Feeling guilty, lazy, and incompetent...

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Specializes in LTC.

I just finished reading the thread about barrier creams and I just had to post how I feel. I work in ALF and many of of residents have barrier creams some otc but most prescription.I.e zinc oxide. Calmeoseptine. I admit and very sorry to admit that I do delegate those tasks to the aide. I also don't always fullow up and sign off that it was done. I'm just being honest even though I know I'm going to get flamed. I do apply the creams when I can but not all of them. I know there is no excuse and the residents suffer. Can someone give me any advice on how I can deal with this? Another problem is just finding the creams. They are in the med cart, rooms, health center, everywhere. I need help, I hate siging things off I know for sure isn't done.

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Specializes in LTC.

Omg my spelling is horrible I know. I'm typing this on hubbys cell phone so that's why.

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I've always delegated the creams. It just makes sense that the aide apply it after a change and peri care.

Don't feel guilty. Just make sure it's being done.

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Specializes in ltc and med surg.

Don't feel so bad. It is not your fault if you are busy with other tasks. You cannot be there every time a resident is cleaned up or toileted, what are you supposed to do apply the creams in the dining room or hallway or wherever they may be 90% of the time. Long term care nurses have responsibililties and tasks piling up constantly you can't do everything just because you are supposed to.

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We have list of creams that can be applied by the CNAs and those they do. Since they are already there, it is pretty easy to do for them. They are really good about letting me know if they are low. Each resident has thier own creams in their room that can be applied by a CNA. The others are in our med carts.

I would find policy on which creams you can delegate and which you need to apply yourself. If possible you can create treatment sheets that CNAs need to sign off after applying. Some of the units in our facility have them and they also include teds, ace wraps, hearing aids, etc. Hope that helps a bit.

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Specializes in lots of different areas.

I also ask the aide's if "so and so's" cream was put on, can I look at their bottom when you do it? They know where to find the creams, and I know which aides I need to ask to make sure they get it done, or to "remind" them. After awhile you get to know who you work with, they get to know you and that you take your job serious. I don't think it's a matter of you being lazy, "overwhelmed" may be a better way to put it!

Guilt is part of the job, because you cannot possibly get to every tiny little detail, as much as you wish. What matters is EVERYONE's taken care of. You get to know the groove, and you'll find your niche. What I've learned about LTC is that it's not perfect, and one shouldn't expect perfection. (I'm not giving any of my examples) HAHA. Don't be so hard on yourself :) Enjoy

Jenny

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Specializes in Emergency, CCU, SNF.

Don't feel bad, it does make sense to have the aides do that when they can and you know which aides are more reliable. It's a matter of necessity at times, when you have anywhere from 20-30 residents, you just can't see everyone's backside. I did try and take advantage of the 2000 med pass to do the creams and I made sure to definitely see the ones who spent more time in bed, but I can't honestly say I did it every night. Unfortunately the way staffing is in nursing homes and the amount of work at times, we have to cut little corners when we can.

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Specializes in LTC.

Thank you all for the report. I'm going to come up with a roster that the aides can sign off on. Today I handed the cream to an aide, she said she will apply it and I get the cream back not even opened with the silver cover sealed. I was so angry ! I will do better, hopfully.

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Thank you all for the report. I'm going to come up with a roster that the aides can sign off on. Today I handed the cream to an aide, she said she will apply it and I get the cream back not even opened with the silver cover sealed. I was so angry ! I will do better, hopfully.

The CNAs behavior was unacceptable here and you should have taken them to task on it. You told them to apply a necessary cream to a patient and they didn't. That's insubordination and more importantly the patient suffers. You should have told them to do it at once and followed up with a write up to make management aware.

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Specializes in pulm/cardiology pcu, surgical onc.
The CNAs behavior was unacceptable here and you should have taken them to task on it. You told them to apply a necessary cream to a patient and they didn't. That's insubordination and more importantly the patient suffers. You should have told them to do it at once and followed up with a write up to make management aware.

Wow that's pretty drastic, yes the aide was asked to do it and she didn't. But to Tell her to go do it isn't going to help a working relationship and could cause a whole lotta trouble. I would talk with the Cna and ask what prevented her from applying the cream not be demanding.

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Specializes in Med/Surg, Geriatric, Hospice.
I've always delegated the creams. It just makes sense that the aide apply it after a change and peri care.

Don't feel guilty. Just make sure it's being done.

Delegate the creams only to those CNA's you trust. That's what I do. And.. if I find the medicine cup with creams still untouched close to the end of the shift after they've already done rounds on that pt, I simply put it on myself. Doesn't happen often though, I have great CNA's so far.

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