here's an ongoing problem at our facility, and needs to be fixed for the dignity of our residents (and because i don't like stepping in poo that has rolled downhill ).
after evening meal our residents tend to get lined up in the hallway along the wall across from the nurse's station. a majority of these residents are there for safety reasons. some of them are there because they don't want to be alone in their rooms. recently someone from admin. was at the facility during these evening hours and was in dismay about the difference from literally night and day...or evening in this case and then reported this to the don. my concern is not with her because, quite frankly, i agree with her. hallways are littered with residents in their w/c's. some of them who constantly try to stand without help or bend over nearly falling out of the chair, others who scream at the top of their lungs, some who plain are just left there. then there are those who roam the halls doing all three behaviors!
the question is: why are all of these behaviors occurring on the evening shift when they so plainly do not happen on the day shift?
quite simply, my answer is this: there is less staff after 6pm. yes, even on the weekend. i include all departments in this simple answer.
there is no social services staff, no admin staff, no restorative or pt/ot/st to stop and say hello or occupy their time. there is not one life enrichment/activities staff member there after 6pm to do an activity or sit and visit. no volunteers come in to chat or play cards or simply sit and hold a hand. these are not solely my excuses but i think it would be a quite obvious reason for the loudness and the line up!!!
so what do we do? well, firstly, those who can be in their rooms, who want to just lay down, who would like to sit in their recliners after meal should be escorted first to their rooms. while other cna's pass out snacks, give them something to do, etc. as a nurse i realize this requires the direction and teamwork of nurses and cna's. but....
here's the "situation" when we have meet the immediate needs of these residents (i.e. toileting) and tried many interventions including pain management, but the yelling and other behaviors what are we to do when these residents are so obviously just plain aggitated or sundowners? some of the nurses have administered prn antianxiety meds but then the next thing they know they are being pulled into "the office" for doing so when it was not appropriate.
give me your input...please!