New Policies

violetrose · Jul 18, 2006

We have a shower aid, she gives the showers starts at 5:30am, does weekly BP, weights, nails, monitors changes in skin condition. Documents all the above. Helps with bkft and feeding. Usually done with this by 11:00AM, then helps in the dining room. This position is very valuable, I've worked at places where the CNA did the showers, no consistancy, sometimes the showers were missed for weeks at a time, nails not done etc. As far as getting a resident up in the middle of the night that is a terrible practice, should be stopped.

marymack57 · Jul 18, 2006

I'm always telling my friends at work "when I'm a resident here...." and then tell them I don't want that, or I do want this.

DON'T GET ME OUT OF BED IN THE MIDDLE OF THE NIGHT, OR BEFORE SIX FOR THAT MATTER, TO DO ANYTHING FOR ME...I might bite

Seriously, its a dignity issue. How dignified would you feel?

vampiregirl, BSN, RN · Jul 19, 2006

Wildcard47833- may I ask where you saw the article?

santhony44, MSN, RN, NP · Jul 19, 2006

It sounds as if this is being done so that night shift will have to do some of the baths!

I can't imagine that it would fly with whoever regulates nursing homes in your state. It would probably be worth finding out. There should be a mechanism for reporting issues anonymously.

I have a friend who is a DON in LTC in Texas, and it would never fly there!! She has one resident who gets up at 4:30 three days a week for his shower, strictly at his own request.

NoWaNrN, ASN, RN · Jul 19, 2006

I would be very unhappy if someone was getting me out of bed at 4 am to give me a shower

Nascar nurse, ASN, RN · Jul 19, 2006

We start baths at 5AM, but only on people who are already awake. We are farm-ranch country,so have many life-long early risers. Middle of the night baths are done only if awake (to relax them) or severely incontinent of bowel.

Have worked 20 years in LTC in INDIANA. We also have many farmers (or farmer's wives) that have forever gotten up with the sun.. they get their showers early is they so choose, otherwise this is an unacceptable practice in any state!

vampiregirl, BSN, RN · Jul 19, 2006

Indiana has a "resident's rights and responsibilities" list and one of them includes a reference to the right to a "homelike" environment. As many previous posters have noted, some resident's prefer to get up early, and some prefer to sleep in. I even had one resident as a CNA that liked to take her shower after the 11pm news was over. I've seen a shift towards creating a more "homelike" environment in LTC. I wonder if maybe the residents of a particular unit were surveyed to see what their preferences were if things would kind of balance out. Even offering choices of times. Probably it would be impossible to grant everyone's frist choice, but often times people will gladly compromise if they are part of the decision making process. I know I've had residents who took significant encouragement to get them into the shower at one particular time of day, but would be waiting at the showerroom door if offered a shower at a different time. I sometimes used a lot of precious CNA time encouraging residents to shower. I also discovered that the more control residents have over their daily schedule, the happier they are. After all, for most of them, they controlled their own schedules for 50 years or so, then come to a strange place where they have no control over their schedule.

banditrn · Jul 19, 2006

we have never had a policy book before, one person is writing it ,she is a part timer who works less than 12 hours a week.
I believe very strongly in patients rights
and patient teaching
I have been trying to teach a patient breathing tech, the author of our policy book says the patient " is to stupid to learn"

The author of that book needs to be :trout: !! I can't imagine a statement of "too stupid to learn" passing any kind of state review.

In our LTC, they put some of them down so early that it's no surprise that they're up by 4AM. We have 2 of them that are usually up and dressed by then.

We do have a bath aide, tho, and that's great - takes some of the load off the aides.

Simplepleasures · Nov 22, 2006

This is not unusual, it happened in the facilty I worked at.I guess if it was the nursing home owners mother that was being rousted out of bed at that time in the AM it would not go over so well, I wonder what a little phone call to the family of the patients would have to say about that?UGH! After 27 years in the dungeons of LTC, I still find myself being utterly DISGUSTED at the GREED that created this awful mess,I am out of nursing now, but my hearst STILL bleeds for what is stiil happening, I have to stop reading all these LTC forums, Im getting deppressed.

ns lpn · Nov 26, 2006

no more than 2 a hall is the main quide at our home and this is suppose to be the residents that want up or are climbing and won't settle. we do have a few that ring at 5 or 6 am to get ready- but everyday there are the same residents dressed and ready for the day? i think the rule keeps the girls from dressing everyone but it is definatly not perfect, and one of the cna's the other night stated that one of the girls gets 4-5 residents up, washed and dressed then back to bed with covers over them - now i'm thinking on top of everything else to do that time of the morning i'm going to have to go and check under everyones blankets to see if they are dressed or not.

our don would have a fit so in our case its not the management its the cna's.

it seems to be an ongoing issue in ltc. i think its because the day shift cna's can not get all the residents ready in time for breakfast if the night girls don't get some readyon nights. the don even told the cna's that its not necessary to have everyone done right off and each shift except nights is assigned showers but it has not helped. one might think it would be better to hire an extra staff for 4hrs each am to help but i'm not management and we all know that extra staffing is not only hard to find but even more difficult to fund.

Simplepleasures · Nov 26, 2006

It seems to be an ongoing issue in LTC. I think its because the day shift CNA's can not get all the residents ready in time for breakfast if the night girls don't do some on nights One might think it would be better to hire an extra staff for 4hrs each am to help but I'm not management and we all know that extra staffing is not only hard to find but even more difficult to fund.

Yes this was a constant problem all the 27 years I was in LTC.The extra staffing can WELL be afforded by the LTC Corporations.Maybe it would mean only one European vacation instead of two.On the days that the state was in the house and we had artificially good staffing /pt. ratios,they were actually some of the best days I spent in LTC, really enjoyable to have a minute to chit chat with our dear old folks,to be able to have time to do a decent evaluation, despite state looking over my shoulder.

banditrn · Nov 27, 2006

30+ years ago when I was a nursing assistant working night shift in a nursing home we were told to start dressing patients and just let them lie in bed until 6 or 7am when we were to get them up to the dining room for breakfast. I didn't like doing it then and as the years went by heard that many a home was dinged by the state for allowing this to go on as it was a violation of the patient's dignity and rights. Recently, we've had showers assigned to the night shift, but only a few. And, they were done very early on the night shift or just before going off the night shift. The patients were chosen carefully as ones who either stayed up late or were very early risers. I would say that the state surveyors from the state department of health would have a lot to say about these practices IF they knew for certain that they were going on.

Daytonite - thank you for sharing that!! :) You've provided affirmation of what I'd already been told. In my ex-LTC, as I've said before, I only had 1 aide at nite. They could dress the couple in the AM that were already up.

Then I found out that our DON told the nite aide to start getting people up at 0330! To help the day shift!! Well, there were a lot more CNA'S on days, plus they had a bath aide. Well, I put a stop to it, at least on the nites that I worked - I felt that this '1' aide had enough to do of their own work on our shift without doing all that. I told her if ANYONE had anything to say to her - she was following MY order, and they could come and talk to ME about it.

Then my son told me (he'd worked for 5 years in another LTC) that it was against the rules to be waking and dressing people that early, and that in their facility they weren't allowed to get anyone up before 6, unless they wanted to be.