Charge Nurse did CNA work. Learned A LOT.

[arelle68]

I did the work of a graveyard CNA last night on my Alzheimer's unit. There was no CNA to cover, so I volunteered to stay another 8 hours. I found out everything that my CNAs should have done, and didn't do. I also found out how hard they work. I know that they work the whole time they are there, and don't always get a break, and the facility quibbles with them over getting out as scheduled. The work that they do is emotionally, and physically exhausting. I have been screamed at, hit, cussed, invited to bed, and barely avoided having my fingers smashed by an angry resident. I feared for my safety during those moments. I moved lots of heavy people, and changed lots and lots of Attends, sometimes with the Rsdt. fighting me. My body hurts all over.

I saw things that made me upset. Bruises that had not been reported. Teeth that had been left in, and not cleaned, with one resident's mouth bleeding. Heels not floated. Heel boots left off. Things that I just trusted that the CNAs would do. Things that I sign on the MAR as done. I don't have time to check on all of these things. I barely have time to initial the little box so that I can hurry and initial the next little box...You people know how it is.

My CNAs need to take care of these things, and I need to make them. Not because my job is on the line, but because it is the right thing to do. The question is, "How?" How do you fo the work without time to do it, and staff to do it? How?

I could tell them, "Ok, these are your residents, these things are what you have to do for them. Do a round with me before you leave, and prove to me that you have done these things before you clock out." That would be the thing to do, right? I know it is in my heart. But then, things will take longer for me, and longer for them, and administration will be all over us about the time.

I am a fairly new nurse, and I want to be the best I can be. I want my unit to shine as an example of excellent care. Please give me ideas, fellow nurses. CNAs, I'd like to hear from you too. What do you think I should do?

[silverbat]

If the "smiley faces" help make the work enjoyable, gets the resident's the care they should have and everyone has fun doing it... go for it!

We have contests similar on occasion and it seems to help motivate ALL the staff. You know how one unit or shift likes to say "they" are "better" than the others?.. well, it gives them a chance to "Prove it"!!

I think it is important to not only DO a good job, but to enjoy it as much as possible. Not that it should be made trivial, because our work is vitally important!

Yes, it is part of the supervisors role to check up on the aides. If they don't like it, they probably aren't doing their job......AND they know it, or they wouldn't be defensive.

I think you are on the right track, OP, just continue learning and guiding!

BTW, I worked as an aide for 6 years before going to LPN then to RN. I worked in hospital and LTC.

[t1nkerbell]

I think your getting a little defensive. I said it sounds like a good system, its just the way you originally addressed it. It did sound demeaning. The way you said it. May be you don't hear it because your use to it. But for someone on the outside looking in, it didn't sound right. It sounded like you were talking about grade school kids instead of mature adults. Thats all. Smiley faces are good! :)

[Flynurse]

At the begining of the shift I make my expectations known and update my CNA's on resident changes and the DON's concerns. I end this brief meeting with "Excellent care makes HAPPY residents and happy residents use call lights less." Nothing is a greater motivator than not having to listen to call lights :) Second, our facility requires "compliance rounds." This can be and started out as, checking everything they are suppose to do by the end of the shift from mouth cares to positioning devices to low beds, etc. Now, since they know what we are looking for, we do a "focus compliance round" (i.e. call lights in place, mouth cares completed). However, it is best they don't know what the focus will be. We fill out a worksheet with all of the things that need to be corrected (and in which room, bed) before they leave shift, and sign what they corrected. Again, great motivator because no one wants to go back and do what should have been done. Yes, it is TIME consuming for you but believe me it worked when we began and continues to remind everyone what needs to be done. You will find less and less wrong and by the time it becomes routine it will take but 5 minutes or so because almost everything is RIGHT!

A "Great Job!" and "Thank You for your help!" are in order at the end of the night when all is well. I think we all forget how simple phrases can make people feel needed, esp. at their jobs.

As a whole, our facility also has a couple rewards systems. 1) A "Star Performance" board which is based on our facility's mission statements. If someone writes you a note for something POSITIVE you did and posts it on the board you get a treat with your note at the end of the month meeting. 2) Laminated cards for a job well done. If you collect 3 you can go to HR to get a treat of your choice (pop, candy, popcorn,etc.) Who doesn't love FREE stuff!?

[t1nkerbell]

Touche!!:yeah: