sassynurse78

I am so obsessed with lists, I write everything down on lined paper starting at the top and then can check off what i have done, what needs done or what to pass on, and I never check off anything until it is taken care of.

Sorry but I had to giggle when I read the first line of your post...mainly because I have encountered so many of these types. The best one was a man who would get the new staff who didn't know better to shave his peri area, telling them we all did that for him to prevent infection lol. A new CNA finally came to me after a month of weekly shavings asking me how this prevents infection! I wanted to laugh but calmly explained the situation...poor girl.

I have one I use a lot, but when I first got it I used it along with the manual to make sure it was accurate. It was, I use a brand called Omron. Others I work with do to. I rub a little alcohol gel on the cuff part every couple days just in case but honestly when does anybody ever clean the manual cuffs anyways? I never see it done. The only thing that drives me crazy about them is the nurses that will get a wacky b/p and chart them without rechecking with a manual. You would think that would be common sense. Mine cost me 80$ and was worth every penny!

I think it is something you should try, although it isn't for everyone. I would suggest walking into a facility you are considering around 6 pm when the chiefs have gone home and the Indians are fending for themselves, just to see if they seem ok-not frazzled and generally friendly. There is a common misconception in my area that "nursing home nurses" do not use the same skills as a "hospital nurse" would, I can assure you this is not the case. My night is spent passing meds, assessing pts. supervising staff, dealing with families, phone calls, etc. I say give it a go!

Gosh I wish we had someone to come in! I spend a good portion of my time on the phone begging when someone calls off. If it gets to the point where I can find no one (which is usually the case) Me or whoever is on the unit with the call in is "stuck". I have made the decision that if I get "stuck" I make a call to the DON and tell her the situation and that she will have to replace my next shift unless she would like to come in to releive me herself. I always get my next shift off. At times the facility has offered a bonus of some sort like five more dollers on the hour, which seems to help a little to get people to come in for a few hours. Luckily we have a group of professional nurses that tend to always come to work unless it is some type of emergency. Our CNA's on the other hand need a lesson in that department. Replacing CNA's is almost a joke. I work second shift, and it seems the fact that third shift does not have to call in and talk to management to actully call in, increases their call ins. We did try for awhile to have everyone call the management person taking call ins for the day at home to call in, it helped a great deal, but the management slowly began to complain about the middle of the night phone calls they were getting. So in other words no, our Don, MDs nurses do not feel like they need to work the floor. Heck you can't even get them to during the day when they are there unless it is really really really bad. Then we hear about it all week that "So and so called in and I had to work the floor!" :chuckle

Money and Greed I think can sum up our health care problems in this country. Although I have always felt this way, I knew it for sure last summer. I started with a headahce and chills, to only get worse and worse. By the time I drug myself to the Dr's office I had a bil. ear infection and bronchitis. The MD prescribed Augmentin and a Medrol Dose Pack. The same week we brought the dog in for a bath and noticed his swelled lymph nodes. The vet prescribed him Augmentin and Medrol Dose Pack also. Total cost of care (including vet visit) for our dog was $32. Total cost of care for me was $150.

Well a quick update...I ran into a nurse I had worked with before. She happened to be working at the facility the CNA went to. She asked me why she left my facility and that she was a terrible CNA. The only comment I made was that she needs to be watched because some of the staff had suspected her of verbally abusing pts. Turns out there have been CNA's reporting that she was saying things to pts that were kind of in between a rude comment or verbal abuse at her new workplace. She told me that she and the other nurses have been standing outside doors listening because they suspected that she was verbally abusing pts. She gave me a call the other day and told me that she took her suspicisons to the DON and that he fired her based on the fact that her nurses suspected something and that the other CNA's reported comments. At least I feel better that she is not working for right now, and obviously she did not learn her lesson the first time. Hopefully in the future if she doesn't find a new feild to work in, she has etheir learned her lesson and realizes the error of her ways, or it will be obvious at the next place she works at also and they will fire her to.

Thanks for your comments...my position is exactly what I was unsure of. I am not management therefore truely in a way I do not feel like it is my place to say anything. I know our facility did the right thing by reporting the abuse, although since I do not know for fact what all she said or did, I do not know for sure if it did not become a situation of she said/he said. I believe I will take your advice and tell my DON. I did tell my DON that she visited the facility and was told that if she visits again to escort her off the property, if she refuses to leave then to notify the police. It just breaks my heart to think about the pts. that have to hear verbal abuse in what in reality is their own home. I hope that she did learn from her mistakes, she is very young and maybe it was a wake up call as to how to conduct yourself.

The facility I worked at recently fired a CNA after many staff members reported what the CNA said to pts. The CNA was making statements such as telling one pt, "The only thing wrong with you is that your psyhco" Answering call lights and telling the pts, that she did not clean up sh*t, cursing in rooms and even telling one pt. not to "touch me because your nasty". She made many other statments also, and the abuse was verbal. Our facility reported the abuse to the State Dept. of Health after investigating and firing her. The other night, she showed up in a uniform and told other CNA's that she quit because there was no teamwork at the facility. She stated she was working at another local nursing home. I know for a fact she was fired for verbal abuse, and also that it was reported. I am assuming that the other facility did not check references (they are known to do this at times), however she also lied that she quit at ours. So maybe (hopefully) she lied about working at the other facility. So I guess my question here is, what can be done about this? Should I call the state and question why she is working at another facility? Should I call the other facility? I just assumed that if someone is fired once for abuse, then it would be flagged somewhere on her certification that a new facility would be able to see that? It sickens me to think that she is caring for other elderly and often confused pts that may not be able to report what she says/does to them. I do not think this situation is right, however I am not sure where I stand since for one, technically I shouldn't know about the abuse and that she was fired. And two, I really shouldn't have been told it was reported to the state. But I work in a small facility and am close with most of the management. One member of the management confided to me what happend and I seen the report to the state. But really I shouldn't have. I have told no one else at work what I know about the investigation/reporting. Other staff does know about the alleged abuse because they were interveiwed and many reported things she had said. So does anyone know if the new facility would know about the abuse at ours? Or should I do something? Is it my place to?

I find myself somewhere in the middle here. As a former CNA, I do my best to not be that nurse that does nothing to help out. But now being on the other side I find myself knowing exactly why nurses seem to only pass meds, chart, etc. I can remember thinking sure their charting, but how hard can that be? At least they get to sit down! I now know it takes a lot to keep all that paperwork straight. For every two great CNA's I work with, I have one that hides, doesn't do a good job, etc. I spend more time then I should making sure the one does what their supposed to which takes more time away from any helping out I can do. While the CNA's usually have 16-20 pts, I always have 40 or more. I used to help a lot more, until I realized that if I put 10 out of the 16 or 20 to bed, then the CNA's got to the point where they expected it from me. I will never let pts needs go, but I think I have finally found a balance. There will always be a lazy nurse where ever you work. I worked with one that would pass meds until time for the food cart, then chart until the cart came, just so she could then finish passing meds when the cart came so she didn't have to pass trays or feed pts! The same goes for nurses to, 2 out of 3 are great. There is always that third one!

Luckily we do not have too much skin problems, and our CNA's can apply any OTC stuff like A&D, Baza etc. I only have a few that need prescription meds and usually I etheir do it myself or tell the CNA's to yell for me when they are ready to turn and reposition the pt. It works out pretty well that way. I do have a CNA that has completed her first year of the RN program and so I will send her in with some things.

Although an embarrassing subject, I do beleive that they have the right unless one cannot consent. We had a couple once that would forget to shut the door. That was a totally diffrent issue then! :) A co-worker told me her experience once with a confused lady that could not walk on her own, who repeatedly dropped her toy, then would turn on the call light to ask someone to retrieve it from under the bed where it usually vibrated itself into. I do not know how patient I would have been after retrieving it more then a couple times for her.

Wow interesting thread! I too have had so many experiences that it is hard to narrow it down. They have went from scary (a little woman pleading for me not to leave her because three men were there to take her, she died 8 minutes later) to very peacefull. Although the scariest story I have ever heard, was long before I was a nurse. My aunt was the farthest thing from religious as you could ever imagine. She would say she believed in God, but just didn't give a d#@n about him! As she lay dying in the hospital she related the story that the old man across the hall died last night. Upon further questioning she related that no one had told her this but about 3 in the morning three men in black came to get him and he didn't want to go. A couple days later she related the woman down the hall had passed, three white figures came for her and she wanted to go. She related the three black figures came into her room and just looked at her and she knew she was next. She was. I do not know how much I think is 100% true in these cases, but there are enough of them that I do beleive that somehow the "other side" is close enough to veiw to people that are close to going to it. Has anyone else experienced the "death in 3's"? If not, it is regularly said around where I work that deaths always happen in "3's" and also the "3 little boys"? It is often considered important enough to pass on to the next shift if any of the pts. have reported seeing "3 little boys/kids"?

Although, I have never worked in Hospice, I have worked with them together to take care of many pts. in the long term care facility I work at. I have always admired the group of Hospice workers we have now. They are non-profit. The group we had in for a little while that was for profit was not as efficient. Often they had many different nurses in to see the pt, where the non-profit has the same nurse that always sees the pts. Please do not make your decision based on my opinion, since my experience is way too little. I can add that I have noticed a huge difference in the quaility of the care when compared to for-profit and non-profit. The non-profit seem to keep the pt in mind, while the for profit seems to keep the budget (over budget means a cut in someones bonus ) in mind. Just my 2 cents for what its worth :chuckle Best of luck to you though and glad to hear you are doing better!

Yes I beleive that it is the states scope of practice and the facility policy. Our facility IV certified us, but I went to nursing school in another state so I learned there also.