Questions from new CNA

  1. Hi,

    I'm a new CNA in LTC that has worked about 8 shifts so far and I have a few questions about safety and teamwork. I have been reading this forum off and on for months and love it. Now, I need some input from experienced CNA's in LTC. So, here goes...

    How often do falls and drops occur in LTC? Has anyone ever had a belt on a sit to stand pop open? I had this happen on my 2nd day working alone. Fortunately, the resident seems o.k. This may have been my error by not snapping the belt completely closed, but I was also told a belt popped open twice with another resident in the week prior to my incident. Does anyone know if these belts will pop open easier under certain conditions like if a resident twists, the belt is threaded backwards, or if the resident is over a certain weight limit.

    Do any facilities have their CNA's work in teams? I can think of dozens of reasons why having a partner would be a good thing but I haven't heard of any facilities that operate that way. From a risk management point of view, I would think this is the best way to help reduce injuries and provide better care for the residents and it wouldn't cost the facility a thing. Why don't places encourage or require teamwork?

    I'd love working in my facility if we worked in teams. As it is, I'm feeling overwhelmed and now I'm feeling unsure about any transfers. I've already asked management about teamwork in the facility, but they said it's up to my hall partner that day and some experienced aides don't want to work in teams.

    Comments, advice?
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    About LoveToHike, BSN

    Joined: Apr '09; Posts: 40; Likes: 16
    from US
    Specialty: 4 year(s) of experience


  3. by   fuzzywuzzy
    I have no experience with sit-to-stand machines but I can understand your trepidation about using them after what happened. I would grab a coworker to spot you the next few times you use one until you're comfortable.

    It would cost the facility more money to have people work in teams because they'd have to put more people on the floor. Plus I think they like giving individual assignments so they know who to hold accountable if something happens.

    If your coworkers don't want to team up you'll have to make do. I'm sure they have 2-assists as well, so mention one of theirs when you ask for help with yours. And don't expect to team up for anything but transfers and rolling/boosting people in bed. There's one CNA I work with who asks for help "doing someone" and it turns out she wants to do everything together. It does not take 2 people to wash someone's face. I have other stuff i could be doing. So if you're just nervous about doing care by yourself, you'll have to get over that.
  4. by   fwardlaw147
    Teaming seems like agood idea in theory, but you can also get burned by it when the other person doesn't carry their share of the load. Teaming can also slow a more experienced tech down. Things seem hard now, but you will find your rhythm in time and things will get going more smoothly during your shift.

    Personally, I was fortunate to never have a patient fall on the lift you mentioned, but I agree with the previous poster that you should have someone spotting you until you feel more confident that you can hook someone up properly. It is not just in the best interest of the patient, but to also protect you from liability and injury. Sometimes, people fall despite you doing everything "perfectly". I had a spotter on a hoyer lift. I set the patient up as standard, but that did not stop the patient tilting towards the back. Fortunately, the spotter was able to guide the patient into the geri chair without harm. I've been a CNA for almost a year, and still use spotters for that lift.
  5. by   jezzie1977
    Where I used to work, there were teams. You did have your own assignment, however there was another CNA on your wing so that you could help each other out. It didn't last long, however, since they couldn't staff it.

    As for the lifts/transfers, each LTC has their own regulations. Where I used to work you needed at least two CNAs for any lift/transfer. If you feel uncomfortable with using or doing either, then its best for you and the resident to get another CNA or Nurse in the room when you need to preform them.
  6. by   mncna08
    well i have my wing of 8 people, wich compared to other people is not a lot. but we team up. it works out nicely,say we do 3 two person transfers and then we will go to the other side and do 3. just depends i guess. now the stands make me nervous, there great when they fit a person, but yesterday at work we were using a new lift and the the part that holds them up(cant think of the name!) was riding up like she was going to put her arms up and was going to slide right down to the floor. i was not going to take the chance with a possability of a fall like that no way. if it unclipped while the person was standing up i could only imagine the needs to be tagged out or let managment know that they need a new one, and borrow another one if possible. where i work it is policy that there be two people while doing a lift. and it should say on the machine the weight will be frustrated until you get the work down and get to know your resideents, and when you do your time managment and everything will be great it just takes time good luck!
  7. by   nkara
    I worked in a ltc facility before getting the job I have now in a hospital and we never used the sit to stand machine..we would use the hoyer which is required by law to have two people operate. I found in the LTC facilities I worked in it depended on the co-workers wether they wanted to help you or not. I had alot of them who would say "why don't we work together" you bang out the rounds faster and it's safer for all .. you, your back and the patient. I did find in the first place I worked in the other CNA's were awful to me. Talk about a nasty group. They would stab you in the back in a heart beat. Needless to say I didn't stay there long. Good luck where you are. Definitely speak up if you need help. Don't forget it's the patient safety that is your utmost concern.
  8. by   texastaz
    First - work agency so not knowing the patients and the tone of the facility when I walk in - the heavy lifters are always my first top priority. I usualy communicate with the CNA that is sharing the same floor and let them know I need assistance with x x and x patient and ask them who their heavy lifters are so we can plan in advance to get the patients taken care of together. The only time when I have seen teams work well together are when both CNAs are at the same skill level and have the same work ethic. It is common CNAs disappear when you need help and will try to degrate you for your skills, try to claim they are have done ALL your work because they helped you once or twice, forth. I let bad attitudes role off me like water on a duck. I always bring it to the attention of the nurse. If the nurse cannot solve the issue - well as a CNA - I have done what needs to be done. Do not ever risk your safety or the patients safety.
    Most falls I have seen have been from patients that try to move from thier w/c to the toilet, or vise versa and their legs give out. They are patients that are well aware that they need to call for help, but still want to do it themselves (wants to keep some independence), don't want to have to wait for a CNA/or bother a CNA when they need to go. I have seen patients dropped mostly from over confident CNAs wanting to show off how good they are moving patients from Geri chairs - not using hoyers when they should, this is not very common though. I think hooyers are not used enough. Several times instead of depending on another CNA to help with lifting a patient I have used a hooyer. It has caught on in many facilities that I have been to however when hooyers started to be used regular - a shortage or the nets started to be a problem. There are also always falls caused by the patient who will literaly throw themselves on the floor for attention (you always know that one is comming and everyone watches the person). They eventualy progress to some type of restraints and have a matress on the floor.
  9. by   fuzzywuzzy
    We have one lady who likes to sleep hanging off her bed, for some reason. So we have thick pads on the floor and her bed goes all the way down. If she happens to roll over and her knees are touching the floor pad, which is only an inch lower than the bed, it's considered a fall.
  10. by   texastaz
    Quote from fuzzywuzzy
    We have one lady who likes to sleep hanging off her bed, for some reason. So we have thick pads on the floor and her bed goes all the way down. If she happens to roll over and her knees are touching the floor pad, which is only an inch lower than the bed, it's considered a fall.
    Yes this is a excellent example of a fall. Not all and or the majority of falls caused by CNAs-or thier negligence. Drops are another thing. I do know falls must be well documented as in this example because just for the patient to have the padding to be on a bed-rail the doctor has to write the prescription and they will not do so unless there is sufficient documentation.

    Nurses get tired of paperwork and we get tired telling the nurse - however this is how it works.:lol_hitti
  11. by   jennileigh8182
    Are you talking about the EZ-Stand machine? We use those a great deal in the facility where I work, and I've never had an issue with one. I have had one ALMOST fall, but it was a regular transfer, not the EZ Stand...and it was when transferring a woman from w/c to bed and she was wearing this silky nightgown. I got her onto the bed, removed teh gait belt and she started to lay down (she's able to arrange herself in bed, just not stand up alone), and slipped off the edge of the bed. I was still right there and caught her bottom in my hands to keep her from going to the floor.

    As to teamwork...somedays I work with good CNAs, other days I work with bad ones. We recently had one fired, thankfully, who had refused to even SPEAK to me, let alone help me out. However, I've had others that liked company and wanted to team up. We were able to do our two sections together faster than either of us could have done one section alone, and it was safer.
  12. by   azcna
    I always thought that working in teams was a good idea, too. If you get a good partner you can get things done pretty fast. In a facility I used to work at, this girl and I could put 27 people to bed in 2.5 hours.

    The problem is when you have a lazy partner who makes you do all the work, and disappears, and doesn't do anything. It is better to have those people be responsible for their own residents, rather than have them drag the other people down.