LTC Dignity - page 2

I have just completed my 3rd week of 4 in CNA school. Today, was our first day of 3 days in an LTC facility where they allow us to come in and put to use everything we've been learning. Although... Read More

  1. by   drmorton2b
    Safe Staffing ratios are definitely needed in Nursing, different thread though.

    I am working in a Hospital Pharmacy as a Tech and learning a lot about Pharmacology. I work Retail on the Weekends. Well this weekend I walked into the store and was cut down to 6 Hours a week!

    I have been toying with the Idea of being a CNA for awhile now, since I start LPN School in 2009. I am learning 0 nursing care skills at my 6 year retail job. I want to truly start to do some form of assisting nurses. Thats why I'm signing up for the CNA program at my Community College.

    It takes a dedicated person to be a CNA. As mentioned in the above threads and overall, it takes time, something that you thought was hard 1 year ago, is 2nd nature to you now. Do the best you do as humanly possible can do in regard to patient dignity.
  2. by   Lavslady
    Sounds like one of "those" days in LTC...2 admits, a discharge, a room transfer and a fall...on the skilled unit...and at least one new cna...
    Question: How many residents on skilled unit?
    Question: How many cna's scheduled?
    Question: How many cma's scheduled?
    Question: How many nurses scheduled?
    Question: How many call-in? Were they covered...or were you working short-staffed?
    The day started out bad for the Nurses anyway...Report with off-going shift...2 new admits coming, a discharge, a transfer...(do you know what all the paperwork that the nurses have to do for these kinds of activities?...TONS...and checking in coming and discharge Doctor orders, ordering from Pharmacy (assuming )(sic) MDs writing is legible and orders can be deciphered and Drugs ordered are appropriate or do they need to be clarified?), making out the daily schedule for the cnas...letting them know who all needs VS, Wts, I&0s, Special Treatments, etc...going through her treatment books to see who all the diabetics who needed Blood Sugars done and Insulin given before breakfast...
    Cnas not on floor, but in a meeting for 45 minutes...
    Not trying to make excuses for the nurses not passing trays that were delivered at 7:20...but they were a little busy themselves at the time...
    And for the Nurses...the day just got busier...a you know how much paperwork the Nurse has to do for a fall??? besides the initial assessment of the there an injury? is it bleeding? how much? can it be steri-striped? how much pain is the pt. in? can they move everything in their normal range of motion? do they need to go to the hospital? Then actually do the necessary treatments or transfer arrangements, phone calls to notify family and MD...
    And remember...for every set of VS you have to take...your Nurse has to chart on that person, not only the VS that you take...but a whole shift of care. (Lots more paperwork...)
    And you know...I bet...your Nurse didn't even have time to take more than a 15 minute break all day...and even tho you left at your scheduled time...your nurse probably sat at the desk for another 45 minutes minimum finishing up her charting.
    Yep...a typical day from hell in the nursing home...
    So why do we do it? How can we put up with the short-staffing and over-loads for our poor cnas, that cause such burn-out that we lose the good ones and have to put up with the lazy ones? CNAs have the hardest physical job in Nursing and receive the lowest amount of wage...they are the ears and eyes of their Nurses. They are the first person the residents see each morning, and put them to bed each night, keeping watch over them all through the night on noc rounds...they give them their personal care and help them dress, eat, bathe, toilet, take them to activities...and the good ones do it with love and care...those are the ones that talk to their patients and treat them with dignity and become like family to them. Those are the ones we Nurses know we can trust to let us know of any concerns you might have about our patients...we have so much paperwork and "Nurse stuff" we have to do, we don't have the time to give each resident the personal time and assessments we you are our eyes and ears.
    I have been a Nurse for 40 years...most of that spent in LTC...and why do I do it? I love these old folks...they have wonderful stories and l wish I had more time to spend with them and listen to them...but I have sooooooooo much paperwork I have to trust my aides to be my mouth as well. And always speak gently and friendly TO them, ask your questions...most are more than happy to talk to you...don't ignore them, enjoy them, and learn from them...they have all had amazing lives, they have lived through history!
    Sorry to ramble...just wanted to welcome you to the "real" world of LTC...and if I was your Nurse, I'd be glad to have you! I always give my aides praise for the "little things" I see them do for my old folks... And I always try to remember to tell them "thank you for all your hard work" as they leave for the day.
  3. by   TheCommuter
    Quote from Redzie
    Do all or most CNA's become so complacent that they forget to be courteous or respectful? Or is it that they are just too busy? (These CNA's had 7-9 residents each - not sure if that's a lot or a little)
    I am an LVN at an upscale LTC facility, and the CNAs are typically assigned 15 to 20 patients apiece. If a CNA does not show up for work, or if our facility is attempting to save money by cutting back on staff, each CNA might end up with 25 or 30 patients apiece.

    I worked an overtime shift on Monday in the rehab unit of my workplace, and the CNA that was assigned to me had 25 patients to care for all by herself. Of course, I must help her answer some of the call lights. Outrageous workloads of patients incite much stress and hard feelings, and it is my theory that the CNAs go into survival mode by getting everything done as quickly as possible at the risk of forsaking dignity, gentleness, and empathy.

    If my facility cared about patient dignity, they would retain the appropriate amount of staff CNAs instead of trying to save the almighty dollar. Sorry, but 25 patients to 1 CNA is way too much!
  4. by   TheCommuter
    Oops, I did not realize this thread was old prior to posting my first response! :smackingf
  5. by   Pie'nthesky
    Hello all! I start CNA training in a couple of weeks. At this point I think I would prefer hospital over LTC for the range of experience I would receive (I plan on continuing on to nursing school). However I know I may end up in LTC, at least initially. My reason for responding to this post it that I am a former EMT who did alot of pt transports between LTC/Doc/Hosp. Sometimes I feel that working at a LTC would be so frustrating to me, I don't know if I could be happy. Not being able to make the difference I would want to make for my pts because of staffing shortages of course, but mainly because of the lack of compassion (or maybe apathy?) of any fellow cna's or nurses would drive me crazy. It can't be alot of fun living there, much less if your family doesn't even visit you... I had pts ask me if I could stay for a few minutes, thank me profusely, ask me tons of Q's, trying to stall me...etc. I know I can't save the world, but I want to at least make a difference.

    Has anyone ever felt like this? Were you able to overcome the frustration and just focus on being the best you could be for your pts?
  6. by   Lavslady
    commuter: I didn't realize it was old either...but many people will continue to read it and add to it, so it's all good . :-)
  7. by   pagandeva2000
    There is the school world and then, there is the real world and it sorely conflicts. What you can do is make sure as you gain your skills to always try and consider the patient. When they tell you to let the patient know what you are about to do is invaluable.

    Reality is usually that supplies are short. But, you will learn to improvise as well as to keep their dignity intact as time goes on. But, I admit, at times, it is hard. As a nurse, I always try to keep their dignity and tell them what I am about to do and why. In most cases, it works, because the patient is usually more cooperative and they learn to trust you. I have found that negative clinical experiences have encouraged me to be a better nurse, and you can use the negative things you witnessed to improve your practice. Good luck.
  8. by   TheCommuter
    Quote from squeakykitty
    As for dignity, how about that "high pitched talking to a 2 year old" type of voice tone I've heard used on elderly people in a nursing home. :trout: I wouldn't want anyone to talk to me like that at all, it's demeaning.
    I have difficulty speaking to my very demented patients in a conversational, adult, abstract manner, because they simply do not understand what I am saying anymore. It confuses them further.

    How do you propose that I speak to a demented old person who is functioning at the mental age of a 3-year-old?
  9. by   squeakykitty
    Quote from TheCommuter
    I have difficulty speaking to my very demented patients in a conversational, adult, abstract manner, because they simply do not understand what I am saying anymore. It confuses them further.

    How do you propose that I speak to a demented old person who is functioning at the mental age of a 3-year-old?
    The incident I was posting about involved a CNA that was trying to talk someone into taking a shower. I heard her tell a resident, "If you don't get a shower, you'll get 'stinky' "(stinky was said in a high pitched drawn out way [ssstttinnnkEEE!!!])
    It sounded so demeaning, and I never heard anyone speak to a 3 year old in that tone of voice.
    I just use a pleasant tone and keep it short and simple.
  10. by   umpalumpa14588
    What a great thread! The originator of this thread was so pisitive after such a rough first day!

    As many, if not all posters have said truthfully, is does change dramatically when you get out of training. It shouldn't, but it does. And all you can do every day is remind yourself that they are human, and promise to take care of them in a respectful manner, to preserve their dignity. As someone else said, maybe your positivity can change the attitude of the floor you end up wokring on. BRAVO!
  11. by   CT Pixie
    After being a CNA since the mid 80's I can tell you that THIS CNA has always treated a resident with dignity and respect. No, not ALL CNA's loose their compassion, not all treat residents harshly or as if they were children.

    Being busy is no reason to treat any resident abruptly, harshly or without dignity. Not enough towels, bath blankets to use for covering a pt during am care?..improvise, I would use the sheet that was on the bed and a towel i wasn't using at the time or the johnny coat. There are plenty of ways to maintain pt privacy..with or without extra towels/bath blankets.

    I guess what I am saying is, time does not harden a CNA or nurse for that matter. I believe those people were "hardened" prior to becoming one. Keep up that mindset of treating residents with respect and dignity! Thats they way it SHOULD be.