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 agree, the aloe vesta is very important and I really felt ill at ease skipping that step. After coming out of that office holding back tears, I let my emotions take over in a kind of 'okay, if that's what you want, then that's what you'll get' way. It wont happen again, especially since I see up close and personal the results of skin breakdown on a massive scale. I still remember my first unstageable decubits .
fuzzywuzzy
During morning vitals I take note of who needs immediate attention. I work on a 'matter of importance' schedule and make them my first stop after vital's. Before ice is passed, before feedings, before emptying my own bladder....you get the picture. I again make assessments while I'm doing my 11am blood sugars, which I don't actually get to till 11:45 because of the immediate needs of the soiled pts. Believe me, I wouldn't be able to walk off of the unit if there was a pt laying in soiled linen unless I've already done their am care and it's now up to the RN. Not previously mentioned but very definate indeed is the sheer number of bed pan runs through out the shift.
Thank you for your observation. I've seen and been privy to techs walking away and leaving a code brown for the next shift. Often before punch out time. I've been covering the floor after 2pm when my coworker takes her break and had to attend to a situation that I'm sure she was aware of before walking away. I concur that it sucks and have never left a pt soiled even if it means punching out and coming back. These pts weren't soiled but they're bed covers were in disarray and I hadn't had a chance to get the warm water, clean linen, wash them and change their clothes. In my unit they're the 'completes' and then they're the 'should really be an assist but listed as complete anyway'. I don't discriminate, if my assignment says complete then I complete them unless they insist on doing it themselves. Sometimes during report the RN's don't get an accurate picture of a particular pt's actual am needs. It's no one's fault. When you walk on my unit and find all the call bells going off and the previous shift ready to get out of there, whether pt x can help out in their own care is trivial to pt a, b, c & z calling for meds, getting ready to code or having a fit because they want to go home.
In any event, I've given myself permission to do the important parts and walk away without feeling like a heel and don't anticipate anymore imcomplete assignments in my future.
I am really glad to see that there are so many of the CNAs that have encountered these problems and hopefully something can be done as far as relieving the stress from this job. I know that there are many great nurses out there and to them I tip my hat and thank them for all they have done and continue to do. The problem that I see are with the puppets that are hanging on to their jobs because of under staffing and putting the work off on CNAs.
In the time that I worked as a CNA I have never quite felt the closeness or the compassion to do a great job for not only myself, but for my residents as well. What a lot of people don't realize is we are the ones that eat, sleep, and breath our residents, patients, and home care individuals.
At my place, it was horrible. When i first got hired as a cna at a nursing home we were told to do the lifts yourself. And i was at the *** moment cuz you know you can hurt your back. Plus on top of that we had 88 resident and divide that by 11 yeah equals 8 to 9 resident per cna but these resident are physical and mental. You cant get some sort of help because the other CNAs are having their issues too. And plus by that we had to shower our ppls when we have shower teams that lacks off sometimes. I just thought that this was a code violation. The nursing home were i was at was getting too physical for me and i wanted to kept the job for at least 6months but i quit.
I can't imagine a facility deeming a Hoyer as a 1 assist. That is so egregiously unsafe!
We have some hoyer lifts that are considered 1 assists...in fact, we only have two residents that require two people when using the lift. I don't know if this is because it's a children's home for the developmentally disabled or not, but many of our residents aren't very big or heavy, and they aren't elderly so not as many of them are so frail. Maybe that has something to do with it.
For example, one of our residents is a 30 pound 4 year old. He is not fragile, no fractures or anything, and has a lift pad put under him only because he goes to school and the school requires it. According to his care plan, he is a 1 assist transfer and does not require use of a lift.
Lift pads are put under all of our residents, because other than the 5 or so who can ambulate, none of the others can bear weight or are contracted or just unable to understand how to stand, etc. But, most of our residents are able to be 2 person lifts (and those under 50 pounds are allowed to be 1 person lifts). Many of them aren't very big or heavy, and I usually only use the lift on the few residents who are too heavy for us to lift comfortably and safely.
At my facility, operating a hoyer lift requires two people. It's a risk that our resident could fall and injure themselves during the procedure. I work with quite a few cna's that have the gull to operate a hoyer by themselves, but that couldn't be me. I will not jeopardize my job or my certification because of this. If I cannot get any assistance, then I'll just report it to the nurse.
it would be so nice if everyone just helped each other out. imagine how much more pleasant it would be if CNAs teamed up to bathe, turn, etc. things would get done so much faster and more efficiently, not to mention the morale would be a lot higher. instead, you have the ones that can do everything "on their own" so they don't want to help anyone else and even if they did need help they wouldn't dare "shaming themselves" by asking. a RN who was teaching my class was saying she bathes her own patients so she can assess them during that time.
WOW! i was amazed. i'm starting a second degree BSN RN program soon, but i want to get some CNA experience so i can relate to the CNAs i'll be working with later - something i hear that RNs aren't notorious for. hopefully, if i'm the position to delegate tasks to CNAs in the future, i can influence a team mentality. the power struggles between RNs and CNAs is another thing that makes work harder. this is obvious from many personal accounts and the fact that the only way someone such as myself who already has a degree can get work as a CNA is to leave the "higher education" space blank on applications. i'll never understand the hostility between RN/CNA and CNA/CNA. work is always going to be somewhat hard, but it could also be enjoyable and less of a burden if these silly battles would stop.
The battles between rn/cna and cna /cna is only part of it. I figured it out when I was on the day shift. We have 8-10 residents between 7am-11:30 when all residents must be in the day room for lunch. Cna have 10 minutes for resident care per resident. It is impossible to get real patient care that way, granted the shift ends at 3, but after lunch you have a second set of responsibilites, nap time 2 nd changes transporting multi residents to dr, dentist and podiatrist appts.
As far as the hoyer go, or caring for someone that is violent, or very big even for diaper changes, I get help, a hoyer is a 2 person assist, not one, I don't really care if another aide thinks I am a baby, there are definite rules that we go by, I also read the care plan, what the dr or nurse manager writes in is what I follow. If the facility doesn't care about the cna and her career, The CNA HAS TO!
Okay. I am in a PCT program this semester and I officially cannot be anymore scared than what I am after reading this thread. I want to be the best CNA I can be but how is that even possible when others CNAs or RNs or the facility itself make it so hard. I thought I would be able to love my job despite having a lot of physical work to do. The physical work is not what I am afraid of at all. I am very much looking forward to working with these patients or residents. It's the facility that I am worried about. They rush you to the point where you can't provide the best care? Co-workers are cooperating? Idk.
You know it has been almost over a year since I saw the problems that started at the long term care facility happened as much as I hate to say it it left a very bad taste with me. I think that it is a shame that CNA's have to constantly hear "Find a way to work more efficiently. How many time I have heard that. The problems are not always on our side it sometimes must be taken care of on the management side. It's called hiring. Not that hard to figure out. After I left the facility they hired more CNA's and are doing fine. Why does someone have to leave in order for them to get it.
PhoenixTech, LPN
279 Posts
SuesquatchRN
I agree, the aloe vesta is very important and I really felt ill at ease skipping that step. After coming out of that office holding back tears, I let my emotions take over in a kind of 'okay, if that's what you want, then that's what you'll get' way. It wont happen again, especially since I see up close and personal the results of skin breakdown on a massive scale. I still remember my first unstageable decubits
.
fuzzywuzzy
During morning vitals I take note of who needs immediate attention. I work on a 'matter of importance' schedule and make them my first stop after vital's. Before ice is passed, before feedings, before emptying my own bladder....you get the picture. I again make assessments while I'm doing my 11am blood sugars, which I don't actually get to till 11:45 because of the immediate needs of the soiled pts. Believe me, I wouldn't be able to walk off of the unit if there was a pt laying in soiled linen unless I've already done their am care and it's now up to the RN. Not previously mentioned but very definate indeed is the sheer number of bed pan runs through out the shift.
Thank you for your observation. I've seen and been privy to techs walking away and leaving a code brown for the next shift. Often before punch out time. I've been covering the floor after 2pm when my coworker takes her break and had to attend to a situation that I'm sure she was aware of before walking away. I concur that it sucks and have never left a pt soiled even if it means punching out and coming back. These pts weren't soiled but they're bed covers were in disarray and I hadn't had a chance to get the warm water, clean linen, wash them and change their clothes. In my unit they're the 'completes' and then they're the 'should really be an assist but listed as complete anyway'. I don't discriminate, if my assignment says complete then I complete them unless they insist on doing it themselves. Sometimes during report the RN's don't get an accurate picture of a particular pt's actual am needs. It's no one's fault. When you walk on my unit and find all the call bells going off and the previous shift ready to get out of there, whether pt x can help out in their own care is trivial to pt a, b, c & z calling for meds, getting ready to code or having a fit because they want to go home.
In any event, I've given myself permission to do the important parts and walk away without feeling like a heel and don't anticipate anymore imcomplete assignments in my future.