Newbie CNA shocked "care" given by CNA co-workers!

[MidLifeChg2Nursing]

I passed the state exam and received my CNA certification about the same time I started working at my first CNA position at a LTCF - I'm only working weekends; I work during the weekdays at a very good paying job.

I'm changing career with the goal of becoming an ER nurse. I'm working the weekends as a CNA because I'll be entering an ADN or LPN program August 2015 - ADN first choice, but if I get wait-listed, it makes sene to me to go ahead with the LPN program which has no wait list, then do LPN to RN. I'm a 44 year old male and don't think I should wait any longer.

I've been working at the LTCF for 4 weekends (CNA experience - 4 weekends) and I am just appalled at the care, treatment, and/or verbal abuse given by some CNAs to the residents. My wife (yes I am a male CNA), who was a CNA a while ago and is now an MA, said I should tell the DON.

Nothing is more important to a person than his/her health. We as CNAs are entrusted to help maintain their health - that's a huge responsibility, one that I take seriously. Making up numbers on charts is crazy; a non-compliant resident wouldn't allow me to take her temperature, so I asked a seasoned CNA (33 years) to help me - she looked at the previous day's vitals and just copied it. CNAs who didn't feed an assigned resident (they feed others assigned and not assigned) when charting say "well they usually eat and drink this much", and "they usually have this many BMs" - charting what they usually do will not catch changes which may prevent something; c'mon, their health is at stake.

Providing as much comfort and dignity is the next most important thing (of course safety trumps all). Needing help near the beginning of the shift with a resident whose large BM leaked out his briefs all up his back down his leg and all over and through the sheets, the experienced CNA I asked for help said he can wait, we being the only 2 CNAs (short that night) have to distribute johnnys/bibs/pads to the wing before dinner - yeah we were short, but with 2 of us and 1 experienced it wouldn't have taken but 10 minutes to change him and the sheets, instead of him waiting in his **** for an hour - c'mon that's disgusting.

And I can't even number the verbal abuse I witnessed or that they jokingly tell me about.

Maybe because I'm a brand new, wide-eyed, idealistic, fresh, untainted CNA, I expected caring and compassionate healthcare professionals. As was taught in CNA class and re-emphasized during new employee orientation the residents at LTCF have lost all their possessions - all they have now fits in half a room; their home now resembles a hospital floor; they are dependent on others to wipe their butts, or feed them, which in their minds may be humiliating and degrading; they lost a lot of independence; so yeah, some may have a hard time with that and may be a little grumpy. Again, maybe because I'm new, but some of the residents who have "rude" behavior and language doesn't bother me.

I took my wife's advise and told the DON - I'm not trying to be a snitch or get anybody in trouble, but as I said, I take seriously my job of providing safety, care, comfort, dignity; CNAs are also advocates, standing up for them against those who bully them - that's how I see it, as much as we hear about bullies in school, these CNAs are bullying those weaker than themselves. I don't know what actions may be taken, and I am a little worried that I will be found out as the "snitch" - I do have to work with them, and hopefully will get help when asked. I keep thinking of the last 10 months of my dad's life - he was reasonably healthy and lived on his own in an apartment; but, when his body started to shut down, it was a runaway train going down a cliff. He had no major health problems for 77 years, then his health just ran away from him - he spent the last 10 months in a nursing home, and I can't help but to ask, "is this how they treated my dad?".

Treat others the way you want to be treated, and the way you would want your loved ones treated - every time I go in to work, I think of how I would have wanted my dad treated.

I don't want to be the bad guy; but when I think about it, I'm not.

[duskyjewel]

Treat others the way you want to be treated, and the way you would want your loved ones treated - every time I go in to work, I think of how I would have wanted my dad treated.

This is the best guiding principal you can have. It will serve you well.

Hopefully the DON will respond to your concerns, but LTC is notorious for exactly the kind of thing you're seeing. The CNAs at my clinical site had much the same attitude. In their defense though, their higher ups had them running the place very short of personnel. When one CNA is assigned an entire hall of people, no matter how wonderful and compassionate they are, it is impossible for them to give good care. When they're forced to work like that all the time, they become resigned, then cynical, and some progress to bitter. I think that's what you're seeing.

I worked a hospital telemetry floor as my first job, and let me tell you, it wasn't much better. The volume of work they expected me to complete, with basically no help from anyone, in 12 hours was impossible. The other aides found ways to cut corners and encouraged me to do the same, because it was the only way to survive. (Faked vitals on a tele unit....think about the implications of that.) But I'm not that person, and I ended up with a churning stomach every day I had to work, and realized I'd get a bleeding ulcer and end up very sick if I didn't get out of there.

See what happens with the concerns you brought up. How the DON responds will show you what kind of facility you're working in. Then you have a decision to make.

I wish I could make all the bad facilities close down and go away. But I can't. I can, however, avoid working in them. I work hospice now and am much happier. There are other places to work. If it becomes necessary, seek them out.

Here's hoping your DON comes through.

[LadyFree28, BSN, LPN, RN]

Duskyjewel is correct; unfortunately there are some pretty bad places in terms of LTC; however, there are better run places as well as other options that do value safety, dignity, and the best practice.

You did the right thing; a huge part of nursing is advocating for yourself and your pts; always remember that as you progress further in your studies as well as your career.

Best wishes.

[mvm2]

As sad as it is duskyjewel is right and that what you are seeing is pretty typical in most LTC.

The best you probably can do is find ways that YOU want to do your job and leave feeling like you did your best for your residents that day. Even if others are doing things like untrue charting just don't do it yourself. If you need to take a residents vitals and they fight you I'd simply try later and if still refusing write that they refuse on the chart which is the truth. and then sign your initials. If someone else wants to write fake numbers it is on them and their signiture not yours. It is wrong and if this is done ALL the TIME the DON hopefully will just maybe have a staff meetig and reminding everyone how dangerous it is to falsify charts. That way the staff won't know it was you specifically that gave the concern to the DON

Also sometimes unless it is putting the resident in danger you might just have to start to learn to ignore bad behavior from your co workers. Not all CNAs are going to be cookie cutter type of personality. Even though we think all CNAs and nurses should be kind, wonderful, sweet, people and have a smile and kind word to say to their residents and patients everyday, fact is it is not going to be that way. Some CNAs-Nurses might have a personality that you don't gel with or you think they may be rude. but if they have been a CNA for years they must be doing a lot of things right to still be doing what they are doing or so long. So sometimes if they are just at the nurses station and saying things that you do not like just try to ignore it and just know it is just who they are. On the other hand if they are verbally abusive DIRECTLY to the resident that is not right and should be taken care of.

Like any job everyone might have their own ways of doing things and even though you might not agree that it is the best way to do things, or in the order that you would do them as long as it does get done sometimes we have to just let it go. As much as you can do your job in the order and way that makes you happy. Just know that sometimes your well laid out plan might be disrupted because you need to do something else. Would of it been possible for you to have asked the CNA if she could have started to pass the items out herself while you cleaned the resident up, and then helped her when you were done? Sometimes when you are working short you need to do things outside the norm to get things accomplished. Maybe it is typical for two people to do the passing of these items but this time she would have done it by herself for 15 minutes and then you helped the last few minutes. Don't be afraid to open up and give these type of suggestions to the other CNAs. If you would have asked if you could have cleaned him up while she started she might have said ok.

It can be hard your first few months of LTC and knowing everything is not going to be perfect ever.. You will have your good days and your bad days. But just keep trying to do your best everyday and be that helping hand whenever possible to your fellow CNAs and hopefully you can be happy working at your LTC.

[MidLifeChg2Nursing]

I never had to clean something so messy, and thought I could learn something from an experienced CNA. In hind-sight, I should have attempted it on my own - I couldn't have made it any worse. I'm beginning to wonder if I made the right decision in telling the DON. Either way, I'm staying, and try to deal with people and situations as positively as I can. The goal is to stay there during LPN program and get hired there once I pass the NCLEX-PN; then, work there as an LPN as I go for RN.

[HappyWife77, BSN, RN]

You are already showing great character traits as a leader and agent of change. This is what we need in nursing. Congratulations on pursuing your career and I am glad to have you join us.

Don't conform to substandard of care, be a voice and an agent of change. I believe your maturity will serve you well. Just do what you can and keep your integrity.

We are in our field for our residents and patients, not to make friends or to please our coworkers.

God luck to you in your future endevours!

[OnlinePersona, LPN]

Welcome to healthcare young grasshopper.

Find a new place to work, that's obviously the culture of the place.

[joqu102]

Unfortunately, this is very common in LTC facilities. I became certified as a CNA a few months ago and I had major issues during my clinical due to the way some residents were treated. I've seen CNA's who have 20+ years of experience, shove food down residents throat, ignored call lights, disappear off the unit for 15-30 minutes at a time, left their resident's dirty all day, and ignored resident's complains about pain. One day, a wheelchair bound resident asked her CNA to assist her to the bathroom, she left the resident unattended for two hours and became upset when she returned and the resident had defecated on herself. It broke my heart to see some residents being treated this way. I became a CNA to make sure that those who needed my help would receive it and be taken care of to the best of my ability. It saddens me that some of these CNAs cut corners to get the job done. I believe if you have time to disappear off your assigned floor for 30 minutes at a time, then you should be able to devote more time to caring for the residents assigned to you.

[Wheels28]

As a patient who is disabled and uses a wheelchair I want to say thank-you to all of you who watch out for those who can't help themselves. It's people like you who make this world better. Once again THANK-YOU!!

[fawnmarie, ASN]

HappyWife77 is right on the money. You have already shown that you have the integrity and compassion one must have to be a professional nurse. I am very sorry to hear of your dad's passing, and I hope that he was treated with dignity during his final months. Good for you for bringing this to the attention of your DON. Have you spoken to the administrator of the facility as well? I once worked in a facility where the administrator had a very pro-patient attitude and did not put up with any allegations of abuse or neglect. On one occasion, he spoke personally to several patients who were afraid of one particular CNA. The administrator called the CNA at home and asked her not to come back to work, because her patients were afraid of her. Good luck to you, I will certainly pray for you and your patients. You did the right thing!

[Raviepoo]

You did the right thing. Depending on the political situation at your facility, it might rebound on you. That happens. If the DON has integrity, she will take the accusation seriously. Sometimes management does. SOmetimes they don't. Either way, you did what was right. That's all that really matters.

[monkeyhq]

It is our responsibility as nurses and caregivers to advocate for our patients. We need to get away from the 'hurry up' culture, and the 'how big are our dividends this month' mentality.

That change starts with each of us.

We need more of you.

Please keep doing the right thing.

Welcome, friend. :)