CNA/NTs singled out?

[Gromit]

My facility just instituted a new one today. NOW we have to give every patient a card that grades the CNA (and of course NT) performance. Were they courteous, did you like their performance (rate it from excellent to unsatisfactory).

On the whole I have no problem with a form for the patient to complain or compliment on the staff. We have those forms anyway (doesn't everyone?). However, this form is given to the pts (not if they ask, just given), every day, to every patient, regardless (including those who are total-care and just not with our reality).

The real crux of my problem is that there is only one facet being graded here. The CNAs performance. NOT the nurses, not janitors, food service or any other category.

Myself, I get praise from patients (many have -to my delight and surprise, as I didn't think anyone actually did this) have written or told my superiors favorable comments on my work -thats a pleasent surprise :) but then I always strive to go above and beyond, if time permits.

I don't think its fair though, to force 'em to grade just one facet, every day.

If anything would make me considder looking elsewhere, this is a biggie. The disparity is disheartening.

Ok, I'm off my box now.

[ChainedChaosRN]

SleepyEyes, first you've apparently misread my first post. I said nothing about staff being motivated by report cards. On the post about one possible reason a "report card" could be used would be staffing. I can think of a dozen other reasons. I do wonder if it wasn't prompted by complaints from family, residents, or possibly even state. I have used similar audit tools that usually evaluate several aspects: food, cleanliness, care, attitute, call light response, etc. Sometimes we ask for anonymous responses if there is possibly a staff abuse issue (fear of reprisal) and if it's because of a frequent complaining family member a signature. To give you an example of something very recent at my facility: Neurotic daughter approached me saying she was calling the state that on 3-11 there was poor call light response, can't find staff, food is cold. I immediately made up the audit tool for the residents on this unit and family members to fill out anonymously turn it in on a daily basis if possible for a 2 week time period. There were no complaints but from the neurotic daughter - and on a daily basis. Now, if she calls the state, I've did my homework, I have proof other than my word telling a state surveyor I made rounds, visited with residents, they didn't complain to me. How far would my word go??

Just for the record at my well run nursing home it is policy that no one passes a call light without answering it. We are a team. I make rounds several times daily as a decent DON should. I know everyone of my 160 residents and they know me and I know my staffing numbers every shift of every day. If we even get close to minimum staffing ratio's they are to call me and I put a backup system in place, which yes, it does include me going in. Everyday I thank God I have a fine staff and a fine home. We all work darn hard to stay there.

Peace,

Dawn

[Sleepyeyes]

The real crux of my problem is that there is only one facet being graded here. The CNAs performance. NOT the nurses, not janitors, food service or any other category.

Although you've stated that you do audit various departments for certain reasons, this poster is alerting you to a few things:

1) it demoralizes the staff to have their folks singled out-- Gromit clearly states that ONLY CNAs were being assessed, out of all the staff.

2) If the staff being audited is aware that they are being audited, would that not change their behavior?

The very act of giving out the cards every day could motivate different behaviors from the staff when giving pt. care, and in fact, that might of itself be enough to motivate the staff to do things better. That was my assumption, and that was how the "motivation" word got in there.

3) While I have not been given such audit tools as you describe, I have, as a nurse, been asked to DOCUMENT in the chart all aspects of a pt's c/o poor service. For example, if a pt was c/o food, I might chart, "Pt ate 100% of meal and stated, 'This food is lousy; I'm ordering a pizza and Coke" and Pt was reminded that he is on a Low Na, Low Cholesterol, No Caffeine Cardiac Diet, but Pt stated, "Yes, I know all that, and I don't give a s***."

Point being: I still don't get why the CNA's in Gromit's facility would have to hand out cards when you already have access to a legal document about the patient's care. Maybe I'm being naive, but like I said, the CNA's are overworked and overstressed as it is, and I have to ask why the CNAs are not only being singled out but have to do the work of giving the patient the audit tool as well.

I was a night shift charge in a LTC facility, and I knew who the good aides/nurses were and who the slackers were. I worked as a CNA at times if we were short, and I talked to the residents as well.

Lastly, I had the backup of my DON to initiate disciplinary procedures on anyone who wasn't doing a good job.

So call me stupid, but I still don't see how these cards, which are not legal documents, are any different than simple conversations and decent recordkeeping.