A couple of Clinical questions. Is this fair to patient?

fuzzywuzzy, CNA · Apr 4, 2011

What's the point of limiting it if they're not on a fluid restriction? We're always trying to get people to drink MORE. Maybe this person isn't *technically* on a restriction, but he or she is CHF or something?

interceptinglight, CNA · Apr 4, 2011

If a person is not fluid restricted, there's no reason to limit their intake, unless you're trying to do that for your own convenience....like you think they'll need less changes or toileting. I prefer dealing with residents who don't have to be coaxed into drinking more. I also find it more rewarding to toilet someone with a good large void rather than just a few tinkles in the toilet.

As for allowing a puddle of urine to evaporate rather than cleaning it up......I think you probably know the answer to that. If you have linoleum floors, any puddles on the floor will be a safety hazard let alone unhygienic. We have carpeted floors in our facility, but we still have to clean up urine puddles, at least for the sake of odor.

Starletta, CNA · Apr 5, 2011

Thank you for the replies. I thought I correct in these situations and wanted some input.

I was reprimanded last week during Clinical for giving my Alzheimer Resident 3 little cups of water/milkshake. Each cup is 4-5 oz. She is not on a fluid restriction/ nor CHF

My Clinical instructor asked to see me in the hall and told me to use "Common sense" quote. Even though another student let his Resident drink what she wanted, (she was overly thirsty too) and Instructor never said a thing to him.

When we got there in the afternoon (I'm taking a night course) my Resident was soaked. Urine flowed from her brief, pants, wheel chair and onto the floor. After we got her cleaned up, I went to clean up the urine on the floor. Fall hazard, unsanitary, and down right wrong to make a patient smell her own urine while eating supper.

Got reprimanded for wanting to clean up the urine. House Keeping was gone for the day and it would have taken me minutes to clean it up.

I said it smelled and my Instructor even called another CNA in the room and asked her if she smelled it!!!!

I know every facility is different. But I wonder.... Could they purposely withhold fluids to lessen the urine output? It is odd that a Styrofoam cup with lid and straw is left on the bed table. These are TOTAL care Residents and the majority have Alzheimer's/Dementia and cannot even reach!! Nor know the cup is there!! Is that for show if the State Inspectors or family show up?

Consider what you drink. Would 4-5 oz. be enough for you?

Either way, I am meeting with the Director of the program tomorrow. I hope to change my Clinical location.

Not for just what was done above. But honestly, this Instructor has it in for me. Every-single-thing-I-do, she belittle and berates me to no end. Getting reprimanded for taking the initiative for cleaning up a puddle of urine???

I'm left handed and got criticized for using my right hand in certain situations... :confused: I have documented everything.

My class room Instructor on the other hand is the greatest!!!:redpinkhe

Edited to add: Clinical Instructor constantly asked me how I know my Resident was thirsty. Well, she drank 3 small cups like she hadn't drank all day. "She has Alzheimer's, she doesn't know if she is thirsty." Was her quote to me.

She said I needed to look at the Resident's skin, eyes, and do the "Tent test" to determine if she is dehyrated. Why would you wait until she is dehydrated to give her fluids??

Then she proceeded to ask my Resident if she was thirsty!! She tells me one second the Resident's don't know, yet, went and asked Resident if she was thirsty. sigh.....

Hopefully I can change. Or will have to excuse myself from the program and sign up for a course given by the American Red Cross.

caliotter3 · Apr 5, 2011

Sounds to me like you have a good handle on things. Hope you are able to change clinical instructors.

fuzzywuzzy, CNA · Apr 5, 2011

Well that's ridiculous. If the resident is actually willing to drink you should be throwing a party. Most of them don't want to drink anything without being nagged half to death.

The cup of water on the table is a state thing. Everyone knows half the residents can't do anything about it, and the state knows that but they want it there anyway. Once you start working at a place and the state shows up you'll see what a joke it is... common sense will tell you not to bother putting half those cups of water out, but state inspections are 2% about the residents and 98% how well the facility can jump through hoops.

Dorali, BSN, LPN, RN · Apr 5, 2011

An Alzheimer's resident may not be able to come out and say "I'm thirsty" but when something isn't right with their body, they will get irritated and it's a matter of figuring out why.

For example, I have a woman on my hall who does have Alzheimer's. She has fallen multiple times lately. (Her ability to walk has gone downhill over the last few months.) We have figured out that the reason she keeps trying to get up is because she has to go to the bathroom. When she first got there, it would take a few tries to get the word 'bathroom' out of her but that's ALWAYS what it was. Now, she just gets really irritable and frustrated. Yes, she knows what she needs. Can she come out and ask for it? No.

What is hard for me is when she is trying to tell me something and the wrong words come out. She has said, "No, I don't mean that. I am so dumb." Breaks my heart. I know she isn't dumb and tell her so, she is just struggling for the word in her brain to make it to her mouth.

It's a terrible disease.

Dondie

Starletta, CNA · Apr 6, 2011

An Alzheimer's resident may not be able to come out and say "I'm thirsty" but when something isn't right with their body, they will get irritated and it's a matter of figuring out why.
For example, I have a woman on my hall who does have Alzheimer's. She has fallen multiple times lately. (Her ability to walk has gone downhill over the last few months.) We have figured out that the reason she keeps trying to get up is because she has to go to the bathroom. When she first got there, it would take a few tries to get the word 'bathroom' out of her but that's ALWAYS what it was. Now, she just gets really irritable and frustrated. Yes, she knows what she needs. Can she come out and ask for it? No.
What is hard for me is when she is trying to tell me something and the wrong words come out. She has said, "No, I don't mean that. I am so dumb." Breaks my heart. I know she isn't dumb and tell her so, she is just struggling for the word in her brain to make it to her mouth.
It's a terrible disease.
Dondie

Thanks everyone - Yes, putting out a cup of water on the bed stand is totally useless if the Resident can't reach it or is incapable of holding it. :down:

Dondie, Thanks for the explanation. I know she was thirsty. Yet, my instructor kept busting my orifice about it over and over. How did I know? She has Alzheimer's - She doesn't know that she is thirsty.

I'm meeting with the Allied Health Coordinator at the College tomorrow and hopefully will have my Clinical location changed.

Everything is documented and printed up. I will not go back to this so-call Instructor.