Do you change twice?

MissMcCoy · Sep 5, 2011

What kind of paitent load do you have? What area are you working in?

You should ask the CNA's that change x3 at work for some tips. Im sure they are full of advice!

I just work in a group home I just remind my clients to use the washroom on a regular basis... Then I have one fellow whom I change usually 3x by the end of my shift.

I have an interview in a LTC facility at our Hospital this week so if I get the job I would be intrested in hearing some time saving tricks!

caliotter3 · Sep 5, 2011

When I worked as a CNA I was honest in my charting and what I reported to the nurses. Nobody is being fooled by this, they are only turning their heads the other way.

fuzzywuzzy, CNA · Sep 5, 2011

We're supposed to change people every 2 hours, which is 4x a shift.

I change people between 3 and 6 times a shift, depending on how much they pee and how crazy/busy my shift is. But I work with girls that only change people once during AM care and once at the end of the day after lunch. They write whatever they feel like writing on the ADL charts. Those people are the ones that can be found hiding in bathrooms texting or chatting at the desk, so chances are if any of your coworkers are fooling around, they're not really changing their patients more than twice either.

When I worked 3-11 I did everyone 4 times. I had 10 patients on my assignment... maybe you have more than that, which would definitely make it harder. I had to work really fast and be organized in order to get all my rounds done.

Everyone would get changed before supper. That's #1. Right after supper I would try to wash half my people and put them in bed- obviously they would be changed then. Then I would take the rest of my assignment and throw them in bed too. If they were dry, great- otherwise, I'd just change the brief and wash them up later. That's #2. When I got back from my lunch break I would check all the people I'd washed already, then finish doing HS care on the rest. That's #3. I would try and have everyone washed and in bed by 9 and then I would go around changing everyone again. That's #4.

Some things that helped:

1. putting a brief on people in bed. This is actually against the rules in my facility but I did it anyway because if I didn't, I'd have too many occupied bed changes and wouldn't finish on time. I'd rather brief everyone and change them all than not brief anyone and leave half my people laying in pee. During my last set of changes, the briefs would come off.

2. We don't have wipes at my facility so I would wet a bunch of washcloths and put them in a plastic bag for quick incontinence care. I would also carry a bag around for the wet briefs. This cut down on trip to the linen cart and trash room.

3. Putting people to bed with the foot of the bed cranked up so there's less chance of the person sliding down and having to search for another CNA to help you pull them up.

4. Toileting! I know so many CNAs who just want to change briefs without putting someone on a toilet. It's stupid. I know it's different on second shift because once the resident is in bed it doesn't make sense to drag them out of it several times, but I liked to at least put everybody on the toilet before supper, whether they were already wet or not. What if they have to poop? If you don't toilet them, you'll have a big mess to clean up in the bed later. Even the people who need lifts usually do something if you leave them hanging for a minute or 2, especially if you put a warm washcloth on their crotch.

yousoldtheworld · Sep 6, 2011

Most days, I do check my residents every two hours or so. When I get there at 2, when I'm getting them up and around for dinner which starts at 4:45, after dinner at 6:30, and at my 9:00 bedcheck. If I notice someone is wet or dirty at other times, I will change them again.

Most of them are incontinent 2 - 4 times per shift. This is when we are staffed and I have 12 residents...when we're short and I have 16-20, they obviously get changed less often.

nowayis · Sep 6, 2011

Thank you everyone for the replies.:)

@MissMcCoy

"What kind of paitent load do you have? What area are you working in? "

I usually get 13 residents, but it's really usually 12 complete care and 1 self-care/ supervision. The residents at the facility I work at are half geriatric and half MS patients, most with limited mobility.

@fuzzywuzzy

1) Fortunately all of the residents I care for wear briefs in and out of bed, so I'm okay here.

2) Bringing extra towels will definitely be a good idea, I do spend a lot of time looking for towels now that you brought it up.

3) Cranking the feet up, this is another good one.

4) Unfortunately all of my residents - except one- are total care so no use of the toilet.

Great advice, this will definitely save me some time- thanks!

@caliotter3

On some parts of the charting this may be the case, but for the most part I believe the charting is true to form.

@yousoldtheworld

16- 20 residents? That is insane!

yousoldtheworld · Sep 6, 2011

We are supposed to have 10-12 residents apiece...but that's if no one calls in..and they actually have enough scheduled to begin with. I don't know what it is about aides and calling in constantly. Our residents are all total care, so the days when I have 16 or more are pretty terrible.

karamarie91 · Sep 8, 2011

We're supposed to change people every 2 hours, which is 4x a shift.
I change people between 3 and 6 times a shift, depending on how much they pee and how crazy/busy my shift is. But I work with girls that only change people once during AM care and once at the end of the day after lunch. They write whatever they feel like writing on the ADL charts. Those people are the ones that can be found hiding in bathrooms texting or chatting at the desk, so chances are if any of your coworkers are fooling around, they're not really changing their patients more than twice either.
When I worked 3-11 I did everyone 4 times. I had 10 patients on my assignment... maybe you have more than that, which would definitely make it harder. I had to work really fast and be organized in order to get all my rounds done.
Everyone would get changed before supper. That's #1. Right after supper I would try to wash half my people and put them in bed- obviously they would be changed then. Then I would take the rest of my assignment and throw them in bed too. If they were dry, great- otherwise, I'd just change the brief and wash them up later. That's #2. When I got back from my lunch break I would check all the people I'd washed already, then finish doing HS care on the rest. That's #3. I would try and have everyone washed and in bed by 9 and then I would go around changing everyone again. That's #4.
Some things that helped:
1. putting a brief on people in bed. This is actually against the rules in my facility but I did it anyway because if I didn't, I'd have too many occupied bed changes and wouldn't finish on time. I'd rather brief everyone and change them all than not brief anyone and leave half my people laying in pee. During my last set of changes, the briefs would come off.
2. We don't have wipes at my facility so I would wet a bunch of washcloths and put them in a plastic bag for quick incontinence care. I would also carry a bag around for the wet briefs. This cut down on trip to the linen cart and trash room.
3. Putting people to bed with the foot of the bed cranked up so there's less chance of the person sliding down and having to search for another CNA to help you pull them up.
4. Toileting! I know so many CNAs who just want to change briefs without putting someone on a toilet. It's stupid. I know it's different on second shift because once the resident is in bed it doesn't make sense to drag them out of it several times, but I liked to at least put everybody on the toilet before supper, whether they were already wet or not. What if they have to poop? If you don't toilet them, you'll have a big mess to clean up in the bed later. Even the people who need lifts usually do something if you leave them hanging for a minute or 2, especially if you put a warm washcloth on their crotch.

The bolded has helped me out so much. I was getting tired asking my coworkers for help to pull residents up!

LaterAlligator · Sep 10, 2011

I work eves too (1400-2200) at my facility when I do my regular CNA job, and we're also supposed to toilet everyone q2hrs.

My basic schedule is: when I come on shift at 14:00, everyone should have been toileted within the last hour, per my facility's schedule. If I get report that they weren't, I do that person first. I usually do at least one shower before 16:00, so obviously I change that resident. Then from 16:00-17:00, I toilet everyone on my assignment (usually 10-12 people).

After dinner, I do my other shower and change that person, and the ones who I know tend to wet/need to void frequently (usually 3ish people). The rest I do as I get them ready for bed.

at 21:00 or so, I do my last rounds and toilet/change everyone again. If they're mostly continent, I wake them up and ask if they need to go, and if so I take them to the toilet. If not, I change them in bed if needed and leave them be if they're clean and dry.

So most people I'm doing 3 times per shift, though some are a lot more often and very few need it only twice.

I agree with the tips about having your supplies ready. Plus you'll just plain get faster at changing people in bed over time. It takes practice to get used to rolling someone all around and getting the briefs positioned correctly the first time. But once you have it you'll be able to change them pretty quickly.

Good luck!