There is nothing that can fix this is there? (ok it's a rant)

[anonymous1919, LPN]

I use to work on an Alzheimers unit for two years as an aide before I started school. My average 12 hour shift consisted of:

-Having 10 residents

-6 needing to be woken up, dressed, and have basic hygeine performed (brushing teeth, hair brushing, etc)

-2 showers

-4 vital signs to obtain by 10am

-3 meal times where I along with another aide had to get half the unit into our diningroom (30 people), serve them, feed 4 of them (while watching the other 26 Alzheimers residents and trying to get them to focus on eating), escort them all out, collect plates and trays to put back onto dietary cart to wheel back to dietary

- Take 30 minute "shifts" with other CNA's where I had to stop my CNA duties to more or less "babysit" the activity aide while she did activities with 10-15 residents at a time because she could not be left alone with them because she was not certified.

-Walk several (2-10 depending on the day) on my residents for x amount of time because they were in wheelchairs and cannot walk on their own.

- Chart I/O's, ADL's on my 10 residents

All in all, I loved my job. As you can see I was really busy, so my days went super fast, and I got to spend a ton of time with people who truely needed me.

My problem is that the nurses on the unit generally did nothing. This is not true for all of them, but most of them did nothing. The shift started at 6am and ended at 6pm. My day started right at 6am, sometimes I'd come in 15 minutes early to get a jump start. The nurses, their job started around 6:45-7:15 am because the first hour they generally spent sitting at the nurses station drinking their coffee and talking to the other nurse. Breakfast was at 7:30am and the nurse was suppose to be in the dining room helping me and the other aide. Their job duties in the dining room were the same as ours, and legally they needed to be in there because if someone choked and they were not there they could lose their lisence. But instead they would start their morning pill pass around 7:15 am when they were done with their coffee and be in and out of the dining room passing medication instead of helping us. And I do know for a fact that their med passes were scheduled around the fact that they needed to be in the dining room when meals came. After breakfast, they resumed sitting on their behinds behind the nurses desk, but generally they had charts in their hands and were doing whatever they needed to do with the vitals that were due at 10am. Then they would start their med pass again... conviniently about 20 minutes before meal times so again they were not in there to help but to pass a medication. And by the way, that was against policy. You weren't suppose to pass medications out in the dining room. After lunch they resumed being on their behinds, and did a couple dressing changes and treatments if need be, which there weren't many on our unit anyway. They never put ointment on residents behinds because they assumed that I would do it. Legally, the ointments were medications so I could not do it and would not even though most aides would. I use to tell the nurses that all the time and remind them several times who needed it, sometimes they would get around to some of them. And when dinner came, you guessed it, med passing. That's just how it went.

My true problem here is why do these nurses not want to do their job? Why not do your med passes when you're suppose to so that you can have that little resident interaction at meal times? Don't you want to spend any time with your patients? How are you ever going to know if something is wrong, how are you going to know that the doctor should probably lower soandsos dose of blahblahblah because it's making her too lethargic at meal times and is compromising her nutritional status? Doctors are using you as their eyes and ears and I don't see how it's very effective when you're sitting behind the nurses station all day.

I tried to keep nurses as informed as I could as an aide and have even once been told "mind you're own business, I'm the nurse". Are you? Your title says so but are you really a nurse? (I was certainly thinking that but never said it).

I've told managers before and they've spoken to a few about it. It generally helps for about a week... suddenly the nurse is in the dining room, woah! Like I said, it lasts about a week and then it makes the nurse dislike you and complain about how you didn't clip soandso's finger nails to the unit manager (For one, soandso would punch me in the face if I tried so that's why I haven't and if you would have come to me and asked before running of to the unit manager I could have told you that :) ).

Oh well. This is clearly a rant. I just want to know how does this ever change? Have you ever worked in a nursing home as bad as what I've described and seen it slowly turn around? What did they do to make it better (besides fire the nurses, because I do think these nurses are good if they want to be it's just they can get away with not and they clearly think all their job requires is giving a medication)... blah

I'm done, thanks for listening.

[alyssa*]

wow, they [the nurses] have jobs others actually want/need

[anonymous1919, LPN]

wow, they [the nurses] have jobs others actually want/need

I know. My experience is based on weekends only, the 6a-6p Sat and Sun shift with 1$ more for weekend plus 8 hours paid extra, it's called a bailor program sometimes also known as "weekend warriors". There were waiting lists to get the schedule because it's pretty amazing if you are in school to get paid 32 hours and only work 2 days a week.

But since it was the weekends, there was usually only 1 unit manager in the building that just walked to each unit for 10 mintues to check up. So the nurses had no one watching what they were (or in this case werent) doing all day.

[Wise Woman RN]

I work as a nurse in an Alzheimer's facility. I have 24 residents, and I would love to be able to spend some time with all of them, but my duties and responsibilities with medication and treatments has to come first for me. I absolutely help out when I can. Sometimes I don't even get to the bathroom for the whole shift.

The aide that works with me is an angel. She understands that the first thing I must do is get report on the residents, and know what changes have occurred with each. The residents have many, many medications that MUST be given within a certain time frame, and I MUST be very careful with those, in order to prevent med errors. It takes me a long time to get everyone's meds out, and that is a priority for the nurse. I am relatively new at LTC, so I am still learning everyone's meds, history, usual behaviors, and medical needs. I simply DO NOT have time for some of the things that I depend on the aide for, but hopefully, as time passes, I will develop a good routine that allows me to help more. If a fall, or other problem occurs, it will set me back at least 45 minutes. The aide that I work with will say, "I have that, you go do your meds."

I know what she does is very difficult, but she works hard, and I appreciate every minute that she is there, because I know she has my back, and I have hers. I wish that every resident everywhere would receive as good care as she provides to our residents. I am sorry that you are having such a rough time.

[anonymous1919, LPN]

I work as a nurse in an Alzheimer's facility. I have 24 residents, and I would love to be able to spend some time with all of them, but my duties and responsibilities with medication and treatments has to come first for me. I absolutely help out when I can. Sometimes I don't even get to the bathroom for the whole shift.

The aide that works with me is an angel. She understands that the first thing I must do is get report on the residents, and know what changes have occurred with each. The residents have many, many medications that MUST be given within a certain time frame, and I MUST be very careful with those, in order to prevent med errors. It takes me a long time to get everyone's meds out, and that is a priority for the nurse. I am relatively new at LTC, so I am still learning everyone's meds, history, usual behaviors, and medical needs. I simply DO NOT have time for some of the things that I depend on the aide for, but hopefully, as time passes, I will develop a good routine that allows me to help more. If a fall, or other problem occurs, it will set me back at least 45 minutes. The aide that I work with will say, "I have that, you go do your meds."

I know what she does is very difficult, but she works hard, and I appreciate every minute that she is there, because I know she has my back, and I have hers. I wish that every resident everywhere would receive as good care as she provides to our residents. I am sorry that you are having such a rough time.

You sound like you are a good nurse. I love the Alzheimers unit. Those residents are so special. I wish the nurses I work with were new and trying to learn instead of just lazy. I know as the nurse you have a lot of things to do and a lot responsibility. But working with them for 2 years and knowing they have been in the profession for 10 or more, I know they are just being lazy and it's unfortunate.

[Baloney Amputation, BSN, LPN, RN]

I don't know about your place, but any nursing home I worked in had the big pill passes at 8 a.m. and 5 p.m. with smaller pill passes at 6 a.m., 12 noon, and 8 p.m. We had no choice but to pass meds during breakfast, lunch, and supper when the window of time for each pill pass was 1 hour before and 1 hour after the scheduled medication time. Yes, the nurses were available in the dining area if an emergency happened, whether we had a med cup or a spoon in our hands.

The thing that doesn't make sense is that if these nurses were just trying to shirk their feeding duties because they are lazy and sit around a lot, wouldn't they rather help feed than pass pills because you have to sit on your butt to feed?

[kcochrane]

You can't fix people that don't care. I could have written your post except using CNAs as an example. I worked LTC for 5 years. Med passes where long, but if I had time, I would pass trays, feed residents, pass water, etc. I find being busy makes the day go by faster. I'm sorry you have to deal with people that don't want to be team players. It really comes down to management.

[cLmPdN]

I was an STNA at a nursing home, and now I'm an LPN at an assisted living with a locked unit. All I have to say is it's one thing to observe someone elses responsibilities, but quite another to walk in their shoes. I didn't realize how much the nurses were doing behind scence until I was one. We are responsible for so much!

[S.N. Visit, BSN, RN]

" the nurses, their job started around 6:45-7:15 am because the first hour they generally spent sitting at the nurses station drinking their coffee and talking to the other nurse" are you sure they were just sitting around talking? could they have been giving report to the next shift?

" breakfast was at 7:30am and the nurse was suppose to be in the dining room helping me and the other aide. their job duties in the dining room were the same as ours, and legally they needed to be in there because if someone choked and they were not there they could lose their lisence. but instead they would start their morning pill pass around 7:15 am when they were done with their coffee and be in and out of the dining room passing medication instead of helping us. "

some doctors order meds at different times of the day. some meds need to be given every four hours, some say meds must be given with food. meds must be double checked and signed off, could this be what they were doing?

"and i do know for a fact that their med passes were scheduled around the fact that they needed to be in the dining room when meals came. after breakfast, they resumed sitting on their behinds behind the nurses desk," maybe they were charting or looking at new orders? plan of cares? chart checks? calling doctors & family, getting ready for a discharge/admit?

"my true problem here is why do these nurses not want to do their job? why not do your med passes when you're suppose to so that you can have that little resident interaction at meal times? don't you want to spend any time with your patients? how are you ever going to know if something is wrong, how are you going to know that the doctor should probably lower soandsos dose of blahblahblah because it's making her too lethargic at meal times and is compromising her nutritional status? doctors are using you as their eyes and ears and i don't see how it's very effective when you're sitting behind the nurses station all day. " if the nurses are not documenting everything that is being done with the patient, then legally nothing was done! become a nurse, and you'll know how much paper work being a nurse requires. being a nurse is far more than just passing pills. i haven't the time in this small space to divulge all the job duties a nurse does in a day. you seem to be a caring person. i'd suggest you become a nurse to find out what nursing is all about.

[racefan88]

And I do know for a fact that their med passes were scheduled around the fact that they needed to be in the dining room when meals came.

Question...How do you know? HIPPA states that you're only privilaged to information you need to do your job. Med pass is a nurse's job and you have no reason (or permission) to look at the MAR. So, I wonder how you know when their meds are scheduled. LPN's are nurses, not aides. They have an entirely different scope of practice. Why would a facility utilize a nurse in the role of a CNA when they're paying her to be a nurse? Makes no sense. They're responsible for administering meds, wound care, administering prescribed treatments and many other duties throughout the shift, andthey must be sure everything has been properly documented. CNA's are responsible for basic needs and assistance with ADL's. This includes mealtimes. If you're unhappy with your scope of practice, go back to school and become a nurse, but please don't pass judgement on your coworkers until you walk a mile in their tired shoes.

[kcochrane]

I do agree that sometimes it appears a nurse is not doing anything, when in fact they are.

[hecallsmeDuchess]

@OP, I understand what you are trying to say and I have actually worked with people that wanted to get through the day doing the least they can throughout the shift (nurses and aides included). It is very frustrating when you are overwhelmed with work and nobody else is helping out but hang in there and do the best you can.

For those saying she needs to be a nurse to understand, I disagree. A lazy person is a lazy person, nurse or not. Working with patients is supposed to be about teamwork and having each others backs. Being at the nursing station charting, receiving/giving report or calling a doc is totally different from sitting at the nurses' station drinking coffee, surfing the web and gossiping the day away while call lights are beeping (my biggest pet peeve).