What I have seen in some of the stories is something that I think that all CNA's should think about. I too was asked to operate lifts by myself and refused and ran into the same situation as the others and that was you were looked upon as being "less of a CNA". I looked into other procedures or "short cuts", they called, which were being done by the "so called" more seasoned CNAs and found that they violated state procedure policy. This is something that I have noticed at several facilities.
This presents a major problem when you are being pressured into violating, to what you know as to being, the correct way of caring for the resident. CNA's should be aware if you violate a procedure, and you know that it is a violation, you can loose your certification and be terminated. That is a double edge sword because the company that you are working for can turn blind eye to the fact that they have intentionally understaffed the facility to save money.
So the problem is is do you do the right thing and not violate the procedure and risk being terminated because of speed or do you violate procedure and keep your job. I think that this is something that needs to be addressed by each individual.
I'm just curious, if the certification is terminated do we retake the course and all process all over again to get the cert. again or does this mean we cant ever be a cna again? I know this would hardly or never happened to me b/c I'm a very careful person...but yeah that's just my curiosity.
In most cases if you certificate is revoked due to a disciplinary action by the Board of Nursing you can never again work as a CNA or gain any other license or certificate from the Board of Nursing up to and including a LPN or RN license.
I definatly take shortcuts as a CNA. But I never let those shortcuts go against what is ordered by the Doc in the residents chart. One time we had a new resident and I checked his chart and it said he was a "transfer with 1 assist". When I went to transfer him from bed to chair the guy thought he was superman and ended up falling. He didn't realize his limitations. Well the nurses were in an uproar about it, but since I was smart enought to notice what it said in his chart, I was not held responsible. I did what the chart said. Now if he was a "transfer with 2 assists" and I did it alone, that could have been my a**. I am not tryng to get sued by anyone. So while my shortcuts may involve not doing this and that by the book, I always make sure the important things that regard the patients safety are adhered to.:redpinkhe
In most cases if you certificate is revoked due to a disciplinary action by the Board of Nursing you can never again work as a CNA or gain any other license or certificate from the Board of Nursing up to and including a LPN or RN license.
It is sad to think that because there are budget constraints that occur in these homes that the CNA is expected to, "behind closed doors", violate procedures but yet if they are caught by state they will be thrown under the bus. I have seen this done many times by older CNAs that again look down upon the rookie CNAs. It is sometimes hard to look up to someone that is teaching you the wrong in order to keep their job.
Thank you for saying something! I thought I was the only one who encountered the lift situation. It got so bad that I was thinking, "Well, I must either be lazy or a big baby because so and so said she does the lift by herself all the time and she's been doing it for years!"
I never use the Hoyer lift by myself. But I do use the Sit To Stand by myself if the DON has deemed the resident as a SSx1 (Sit TO Stand w/ a one person transfer). Is this wrong?
When I had a resident who was a mechanical lift, if I did not have help, guess what? That resident stayed in bed until someone helped me. Not only is it not safe for you, but it isn't safe for the resident either. I politely tell the charge nurse why and usually they find me help quick....even if she has to get up and help me. Mechanical lifts should always be a two person assist. There are too many things that can go wrong.
As a matter of fact, one of our residents got a broken leg because a cna used the hoyer lift by herself. The CNA did not realize she was bending the patient's leg against the wall during the transfer.....we all know what happened afterwards. The CNA was fired, because when it all comes down to it, the CNA should have known better then to operate a two person assist by herself!
It's called CYA. Yes, I have seen seasoned CNA's use it by themselves and was told by them to do the same. I will not. I realize most times CNA do two person transfers because of poor staffing. In this case, they are safer in bed. Unless it is a matter of life or death, I don't do 2 person transfers alone. There is a reason that rule was put into effect.
This past week I had the highest pt load ever. 9 completes, 3 feeder's, 4 ekg's, lab runs, pt transfers for testing procedures, blood bank runs. I felt completely overwhelmed and did the best I could. I was always told that the hospital is a 24 hr operation and what doesn't get done should be endorsed, but I've always felt guilty about endorsing my work to the oncoming techs. However, it was unavoidable for me this past week and with some aprehension, I endorsed.
I often wondered how other techs could go into a complete pts room to do am care and come out w/in 15min. It always took me at least a half hour. I found out when I came into work and was called into my manager's office because of the pts I didn't get to. I felt very disappointed because I do my best to work with my RN's in whatever they ask, but apparantly being a team player isn't a popular option on my floor. I don't believe that it was just the RN's who complained. I feel that the techs were very vocal about having to come into work and do 'am' care when it's clearly 'pm' shift.
In any event, I came out of that office with a renewed sense of determination and completed my assignment before 1pm with the exception of one pt who needed more than 1 person to handle them. How, you may ask?
I washed axillary and pelvic region, changed draw sheet and pad (sheet only if it was soiled, if not just pad), applied no cream, passed no ice, fed no pts, helped with no transfers, picked up no blood, did no ekg's, and only relieved the 1:1 for her morning break. I gotta tell you I felt like I severly neglected my pts, but since the techs that take these shortcuts always get their assignments done and I was advised by my manager to find a quicker way to do my work, I felt like I had no choice. After all, more staffing is out of the question and even in the face of family complaints, my manager is more concerned with cutting costs than not.
Thank you for this thread and while my situation isn't equipment based, it's still a testament to shortcuts in the name of frugality.
I can understand wanting to give thorough care and feeling like you're neglecting your patients if you don't. But at the same time, giving good care to some people while others lie unwashed in their own excrement all day because you didn't get to them sucks too.
I think it was a little easier on second shift because I could lay out all my supplies ahead of time and after I got someone washed, gowned and in bed I could skip the lotioning and mouth care until my 8 or 10pm rounds. Now that I'm on first shift there's no time to go around laying out supplies or even to search for them in the middle of care. I've tried carrying stuff in my pockets but everything falls out and I leave a trail wherever I go.
On first shift I have to admit I usually fly through my care if I'm on one of the hard assignments on the heavy hall- it's wash face, hands, and butt, throw on some clothing, and haul 'em out of bed. There are tons of feeds some of the people can be fed in bed, and a lot have to be up. I end up changing wet pads on the breakfast-in-bed people as I go along passing trays. Then when breakfast is finally done I'm scrambling to wash those same people and get THEM up, AND do rounds on the people I got up before breakfast. Meanwhile the nurse is on your butt to do the vitals and pass waters and snacks. And there are beds to be made. And before I know it, it's time for another set of rounds before lunch. After lunch is all about getting people walked, changed, and laid down for naps in time to do paperwork and chores before 2nd shift gets there. There is no time to "go back" and do anything you skipped.
PLEASE apply the butt creams. Otherwise, you have to do what you did to get done. There's no way, with everyone requiring so much ADL care, to get it done and also run errands and EKGs for others.
Bug Out, BSN
344 Posts
In most cases if you certificate is revoked due to a disciplinary action by the Board of Nursing you can never again work as a CNA or gain any other license or certificate from the Board of Nursing up to and including a LPN or RN license.