Latest Comments by Seliah

Seliah 781 Views

Joined: May 20, '10; Posts: 6 (50% Liked) ; Likes: 6

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  • 1
    SuesquatchRN likes this.

    He's got an apptt with the primary tomorrow morning. Thanks.

  • 1
    Leelee2 likes this.

    Quote from litbitblack
    hmmm I have no idea. Did you ask them. Do you guys not treat the combative behaviors? Why not ask them.
    Absolutely chart it! Resident could injure themself or others, and if it's not charted, you have no legal doocumentation showing prior agitation and combative behaviors! Charting is your only legal protection against possible fallout from a combative resident's behavior!

  • 0

    Don't know about other facilities, but where I work? Yes, they can. They call it 'Mandate' or 'Mandation'.

    If we have a call off and no one can be found to cover, one person from the previous shift gets stuck working. Company policy is they can mandate us to work another 8 hours (16 hours total in a single 24hr period), each DAY.

    So If I work Mon, Tues, and Wed, and we have call-offs all three days in a row and no one can be found, they COULD theoretically mandate me to work 16 hours all three days. Normally we don't do that to one person in a row - normally we'll rotate such mandations between personnnel if poossible, but sometimes it just isn't possible. I've had weeks before where I've worked 4 16-hour days due to relief calling off.

  • 4

    Quote from Plagueis
    At my facility, the CNAs do brief changes and pass out water on the 11 to 7 shift, so there is some down time, which can lead to sleeping. What do the CNAs at other facilities do during the 11 to 7 shift in addition to those duties?
    Where I work, we only have ONE single CNA on the overnight shifts. (Campus of houses holding 12 residents each rather than a centralized nursing facility.) And uhm.. I'm honestly surprised sleeping's allowed anywhere on the graveyard shift. Where I work, if you sleep and someone sees you sleeping, there are no ifs ands or buts - you are literally fired ON THE SPOT, right there and then. Do not pass Go, do not collect $200, you're history immediately. No second chances.

    In regards to the CNA duties in other facilities? Where I work, overnight CNA handles the food prep for the meals. They handle their usual rounds, toileting, personal care, charting. Stocking. Cleaning of the house (except vacuums since we're trying to let people SLEEP ... lol). Laundry is washed, dried, folded, and placed in resident's rooms on the night shift. Ordering supplies (dietary/gloves/briefs/etc) is usually done by the night shift worker as well.

    If after ALL OF THAT is done, I actually HAVE any downtime (a very rare occurrence, let me tell you) - I am allowed to sit down to the computer for a few minutes provided no one is ringing at the time. (Also a rare ocurrence.) Down-time happens maybe once a month on the night shift if we're lucky. We get docked for a half hour break that we don't get to take (the nurses have THREE houses they're runnign between. I'm sorry, I knwo some of the CNA's in my facilty have no hesitation calling the night nurse in to cover a half hour - but in my opinion it is not the RN's responsibility to cover my break. if I drink coffee, I drink it in the kitchen, in the house. I count that two minutes as a 'break'. If I go outside for a smoke, that is a break. If I sit down to eat somethign, that is a 'break'. We get our break times, we just don't get it in a lump 30 or 15min group the way most conventional facilitis give it, and are frequently answering call bells annd such in between bites of our lunches.

    I guess, speaking as a CNA? To me, if you are working the noc shift and it's a regular shift for you to work, there's no excuse (shy of extenuating circumstances), to be falling asleep. I sleep during the daytime - my 'day' goes from about 2pm until 8am. My breakfast is usually a cup of coffee and toast around 2.30pm. If you cannot live as a nocturnal creature, IMO, you shouldn't be holding a night shift in a medical faciltiy. It only takes an eye blink for a resident to fall OOB and break a hip, or crack their skull open. I don't ever work the 7a-3p shift because that IS my night time, and I know I would be falling asleep because I can't adjust to that kind of schedule. If a CNA is regularly falling asleep on nights, perhaps they should be not working nights.

    As mentioned earlier in my post... where I work, you get caught asleep, you're fired on the spot, no questions asked. They don't put up with it where I work. At all.

    ~ Seliah

  • 0

    Hello,

    I work in an NH as a CNA. In my 'off duty' time, I have something of a private case I take care of. The gentleman who lives upstairs from me - for about a year and a half now I've been taking care of him (he does have a visiting RN but only after hospital stays). He's 70 - definitely geriatric.

    And.. I have a question, but I'm going to give a basic care history just in case its needed.

    He has the following DX's :

    COPD
    CHF
    Diabetes (adult onset)
    Triple abdominal hernia (90lbs in hernia weight, multiple surgical fixes done in the past to no avail)
    Peripheral arterial disease

    Some basic medical history :

    He had one major heart attack about a year ago, and had a second, minor one a week after being released from the hospital from the major one. He's had a bypass of some sort done in LLE due to poor circulation that led to loss of the great toe on the left foot. He has perfectly good bowel function and no problems voiding. Still fairly independant for the most part. Poor appetite (eats just a little bit here and there, sometimes won't eat for two or three days despite encouragement - can sometimes solve it if I bring him homemade soup or stew), but does take in a lot of fluid without a problem (yay for marines and their love of coffee and water!).

    I can provide a med list w/dosages and frequencies if it's needed (it's lengthy), as I'm the one passing him his meds (his eyes are poor and he can't read the labels, so I fill the weekly pill boxes and do the afternoon pass/nebulizer setup.) I suppose this is basically a home-care sort of case, when you get right down to it.

    I know that during summer and spring CHF and COPD symptoms will frequently flare up - however, can such a flare up present as simply a runny nose? This poor man's had for about a week now, an excessively runny nose, an excessive cough. Cough is productive, but I'm just not sure if it's mucus buildup due to the COPD/etc, or not. No fever. No wheezing of any kind. No SOB outside of what's "normal for him." (he's on 2 liters of O2 WIB w/PRN usage, rarely needs the PRN usage). His BP, pulse, temp, respirations are all within his usual normal ranges, nothing out of ordinary there. O2's are running about 95-98 as well. Will dip down to high 80's w/exertion, and then raise back up to the mid-to-high 90's once he's been sedentary for a few minutes.

    Is there anything I can do to help the runny nose or does he honestly just have a spring cold? He does not have allergies, he is completely cognisant and mentally competent. He can go through 1-2 entire ROLLS of paper towels in about two days on it. Mucus is clear or a little yellowish. No swelling observed in his extremeties so far this spring, no weight gain or loss or noticeable outward sign of fluid buildup.

    I'm just trying to handle this as best I can. Am I reading too much into the runny nose, is it possibly just a flareup symptom, or is it more likely to just be a spring cold?

    Thanks in advance - and I apologize for the lengthy post...
    ~ Seliah

  • 0

    I work in a nursing home. I'm a CNA, not an nurse. We have the same issue, however. The particular setup to the way this NH runs is very unconventional. We are broken up into houses on a campus rather than a centralized skilled nursing facility.

    The end result is that if we have to calll out sick - we are required to find our own coverage, or else we have to come in sick (even though they will tell us constantly NOT to come in if sick.)

    If we have an emergency - we are still supposed to make an attempt to find our own coverage.

    The CNA's handle the dietary needs, the laundry needs, the basic grounds maintenance, ordering of supplies, ordering of food, cooking... this is all in addition to the standard personal care and other typical CNA duties.

    We are also required to find our own coverage to take scheduled time off - IE vacation time, holiday time, etc. Now, with our holiday time, if we do not use that time in two weeks, we lose it completely. It does not tally up, we do not have the option to just have them pay us for having worked the holiday.

    Most of the time, we can't get coverage. Usually, no one is willing to work for you.

    There is of course, nothing in the employee manual, the policies, etc, about this. HOWEVER, we are told right during the hiring interview that if we want to take the time off that we will have to find our coverage, and HR will enforce this as company policy.

    We also don't have the ability to bring in agency workers, as we have an extra creditation that is required in order to work in the facility.

    I wish I had some possible solutions to offer you, but we're still struggling with how to solve the problem ourselves, too. Most of the time it comes down to "i'd really like x-y-z days off, and if you cover them, I'll cover your x-y-z days off that you want."

    But if nothing else... I suppose this lengthy response amounts to, "I totally feel your pain."

    ~ Seliah



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