Bullying CNA students in Clinical

[rnforforty]

I teach CNA's. Yesterday while in Clinical at a local LTC one of the charge nurses (LPN) danced all over one of my students. I was busy and the student reported it in post-clinical conference. She had been helping facility CNA's make beds (her resident assignment was completed and resident napping) and the nurse saw her come out of the linen closet with fresh linen for a bed. She yelled at her "you are supposed to have those in a plastic bag, it is policy!" Where upon, my student said sorry, she wasn't aware and that she had looked in the linen room earlier for a plastic bag for something else and there were none to be had. A facility CNA then went into the dirty utility room and came out carrying a plastic bag she flung at the student to cover the linen - plastic bag was wet and dripping! This aside as being a complete violation of the very basic of infection control standards, none of us had seen any of the facility CNA's covering the clean linens they removed from the linen room with any plastic bag or even a towel at any time we had been there that week. That said, this is the first clinical I've had here. I'm new to my role and this is the only LTC facility in my area where I have never worked. I spoke with the DON the week before clinical and found there was no staff development person on staff to orient my students so having to do it my self, I needed orientation. Said person assigned to do so never showed up at the appointed time so I did an "orientation" of myself. I find multiple violations of the most basic of infection control standards (yep, I was a CIC for over 18 years in an acute care hospital). Also, this facility has a major problem with MRSA, CRE, VRE and ESBL with multiple patients in contact precautions (but cohorted with supposedly UNCOLONIZED/INFECTED residents - explain that!) that they are trying to tell me came to them from the local acute care hospital (and I know better as I worked closely with that CIC as we were within the same system). All that aside, my ultimate question is how to handle this situation? Going to another LTC facility for clinical may not be an option: 2 are about 40 minutes away on bad roads in winder and the other 3 have their own CNA classes and will not allow us in day shift on weekdays. And while I'd love to simply make a call to the State regarding these and other issues I've noted I can't burn my bridges.I teach CNA's. Yesterday while in Clinical at a local LTC one of the charge nurses (LPN) danced all over one of my students. I was busy and the student reported it in post-clinical conference. She had been helping facility CNA's make beds (her resident assignment was completed and resident napping) and the nurse saw her come out of the linen closet with fresh linen for a bed. She yelled at her "you are supposed to have those in a plastic bag, it is policy!" Where upon, my student said sorry, she wasn't aware and that she had looked in the linen room earlier for a plastic bag for something else and there were none to be had. A facility CNA then went into the dirty utility room and came out carrying a plastic bag she flung at the student to cover the linen - plastic bag was wet and dripping! This aside as being a complete violation of the very basic of infection control standards, none of us had seen any of the facility CNA's covering the clean linens they removed from the linen room with any plastic bag or even a towel at any time we had been there that week. That said, this is the first clinical I've had here. I'm new to my role and this is the only LTC facility in my area where I have never worked. I spoke with the DON the week before clinical and found there was no staff development person on staff to orient my students so having to do it my self, I needed orientation. Said person assigned to do so never showed up at the appointed time so I did an "orientation" of myself. I find multiple violations of the most basic of infection control standards (yep, I was a CIC for over 18 years in an acute care hospital). Also, this facility has a major problem with MRSA, CRE, VRE and ESBL with multiple patients in contact precautions (but cohorted with supposedly UNCOLONIZED/INFECTED residents - explain that!) that they are trying to tell me came to them from the local acute care hospital (and I know better as I worked closely with that CIC as we were within the same system). All that aside, my ultimate question is how to handle this situation? Going to another LTC facility for clinical may not be an option: 2 are about 40 minutes away on bad roads in winder and the other 3 have their own CNA classes and will not allow us in day shift on weekdays. And while I'd love to simply make a call to the State regarding these and other issues I've noted I can't burn my bridges.I teach CNA's. Yesterday while in Clinical at a local LTC one of the charge nurses (LPN) danced all over one of my students. I was busy and the student reported it in post-clinical conference. She had been helping facility CNA's make beds (her resident assignment was completed and resident napping) and the nurse saw her come out of the linen closet with fresh linen for a bed. She yelled at her "you are supposed to have those in a plastic bag, it is policy!" Where upon, my student said sorry, she wasn't aware and that she had looked in the linen room earlier for a plastic bag for something else and there were none to be had. A facility CNA then went into the dirty utility room and came out carrying a plastic bag she flung at the student to cover the linen - plastic bag was wet and dripping! This aside as being a complete violation of the very basic of infection control standards, none of us had seen any of the facility CNA's covering the clean linens they removed from the linen room with any plastic bag or even a towel at any time we had been there that week. That said, this is the first clinical I've had here. I'm new to my role and this is the only LTC facility in my area where I have never worked. I spoke with the DON the week before clinical and found there was no staff development person on staff to orient my students so having to do it my self, I needed orientation. Said person assigned to do so never showed up at the appointed time so I did an "orientation" of myself. I find multiple violations of the most basic of infection control standards (yep, I was a CIC for over 18 years in an acute care hospital). Also, this facility has a major problem with MRSA, CRE, VRE and ESBL with multiple patients in contact precautions (but cohorted with supposedly UNCOLONIZED/INFECTED residents - explain that!) that they are trying to tell me came to them from the local acute care hospital (and I know better as I worked closely with that CIC as we were within the same system). All that aside, my ultimate question is how to handle this situation? Going to another LTC facility for clinical may not be an option: 2 are about 40 minutes away on bad roads in winder and the other 3 have their own CNA classes and will not allow us in day shift on weekdays. And while I'd love to simply make a call to the State regarding these and other issues I've noted I can't burn my bridges.

[Whispera, MSN, RN]

anonymous call to the state...gotta advocate for the patients!

[mamagui]

How in the world did this post get triplicated?

[ponymom]

Whoa, Groundhog Day...

Seriously, you owe it to your students and especially to those residents to make that call if that place is that bad.

[rnforforty]

How did that thing get triplicate?

[motherof3sons]

Honestly I would take aside the charge nurse and tell her that you are the instructor and if there is a problem with a student to let you know and you will handle it. Be kind and firm. A call to the state to let them know what you are seeing would be in order too.

[HappyWife77, BSN, RN]

That is a standard policy to bag linens. Try to have students have plastic bags in their pockets for when they need to use them. If you dont know where to find them....ask the DON how you supply them to the students.....after all it is standard policy.

Just remember that and look at this clinical as your "breaking-in" clinical experience. You are learning the facilty, the staff, the rude nurses who think they can yell at students, the administration and so forth.

Teach students to let you know if something happens and I suggest Immediately addressing the nurse or other staff that spoke that way to the student, be a voice and an advocate -that it's not gonna go down the way nurse handled it. We were all students we all started somewhere.

That is what is annoying about nurses and CNAS with attitudes against student's. ...they were once there too. Have some respect.

Go to the administrator and DON about it, hopefully the staff will be addressed from their powers that be .... after you let the nurse know they need to come to you as you are responsible for them and that you will not tolerate hostility or any other rude comments to your students.

Maintain the utmost professionalism the whole time... You are also teaching your students how to behave in their future conflicts. Let the staff there learn your leadership style and they will know what to expect if and when you return with students.

Also let your students know they can vent in post - conferences.....and believe me they will! :)

I would also suggest you brush up on State regulations while in facilties so you are aware of the standards of practice (even if the staff aren't compliant you need to be teaching and practicing appropriately)...such as bagging linens, using clothing protectors when feeding. We had a place that tried to give us towels to place on residents when they were being fed, that is unacceptable and an issue of dignity. The laundry department wasn't happy because they actually had to hurry and wash the protectors for all three meals because our clinical days are 12 hour shifts.

I would definitely make that call to the state. You are not burning your bridges. The facilty will love having help of students, especially if state is visiting or investigating. Hopefully you will be a part of the improvement in that place just by having students there.

Sometimes is seems the issues are with the students other times it's the staff at the facilty...and some classes it both sides of the equation! However, just try to implement the same style of leadership with all parties involved by being consistent. Don't forget to have fun and most of all don't complain to the students about what going on either. ( come here to AN to vent!) Keep redirecting everyone to the ACTUAL ASSIGNMENT at hand and that is learning resident care procedures and passing state certification and moving on with their lives!

I have taught CNA classes in the best and worse of clinical sites. Feel free to pm me anytime. Good luck!

[rnforforty]

I already know the state regs regarding laundry handling - I drafted multiple policies and taught said policies to hospital staff in this state for the last 20 some years in my capacity of CIC manager so I do teach proper handling and techniques. The students are just letting it roll off their backs and concentrating on learning the correct way. I am going to have to approach this nurse and settle the issue as you suggest.