Kind of disgusted with the place im doing my CNA clinicals:

[adruiz01]

i started cna classes this month and the number one thing we learned to prevent spread of disease is wearing gloves and washing hands before and after any resident/patient which to me seems like common since among a few other things you shouldn't do, like putting linens back into the linen closet after its been taken out whether it was used or not, especially if it was on someone's bed and that person has mrsa, or when that person is in isolation and u have to put on the gown, gloves etc. and taking them off before exiting the room, am i right? well last wednesday was my first day of clinicals at this nursing home, one of the first things i noticed during my clinicals is that the aids almost never wash their hands sometimes don't even wear gloves when they should, don't get me wrong some of these aids where good but where not following standard precautions at all, of course i couldn't stop washing my hands. well sat i went in and i was in the alzheimer's unit and we went to toilet one of the residents, come to find out this resident has mrsa in her eyes, now mind you this person has alzheimer's and romes around the unit touching everything, shouldn't they have some kind of isolation for that person instead of letting her rome around touching everything with her hands after she is rubbing her eyes that have mrsa, bc when it comes down to it someone may come along touch the same object or her hands for that matter (anyone who has worked with alzheimer's patients know that they like to take you by the hand and go for walks or just hold your hand) then touch an open sore or their eyes and end up getting mrsa, please tell me if i got this wrong? last night was my 5th day in clinicals, so i get there and they put me on the hall i was on the first day, so i didn't think anything of it. well i started passing ice, come to find out one of the residents on that hall has mrsa in her osotomy opening and they didn't tell me till after i had already went into her room, thank god all i did was grab her water pitcher! but still my point of that is, i have a 17 month old so i like to know a head of time what im dealing with if you know what i mean. so as the day went on i went about my business helping the residents washing my hands nonstop (which i never seen the other aids do but maybe a couple times) there was one gentleman on that hall that i was helping with changing his clothes, toileting, transferring etc. well come to find out he has mrsa too in his urine! i didn't find that out until 5 min before my shift ended! although i wore gloves and washed my hands i still would have loved to know. this gentleman is right across the hall from this other lady that has it also. tell me if i'm wrong but isn't mrsa only spread through contact? because i find it kind of ironic how the aids never wash there hands or follows standard precaution and there is 3 people in that nursing home have mrsa and 2 are on the same hall, doesn't that say something? also, i seen the nurse of all people come out of this ladies room with gloves gown and the whole nine yards still on (after dealing with her osotomy where the mrsa is), taking them off while she walks down the hallway! shouldn't she have taken it off before exiting? then after that the aid i was working with goes into her room starts touching her bedding and everything without gloves, takes a couple of the bed pads that where on her bed and throws them back into the linen closet and we where taught to never do that, if it comes out and whether it's used or not it goes into the dirty linens to be washed. i was so disgusted by the end of the night with how they handled all this, i felt like i could have puked! i couldn't stop washing my hand bc they never wash theirs and they touch everything with their hands after dealing with the residents, so i was afraid i was going to touch something that they touched with their dirty hands. . . .im not trying to sound like i know everything and im not at all trying to say anything bad about the aids or nurses i am just so disgusted by this and feel that they are putting everyone at risk, am i wrong? i just feel that there is no such thing as being too cautious when it comes to this kind of stuff when working in the medical field and i don't feel that they were being cautious at all! is this something i should report?

[eldragon]

They do still have it, these residents are still in isolation, besides the one in the alzheimers unit. If they didn't have it they wouldn't be on isolation, right? Im guessing if they didn't still have it the nurse wouldn't have put on all her PPE , which should have been takin off before entering the hallway right?

Yes, the nurse should remove her gown, gloves and mask while inside the room and discard it in a red bin, which should be stowed in the rooms bathroom. And soiled linens should be kept separate in red bags and brought to laundry separated from other dirty linens.

And anyone in that room should be wearing gloves, gowns and a mask.

But not everyone is mindful of doing the right thing, even though they are probably spreading germs to everyone, including themselves. That same nurse or aid that doesn't wear gloves and wash her hands goes out and picks up a ringing telephone and leaves germs on the receiver. She opens the door to the restroom and leaves germs there. She absentmindedly picks her teeth or eats something without washing first. Yes, she's ingesting the germs when she does that.

I have seen nurses touch patients food, while preparing it, and not be wearing gloves. Last week I had to correct an aid who picked up a patients baked potato with her bare hands, and squeezed it before attempting to put seasoning on it. I told her to never touch a patients food with her bare hands again, but I was nice about it because ..........as you'll likely find out when you get your license.........it's important to have a good working relationship with your nurse/aid.

You are right about most of what is bothering you, but the other posters are correct when they tell you to discuss it in post clinical with your instructor only. Your instructor will most likely reiterate what you have learned about precautions.

Meanwhile, continue paying attention to your own good hand hygiene. That's really all you can do anyway.

[EverNurseRN]

if this is true then why do they put this stuff on their care plans? sounds to me like this facility goes against a lot of state regulation. how are we as students suppose to learn what is right and wrong when we are learning and watching everything that goes against this.

it does sound like this facility may have some faults..the care plan sheets that the cnas use should be different from the complex care plans in the patient's chart. they should only have adl pertinent info on them.

and i will say that it is shocking going from school to the 'real world'. we learn things in nursing school and find that in the clinical setting, 75% of what we are taught is done the 'wrong' way in the real world (sometimes good, sometimes bad). i've worked in long term care since i graduated nursing school, and some of the things i've witnessed is down right insane. cnas that do bed check on an entire hall without ever donning gloves or washing their hands or even using hand sanitizer. i've seen nurses change deep deep wounds so big you could fit your fist half up your forearm that are pouring with infection and smell like death with their bare hands. :barf01:disgusting. i go through about two boxes of gloves a night at work and while some tease me for it, i could care less because i'm protecting myself and maintaining my procedural skills.

everyone's right, though. the best you can do is protect yourself by maintaining optimal personal health and using precautions at work. you can encourage in a delicate manner to others once you are licensed, but be prepared to be met with blow offs or attitudes. for most people, habits die hard. i hope your instructor can help you with these issues.

[eldragon]

The last post reminded me of a time when I watched a very experienced nurse trim a patients toe nails, which were very thick and very long, without gloves on. Pieces of toe nail were flying everywhere and this nurse just kept her grip, trimming away without a care in the world!

Nasty!

[shellyjel]

Unfortunately, this is the practice I have also seen. I am a recently graduated LPN. I have my first job in a LTC, and I have seen the same thing in my clinicals AND at work. However, I have also seen someone do it right. I saw in clinicals an RN with UNWASHED hands change a dressing on a surgical hip incision with his bare hands, touch the skin, put a saline rinse on it where he touched the tip to the wound, and the put it back to use later ( I threw it out). I have seen them also put hands IN THE stage 4 wounds. It is disgusting and I determined, I don't care what they think, I go through the gloves and do it right. I just have determined not to let it get to me but lead by example and do what is right myself for my and my family's protection. I take off my scrubs and don't track through the house with my shoes on. I have hand sanitizer in the car.

Be careful of licking your finger to flip through books (one good nurse does that:no:). Lay paper towels on nightstands to put things that need to be clean on them etc. I have seen GREAT CNA's change urine soaked bedding and wash bottoms with washclothes BAREHANDED - ewww. AND NOT WASH AFTER. It bothers me immensely, and when I am an older, MORE EXPERIENCED LPN and it is my floor - we WILL discuss this! In time...

YOU ARE RIGHT, not them!!!