Highly disturbed today at Clinical...

[cookiesandcream22]

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?

[anonymous1919, LPN]

The only thing I can think of next time you are assisting a CNA or LPN with someone don't ask if you can put a sheet on her, just go grab one and put it on. If you take the time and just do it and it's already there, what can they do? They aren't going to take it off.

[cookiesandcream22]

Sorry to not give an update for awhile. I have three tests this week eeek. I told my clinical instructor the situation. I am not really sure what she plans on doing, but she assured me she would deal with it. In retrospect, I should have just gotten the bed sheet for the woman to cover up with. I guess the fact that it was my first day (ever) at clinical, not to mention only my third day of nursing school, made me hesitant to be more assertive. I still have noticed a lot of things that bother me, i.e. today the LPN was joking around with a resident that she was going to beat her up if she didn't comply. This resident had laundry list of psychological problems and I just gave the LPN a shocked looked. Several of the LPN's are really rude to the nursing students and our instructor, so I am thinking this is more of a staff issue than anything else. I guess the whole thing just bothered me because the treatment of patients in the LTC facility is the polar opposite of what I am learning in my classes. I am hoping my next rotation in a hospital will not be like this.

[Siennah]

When you know what is right: DO NOT ASK.... DO IT!

These behaviors, on the part of the staff, are the very things that make many patients snap and end up at my job: Gero-Psych.

Someday that these jackasses, themselves, will be carelessly run through a cold shower like a car through a carwash by a stupid nurse or aide.

Then they'll get it.

ALWAYS ALWAYS ALWAYS advocate... which you did eventually do but, again, don't ask... just do it!

Holy cow, that frosts my buns!

"Someday that these jackasses, themselves, will be carelessly run through a cold shower like a car through a carwash by a stupid nurse or aide.

Then they'll get it."

:hhmth:

I certainly hope so!

[PPSNurseNancy]

no, you are not naive at all. the way the lpn responded to you is not only wrong, but totally against resident rights in a facility. the rights of the residents are very specific and spelled out for any staff member there. i am appalled that an lpn would continue to work in that setting and feel the way she does toward her patients. you would think that the already licensed staff members would at least try to set a better example for the student nurses there. bottom line is that is abusive and should be reported to your clinical instructor. in the ltc facility that i work in, that type of behavior is not tolerated. and it seems like the staff here watch each others' backs, in case of a lapse of judgement where a patient might be exposed. curtains are pulled, doors are closed, towels or sheets are used, and by all means, if a resident makes a request, that request is honored if at all possible. i am sorry that you are having it so rough, but please hang in there. it is your concern that will make you into a good nurse, the kind of nurse that makes a difference in those little resident's lives.

[darrell]

You did well and they might wish to rethink policies and procedures. Remember there may be multiple conflicting drives in play with which you are not familiar. For instance, someone may have lectured the direct care staff about linen costs recently, resulting in conflicting priorities It doesn't take much of that to drive the average person to bitterness.

For my part, I do not raise the battle flag and charge screaming into battle. Instead, I do just what you did: I take it one opportunity at a time and decide with therapeutic kindness and clinical judgment as my guide. Although the reality of things may differ from the ideals, there is no reason you can't at least try to implement the ideals.

D

[gusblom]

I could make many excuses for such behaviors including staff shortage but the truth is regardless of any circumstance certain things are basic regarding caring for Residents and requires not much effort. In my opinion you have witnessed abuse which seem prevalent at this facility and, further, if it is prevalent as I suspect then management must be aware of it. I have had to walk out of a job after I attempted to work with management to eliminate abuse. Management did not support me in the end and after leaving the job I called and wrote to the State agency regarding the things I had witnessed and let them know that management was aware and did nothing about it. This company is huge and I will never work for them again. We must not forget that though we put ourselves at risk that we need first to protect the Residents. I am not over-emotional which allows me to do what is right towards my Residents. Abuse in any form should not be tolerated and if you cannot address it so as to prevent it from happening in the future then you need to report it.

[pattyb57]

i simply do not understand how people can be so cruel. you were right to question this. i have been a nurse for 30 years, and i have never put time before privacy. the only thing i can tell you, is that you as a human being have the responsibility to be that patients advocate, student or not. learn now that people will intimidate you when you try to be that advocate. you alone have that mirror to look into when you go home. who will you see? don't let your fears dictate what you will allow another person to do to another. i know i am making something very difficult sound easy, and i understand that. you must make an effort to be as tactful as you can, but in the end, be the patient's advocate. :)

[chacomom]

In a LTC facility(or anywhere for that matter) sometimes a patients dignity is all they have left. You respected that. It something feels wrong don't do it.

I agree that this should be reported to the state. It is a breach of responsibility to the patient for privacy.

[MSALLE]

I am a firm believer in reaping what you sow. If we want to improve, lets all pitch in regardless of titles. Politics in the care of a human being has no place. I want each of my coworkers to tx each person with the respect and care they would want. It is not only a job, but an honor to care for someone unable to care for themselves. Nursing is definetly a higher calling that some people are not called to do.

[LevitateMe, RN]

This is really sad. I am an LVN in an RN program and I have seen things like this working and in clinical. It is horrible. But my advice to anyone in this situation (assuming your clinical instructor is a good nurse and teacher) is politely refuse to continue with what's going on and immediately go talk to your instructor. My teacher is great and says never to anything we know better than to do. And the unit knows better as well. If you report the problem to your instructor she should appreciate you for doing the right thing and hopefully she can report it to the unit manager. There is no excuse for stuff like that to go on. : )

[nurseangel368]

you certainly are not naive.. unfortunately the cna's are rushed.. not making excuses by anymeans.. i was a director of nursing at snfs for almost 9 yrs.. i did not sit behind a desk.. i was out on the floors.. when i would see things like this i would rectify it immediately .. i would have inservices with the staff to correct these incidences from occuring.. and it usually helped.. it is important to talk to your instructor and hopefully she can go to the charge nurse or supervisor and report this.. i also teach lvn students on weekends.. when i see this.. especially with my students.. i do fix this.. remind them that it is inappropriate and put them in the bed asking how they would like to be treated like that.. the nurses i have interacted are usually good and will talk with their cna's if this is found.. remember this experience when you graduate so you can rectify it immediately as an rn!!..

[penlight]

You are definitely on the right track, because this is called PATIENT RIGHTS. I was a LPN for 7 years in ECF and now am an RN for 7 years on a neuro unit. It is a dignity issue for the patient being exposed. The staff told you not to get the linens because they are lazy, don't care, and are unethical. You will be an awesome nurse.