Clinical concerns

[Asclepios]

I just started my clinicals for my CNA course and I have some concerns that I was wondering how common they appear. I realize that this work is tough, and I expected nothing less, but I also believe that we should always place the well being of the residents that are under our care first. We are here to improve health were we can, not make it worse.

Throughout the day I noticed that the majority of CNA employed at the facility were quite rough and impersonal with the residents. In class I was taught that we needed to greet the residents and state our business, what we were going to do for them, before we began any process. Yet, I saw none of this happen. The caregivers just walked in and began their duties, not once did i see anyone greet the resident before starting. While offering care there were little, or no, words spoken to the residents. It was very mechanical, and harsh.

I noticed during the range of motion exercises the aides were moving the limbs in rapid and rough manners. One resident had a stiff knee, and the aide forced the leg to bend in a very harsh fashion. It appeared that there was alot of over stimulation to the resident that could make their condition worsen. Often I noticed that the residents that could not speak showed obvious pain during these exercises, and that the aides bluntly ignored their groans and moans of discomfort.

I saw that perineal care was rushed and incomplete, leaving fecal matter on the resident. At some points I noticed aides ignore a plea from a resident to go to the restroom. Even their dining was rushed and forced. By "force" I mean that exact wording, it was as though the aide crammed huge spoon fulls into their mouth. It was such a risk for aspiration and choking.

My first day at clinicals had me heartbroken, I went home that evening and cried for those residents. Many of them had cried when my class had to go. Just in that one day I feel that I have made many friends of those residents, and it hurts me to see that their care is so disappointing. I did speak to my instructor about these concerns that I observed, and hope that they will be brought up to the DON. Keep in mind that these are just a few of the things that I noticed wrong..

Is this activity of care a common thing? Why do people that are so unconcerned for a persons well being involved in providing care in a medical facility? I appologise for my rants, but I had to get this off my chest, it is so sad for me to see this occur.

Thank you for your time in reading this.

[Nina2bRN]

systoly - lol...I did think that was funny (the whole quilty thing ). That facility you mentioned in Europe (without tv etc.), does sound a lot different then most nursing homes you hear of...did you get to talk with any of the residents about any of the activities there...they didn't have tv, so what did they do for fun? Just curious.

Asclepios - I think everyone (definitely myself) just misunderstood one another. I know I've learned that sometimes when you say something..even something so small..can get misunderstood, and I definitely see how I might have offended people...and I'm sorry for taking your thread and turning it into a debate. That was not my intentions at all.

[systoly]

the facility without tvs was a hospital. i did see one nursing home. most of the resident's rooms were private with a few semi private rooms occupied by couples. i don't know about scheduled activities, but there were a lot of visitors. the noise level was surprisingly low, however. i briefly visited a handful of facilities so i have no idea what the big picture looks like over there - just wanted to point out some differences i observed. as far as debate is concerned - what's wrong with debate and disagreement? that's why i love this board: you can vent, debate, state opinions, ask for help, have fun etc., etc. i might not like someone elses point of view and debate it heavily, or respond with sarcasm, but in the end i usually learn something. i believe people participate in this forum, because they are passionate about the topics.

[sing_anyway]

k, I am new here, but I am responding to the original question,

you really hit this one on the head,

I am a nurse aid in training, and that is how i felt too,

I swear that I will never treat my residents (LTC) that way,

I don't know how many I have found in briefs that smelled of ammonia, as though short staffing is an excuse, when I just saw your butt leaning against the wall 10 minutes ago, ya coulda tried to get to one more,

After my rotten night alone with noe float to help, I know I didn't get everyone perfectly, but my God I tried, so I try to keep that in mind when I find someone who isn't left as I would have liked to find them,

I keep hearing from those that did this a long time ago, don't forget how you felt right now,

but I also here this one:

there's Utopia, and there's reality, and you aren't going to find Utopia here.

Well, I just want to find the middle,

[bigbadduck]

asclepios,

:tku:[color=#2f4f4f] we need cna's like you! first of all, although it's sad to say, this field is just like any other speciality career. there are people in it that just don't belong. eventually they are weeded out. all you can do is be there to make your resident's life meaningful as well as provide the best nursing care you can. don't police the other cna's "attitudes". it's so not worth the stress. you have enough stress of your own. those cna's [color=#2f4f4f]won't be there long anyway. be there for your new "family" and make the best of it. :redbeathe

[fuzzywuzzy, CNA]

So let's say a man's been sitting in a wet brief for a while and he smells. Maybe the CNA didn't change him because

1. she's lazy and uncaring.

2. he's heavy and she tried unsuccessfully to roll him by herself and now she has to wait for another CNA to help. She asked someone twice, but no one was available. She answered several call lights in the meantime. Now she's "leaning her butt against the wall" waiting for that help she asked for.

3. he screamed, dug his nails in, took a swing at her. She came back 10 minutes later, hoping he'd forgotten, but he acted the same way. 10 more minutes and another CNA tries. No dice. She documents it, tells the nurse, and decides to try again later.

4. on her way to get another brief, someone's alarm went off. It takes several minutes to get them safely sitting down again. She gets 2 steps down the hallway and the alarm goes off again.

5. She has no idea he's even wet in the place because she's been swamped for the last 2 hours. She has an admission and it's throwing everything off. By the time she gets to him she can tell he's been wet for a long time and she feels guilty but there's nothing she can do about it now. Tomorrow she'll try to adjust her routine.

Aside from #1, all those reasons that the man ended up sitting in urine for too long are out of the CNA's control. It would be easy for an outsider to think, "how awful- I would never do that" but it can and does happen.

[sing_anyway]

absolutly!

this is just it, it didn't take long before i was in each and every one of those scenarios,

however,

those were not the case here, and i say that only because it was true.

I guess that's what is so frustrating,

we try so hard, and we cannot do everything, just can't,

but when you are introduced and you see the bad, without seeing the good as well, it paints a picture that stays with you no matter what.

I don't even think she was "lazy and uncaring",

I didn't mean for it to sound like that,

But as a new person, finding a strong smell of ammonia that is strong enough to make the eyes of the one training you water, you think, no way! no way could this happen without someone at fault!

I still belive that what is at fault is the amount of staff given, but that problem is made worse by those that are there as a pit stop or a paycheck.

I guess my real thing is, do you have to stop caring to be able to get by? because the guilt gets to a person, and the belief that as just one person they can change things, that goes fast too, so do you really have to get that thick skinned that you wouldn't say to the oncoming, hey, it's been crazy, you're gonna want to check this one first?

sorry for sounding so mean, I didn't mean to, the shock of what you get thrown so quickly into kinda hits hard.