135ctv

Mice and maggot infestation at Kansas City VA Medical Center: http://story.news.yahoo.com/news?tmpl=story&u=/ap/20020329/ap_on_go_ot/va_hospital_infestation_1

The Wichita VA Hospital participates in the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) accreditation process. You can submit complaints to them. Instructions are on their website: http://www.jcaho.org/compl_frm.html From my own experience, Patient Reps seem to be very ineffective. The rep I have dealt with over the past six months has accomplished little. I had an endoscopy at a VA hospital two months ago (was given demerol). After the endoscopy, I began to have muscle spasms in my abdomen and legs. They scheduled me for a PIPPIDA a few hours after the endoscopy. I could not complete the PIPPIDA as the muscle spasms were too severe for me to lie still for the test. They left me alone in the room for the PIPPIDA. I finally called loud enough that someone came. I told them what was happening and kept saying "something's wrong". The nurse called the Radiologist and my GI doctor. They were more concerned with the fact that the test was stopped than with my condition. They gave me another appointment for the test and walked away. The spasms lasted for 2 1/2 days. I called my primary care physician at the VA and she said that there was nothing she could do, I needed to contact the GI doctor on call. That doctor did not answer the phone (it just rang). I finally reached the doctor who performed the endoscopy and all he said was "Well, I don't know, everything went fine with the endoscopy". I tried to reach the GI doctor, but he did not return my calls. I still don't know what caused this. I have had both and endoscopy and a PIPPIDA in the past (outside the VA), with no problems. I have also had demerol in the past with no problems. I have still not recieved any answers from the VA on why this occurred.

I am not a nurse, but I am not turned off by the "venting" I have seen here. Venting (in ANY profession) is a NORMAL occurance. As someone who works for nurses, I'd like to understand some of the problems or issues that they face. I think it would only help me to have a better working relationship with them. Also, I'd much rather people vent in a forum like this than to take it out on others at work.

I read these threads because I work directly with and for nurses both in hopital and LTC environments. I think that I will be more effective if I have an understanding of what nurses go through on a day-to-day basis and the issues that affect them. I've learned a lot from these threads. I do post to threads that are not specifically nursing topics. I especially post to threads regarding unlicensed assistive personnel which is what I am. Some of the issues discussed occur in other fields besides nursing. If I feel that I have some knowledge, experience or observation regarding those issues, I will post to those threads. I don't try to pass myself off as a nurse. I do not post to any threads which discuss nursing procedures or require a given amount of medical knowledge. I do believe it would be innapropriate of me to comment on those threads.

Well I am "just a CNA". I don't think that what I do is insignificant or unimportant. I just don't define my importance by a job title so it doesn't matter to me if I'm called a CNA or NA or aide or PCA or UAP. Just don't call me anything with profanity in it, I find that offensive. I don't want to be called "nurse" because I'm not a nurse. I do know UAP's who do refer to themselves as nurses, but it is illegal. If you feel that someone does not fully understand the scope of your responsibility, then take that as an opportunity to educate them. When someone asks me why I would ever want to be an aide, I explain to them that I gave up a career to do this and I explain why being a CNA is important to me. You will never begin to get respect from others if you don't respect yourself first. If you want to be treated as a professional, be sure that you behave in a professional manner. And understand that, no matter how professionally you conduct yourself, there will always be people who will discount you or look down upon you. This does not just happen in nursing, it is part of life. If you are looking to others to define your importance, you will be disappointed regardless of the profession you choose. Why do some nurses put all their degrees after their names? I can understand BSN as it relates to nursing, but I have also seen BA, MA, MS, MBA etc. Wouldn't LPN or RN or BSN be sufficient?

Prior to taking the CNA course, I also refered to everyone who was not a doctor as "nurse". I didn't know that there was a difference and, frankly, as a patient, I didn't care. I understand the difference now, and I do explain to anyone calling me "nurse" that I am a nurse's assistant and not a nurse. I do refer any questions or requests outside of my scope as a CNA to the patient's nurse. I do not want to be a nurse and have no interest in pursuing nurse's training. I am more interested in helping people with activities of daily living. I think that what I do is important. I did not go into this because I wanted to impress people with my job title. As long as I feel that my work is important, that I'm making a contribution and helping to improve someone's quality of life, that's enough for me.

sandigapeachlpn: As I stated earlier, there are many nurses who, while they may have excellent nursing skills, lack the skills needed to function effectively as a supervisor. You definitely understand what is required to be a good supervisor, and you practice this. First, you treat your subordinates with respect. The same respect that you expect from them. You don't look down upon them or belittle them for their career choice, you understand and respect what it takes to be a CNA. You realize that success on your shift depends upon a team effort. You are not above jumping in and assisting when needed nor are you afraid to ask for help when you need it. You understand that teamwork involves give and take. You don't lose focus on the fact that your shift's main goal is to "be there for the residents". You don't tolerate behavior that compromises or detracts from resident care. I'm glad to see that you take breaks with your aides. Sometimes in an informal setting, people relax and open up more. I have worked in facilities where the nurses sat away from the aides at breaktime and did not even acknowledge them. They are missing out on an opportunity to get to know there staff better, a chance to informally discuss problems or obstacles and bounce around solutions, or a chance to bring up ideas on how things could be improved. It also lets you see each member of your staff as an individual and not just a generic and interchangeable aide. I'm sure your aides appreciate this. Finally, and perhaps most importantly, this is not just talk. You demonstrate this in the way that you work and the way that you interact with your staff. You set the example. I hope that other charge nurses read your post, as many could learn from it. You seem to have a good handle on what it takes to be a charge nurse.

You should not have even had to tell them to clean the nails. I feel that it is my responsibility as a CNA to keep residents clean. In other words, if I were doing my job, a nurse should not find any of my residents "dirty". The fact that the aides had to be told to do this amazes me. The behavior of the aide who stood up to you is inexcusible. Welcome to the world of long term care! As long as this is tolerated and as long as management looks the other way it will continue. AIDES NEED TO BE HELD ACCOUNTABLE FOR THEIR ACTIONS. I have worked with aides similar to the one you describe. Aides who bully coworkers and even nurses, who are loud, and even a few who make threats. (Are these the type of people we want working with frail, defenseless people?) You did the right thing by asking the aide to leave the shift, the ADON should have let you follow through. As this person's supervisor, you have the authority to tell her to leave. I wish there were more nurses like you, it would make my job as a CNA a lot easier. Have you ever thought of becoming a DON?

I agree. There are many aides who are unprofessional and undisciplined. Were they to work in any other industry, they would be fired for their conduct. For some reason, these aides are retained on the payroll in long term care, sometimes for years. I have worked in long term care for 1 1/2 years. I have met several good aides, who really cared about their residents and who worked to improve the quality of life for their residents. Unfortunately, I have also met a great many who are lazy, loud, vulgar and just plain stupid. This should not be tolerated. Aides who behave in this manner should be disciplined and should be terminated if they cannot or will not perform in a satisfactory manner. Many aides come from limited educational backgrounds and have had limited exposure to good role models. Perhaps some inservice topics could cover basic communication skills, conflict resolution or customer service skills in addition to nursing topics. RN's and LPN's need to set the example and make their expections clear to their staff. Being a charge nurse is more than just having good nursing skills. You must also be an effective communicator, trainer, mentor, and supervisor. If you are not skilled or lack interest in these areas, perhaps you would be more suited to a position which focuses more on your nursing skills.

Your problem with the CNA's will continue as long as it is tolerated. I have worked in many different facilities through agency assignments. I have observed everthing that you describe in some facilities. Other facilities do not tolerate this and it does not occur. I often wonder if some CNAs would be able to hold any other kind of job. Some CNAs clearly should not be working in this field. Others are so unreliable or have such a poor work ethic that I believe they would be terminated from entry-level positions in any other industry. Staffing shortages and high turnover often allow these aides to be retained, sometimes even for years. Are the aides who finish their rounds quickly really taking care of the residents? Or are they just doing very minimal care? Do you even know? If they are finished rounds, is there anything else that they can do? What about the 17% who do provide good care? Do you recognize this? A few words of appreciation can go a long way. Do you ever see anything positive in the other 83%? If you do, take notice of it. Positive reinforcement can be a very effective motivational tool. A meeting is a good idea, but also get to know your aides on a more informal basis. Try to occasionally take your break with some of your CNAs. Get to know them as individuals, not just generic CNAs. Ask for their opinions and suggestions. You may have excellant nursing skills, but your role now also requires you to be a supervisor. What are you doing to develop or improve your supervisory skills? Many seminars and classes are available to help people become better supervisors, regardless of the industry they are employed in. This may be worth checking into.