Concerns of a CNA student + a little story

[semiranda]

Ok...so, heres the deal...I am a CNA student getting ready to sit for the exam.

I really think have this bad image suck in my head of nursing homes and hospitals etc. from the death of a family member. She was diabetic and developed gangrene in her toe and cellulitis in her legs the shin/calve part. I visited her regularly from the time she was admitted to the hospital. A couple weeks later she developed bedsores in the area where the stomach fat laid on her legs, then her back. Although I complained and several family members complained things seems to get worse and no changes occured. After a month the grangrene had spread to the middle of her foot and she cried out in pain all the time. I studied alot and couldnt find out if it was the cellulitis or the gangrene causing pain-maybe even other underlying causes due to dibetes or other health problems. She was given morphine constantly and started having delirum, telling me the nurse were going to kill her and she'd constantly beg me to take her home. I couldn't do as she asked nor could I be there all the time for her. She was on the ICU after an amputation(full leg). They finally decided she would get blood posioning if they didnt take care of her leg. So, still on morphine she stayed pretty much out of it...she would be bedriddin for the rest of her life considering she was 78 and before the feet problems--limited in mobility. She healed faster than anticipated and transferred to LTC, where things again went to hell and she basically became a big bedsore. Eventually passing away.

I am fully aware everyone's situation is not the same nor will all be that bad, and some worse. But, Im so concerned about dealing with sick people, bedsores, finding a patient that has passed etc. it was tough seeing a loved one in such a horrible position. I am not concerned about the vomit, blood, or poop. I am aware there will be tons!! My mother was a CNA and she said you get used to it. Ok, but what happens and how do you deal before that happens. I'd love to hear about others personal experiences and feelings how you deal with some of the things you didnt think you could or weren't ready to.

Thanks everyone!!!

[fuzzywuzzy, CNA]

Everybody has to die sometime, no matter how well they are cared for or how many life-prolonging measures are taken. The one thing the care team can control (to the best of their ability), is the comfort of the patient/resident. So try and focus on that. Hopefully you won't have to "find" someone that has passed- someone should be in the room with them so they don't have to die alone. I'm sure that in your class you learned what a CNA can do for a dying resident- repositioning, low light, lots of mouth care, lotioning, handholding, talking softly, cool cloths on the forehead, changing the sheets if they get hot or damp, etc. I also like to keep the room very clean and presentable. The biggest obstacle in being able to do these things is knowing you have other duties. If you manage your time right and communicate with the other CNAs and nurses you should be able to pass some stuff off onto other people (within reason), or take turns. No one is going to get all pouty about having to do extra work so you or they can tend to a dying resident. Near the ned if they have family, the family members are usually in there with them but you still still check on them a lot and make sure they're well taken care of. After it happens, and you know you gave the best care you could, you feel kind of at peace for the person. I have been a CNA for 3 years and death is still mind-bending to me, but I'm used to it at the same time. You should read about what happens when someone is dying- what the process is and all that. It helps to have that kind of perspective.

As far as non life-threatening illnesses and bedsores go, you get used to that too. The place where I work hardly ever has bedsores unless the person had them when they were admitted. Keeping up with incontinence care and repositioning and reporting signs like redness immediately (because the nurse doesn't have the ability to do a full body check on everybody and certainly not every day) cuts down on that problem. Sores in fat folds are hard to prevent but if you dry them really well that helps. After those start to get red they have creams, powders, pads or whatever, plus nutritional supplements to help it heal faster. In my experience most of them don't even seem bothered by the sores, so I'm not bothered either; but we never get really bad ones.

[semiranda]

Thank you so much for your response. I think that knowlegde of the dying process is important to properly care and understand the dying. Guess, the experience makes it real. I'm very happy to hear that bedsores are not all that big of a problem in all facilities and even better to know it seems as though most are not bothered by them. Certainly by the textbook and information I have obtained they look pretty painful but, obviously that isn't always true. Thanks for taking the time to reply.