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?

Don't you dare listen to the staff at long-term care facilities ! You are 100% correct in wanting to maintain patient dignity. Stand your ground always for patients. What is going to happen to you? You'll be "disciplined" by your BSN instructor for doing a good job? Say something like this to those idiots at the facility, "Oh, I'm sorry, but if my instructor sees me NOT maintaining patient dignity and respect, I'm in a lot of trouble, so let me just cover her up...." I won't even begin to describe what would happen to those facility staff if a State Surveyor were on the grounds and witnessed a hoyer lifted patient being naked ! You will see a lot of clinical staff who have no business being in nursing; don't become one of "them". Always picture yourself in a patient's shoes, and you will be reminded as to the proper treatment to be given.

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First I agree mean and wrong. Next having work in LTC before MANY MANY times there is not enough linen this is

no excuse and management does not care. If you are concerned ask if this is this issue. Ask if YOU can call the DON.

Bet 1 or 2 things will happen 1) you will be told to call and praised for it ( you don't work there) 2) if this is not the

case you will get your linen. And just wondering what LTC you were @ that any LPN was giving a bath?

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As a student, I am not sure how much weight your opinion would carry-I doubt very much. I would mention your concerns to your instructor. It wouldn't hurt and if your instructor decides to say something, well, they will be listened to.

Also, I would just take charge of the situation. Don't ask these CNA's or LPN's whether the person should be covered up-get a towel or sheet and just do it. What are they going to do about it? Nothing.

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Don't you dare listen to the staff at long-term care facilities ! You are 100% correct in wanting to maintain patient dignity. Stand your ground always for patients. What is going to happen to you? You'll be "disciplined" by your BSN instructor for doing a good job? Say something like this to those idiots at the facility, "Oh, I'm sorry, but if my instructor sees me NOT maintaining patient dignity and respect, I'm in a lot of trouble, so let me just cover her up...." I won't even begin to describe what would happen to those facility staff if a State Surveyor were on the grounds and witnessed a hoyer lifted patient being naked ! You will see a lot of clinical staff who have no business being in nursing; don't become one of "them". Always picture yourself in a patient's shoes, and you will be reminded as to the proper treatment to be given.

Unfortunately, that would never happen in LTC. Whenever they know an inspection is coming up-they are tripping over themselves to avoid any citations.

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You are totally not overthinking it. I understand that things get busy or that resources are limited but I think its very important to maintain a Pts dignity at the very least. When I did clinicals in LTC I observed similar things. If I grabbed an extra towel, I would get yelled at by CNA not to waste towels (only 1 wash cloth and 1 towel per pt is allowed, regardless whether the other ones were too soiled to use). They even would get on my case about wasting gloves and say, you dont need it. Im sorry, but even in that circumstance I was like I am not putting myself at risk simply because you cant afford gloves.

Anyway, I am sorry you had to go through this. LTC is a tough place. Good luck though and I hope your experiences get better.

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Specializes in mental health.
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.
Yes, I can see how this can happen. I'm normally a very assertive person, but not in clinical where I keep feeling like "what do I know?". But that is going to change from next semester, I swear! I have been practicing at home! :)
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I have worked at 4 different LTC facilities and have seen similar treatment. 2 in the North East & 2 in the South East. Seeing this type of treatment was the reason I quit work to care-give my blind Mother. To keep her out of these places until she died 4 years later. We didn't have money for the expensive ones. Anyway I have thought about this a lot. I always left those jobs because I couldn't tolerate seeing the poor treatment these residents receive and ultimately went to work in a clinic for 17 years. I think these places get away with this treatment because caring staff simply would not work there...this leaves people that don't have a problem with it. State inspections are a joke....The facilities prepare for them and they seldom get shut down because what would they then do with the residents. It has always bugged me the way we treat the elderly in this country.

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I have worked at 4 different LTC facilities and have seen similar treatment. 2 in the North East & 2 in the South East. Seeing this type of treatment was the reason I quit work to care-give my blind Mother. To keep her out of these places until she died 4 years later. We didn't have money for the expensive ones. Anyway I have thought about this a lot. I always left those jobs because I couldn't tolerate seeing the poor treatment these residents receive and ultimately went to work in a clinic for 17 years. I think these places get away with this treatment because caring staff simply would not work there...this leaves people that don't have a problem with it. State inspections are a joke....The facilities prepare for them and they seldom get shut down because what would they then do with the residents. It has always bugged me the way we treat the elderly in this country.

I was kind of surprised at the people who seemed surprised. I'm sure there are some good LTC facilities out there but evidently, I've never been to one. All the nursing homes I've been too offer substandard care. And that's being generous. I've experienced the BS about using too many towels and wash cloths, too many gloves, too much of this, and too much of that. The last one I went to for clinicals didn't have washcloths at all and used these baby wipes. You had to use a million of them if someone had a large BM but HEY, that wasn't ALLOWED. We used too many. I don't know what the heck else we were supposed to do...

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No you aren't naive. You are a compassionate, thoughtful, and decent human being. And you have already the qualities of an excellent nurse - these things you cannot learn - you either have these qualitites or you don't - you, my friend do. Speak to your clinical advisor, and she may put in a comment to the charge nurse there (journal upon this - it'll help you work this out within yourself). Keep it up, I know when I first did LTC in my second term, I still think of some of the things that happened there - don't let anyone ever tell you any differently. May God bless you...:nurse:

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Specializes in OR, public health, dialysis, geriatrics.

Not to defend the CNA who was surfing for insurance, but sometimes you only can get access through the in-house computers to do these changes. Now she/he should have been doing this on their break or lunch and not during the time when they are caring for patients.

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I agree with your outrage...I cannot believe how people like that get jobs working with others, especially in caring occupations like nursing! You did the right thing, but I think I would have just gotten a towel or a sheet and covered the patients despite the snotty protests of the LPNs and STNAs/CNAs. You are there to put the patient's needs and care FIRST not what is convenient at the time or what you want (I don't mean YOU in particular, this is a general You ;) . Craziness all around us, and it never ceases to amaze me how much foolishness is out there!

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I once had another CNA tell me not to cover the resident while the resident was in the hoyer. I looked at her and just grabbed the sheet anyway. I was not having my resident be humiliated or feeling uncomfortable while being exposed. Not on my watch. Uh uh.

My eyes basically dared that other CNA to take the sheet away from the resident.

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