Not-So-Patient-Focused Care

[startthejourney2013]

I just recently started my journey into Nursing, inspired by my mother who graduated as an RN in 2009. She always tells me stories and experiences; and some of them were about how bitter some nurses become after years of doing it.

I started my clinical a few weeks ago, and I am already seeing signs of this deterioration of care in CNAs who have been in practice for only a few years. To be honest, it shocks and truly upsets me to see such corner-cutting in this Assisted-Living Facility. They have residents sit in front of the nursing station doing nothing while the CNAs just chit-chat, some sit in front of a blank TV because no one will take the 10 seconds to put in a new video, there is still BM from a previous resident half-washed away in the tub rooms, they still have BM trails on their bottom when I do peri-care, still dirty briefs in trash cans - if there are even bags in the trash cans - and gait belts? Please! They just grab the residents by the arm and lift them up that way.

All procedural ignorance aside, I was giving a shower to a resident with a CNA from the facility. While she was complaining about the lack of care that the residents get - this one in particular, being that she is mildly "uncooperative" and most just don't want to deal with it - she talked about the resident as if she wasn't even there. As in while brushing her hair saying things like "See how thin her hair is? It's just so sad." And "Look at how dirty (the resident) is. She probably hasn't been bathed in at least a week." The resident was able to talk and able to hear, and even if she weren't I would never talk about someone in that condition in that manner while they are in the room.

I just want to know that not all nurses become like that. Perhaps some people just enter the Nursing field for the paycheck and are not very caring people by personality. My mom says that true nurses can't be trained, it's just something you have in you. I feel like I'm just like my mom in that I have it in me, even my instructor says I am really coming out of my shell and display the care of a great CNA. I know that not everyone can be Virginia Daniels, and I know that the perfection displayed in textbooks and videos is far from reality; but this just does not seem right.

Thoughts?

-Jennifer, CNA student

[esand]

I was faced with this same realization when I got my first job as a CNA, and at first I was really angry about things and even had a plan to change them myself. As the weeks went by, I started to realize that most of these problems are due to short staffing and the heavy work-load that is placed on CNAs these days. You won't always have the time to take care of the few extra things that the resident needs because you're got the rest of the hall who need things as well. Being a CNA is a very hard job because you have to pick and choose which things will get done in order to get everything done, if that makes sense. I mean, of course it's also hard because of all the physical work you do, all of the remembering you've got to do, etc, but in my experience, the hardest part of it is having to admit that you can't get it all done, there's no way.

I'm not defending these CNAs who are leaving their patients in such ways, but rather am trying to help you see it differently. Shame on CNAs who don't take that extra step when they have the time, they truly are in the wrong, but for those who are really not able to, it's not their fault.

[funtimes]

I'm surprised you did clinicals at an assisted living facility. We did ours at an SNF with residents who were almost all total care, which is generally the type of place CNAs work at. I'm not sure aides even have to be certified at an assisted living facility.

It may be that the residents are assumed to be able to largely take care of themselves at this facility, which may or may not be the reality, but I dont think its the same thing as a Nursing home. I've never worked at an assisted living facility, but that was my impression.

[mskrisCNA2bRN]

Not defending those cna's that do that but i honestly understand what's going on there. Where i work we are extremely short staffed and my patients sometimes have to suffer because of it. Sometimes all i literally can do is change them every 2 hours and check to make sure that they are alive and breathing. Especially when I have 25 people to myself it's hard

[jusbeingme2007]

I can honestly say ive seen both sides of the fence on this one. From personal experience yup short staffing and trying to handle it like superwoman, which i have learned is immpossible. But i have also worked with some lazy cnas who just didnt care. I worked night shift and on the third round, the people that got a bath didnt have to get changed which made sense because they got A bath right after the round was over. Well one of the cnas i worked with decided that if they were getting a bath that they didnt need to be checked/changed on the second round either. All i could think was how that girl would feel if that was her own parent... It is sad...they are out there..

[i_love_patient_care]

I would tend to say you can tell how lazy someone is when you've worked on their run yourself. It's quite different when you become a CNA, and can't do everything how you were taught in class. I agree, I felt the same way until I actually started working as a CNA. That being said, I always try to be as gentle as possible, even when working fast.

[Prac]

Lol. Sad but true startthejourney. It depends upon the place too!

[Kris10Noel]

As a CNA I am all about good patient care. I will go the extra mile when I can (basically when I have the time). But as other posters have said, understaffing is a huge issue! It comes to the point where you do what you can. Sometimes I go home and feel extreme guilt because I have incontinent patients whom I was only able to change once during my 8 hour shift. And when i did their bed was completely saturated. It's sad and unfortunate. But you can't be at 15 places (or more!) at once. Just take this experience as a lesson, and when you finish your schooling and are a nurse, be willing to put in that extra care your overworked cna cannot, if you have the time of course. Some nurses no longer see "wipe, dope and flip" in their job description even though it is learned in nursing fundamentals. I am grateful to be a cna working toward my RN. That will make me a far better nurse than those who do not know of such work, stress and struggle!

[TurtleCat]

Sometimes I go home and feel extreme guilt because I have incontinent patients whom I was only able to change once during my 8 hour shift. And when i did their bed was completely saturated. It's sad and unfortunate.

That guilt was one of the reasons why I couldn't keep on working as a CNA in a nursing home... I would go home every night feeling so guilty and horrible because I couldn't give my residents the care I felt they deserved. My heart broke for these poor souls that had to suffer. However, I stumbled upon a better job as a CNA in a small group home, where I have two elderly ladies to take care of and I love, love, LOVE it so far. I'm able to spoil these ladies and give them the thorough care and affection I wanted to give those in the nursing home but never had time to.

[techhappy]

You will find this every job you will work in as a CNA their is always the complainer the do good CNA and the one who wants to be the savior and try and change things and I can tell you that in 17 years of being a tech. It don't seem to matter how much you try and fix and how many times you complain to your DON or LPN or RN it goes in one ear and out the other. There are favorites and butt kissers galore and your at the bottom of the food chain..I go to work every night praying for a miracle something has changed and no matter what do my best while my patients have me on the clock. I am glad to hear them tell me I am going to sure miss you on your days off or man I am glad your back it makes me keep going. You will see and hear some of the most rudest things and witness things that you never wished you seen and days you go home crying and days you don't even know if your going to return to work. You can't change others way of giving care you can only hope that what comes after you and witnesses your level of care is carried on and that person learns from you and your passion. Remember that no matter what you have to feel empathy and have compassion and above all else feel like you gave that person the best you had to give.

[techhappy]

most places will tell you that they are staffed to the state regulation what is needed per patients ratio however they don't go by the level of care needed just a head count it is with great sadness that you are right those ones that can't push the call lights or roll themselves are the ones that go without due to the button pushers and the ones that ride the call lights over there air. lights, food, covers, move this or find that or wanting meds.