Horrified at what I have seen go on in this nursing home

northernguy · Oct 30, 2012

Thank you for the advice. I will be contacting the State Health Department because this kind of treatment is inhumane.
As for the one saying "untrained = less credit" that's complete crap! Abuse is abuse no matter who witnesses it!
For those who said I should contact the DON, my instructor IS the DON, and because of the resident's whom this was happening to she justified it as their basically just a pain in the ass and they have tried "everything"....so like I said...I will be contacting the State Health Department. Thank you again for the good advice!!

Ive only worked in a couple nursing homes that had really strict hiring standards, paid their employees well, and fired and investigated people at the slightest suggestion of abuse, as in we went through a least an employee a month because of suspected rough treatment, inappropriate tone with the residents, somebody fell etc, most of them new employees who were overwhelmed by the job. Ive personally reported CNAs for abuse when I thought it was occuring, so its not like I just dont care, and Ive never had any complaints against me that im aware of.

However ill use one example to illustrate why its not always so cut and dry, although I could give many examples. We had a patient with crippling rheumatoid arthritis whose wife angrily accused an aide of rough treatment. The aide was suspended, investigated, and fired after a CNA on orientation(who had no previous experience) validated the wifes claim. Then she accused another aide of the same thing, with the same results. Before long she and her daughter were accusing people of abuse left and right. Any time her husband yelled or cursed(which was often given the poor guys condition), she was sure it was because the aide did something wrong. It got to the point aides were afraid to go into the guys room or even touch him. Eventually the new aide who had validated her claims of abuse was in turn accused by the wife of abusing her husband. The state was there investigating and observing us on at least one occasion.

One day I asked her if I could demonstrate how we are trained to transfer her husband, with a physical therapist watching. We made sure the guy had pain medication before moving him(which we always did anyway), he verbalized some pain, but not as bad as he sometimes does, and the wife got angry. I asked the PT outside of the room what I did wrong. He told me you did it absolutely perfect. I then asked the wife if she could demonstrate to me how she transfers him, which she sometimes did. She did it, struggled with him, refusing my assistance, and barely got him into bed, with him howling in pain.

In the end 2 aides were fired as a result of this guy. Did any of them actually abuse him or do anything wrong? I doubt it. Im sure most CNAs whove done this job for a long time have similiar stories. So no, because one person says abuse doesnt mean theres abuse, and its not always black and white.

Does that mean you shouldnt report it? No. Only that I give less weight to the opinion of someone who hasnt done the job over someone who has. But obviously if your instructor is the DON at that facility there is a conflict of interest and her opinion is biased, but you didnt mention that earlier.

eroc · Oct 30, 2012

^^^Perfect example of what "experience" means, and why experience means so much.

Lame · Oct 31, 2012

I agree w/ northernguy. When I first started my job, we had a resident who would curse, scream, yell, etc every time we tried to move him. I remember thinking that my coworkers were being too rough w/ him and that maybe I couldn't work at a place like this because they weren't being gentle enough w/ the poor guy. But as time has gone on, I have found out from first hand experience that no matter how gentle you are w/ this resident, he will always scream as if you have stabbed him w/ a knife. I've tried to take my time and be EXTREMELY gently w/ him while doing transfers, but it doesn't work. He will say he is in pain no matter what. What other choice do we have but to transfer him to the wheelchair when he needs to go to the dining room for breakfast? Or when he needs his IC pad changed? We have to make sure we assist him w/ all his ADLs or we aren't making sure his rights are being met.

My coworkers and I try to assist him as gently as possible (he's a big guy so sometimes it takes 5 girls to transfer him). That being said, we all have 20 other residents who need us so we can't spend all our time w/ him. So yes, sometimes we accidentally bump his foot when trying to get him out of the hoyer lift while he's screaming bloody murder at us.

Now I'm not saying what you saw wasn't abuse, but understand that you may not know the resident as well as the CNA that you were shadowing. However, it's your right to report suspected abuse. Better safe than sorry.

kpossible · Nov 3, 2012

Defs go with the anonymous report! You need to be subjective as noted by the other people said! Good luck with the rest of your clinical and make sure your CNA care is top-notch instead~

downsouthlaff, LPN · Nov 5, 2012

I was a CNA in the nursing home for about 5 months, Worst 5 months of my life!! The best decision i have ever made was to go to Emergency Medical technician school, Ive been a ful time EMT-B now for a well known ambuance company down south and love it, i am so happy with my job!! No more drama! No more backstabbing LPNs, who write you up for a wrinkle in a draw sheet!! Its just me and the Paramedic! Now we get dispatched to nursing homes like this and save elderly people from that kin of torture in LTC! I will never be a Nurse i love EMS too much!! alot of reasons and more why i quit being a CNA was for the reasons you describe! Plus here where I live EMTs have a broad scope and can administer any prescription medication over the phone with the medical director, and can administer a few without a doctors order from standing protocol! Dont let any nurse convince you that those youtube videos with those Paramedics vs Long Term Care Nurses dont really exist in this world but they do!! One of my first calls as an EMT was to the Nursing Home that I worked at for 5 months boy i will never forget it, gotta call from the LPN saying that Maw Maw couldnt get out of bed this morning she screams and yells when the Morning Shift CNAs try to get her out of bed in pain, we get there we apply the Cervical collar, put on her on a backboard then on a stretcher, do my assessment, our findings were that she was bleeding internally from a possible fractured femur! Probable Cause unreported fall overnight!! I suppose Doctor and Family had a word or two for the Administrator monday morning!!

neuron · Nov 5, 2012

Some CNA's in CA should not be CNA's. RN's certify them. Maybe they should be held responsible.

psu_213, BSN, RN · Nov 5, 2012

Some CNA's in CA should not be CNA's. RN's certify them. Maybe they should be held responsible.

I can't tell if you are being serious or not, but the state certifies them, not an RN. The RN only verifies that the candidate can correctly perform a certain set of skills. The RN 'signs off' on a person if they can change a bed occupied by a mannequin. They are not certifying that they think a given person will be a good CNA.

neuron · Nov 5, 2012

The state follows the direction of the RN's. Indeed they are responsible for 'verifying' if they believe the candidate will be appropriate or not. Indirect care and dignity are graded on the state exam.

psu_213, BSN, RN · Nov 5, 2012

Indeed they are responsible for 'verifying' if they believe the candidate will be appropriate or not.

Well, I'm not sure about CA, but in my state, the RN at the testing facility verifies that the candidate satisfactorily performs certain skills based on specific standards set the by the state. They in no way verify that the candidate is "appropriate."

If we hold these RNs responsible we should also hold the CNA's instructor responsible if the CNA abuses someone...after all the instructor felt this person would be appropriate as a CNA. We should hold a nurse educator responsible if an RN they had in clinicals makes a fatal error once that person becomes an RN and works on their own...obviously that instructor should not have signed off on that student! We should also hold NCLEX question writers responsible since that person passed and their test did not weed out a bad nurse.

neuron · Nov 5, 2012

I agree.If you look on the state registry (at least in CA), it is almost guaranteed that on the first and second page, and so on, you will see 'license revoked' or 'license denied'. Haven't looked at RN's.

zimmer894 · Nov 9, 2012

You are LEGALLY obligated to report this to the state. I would strongly suggest doing that, your license may be at steak if you have witnessed this and didn't report it to the Department of Health.

Ntheboat2 · Nov 11, 2012

If it was abuse then it definitely needs to be reported.

Some of the descriptions are a little vague. Putting dirty socks back in the clothes drawer? Are you calling them "dirty" because you saw someone take them off a resident's feet and put them into a drawer? Just because they were wearing them (while lying in bed and making no contact with the floor) doesn't make them dirty. I dunno about that one.

I also know (from experience) that what might seem like "rough" to a new student who has never done the work of moving patients may just be someone who is comfortable in moving patients around and no longer handles them like a fragile feather like we all do as students.

If you do report then you might want to have some more descriptive, specific examples of what you witnessed.