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

Nursing Students CNA/MA

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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.

You absolutely did the right thing! And I would love to work with more people like you:up:

Specializes in nursing education.
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. :)

Like x 1000. If you can stay strong perhaps you can change the culture in this facility. You do sound like a true leader. My experience in LTC was similar to yours.

Specializes in Neuroscience.

I feel the same way. I got a job as a CNA this summer, and while my residents LOVE me, my co-workers aren't feeling the same way. I am apparently too slow, I listen to the residents, I actually use wash cloths to wash the urine that has not been wiped away the whole shift.

We are short staffed and we are super busy. I don't cut corners. I think it's great for the residents that you don't either. Trust me, they don't have much in terms of advocacy on their side.

Specializes in none.

Welcome to the LTC CNA life. You are in charge in the night shift for caring up to 20 residents. None of them can do anything for themselves.

good luck

You are absolutely right to bring your concerns to the DON! Whether or not it will do any good is a whole new subject, though. Depends on the facility. Some are much better than others. Facilities that promote "people moving" as opposed to focused, quality care are ones you need to run like hell from!

Any concern you have that affects a resident's safety and well-being needs to be addressed and taken seriously! I always keep in mind that everyone who I care for is someone's mother, father, grandmother, grandfather, aunt, uncle, etc. When caring for residents, I always do so in the same way that I would if their family was right there. I could be in a resident's position someday, and I care for each resident in the same way I would want to be cared for.

If the facility where you work doesn't promote that kind of care, run for the hills! Not every facility is like that. Some CNAs are also "bad apples" who can spoil the whole bunch if bad practices are allowed to continuously go on.

Best of luck to you as you venture into your new career path! Just keep doing the right thing and continue to be an advocate for your residents' health, safety, and well-being.

I don't see any problem with reporting suspected verbal abuse, as you are a mandatory reporter and are expected to, and this is the kind of thing that if it is happening needs to be nipped in the bud before it escalates. Just make sure the verbal abuse isn't something taken out of context and that you don't exaggerate or give your own opinion.

I would be more reluctant with going to the DON about the other things though until you have more time and experience on the job and know from that experience that you yourself can live up to the standards you are setting for others(which quite often turns out not to be the case). A lot of new CNAs continually fall behind because they are trying to be super thorough or continually cave in to the demands of every resident(or the residents that know how to manipulate new CNAs).

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Welcome....Keep up the good work!

@ funtimes:

Telling me directly in front of the resident, "he didn't poop, he just smells like shyt" Nothing taken out of context there. One resident with some dementia sometime talks of Jesus (whether you believe or not, be respectful of their beliefs and culture) - one CNA joked that she told that resident "Jesus is in hell, and that's where you're going to meet him." Nothing taken out of context there.

I understand what you're saying, but the standard so far I expressed was simply not letting someone lay in sh!t for 1.5 hours, not faking vital signs (I just needed someone to hold her hands for 10 seconds while I put the temporal thermometer to her head), and not faking I&O - where I did my clinicals, the CNA who took up the tray immediately filled out the I&O for the owner of that tray, whether that resident was assigned to that particular CNA or not, efficient and effective. I think I can live up to those standards.

You are right... These are the kind of stories that just make me sick. Why can not our dear elderly people get love and respect that any other human wants and expects. For people to think it is ok to talk about and talk to people like that is just beyond me. Saddens my heart and I can only pray someday people will truely understand the hurt our tongues can do.

Welcome to LTC and nursing homes. Although some will say that all nursing homes are not like the one you experienced, In MY experiences, every single nursing home was exactly like you describe. Its so sad and disgusting, you end up crying or quitting.

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

I worked in LTC for six years before I became burned out and entered a different specialty. What I'm about to mention might be viewed as controversial or terribly offensive to some parties, but here it is.

Due to welfare-to-workfare regulations that have existed in all states since welfare reform laws were enacted in 1996, many caseworkers are under immense pressure to get people off the public assistance rolls and help them transition into paid employment.

Job training is a major aspect in this transition into the working world. Healthcare training programs such as CNA, HHA, medical assisting, phlebotomy technician, and dental assistant are popular offerings because they're cost-effective and can get a person trained for a new job in a few short months.

Here is the problem. While many of these women love their new jobs and the sense of self-efficacy they receive, there are many more who are part of a forced workforce. Essentially, a number of the aides with whom we work do not really want to be there, and are simply going with the flow to avoid sanctions.

When someone really does not want to be there, they have the tendency to objectify the residents and do less than the minimum to survive on the job.

I don't see any problem with reporting suspected verbal abuse, as you are a mandatory reporter and are expected to, and this is the kind of thing that if it is happening needs to be nipped in the bud before it escalates. Just make sure the verbal abuse isn't something taken out of context and that you don't exaggerate or give your own opinion.

I would be more reluctant with going to the DON about the other things though until you have more time and experience on the job and know from that experience that you yourself can live up to the standards you are setting for others(which quite often turns out not to be the case). A lot of new CNAs continually fall behind because they are trying to be super thorough or continually cave in to the demands of every resident(or the residents that know how to manipulate new CNAs).

I understand what you are saying when it comes to residents who are super demanding! It is impossible to meet every resident's every need! Getting every resident's basic needs covered is of utmost importance though. You have to weigh your choices. I've had one resident scream and yell in the hallways because during a linen change, I was interrupted and had to take another resident to the bathroom and get others up for supper. Her need for wanting her bed made RIGHT NOW was put on the back burner because there were others who had more important needs that needed met. Sure, this is a really obvious example of choosing what to do. But sometimes you're faced with more difficult choices, even ones that create more work for yourself, but it's all part of the job. I've also had a resident who needed to use the bathroom to have a BM who I couldn't take right away because another resident who was a fall risk hopped up from their chair alarm and was trying to wander. I had to promote the safety for the resident who was a fall risk and couldn't get the other resident to the bathroom on time and, of course, needed to get that resident cleaned up right away once the other resident was safe. I hate having to make those kind of choices. But everyone was safe and taken care of.

There are also times when you have to assert yourself to demanding residents, particularly when their demands take away from your ability to care for others who need their needs met. Sometimes just handling everyone's most basic needs is all you have time for and then there are times you're able to go that extra mile and throw in a nice back or foot rub at the end of a shower or look at pictures of a resident's family and listen to stories about their life. Those moments are priceless!

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