Deeply saddened

[recentlycertified]

I recently became a certified nursing assistant, and quickly found a job working in skilled nursing/rehabilitation for the elderly. I was very fortunate because I had quite a few job openings available to choose from. I have been working for a few weeks now for a major company, and have become very disappointed with the behavior of the other nurses. Before deciding on which job I wanted to choose, I wanted to get all the information I could on my company, after doing some research I found a lot of lawsuits against them for medical malpractices, but I met the staff, met the residents, and thought well, if my family members recently passed away, I'd be filled with a lot of sadness and anger, and I'd want someone to blame, so I'd blame the people who were supposed to be providing care. I also understand, that there are a lot of people just trying to get money, and suing for a medical malpractice is a good way to do it.

Before taking the job, I had to meet the residents and understand their needs, I guess they wanted to make sure it was something I could handle before taking the job. I of course, instantly fell in love, and put all the lawsuits in the back of my head, and took the job. The first two days were very stressful because as I'm sure everyone knows, everything is on a need to know basis so I didn't really know the residents needs very much, but they've been putting me with the same residents everyday, and after getting to know them and getting organized, it's been much easier. I'm a very fast learner and very fast paced, and very detail oriented, and organized so being a CNA has been very easy for me. I've been getting my work done so quickly the past few days, I've been noticing a lot of things that really irritate me.

1. The line..."that's not my room." a call light will go off, and the other nurses say,"it's not my room," "it's not my assignment," or the wonderful line from the lpn or rn, "that's not my job."

2. If a resident doesn't want their food, the nurses will eat it. from my understanding we're not supposed to take any gifts, or money, and under policy we're not supposed to take their food.

3. Putting an annoying resident in their room, and than locking the brakes on the wheelchair.

4. Discussing resident issues with people who don't need to know.

These are all little things that have just been getting under my skin, but I've just been putting it off. But the other night, I was working, put everyone to bed, finished my checks, did everything that needed to get done, and decided to just walk around to see if anyone needed help, or if any call lights were going off. and I walked down the hall, and heard some yelling. So I decided to see what was going on, I saw a group of 3 CNAs taunting a resident who had a heart attack, who could barely speak, and has very limited movement with her arms and legs. They were picking at her sweater, poking her, and tugging at her hair. She's known to be very combative, but when I saw that, I had a feeling that the reason she was so combative was that she didn't trust the other CNAs. I was so disgusted. I spoke with her at the end of my shift and told her I was going to be watching everything, and she started to cry.

I had her the next day, and she was very pleasant with me, no biting, nothing. Which further makes me believe, that the issue lies with the CNAs. Is this technically considered abuse? Is this normal for CNAs to be basically **** on by the RNs? Is it normal for CNAs to not want to help other CNAs, because it's "not their room?" I got into this to help people, and I do the best I can to help all my residents, and I feel I do a pretty damn good job. Any advice for a new CNA?

[recentlycertified]

Well, I just let my supervisor know, about what I saw with the pulling the hair, and the sweater. I hope I did the right thing. For some reason I feel...guilty, but I know I shouldn't. They said they have to investigate it, so, I hope this is going to be okay.

[NM nurse to be]

I'm SO glad you reported it! You DID do the right thing and they do have to follow up. Don't expect miracles but it will shake things up a bit. And it may be a bit rough for you for the time being. I look at it this way, if it makes my life a little less fun to have stood up for my residents, at least they end up getting better care out of it. Keep us posted on what happens now!

[Moogie]

If you witnessed abuse of a resident by any staff member, you are required to report it to the appropriate authorities, starting, as you did, with the supervisor. If nothing is done, you may need to take your concerns higher up the ladder, even outside the institution to the ombudsman and/or your state department of health.

You also need to be certain of what you saw. Were the other staff members taunting this person? Would another person agree with your conclusion that they were being emotionally abusive or could there be another explanation? I am not saying this to give you a hard time or to make it seem like I am doubting what you said---but should you need to go to a higher authority with this concern, you need to be able to justify your conclusion that what you witnessed was emotional abuse.

It's much easier to recognize physical abuse. If you see another staff member, say, hit a resident, you know you need to report it immediately. Emotional abuse---unless you witness another staff member screaming profanities or insults at a resident, it can be harder to prove that what you saw was in fact emotional abuse.

I would suggest you start documenting these things on your own, say, in a personal journal or diary. You don't need to include identifying information about the residents but do write down EXACTLY what you saw and EXACTLY what the resident's reaction was. If you are ever asked about these incidents, you will want to keep a clear head and make sure you are accurate in all your details. Time has a way of changing perceptions and of making us doubt ourselves. Make sure you write these things down when they are fresh in your memory.

Regarding the other staff behaviors such as the nonsense of refusing to answer a light, etc., unfortunately these things happen even in good work environments. They're due to a lack of work ethic and a lack of common sense. Unfortunately, there are people at all levels in health care who lack work ethic and will spend more time getting out of work than actually doing work. (There are also many people who just plain lack common sense, but I digress...)

You seem like someone with very high standards and, as you said in your original post, there were other facilities that were interested in hiring you. No one can make that decision for you but I will ask---do you really want to continue to be employed at a facility in which residents are not treated with dignity and respect? Do you still want to work there even if you know you will be treated poorly by other staff (who may, as Fuzzywuzzy said, put you and your residents in jeopardy because they might be reluctant to help you transfer, turn, toilet your residents)? Do you really want to continue working for a place that has a bad reputation? In the long run, that could hurt your career; someone could look at your history of employment, see that you worked for X years at this facility, and decide not to hire you because of concerns you picked up some of the bad habits other employees at that facility have?

Something to do the next time you look for a job in a LTC facility would be to read the most recent state surveys. If, according to those surveys, you find that the facility has a history of deficiencies due to actual harm or immediate jeopardy to residents because of things the nursing staff has or has not done, you may wish to cross that facility off your list and not even apply there. I'm also saying, look at several surveys; if something pops up frequently in recent surveys such as deficiencies for ignoring resident rights or violations of resident dignity, that is definitely a red flag that the emotional atmosphere of the facility is dysfunctional and you may have to compromise your principles to work there. I would not let one negative survey completely sway my decision but I would also want to see if anything had changed since that survey, say, if there was a new DON who made changes that the previous one did not or could not make.

I am very sorry you are going through this. You seem like a very conscientious employee, someone who would be an asset to any facility. Frankly, though, I would consider getting out of there ASAP because your employment at this place could hurt you in both the long and short term.

[Hygiene Queen]

HELL NO! That's not "normal" and don't you dare ever believe it is.

Unfortunately, CNA class can teach you everything, in terms of skill, but it cannot teach one empathy and it cannot force one to have a conscience... hence these bozos get to be CNAs taking care of the most vulnerable of our society.

I know for a FACT that patients behave they do, at least in part, as a result of how they are approached and treated. Even the most combative patient can be worked with if one practices patience, care, empathy and common sense.

I have been in this field for over 20 years and you will not tell me different.

YOU be standard to which all others can be held. YOU go out there and kick butt being the best aide you can be. Those patients NEED YOU.

Sorry, I could write page after page on this subject. It truly touches a nerve with me.

[Miwila]

You do have a right to be deeply saddened. Personally, I feel the LTC industry needs whistleblowers because it is really awful the kind of "care" considered tolerable for people who are elderly and unable to help themselves. I personally would never put anyone I love in an LTC facility. I don't care if I have to starve trying to take care of them myself.

[KEN44]

I understand what you are going through. I just did clinicals at a nursing home and was appaled at what I saw!! I reported them and had no guilty feelings what so ever. I don't care about what people think, the fact of the matter is these residents are human beings that deserve to be treated with respect. We are there to take care of them. That is our job. My focus is on providing the best care I can and making a difference in someones life who needs me. Those CNA's need to be in another profession if they are abusing patients/residents in anyway and I hope they all get fired. There are plenty of other people looking for a job that will treat them as a human being and not a worthless piece of trash. If there's not, then they need to downsize their establishment. there is no excuse to treat people that way.

[recentlycertified]

Well, after I reported what I saw, they asked me to come in to work, so I did, and when I came in, there was definitely a lot of people there who were looking into it. There were a lot of people there that had on suits and stuff that I've never seen. I saw one person go into the residents room, and I saw them examining her, I guess looking for bruises, (which I highly doubt the will find anything). They usually just leave her in the middle of the hallway, but yesterday they had her seated in front of the care plan manager's office. All the supervisors and stuff leave at around 6, but I saw her there when I left at 11. They didn't have me sign any paperwork, which I really don't want to, all that legal stuff makes me kind of nervous, but I understand why they do it. I feel very scared and nervous for some reason, I guess it's because I'm a new CNA and I don't really know what to expect. I don't really think there's too much they can prove because I'm the only one who saw it, and if they keep their jobs, they're going to know I was the one that told, because when I saw them, they stopped what they were doing. I heard a story of a girl who reported abuse, and they didn't find anything, and she lost her job, because after they investigated it, didn't find anything, they just thought she was lying...I hope that's not me. I know I did the right thing, but why am I feeling so nervous?

[One Flew Over]

Is the resident alert and oriented enough to speak up? If so, they'll most likely interview her and get all of the info they need. Don't feel sorry, you did the right thing. And if nothing happens, this will at least keep these cnas high on management's radar.

[KEN44]

You did the right thing and stuck up for those patients. I am proud of you! Those people are someone's mother, son, daughter or father. They deserve proper treatment.

[jolly_tamale]

I have had some experience in this area. I once saw a coworker (who had been with the company for several years) slap a client (hard) when I had been there about a month. I went directly to our boss and let her know what I saw. I thought that she would take care of it and that would be the end of my involvement. I ended up having to come to a meeting and explain what I saw (even a police officer there), with the coworker sitting right across from me. It was very intimidating. Luckily, they found proof and I had 110% support from my boss. However, the coworker had friends that worked with me and I went on to be harrassed for over a year when the last one of her friends quit. It was horrible. I spent many nights throwing up from anxiety, but I sleep like a baby at night now because I know she is no longer out there working with patients (and never will be allowed to again).

[fuzzywuzzy, CNA]

wow....

[KEN44]

I am greatful for people like you and I am sure that woman and her family was as well. Thank you for reporting her!