Is this Wrong?

[One Flew Over]

Hello! I am a CNA in a LTC facility. As long as they have been open we have been getting our trays sent up with everything on them, so all we need to do is pass them, set them up, etc. We have a new kitchen company, and they have been making all sorts of crazy changes to cut costs without consulting the nursing staff. Nurses are fighting for pudding to help with giving medicine, orders aren't being sent up in a timely manner, etc etc. Fine, dandy, we'll deal. But now they've decided to stop sending the coffee and tea with the trays. Now they will send a cart with two pitchers and a handful of cups. They expect the CNA's to hand it out. Now I don't want to sound spoiled, or anything but I feel as if this is wrong.

Our typical breakfasttime has about 30 trays, with 4 CNA's (if we are full staff) to pass them/set them up. This can take up to a half an hour, depending on who orders alternates etc etc (especially now that the new kitchen forgets a lot and sends the wrong thing) Usually after this we begin feeding the 4 feeders (all bedbound in seperate rooms). With this new system, we now have to pass coffee/tea etc which takes about 20 minutes (our floor is filled with a mix of demanding and demented patients and they all LOVE coffee ). That means that we can only start feeding residents roughly an hour AFTER the trucks come to the floor! So about 30 residents have finished/enjoyed their breakfast, while 5 feeders haven't even gotten a bite or have just begun. Isn't there something wrong (legally) there? Is that grounds enough for me to speak with the ADON and insist that we have a dietary aide or ANYONE to help pass that coffee, so we can help our feeders in a more timely manner?

Edit- I forgot to mention, that by the time this all gets settled and we're ready to start feeding, the patients from the dining room are all starting to return and ring for the bathroom! Sometimes the floor can be chaos :)

Thanks for reading this somewhat scatterbrained post )

[chenoaspirit, ASN, RN]

Dang, thats a mess. Our trays come with coffee on them, then an extra pitcher with cups for those who want extra or who didnt order it. I dont blame you, that would take forever. Can your manager advocate for the staff? I mean, if the managers all complained, maybe something would change. I would first go to the unit manager, then go to the DON and on up the chain of command until that was changed. It probably seems like such a small thing to some, but to those who have the additional workload its not such a small thing.

[One Flew Over]

I forgot to mention, that by the time this all gets settled and we're ready to start feeding, the patients from the dining room are all starting to return and ring for the bathroom! Sometimes the floor can be chaos :)

[Absolutely13]

I certianly don't envy you, but let's try to make some lemonade here. Is there any way the clients that need assistance eating can be fed first?

The decision makers will probably be the last ones to figure this out, but it's never to early to plant seeds in a constructive way.

I wouldn't delay toileting after a meal at all costs, and I'm sure you feel the same way. This is a huge dignity issue for the majority of the clients, nevermind the risk of unnecessary additional work for the CNA's.

It appears someone lost view of the big picture. Good luck and keep us up to date on changes.

[nicunana]

You asked if there was something "legally" wrong. Not necessarily leagally, but your facility may not be meeting other guidelines that could be related to food safety. What is the actual temperature of the food at the time it is served. Does the hot food stay hot enough & the cold food stay cold enough to meet federal or state guidelines? Can you prove that this system is hazardous to the health of some of the patients and may cause food borne illness? Perhaps a call to your local health department may stimulate a visit from them to check things out. Putting patients at risk to save a little time in the kitchen is a very bad practice for any health care facility. Good luck!

[CoffeeRTC, BSN, RN]

Okay...I work in a LTC with 48 beds (one hall has 22 the other 24) each. There might be at least 10 who need fed and more that need cue or assistance. On days we have 4-5 CNAs sometimes 6.

Our trays come out one hall at a time...everything except milk, coffee and tea are on them. (for some reason juice is included and the thickend liquids are on them too)

What we do is start one hall, pass the trays and make up the coffee/ tea/ milk as we pass the entire hall. Normally while passing, a few cnas will start feeding the ones that need fed.

Next, they move to the other hall and do the same..when trays are all passed who ever is left helps feed then the others will go to the first hall and pick up trays.

As far as food temps....if the food is left on the carts until it is passed with the door closed or after it is passed with the top on the plate...you should be fine. Milk is kept on ice till passed. Hot liquids are in a caraft until poured.

I think it will work if you can get a system together and juggle times around.

[RheatherN, ASN, RN, EMT-P]

talk to your super. have all the aids do the same thing. you need to do this as a team so they realize something is wrong. unless it ends up being one of them cases where they just dont care what u think.

-H-RN

GL!

[One Flew Over]

Thanks everyone! They didn't do it again today, I wonder if there were enough complaints. I'll keep you guys posted though with any changes! :)

[LoveMyBugs, BSN, CNA, RN]

Can they stagger the food carts, or have the feeders food come first? When I worked LTC, there were 5 food carts that came out a half hour after each other. The first food cart would be for the feeders and then everyone else.