Experienced but 3t11 shift is nasty at that place. I know how she works so Im never bothered. The RN was new to ltc/snf and couldn't be timely. It happens but the bad news was, she was nightshift and would hold up morning shift. Im talking a full hr before 7t3/7t11p could get the cart. Routinely. I had to work behind her on mornings on occasion. It was a mess.

    -- If you work nights, get your urine specimen at the start of the shift with the aides. I have more luck then.

    Good luck, OP.

  • Mar 31

    The electronic littman is great if you have hearing issues. The cardiology iii is just as good. Lighter, too.

    You're a student, though, so get something durable and cheap. You can blow your money in fancy-pants equipment (as one of my supvs calls it, shaking her head) when you graduate.

    ADC makes durable cuffs so I'd think the stethoscopes would be good too. Prestige stethescopes are nice. I dont know how well they work, though.

  • Mar 30

    Well, I've already discussed being a self-hating aide. LOL No, I'm just kidding. It's just that...you can never have an aide staff where everyone's on point. There's always two or three who are bound to be ate the hell up. No one wants to fire them, either. It's honestly the part of the job that I dread. I've managed. I've supervised. I've trained. I was NCOIC of the rad dept for a time. I've done lots in the ways of leaderships.
    ...but I've always hated leading. I've always disliked managing people. Always hated supervising.
    I really didn't know, until nursing school, that this was a part of the job. I'll do it and I look at it as...an opportunity to be a better leader, I guess. I just really don't want to have to run behind people to ensure that they do their jobs. I don't like dealing with employees and their issues. I see some of the aides (well, those who quit after being told 'there's the door') and they did nothing but bother the nurses with their interpersonal issues...and I'm like, "Why can't you solve these issues on your own...?" Now that they're gone? No problems. We're short, but all but 1 were dead-weight anyway.
    More importantly, I know how hard I work as an aide. It will annoy me when I deal with people who slack off. That's when the paperwork begins. Do you job or go the hell home.

    *********************

    On the other hand?
    I think it's easy for someone to throw blame off on those in their charge. Did you manage before being a nurse? Doesn't sound like it.
    It also seems like you just annoy the hell out of the aides for one reason or another. I mean, you said CNA (plural). You want everyone to drop what they're doing to help you with ADL's?
    Why are you rushing the aides along? That's what it seems like. Can the residents not dress themselves and if they need to be dressed? Can they not wait until the aides finish with the other residents, first? Of course, the CNA students will jump and answer you pages.
    They need a job. LOL I do a fair amt of hoop jumping myself to secure my position. My charge nurse and the others do haze me a bit. Plus, they probably take pity on you. You can spot a new grad from a mile off.
    So, yeah...I jump hoops. My nurses never needed help with anything besides tube-feeding combative residents, though.
    What are you doing to the pt's that you require so much assistance? If one had a pattern of constantly needing help because she was jumping the gun, moving in on my work...doing it half-assed...then calling for me to stop what I'm doing and finish up her mess because she's late with her assigned tasks and blah, blah, blah?
    I'd be annoyed with her, too.

    Are you giving the aides time to complete their tasks? We have nurse assistants for a reason.
    If you have nurse-y duties to complete, why aren't you? If no one's dying, why are you stripping beds when the med pass takes priority?
    Notify the pt's aide that the pt is dirty and pukey and that there's pooh everywhere...and tell them to get to her as soon as they can, 'please'.
    Continue passing meds.
    If the pt isn't clean within the hour. Find the aide, pull them to the side and figure out what's going on. If this behavior is a pattern and continues? Start throwing down paperwork.
    Period.

    If you say that you're in 'busy' area that makes me draw from own experiences as an aide. Perhaps they don't have time to help you. If this is an LTC? It makes a bit more sense. Are you as respectful of the job that they have to do?

    I absolutely hate it when I'm running around trying to keep pt's dry and beds from being stripped when this or that person calls me out of the room to handle mundane tasks.
    Mundane = 'can you change her?"

    Let me tell you what I mean (a long scenario that reminds me of your situation):

    At my facility, it's not the nurses who do this. They 'get' it.... Sure, they might 'bomb' half the residents and laugh about it. I swear, it's for poops and giggles. But, they get it. They help out when they can. You don't expect it, but it's nice when they do.
    They're good leaders.

    So, it's not THEM. It's one of the girls who works laundry.
    So, I'm in the middle of a transfer and she's hollaring down the hall for a CNA. "I NEED A CNA!!! CNA!!!"
    sigh
    I know that it's her...I know that she's interrupting my work to deal with a non-emergency... and I'm in the middle of trying to get people up for their meal.
    So, I complete the transfer. I get my little resident settled and head on out the door with her in the geri-chair.
    Meanwhile, Laundry Girl is still hollaring down the hall like a nut.

    I stroll over...and I meet another aide who is also strolling over. In ways, I think she feels the same as I do. We both had that look of annoyance.
    Me: 'What's going on...?"
    Laundry Girl: "She needs to be changed...!"
    We look in the room.
    Coworker sighs: "She's fine..." and walks briskly away.
    I went and got my resident.
    She was pushing her laundry cart and popped off about the residents not being changed.

    FIGHTING WORDS!!!!
    LOL

    I said while pushing my little lady to the dining hall, "I'm in the middle of a transfer. I'm not going to drop everyone and possibly drop Ms _____ running out to change Ms ____. Next time you scream down the hall like that, I'd better find a resident on the floor twitching and foaming at the mouth and surrounded by clumps of doo-doo..."

    I change that woman every hour, are you kidding me?
    Hell, if Ms _______ would stop guzzling diet Cokes like an addict, she wouldn't be so ***** all the time, in the first place. That woman has a 12 soda a day habit!
    Yet and still - this woman can take herself to the bathroom. She just...won't. She knows when she has to urinate. She just pees in the brief. She doesn't even go to the toilet, anymore. I think she's regressing because she can't make it to the toilet. I don't think it possible to wean her off. It's her right to drink her soda. What are you gonna do?

    But I know when my residents need to be changed. Ms ____ will tell you. That day, she told me and I told her that I'd 'be with her in a second'. But, see...Ms. _____ is impatient.
    She's in the midst of a Burger King delusion and either doesn't undertand or doesn't care that I'm servicing 10-20+ rooms (at times) of people besides her.
    So, she yells 'I'm wet' and 'change me' to any able-bodied person who happens to walk past the door. LOL

    This is where Laundry Girl came in. I've thrown a sheet over a naked resident and practically fell over the trashcan (that I was throwing the dirty diaper and wipes in...forgot it was there) running to get to her screaming, 'I NEED A CNA!!!!' in the past. I get to the room and discover that it was all for not.
    "She needs to be changed!"

    Jesus -- take the Wheel!
    My under-eye was twitching. That was the closet that I ever came to a TIA...I think. Well, thus far. My nursing career has just begun. LOL Something tells me that I'm only on the cusp of seeing 'the crazy'...


    I just stared at her a beat. Told the resident in even tones, "I have to step out. I'll be with you to change you in a second, ok mama? Alright."
    Turned around and stalked out of the room.
    So, if Laundry Girl wants to do rounds like she's part of the nursing staff? She can slap on a pair of gloves and change the residents herself. She doesn't want to do that. So, she needs to stay the f out of the resident's rooms and stop bothering everyone with her non-emergencies.

    She needs to concentrate on not losing undergarments instead of worrying about what CNA's do.
    Every freakin' day the nurses have to deal with crazy family members interrupting important business to run around on wild goose-chase looking for Grandma's socks or Tia's draws. Ugh... Hell, the aides sort the laundry for them! Laundry does arrange the laundry by floor when they dry it.
    How hard is it to put the crap in the right closet?

    **********************

    So, the big question is: Why did we respond like this to her?
    Firstly...she's annoying. Obviously. I swear, I nearly pop a blood vessel when she comes around.
    Secondly...we knew that she didn't want anything. Thirdly... CNAs have to maximize their time and prioritize like everyone else. She does not try to understand how we - I - go about my tasks.
    When she demands and screams, it is done without respect and understanding to our job and duties.

    I was changing and assisting other people. We both were, the other aide and I. Ms ____, the resident in question, was standing up out of her wheelchair waiting for someone to wipe and change her. Yes - she can wait.
    The priority is getting to the people who CAN'T ambulate or stand or take themselves to the bathroom. Those who require self-care.


    ************************

    Dirty linen on the floor? Depending on who you are, that would tick me off. LOL
    If you're one of my nurses that I know and love and notified? I'd say, "Hey, thanks.... No, I'll go get it off the floor...."
    If you're one of the aides and told me, I'd say, "No, I got it. Thanks for helping. You need help with anyone?"
    If you're Laundry Girl? "***** If this b is going to do everything half-assed. Don't do it at all!"

    If an annoying nurse did it and didn't say anything? I'd think...similarly. LOL.

    "Why is the nurse leaving dirty linen on the floor...? Hello, infection control."
    ...because you're a nurse. More importantly, what if I wasn't able to get to the room...and didn't know that dirty linen was left on the floor?
    The Charge or management would walk by the room, see this...and chew us all out.
    It'd be a real and vague generalized comment, too.
    An announcement would be made that so and so 'saw dirty linen in one of the rooms and disposed of it properly'.
    CNAs would be looking at each other: "What dirty sheets on the floor...?"
    Regardless...let the haranguing and finger-wagging begin.
    PERSON IN CHARGE: "The point is.... there's dirty linen on the floor. Everyone needs to check their rooms and cut the lights off, too. Mr ____ walked by the room and saw 3 lights on this morning. This is a no-go! Why if state came through and saw --""

    Can you tell that this has happened to me before?
    LOL

    If you start a task, complete a task and notify when you can't.
    Don't leave dirty linen on the floor, ma'am.
    I don't care what else you were doing. Rooms usually have trash cans. You couldn't set it atop the trash can?
    Do not leave dirty linen on the floor, ma'am.
    Changing a bed, cleaning up a pt and changing their brief would take you (someone with no aide experience...it's obvious) a heck of a lot longer than it would for you to take the dirty linen and dump it in it's receptacle.
    You wasted 20-40 minutes practically doing a bed bath with a bed change on a pt. You can't take 3 more minutes to gather that pukey, poopy linen and dump it correctly?

  • Mar 30

    Honestly, you're supposed to do count whenever you take the cart. Is the RN not counting with you? That's a problem.

    Corrections is odd. Where I work, some used to flip the cards upside down. The supv found out because another whined to her about it and blamed the new staff. I came in once and the supv gave me a talking to about it. I was like: ??? "I just got here. The cart is always 'like that when I get here'. I dont flip cards." Most of us came from the nursing home. Flipping cards upside down isnt a bad habit learned ... from the nursing home.

    Your supervisor is completely useless, by the way. I never ran across so many lazy mini managers until I did that specialty.

  • Mar 30

    A bonus plan for 'the heart of the nursing home'.
    Yeah, because the rest of us run around, miss breaks, work off the clock, leave late and do nurse aide AND nursing tasks due to shortstaffing because we... don't care? The heart of the facility typically stands at the clockout machine 5 to 10 minutes before shift ends. Our aides work hard but let's be real, here.

    I don't need a slap on the back but everyone busts ass in the nursing home sweatshop. Nursing, housekeeping, dietary and maintenance. It's not one group more than the other.

    "Perhaps we could find a way to evaluate and track ---" Uh, uh. I dont like the sound of this already. I, for one, am not keeping track of or documenting *expletive*! If you pay them and support them? They will come and stay.
    If you want to give money, offer more money per hour. The end.
    The fact that you offer gimmicks instead of actual benefits is telling. I wont even pretend to be shocked. Frankly, I dont know how youd track anything but you guys are going to have to handle it on your own. No one on the floor has time to be doing corporate 'busy work'.

    Ive found a very nice facility. Well staffed. Pays very well. Training is great and the only reason why it runs so efficiently, Im convinced, is because the CEO is a NURSE.


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