False reporting

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Specializes in Hopice and School Nurse.

Today was my first full day doing clinicals at an LTC facility. The CNA I worked with was really nice, good to the patients and I learned a lot. She was patient with me and the residents and I was really impressed with her attitude. However, at about lunch time I realized from talking to the other CNA students that they were doing things like bed baths and peri care and I hadn't done even one. I was on the skilled nursing side with several bed bound patients and a few that could minimally help with transfers and could feed themselves. All were in briefs but a few used the restroom with assistance.

Anyway, at the end of the day when we sat down to do the chart logs (done on a computer) the CNA I worked with was charting that she did peri care and bed baths on everyone. I asked her about it and she said the patients did it on themselves. Um, the one guy was on hospice and didn't even wake up the whole time. I did not witness one bed bath or true peri care all day on anyone. Wiping with toilet paper and once a towel to the bottom, but nothing that resembled the peri care we did in class (soap, rinse, dry). Definitely no bed baths although she handed one patient a wet towel to wipe down his face.

I reported this to my nursing instructor who said it was par for the course and some CNAs were lazy. She didn't seem lazy at all. Just didn't do those couple tasks. My problem with the whole thing is that this same CNA works day shifts pretty much for the same patients all week. If she charts that she does peri care and bed baths everyday but never does them, then when do the patients get this done at all? The PM shift figures its been done because its in the chart. Maybe the weekend people do it, but that means that these poor folks only get it once or twice a week.

I didn't see any signs of neglect, so it could be the first time she didn't do it or she was really quick and did it while I wasn't in the room with her. I just don't know for sure. I've asked to be partnered with a different CNA tomorrow so I can learn these skills. It was a pretty easy day for me, but I figure its because we only did half the work we were supposed to. The other students were exhausted and well trained by the end of the day.

Oh, and I only saw her wash her hand a half dozen times. I washed mine like a hundred times and my skin feels like its falling off. For that matter, I didn't see anyone but the students wash their hands.

Anyone else experienced this stuff? I don't want to be judgmental since I don't really know what is normal or right. Just seemed like all the stuff we learned in class and what we are tested is not being done in the real world.

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Specializes in Alzheimers and geriatric patients.

it could very well be that this CNA was fast enough that you just didn't catch her giving baths. In the real world you have to be quick on the draw to get everything done. The way you described her, it seems weird that she wouldn't give baths at all.

Perhaps you should ask the first CNA you worked with if she will show you how to give a bed bath. Don't say anything like "you didn't give any baths the other day", but just tell her that you want more practice doing them. That way you aren't being offensive.

You are supposed to wash you hands when you enter, and leave a room. Period. Infection control anyone?

I don't think voicing your concerns to your proffessor is a bad thing, in fact I think it's a good idea. Just be careful about not voicing those same concerns with classmates, etc as 1- It is unproffessional, and 2- It might get back to the CNA and they won't want to work with you anymore. No seasoned CNA wants to be judged by a student (not trying to sound harsh but that's the way it is). I'm not saying you've done this, but I just wanted to warn you in advance. I know after a bad day I feel like telling everyone around me why it was crappy.

I think it's great that you want to get in there and do things. Be viligant, but tactful as you continue in clinicals. I wish you the best of luck.

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Specializes in Hopice and School Nurse.

You're right. She could have easily done 9 bed baths without me knowing about it. She seemed really efficient in every other way and I probably just didn't notice. I wasn't with her every minute of the day but tried to follow her around as best I could unless she walked off the floor. There was about a half hour that I was busy doing vitals and she could have been doing bed baths all around. I just wish she would have shown that to me if she was busy doing them. In the skills book there are like 32 steps to bed baths. In real life I'm sure its a lot less time consuming.

I will try harder not to share this kind of stuff with my fellow students. At the end of the day we all had to give a verbal report of what we did and I said I hadn't done most of the things they did with their patients. I made sure to point out that I learned a lot of things about being kind and patient with the patients, just not all of the skills. I definitely didn't judge her, was just concerned about missing something.

If I get her again tomorrow then I will ask her if I can observe for the bed baths and peri care since I need to get the experience in clinicals and see if she will teach me. Everything else she taught me was really great so I'd like to learn it from her. Another thought that came to mind is that maybe she thought I had enough to learn and was trying to break me in more easily. I wasn't overwhelmed but might have been if I had to do everything the first day.

Anyway, I feel better about it now that I've had the chance to think about. Thanks for the reality check!!

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Specializes in Pediatrics, Geriatrics, LTC.

I am working at a place where false charting is par for the course. They chart that they do like 10 things and they really only do one. Plus they chart that they t&p every two hours but all they really do is check the depends and put the poor peeps right back where they were. It takes me an hour and a half longer than anyone else who works there to do my cares on 14 people. that's because I actually do them! Every one else who works there does just depends and total peri care once a shift and then sits at the station texting and gossipping.

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Specializes in Hopice and School Nurse.

Today was much better although I didn't see her chart so I don't know what she put in them. I just told her at the beginning of the day that I needed to observe and participate in showers, peri care, baths, etc. She was a great teacher and we did several of each. She must have done them yesterday while I was doing vitals. That girl is faster than a speeding bullet. She just knows what she needs and brings her supplies with her, know exactly how to position people and is super efficient. Maybe not everything gets done on everyone by the book but her patients are happy.

The only thing I haven't seen a lot of is oral care. It's being done on the hospice patient and those with dentures (just cleaning the dentures) but not on anyone else (again that I could see). The patients can probably do it all themselves though. I'm going to ask her to show me oral care tomorrow.

What a day! I'm pooped!! I don't know how you all do this day after day for 8 to 12 or even 16 hour shifts. My hips feel like they are popping out of their sockets.

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Specializes in Med-Surg/urology.

Concerning oral care- maybe some of the residents will not allow her to do oral care? I know thats a big problem for me. A few of my residents wear dentures and I'll remind them to take them out for me so I can brush them..sometimes it works sometimes it doesn't. But the rest of them will just simply not allow me to brush their teeth :(

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Specializes in Alzheimers and geriatric patients.

Oral care is tricky to do on some people. Especially on alzheimers and dementia patients. They bite anything that you try to put in their mouths! I'm so glad that you got the training you needed! Good Luck to you in the rest of your clinicals!

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Oh, you're lucky at least that you got a good CNA to assist. My first day the CNA me and my partner were assisting gave one shower and then spent the entire rest of the time bringing ice to people's rooms while we followed her uselessly in the hallway. Our classmates wanted to murder us because they all made about a hundred beds each and did bedbaths and oral care and shaving and multiple showers while we did nothing, but we felt bad too because we were wasting our time!! Our instructor started switching us around, though, and now we all fight over the 'good' CNAs who will actually teach us and not just brush us off.

Some of the not so good CNAs will tell us "Oh it takes too long to do it the right way, as long as you do it right for State it doesn't matter" but it makes me really upset when I see people doing things that offend the dignity of the resident, or do things that outright break infection control rules (I admit it, I'm a germophobe.)

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