CNA Oriention Dementia Unit

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I was on the dementia unit last night. I work 11pm-7am. There are 26 beds and no nurse on the floor. There is only one CNA and its expected that someone will fall out of bed. I have no idea what floor I'm being assigned to and I'm having a hard time getting to know the patients because I'm being bounced around. Which leads me to believe I will sometimes be working on this floor. How would you handle taking care of 26 patients with various stages of dementia on overnight alone? I'm really nervous about being responsible for 26 people.

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Specializes in OB.

Are these patients in restraints? 26 patients for 1 CNA and no RN seems like a bit too much. I don't think I would be ok with this huge responsibility!

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Specializes in OB.

Is this even legal?

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They are not in restraints. Most don't have bedrails and some have floor alarms.

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Specializes in OB.

Wow. No bed rails? I don't think this is even legal. It's just an accident after an accident after another waiting to happen.

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Specializes in Short Term/Skilled.

having 2 full or 4 half bed rails is considered a restraint. At my NH we could have 3/4 up or 1/2. I don't know why anyone would have none, though.

Where is the nurse? There must be one in the facility.....Is this a SNF or assisted living?

Most states don't have laws regarding ratio's but some do. If you do end up on this unit the best thing to do is prioritize and manage your time. When rounding try to do multiple things at once....If you have to get anyone up in the AM, get them dressed the same time they ask to go to the bathroom or be changed....if you find you have time where its "slower" try and do things then that you would normally do later. Give full bed baths/showers at night instead of in the morning, etc.

Try to eliminate falls by taking safety precautions. All beds to the lowest position, pads on the floor if they're provided. Even talk with the nurse (wherever he/she is) about individual things that could help certain patients such as actually putting the W/C next to the bed combined with a bed alarm for those patients that you know for a fact will get up without calling.....think outside the box, so to speak. Patients who get up at night often do because they're scared or need the bathroom. Providing a night light or taking them to the bathroom even if they don't ask can sometimes help prevent falls.

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What if there is a fire or an emergency? Or you get hurt and no one is around.. Then what?

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I had a similar assignment and it was rough. I had 32 residents on a locked ward w/ no nurse. Yeah, lots of falls. One thing that I found that helped was to let your midnight wanderers stay up. Put them all together in one room, try to give them snacks or activities (lol's like to fold washcloths) and try to keep them busy when you round. It is not safe though, and a shame that our elders are treated that way. I had to get out.

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