How many CNAs do you have on your floor?

[crx971]

I worked 4 years in a nursing home. It was a common sense that the more CNAs you had, the happier the pts were. They got fed on time, they got dressed, they got changed more often etc etc. Simple, common sense. Nurses didn't have to do anything with poop. Or pee. Or dirty dishes. Or moping the floor. Or fetching soda pop. Or other things that don't really require BSN in anything. We could actually focus and spend all our time doing actual nursing whatever it was. Meds, tx, orders, labs, admissions etc. The stuff nurses go to school for, you know.

Imagine my surprise when I started my new job at the hospital and found out there's like one aide for the whole floor of about 40-50 people at night, and she's kind of doing her own thing and I'm supposed to do all the work. Now, I'm responsible for wiping poop 10 times a night instead of watching a titratable heart med administration. Or I'm sorry, another of my pt is having a stroke? Too bad, find somebody else, I'm currently to my waist in diarrhea and pee and vomit in a isolation room with my pt in a very awkward position, can't leave him like that, and it will take me a few minutes to clean up and exit the room properly. Can't run to another room like that! Anything else? Critical lab, you say? Doesn't matter, can't do it, tell them to wait or call the charge nurse... See, I got my BSN so I can wipe butts, not do critical thinking or take care of acute medical problems that requires several years of education. Sorry, once I take a set of wipes and briefs, I will be unavailable for at least 20-30 minutes. If anything happens... there better be other nurses around who can figure out what's going on with my pt right away, like his detailed hx, meds, etc etc. No. It's all equally important for a nurse in a hospital to do both poop wiping and high-level nursing. Because hospital can't afford a $14/hr aide or two. 10 nurses per 40 pts ok, but 2 aides instead of one - that's insanity! Gonna go bankrupt overnight. Hospitals aren't as rich as medicaid nursing homes that can afford 3 aides per 20 pts.

Do you get where I'm going? I hate it. I love hospital nursing, but I absolutely hate doing CNA job. I can help out, always did, but I hate being pretty much solely responsible for all that crap, pardon me french. It's like when you eat a delicious cake and stumble upon a piece of poop in it, literally, a piece of poop in the cake. And then you try another cake, and there's poop too. And almost all cakes have it. Some don't, but most do. That's how I feel about my shifts in the hospital. 2-3 complete bed changes a night completely **** me off and make me hate being there... and also makes me wonder - what the hell do hospitals think? How come nurses allow it? It makes zero sense. It's plain stupid. Why don't we strike and demand more aides?

So how many aides do YOU have? How do you deal with poop? Do you just accept/tolerate it? Love it? Does it make you hate your job sometimes? How do you feel?

[Here.I.Stand, BSN, RN]

Am I the only one who wishes they only did 2-3 complete bed changes per night? We have two aides (on an appropriately staffed night, 0-1 on a bad night) for 38 beds and I did incontinence care/ almost all total bed changes at least 8 times last night between two patients, if not more and that was WITH my nursing assistant's help since they were a 2 assist to roll! I'd love to do less but with liver failure and lactulose making up the majority of my population, well that's the way the cookie crumbles. Great way to assess my patients skin and keep them comfortable.

Hehe, before finishing this post I looked at your specialty. I thought "transplant...that explains it!!" I used to take care of a lot of liver patients, and lactulose made life interesting. I remember one patient was stooling constantly...IIRC, he got lactulose q 2 hrs. I'd put a rectal tube in him, but he kept bearing down and pooping out the balloon. And then with all his wiggling around, he'd get the poop all over the bed and his legs/feet as soon as it exited his rectum. That was a looooong 12 hours, and he was one of only 2 pts (this was in an ICU)

[Here.I.Stand, BSN, RN]

and no, you're not the only one! A couple weeks ago we had 3 pts on one station (8 beds per station) who required q 2 hr total bed changes for large amounts of stool. One of them got a rectal tube but it kept leaking so needed linen changes anyway; the others had large/loose stool but not quite runny enough for a rectal tube.

It is what it is, and care is about what the pt needs. Even with 3 CNAs on that night, they couldn't do all of that; and anyway since it was critical patients, the RN kind of has to be present anyway.