Highly disturbed today at Clinical...

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Hi everyone,

This is my second week of an accelerated BSN program. Things are crazy and we are already doing clinical at a LTC facility. Today driving home I almost broke down in tears because of the way some of the STNA's and LPN's were treating the patients. Now I am obviously no expert, and I am fully aware of how short staffed these facilities are, but it seemed like they were doing everything I have been told not to do. For instance, I was bathing a woman and was going to cover her with a towl so she wasn't cold and exposed and the woman working said not to waste an extra towel on that and the woman would be fine. Another patient I helped was put naked in a Hoyer Lift and was almost in tears because she kept asking to be covered and how indecent this was. I asked if I should go get a sheet to cover her and was told no. I had to wipe the woman afer we go her into bed and I again asked to get a sheet and was told it was unecessary. When the LPN left the room, I went and got the woman a sheet and you should have seen the relief in her eyes- I have never seen someone look so thankful. I know nakedness cannot be avoided and nurses and aids are always extremely busy, but I couldn't help but think what my own reaction would be in that situation. I am incredibly modest and would want to be covered up if it was possible. Am I totally naive in thinking this way?

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No, you are not naive, you are thoughtful. How much more effort to get one sheet or one towel? And one sheet or one towel is not going to make a difference if they are short of linens.

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Specializes in Home Health, Nursing Education.

That is very sad. Did you ask your instructor what she thought about it?

Personally, I would notify somebody in charge... but that could be tricky, too. Maybe an anonymous tip or letter.

I am glad you are going into nursing. You have empathy. :redbeathe

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Well it is kind of sad.

However- when I see stuff like that- I try to look at the other side as well.

I'm on a medsurge floor this 8 weeks. The gentleman I was taking care of couldn't get out of bed. The CNA that he had also had 18 (yes 18) other people to take care of (vitals q/4 baths etc, etc). He was weak, and pretty much a full assist.

Well- the bed hadn't been changed. The CNA asked me if I'd change the bed. And do a bath The bed was NASTY. He's incontinent, and there was poo all over the pad. Food all over the sheets (I don't think the bed had been changed in days) It took me 10 minutes to ambulate him from the bed to the chair. This was after 10 minutes to try and wash him (and I got the really nasty parts clean). And then change the bed. That's almost 30 minutes on 1 pt. And remember the CNA had 18 of them.

And then I felt bad b/c a fellow student had a pt who was bed-ridden and had a hard time moving. And she had an explosive BM, and she had to clean it up by herself because the 7 of us were busy with our 1 patient.

During post-clinical we talked about this. Because several other students made the same comment, how overwhelmed the CNA had to be. And the nurse was telling me (apologizing actually because I hadn't seen her all day) that she was behind on meds and she was sorry she didn't have more time to spend with me today.

And then we kind of freaked out- we're supposed to go to 2 patients by the end of this semester (I'm almost halfway through a diploma RN class) as to how we're supposed to get everything done.

Then of course is the flip side- where I asked a CNA for help and she couldn't help me b/c she was surfing the hospital site so she could update her MEDICAL INSURANCE

Cheryl

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I see I am not the only one who has run into this. I am glad I am not being overly sensitive. We write journal entries every week and turn them into our clinical instructor. I think I will bring up the feelings I am having without offending anyone- maybe just seeking some clarification. I know it is definitely a balancing act when you have so many patients to care for. I just think that you can do quick things like cover with a towel when you are preparing the shower- that takes 2 seconds.

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No you are not naive, you have empathy. You'll be a great nurse

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Specializes in IMCU.

Seriously? My first clinical was at a state facility and I was impressed with how they treated their residents. Each aide had 6 residents -- some full assists some partial assists. The skin surveillance was excellent.

I think of it this way -- would I be OK with someone doing that with a family member? No. This isn't about another side or the poor CNA with too many residents. It is about the facility. The facility should be reported. Of course that puts you in a cruddy position unless you do so anonymously. Anonymous complaints are probably difficult to investigate.

I am sorry this was your experience but I am even sorrier that those poor residents have horrendous care and are not treated with dignity. No much makes me want to cry but this sort of thing does.

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Specializes in Infusion.

When you are put in a position like that with residents being treated that way, it is hard not to objectify people in order to get through your day. We need to be certified CNAs in order to go through the ADN program at the local CC. I was thankful to get my clinical training at a very well run hospital. We were busy but they tried to keep pt to CNA ratios to 7 or 8 to 1. Sometimes 6:1. I think the person who ran our program would have been horrified to see a patient or resident treated that way. Safety and dignity should be the top priority.

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I am a CNA in a LTC facility and care for anywhere from 15-25 residents by myself and there is just NO EXCUSE for not covering up a resident.

This is Nursing 101 -- PROVIDE PRIVACY

Definitely bring this issue up with your instructor -- it NEEDS to be addressed.

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Am I totally naive in thinking this way?

No. You should report this facility to the state.

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I have heard stories like these, some worse. My friend was an STNA for many years and worked at one location where they beat dementia patients. She quit because of it. I think she did report them but who knows if they did anything because every time state came around, they all put on a good face.

I haven't heard stories like this about the clinicals my school does. Patient's needs come first. I wouldn't want to be that patient. I understand the CNA may not be able to get around to all patients since that CNA was overloaded, but SOMEONE in that location should have been able to help. Thank goodness you did.

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Specializes in Post Anesthesia.

I'm not LTC but we see the same in acute care. There is a yearly "push" to reduce the linen usage costs in my facillity. I'm sure it is more common in LTC. This is always accompanied by a list of what it costs to launder and restock each item of linen. It has always driven me nuts! This lack of consideration for basic patient privicy needs has been sanctioned by the company. I'm sure Joint Commission wouldn't approve. My advice- learn what you can and never consider working at this LTC when you graduate. It is a sign that they are so tight on the budget that other patient care needs and staff safety equipment may be "optional" as well. I would encourage you to keep this in mind if you ever are asked about (or need yourself) placement in a LTC facillity.

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