amanda1229

I figured this was the best place to ask the question. I'm in nursing school and for one of my classes, we have to make up a scenario for our fellow classmates to read and solve, like a case study. I have ideas, but I don't really know what would happen from beginning to end with my patient. My "patient" slipped on the ice and hit her head, lost consciousness. Her boyfriend brought her to the ER in his car. I want her to be out for the entire car ride and long enough in the ER to be hooked up to an IV (would they do this for a concussion? Since it could be anything, really? And would it just be fluids?). Would she have long-term damage if she was out that long? As long as she was breathing and had a pulse, is that common? For people to be out that long? I know afterward that they might do neurological exams -- would this follow the q15 mins x4, q30 mins x4, q1h x4, et so on or are they different? Or do they differ everywhere? Are scans mandatory or only in cases where they're symptomatic? How long are they normally in the hospital? Would it be realistic for her to be discharged the same day as long as she was asymptomatic? Just in case it needs to be said, this is merely for a school assignment and there will no profit made or anything with this. :)

I have been thinking about making a change, possibly moving to Chicago (I live in Iowa right now). I'm a CNA and have only started some of the pre-reqs for the nursing programs here. Are there any good community colleges in Chicago or close by that anyone knows of? And would it be difficult to get a job as a CNA at a hospital or a nursing home in the area? Thanks. :)

I'm trying to get a hospital position as a CNA, so I'm in the same boat to some extent... But right now I'm volunteering there, talking to all of my nursing professors and looking for connections, asking for specific people, talking to the people I work with at my LTCF, mastering any skills I need as an hospital aide that I don't as an LTC aide .. good luck to us both I suppose. :)

I agree, I think male pericare is so much easier. And I'm a female! It's only because, really, who uses eight washcloths to wipe after they use the bathroom? So this whole lengthy procedure involving eight corners, etc. is INSANE to me. Makes sense, but so annoying! The worst thing I've ever seen was, when performing male pericare, is a HUGE wad of yeast-like buildup when pulling back the male's foreskin. I had seen it before in female pericares, but I was just .. oh, it was just weird, and it was so much, I was shocked.

I want to start practicing VS more often. I work in a LTCF where CNAs don't do VS, but I want to be prepared for nursing school next semester and I'm also applying for hospital CNA positions and I've heard that's what you need to know how to do. I need a nicely-priced bp cuff and stethescope, what's the usual range? Any better place online to get them?

I didn't read all the responses, so I may be repeating, but this can't go on. What if the resident could call sexual harassment on your sister, which seems like she'd have a case? I'll just say it -- ick. Most of the time, unless it's a larger woman, she should be able to do peri cares if she can feed herself. We're supposed to encourage it anyway, so next time tell your sister to say, "Okay, let's clean up now," and hand her the washcloth. And, of course, the nurse needs to be charting on this every time. It's no different than when we have male residents say the same things -- OF COURSE all the CNAs go running to the nurse and tell them about it, but it's just strange when a female resident says it! Unless dementia is the case, I don't really allow any of it, I don't have to be harassed or accused of sexual harassment one day. I tell them it's not needed and that I'm only trying to clean them up, and that the supervisors will be notified. We had a male resident who was a little person, and he had to hop up onto the toilet because of this. In the process he would always pinch his scrotum with the toilet seat, and one day as the nurse came to put some ointment on the wound, he said, "Hey that feels pretty good, it's been a while." The nurse was disgusted, as she should be, and threw down everything and said, "[Greg], that's really gross, and trust me, that's not what I'm here for." This resident is totally with it and everything, he just gets inappropriate at times. The nurse said she wouldn't have left the resident if it weren't during the day with other supervisors there, but instead just told them about it later. But our administrator did talk to him about it and he apologized to the nurse. But it was totally uncalled for and I don't blame her for getting upset -- we're performing a service and we don't have to be harassed while doing so, we're busy enough!

It seems weird that you can't mandate organ donation in your will, as if it's just another property you're leaving behind, hmm. I know that when I die, anyone can have any part of my body they wish. I think it's such a waste and crime to BURY parts that may work perfectly and can save someone else's life. Thanks for replying everyone. Since the incident with Herbie, I've been finding out more about which residents are full codes or DNRs. My next topic of debate is people with Alzheimer's. Most of them are full codes because of the family. What do you think of this? Because the person's wishes can change every five minutes in severe cases, I think it is best for the family to make the decision. And, I think, if I had this severe of Alzheimer's, I'd want to be a DNR. But most people can still recognize their family. There's a resident where I work, we'll call her Jo, who can still recognize her husband (where as other women are looking for husbands who are years and years younger, you know). But because of her status and disorientation at other times (when I would change her on third shift, she would get combative and resistive), I guess she's a DNR, her family doesn't want her to live with that confusion. I don't know, I would just think it would break my heart to have my husband be a DNR just because at night -- when I'm not there -- he's different. Huh. Thoughts?

In an LTCF? Here's the basic rundown of my day as a CNA in a LTCF. 6:30-8:00 - Arrive, dress, check & change, and get-ups for every resident. Make sure they are groomed properly, have their dentures in or glasses on if needed, teeth brushed, and sat at the breakfast table. We are really lucky if we are on time everyday, because between close to thirty residents (eight of whom are Hoyers, and four of whom are confused), it's a LOT of work, sometimes I show up closer to 6:00 just to make it to breakfast on time! After each resident is up, we also make all the beds (which adds about ten minutes total onto the breakfast prep time, it sucks!). 8:00-9:00 - Feed residents. At our facility, we currently have close to twenty assisted feeders. Some of whom are confused, and two are MR, so they need COMPLETE one-on-one feeding assistance. We also have a bed-bound resident who one of the aides needs to feed, and she is quite difficult to feed. Breakfast is busy, but we have to get food and liquids down everyone (it's obviously important) so it can be a struggle sometimes. 9:00-9:45 - Check and change, strip, and lay down every resident. I was taught to leave no clothes/briefs on below the waist for any resident (unless independent, obviously) but I've heard other facilities don't do this for dignity reasons -- which I can see. But it's just to help eliminate skin breakdown. 9:45-10:30 - Since everyone (except those who don't lie down, on my wing only a few) is in bed, we are answering a lot of call lights, toileting residents, getting showers done if the bath aide isn't working (which is usually seven or eight showers, ten to fifteen minutes each). And, again, you can see where time is a restraint there. I usually use this time to get some of my charting done, too. Charting for a CNA at my LTCF includes BM charting for every resident, restraint record logs, and behavioral and assistance charting for a few residents. We also take our fifteen minute paid breaks at this time. 10:30-11:30 - At 10:30, while still answering call lights and toileting residents, we start checking and changing the residents, and getting them prepped for lunch. I usually let me aide partner go on break at 11:00, and I continue to answer lights, toilet residents, and get them prepped. I also get up a couple of Ax1 residents, or all depending on my partner, before I take my lunch break. 11:30-12:00 - When I get back from my lunch we finish getting our people up, which goes by SO much faster when they're all prepped! We get them up, groomed, and out to the table. We're usually RIGHT on time or a few minutes late for lunch at 12:30. 12:30-13:30 - Everyone eats lunch. This is usually the better of the two meals. Everyone likes a meal at noon, I mean, really -- I wouldn't want a complete meal at breakfast (juice, water, milk, coffee, eggs, bacon, toast -- geez!) Not that I don't understand WHY they get the big meals, but still, that's a lot for someone to force down your throat. 13:30-14:00 - Once again, everyone is laid down, checked and changed. 14:00-14:30 - The day gets easy after this, I chart, take down trash and laundry barrels, ask my independent residents if they've had BMs during the day (do this do this do this! Don't let residents who don't need suppositories get them, not fair, too many aides are too lazy to do this). I also might visit with some residents, or if I have time, do things like paint their nails or massage their arms and hands (esp. if I'm on our Alzheimer's unit, there's more time for things like this). I report anything to the nurse I've noticed during the day (unless it had to reported immediately) and give her my outputs for any residents with catheters. I really, really love my job. Even if I have to get up at the a$$ crack of dawn, it's still exciting to go to everyday. The only bad thing is the time schedule is so delicate, unless third shift does a lot of prepping residents for breakfast (I usually get everyone dressed and prepped when I work third), then you can easily fall apart. If there is a fall, it is pretty much guaranteed you will be late for the meal. And when you're late, the administrator or DON and ADON will complain and you will hear about it -- but it's their job, so I don't fuss about it. But I do love being a CNA, and when I get my LPN and eventually my RN, I will be sad and miss it, you have so much contact with the residents. Just remember to stick to procedure, your coworkers will not use gait belts because it takes too much time, but just do it anyway. You don't want to get fired. Don't do Hoyers alone. Don't do Ax2s alone. Read the care plans and know them well, know your residents well so you can personalize their care, ask their family about them, etc. We had a woman on our Alzheimer's unit who could never explain to us why she was so uncomfortable and so upset -- until her granddaughter randomly told me she was NEVER barefoot or plainly dressed at home, and when I implemented that into her care, she's been happy ever since. Family will be a great resource. Also, remember to choose a shift you will be happy with, you have to happy in healthcare or else you won't be the best giver of healthcare (and so on, yadda yadda, but it's so true). Whew, long post!

Hello all, I've got some questions today. I'm a CNA and nursing student, and my goal is to eventually be a L&D nurse. I've been working for about five months in LTC, and I only worked there so I could actually take the exam and get my certification, since all the test covers is LTC practices. I hear everywhere that Med-Surg experience helps a lot, so I figured I would apply for CNA positions in L&D or Med-Surg units at the local hospitals. What do the CNAs at your Med-Surg units do? Is it really different from LTC? I don't live near any rural hospitals, so if your answer covers one of those, it probably won't pertain to me. I really like the hospital setting, and working in a hospital has always made me really excited (even though I've never been an employee, I've been a hospital volunteer for so long and still get excited walking through those hallways!). Plus, if I do in end up in L&D, from what I hear Med-Surg experience is a big plus. What kind of patients do you see in Med-Surg? What is the work like? Is it a really busy day? Did you like your job as a Med-Surg CNA? Thanks. :)

My absolute, hands-down worst fear upon starting in a LTCF was skin tears. I thought moving any resident was going to result in a big ol' foot-long tear down their limbs. Because of this I moved so slowly, and so cautiously, I was always behind. Over time I realized that these residents are not made of tissue paper! I am still gentle, but you can get things done smoothly and quickly with experience. And, of course, with the extreme skin alerts, you know how cautious to be and you aren't afraid to take time where it needs to be taken. With any fear in this field, you'll get over it with experience. Although memberes and poop never scared me, my other fear is one I haven't experienced yet -- vomit. It's not that I mind seeing someone do it, it's the smell of it and having to clean it up that make me cringe. I'm bracing myself for flu season! I think the thing you have to remember is that when you're taking care of male pericares, always ask if they want to do it for themselves, it'll save you a step and it helps them take care of themselves more, which is always the goal at a LTCF. And with poop episodes, always always always remember that sadly it is so much harder on them, and that they are probably embarassed out of their minds every time it happens. I get so mad when I see other aides make faces and noises and "Ugh, disgusting" or "You need to tell me when you need to poop!" to these poor residents that have simply lost the ability! Just remember that and you'll become so much more comfortable with it all. Good luck!

I love working in my LTCF, and I've never worked in an ALF. But from what I hear, an ALF is so much easier. The problem with my LTCF is the level of care needed by all of the residents, and how much time is actually allowed to do it in. On my usual wing, there are twenty-seven residents. Of these, there are only three independent people who don't need help or encouragement for ADLs (there are a couple other independent residents but they are badly confused and need lots of help, just not for transfers). The rest include five Hoyers, and other Ax1 or Ax2s. Usually this wing has one or two aides for all of them. We have about an hour and a half to get all of these people dressed, groomed, hygienically taken care of or else we are in big trouble by our superiors. What needs to be done does NOT get done. It is hard to spend about ten minutes with each resident, when it reality, 1.5 hours among a little over twenty residents leaves you with about FOUR minutes. It is just not possible. This is my frustration with the LTCF schedule. Not to mention that on our CCD Unit, we have to get people up by 7:30 (only gives me an hour to get all of these people dressed and ready!), out by 9:00, down for an "hour's" nap by 9:30 AND UP AGAIN AT 10:00 FOR A MANDATORY SNACK. So screwed up! I don't mind constantly moving and working and doing my job, it's the complete lack of intelligence and common sense that went into making this stupid schedule. Plus, I don't care what anyone says, not EVERYONE in LTCFs need to lie down between every meal, or lie down at the end of every meal to the start of the next (sleep, eat, sleep, eat, sleep, eat, sleep). But, anyway, I imagine and hear that it's different in an ALF and therefore recommend trying one of those instead. Rant over!

I love our activity staff. They always have fun things for the residents. We have a really good director who must have been here for a while, because she just knows every resident so well. She knows which residents to pull aside for certain activities, like some who love to cut out paper decorations to put around the center, or the ladies who just love to fold the towels for laundry and have the morning coffee and juice afterward. It's so great. And the best thing about an activity staff is having some insight into the residents' prime years -- knowing old folk songs, or discussing parenting tips they must've used, or talking about pop culture icons, etc. all while playing Bingo, or playing old card games, singing along to old Elvis, or whatever. My heart is with activities for our CCD Unit, though -- I really love the idea of incorporating their memory and past life with little activities. Especially music, it seems almost every little old lady on our unit loooves to sing, and even a few of the men. When we all gather for church on Sundays, the song may be sung at five different tempos, but it's with such heart and passion you can't help but get caught up sometimes!

After being a LTC CNA for only four months, I am officially sickened by people who support this! We had a new admission Friday evening. I'll call him Herbie. Herbie is confused. He has a foley, colostomy bag, g-tube, and constant o2. He has a PSA because he frequently tries to get out of bed, and he uses his call light to request the bedpan (even though he clearly does not need one). In report, one the leaving aides told me to take a look at him -- I've never seen so many hookups to one person, having only worked in LTC so far. Our rooms don't usually look like small hospital rooms! This poor man was just lying there, sweating -- the DON and I were actually worried about him. We stripped him of his gown, pulled the blanket down to his knees, pulled his privacy curtain and just had a fan right in front of him. It barely helped. The DON and I were talking as she helped me repos. him, and I simply said, "I could never live like this, and when I get older, I'm going to make that known to my family." The DON told me that Herbie was a full-code and had all of this because of his daughter. And she told our DON that she was "happy to have him out of the hospital, and excited to have him home one day, on his feet and back to his old life!" I almost choked! Herbie could barely speak. And when he did, you could barely make out anything he said. In fact, the only things I heard him say were "hi" in response to my introduction, and "no, no" when I replaced his cannula that he took out. I cannot believe that some people are still full-codes and we're pulling out all these stops to save these 90 or 100 year-old people! When the body starts to break down, in my opinion, you can only go so far before someone just has to rest in peace. How can these little frail old ladies who are just bones still be full-codes? Do you really want us to perform CPR on someone when we know it will just break their bones in half? All of this just hit me like a train with Herbie. Not to mention he has such terrible circulation problems in his legs, they may as well just not be on his body anymore, and for the better. I just don't understand, are you trying to make someone live forever, or just more comfortably? When it gets down to it, perhaps science could just make us live as long as we'd like, all these things Herbie had are just the start of it -- can't eat, void, defecate, or breathe properly? We have the fix! What's next -- mechanical organs or limbs, artificial fluids or tissues or whatnot for people turning 100something? I went home and talked to my boyfriend's sister, who works in the same facility, about how disgusted I was with it all. She agreed 100% and told me Herbie had died last night. The worst part -- his daughter thinks it was somehow the facility's fault, as if we made some crucial error. He had labored breathing the only time I spoke to him. We all knew he was on his way, and as soon as he wasn't skilled, they wanted to talk to the daughter about hospice. I think it's just a shame that he went on to live like this, that he couldn't have gone sooner, perhaps when he could still have memories in his mind, or feel a little more like a human being, and not just a body on auto-pilot.

Thanks for the sites, guys. :)

I've posted about looking for a job as a CNA in the L&D unit nearby, and hopefully being a RN there, too someday. Does anyone have any good sites on hand that have a lot of info (conditions, abbreviations, examples, whatever) about L&D, labor, baby, pregnancy health I can use to catch up on? Thanks!

On our locked unit, it's considered "low-stimulation," so I often got chewed out for having some of the TVs on at night when everyone was in bed. I'd turn off a few, but some I had to leave on all night -- these residents are the ones who told me they'd fall asleep every night with the TV on! I'm the same way, just because it's just low-stim doesn't mean they can't have a life like they used to -- the life they used to have is the one they're often living on the unit! I just close the door a bit to make sure the other residents can sleep. When I turn the TVs on, I like to make sure it might be like they used to, though. We don't have a TV room on the locked unit, so I'll get blankets and a snack for the residents, sit them in their chairs, and turn on the TV. And tune it to a station like TV Land, of course, or TCM (Turner Classic Movies, or whatever). And sit along and laugh with them, just like they might have long ago. Some other ideas for activities you can do, if your activity program is mediocre at best: * Singing or music. Some of our residents love to sing. http://en.wikipedia.org/wiki/Show_Me_the_Way_to_Go_Home This is the theme song for our locked unit. Get them in a big circle and sing some old songs, or songs that we all know (Jesus Loves Me, You Are My Sunshine). They may sing at five different paces, but they'll just light up. * Looking through magazines. I thought residents would get bored, but it sparks a lot of stories. Especially if you start them. IE: Ooh a pretty wedding dress, what was your wedding like? What did your husband do? How long were you married? And some of them will love to see pictures of farms since most of them were raised there. * Puzzles. Puzzles with pieces are fun for the more focused resident. For instance, we have a few dementia residents that will retain a fair amount of their memory for a day or so, and they have far more capacity for putting together 100 or 200 pieces than the average dementia resident. I also brought in a puzzle book with differences between two pictures one night (to keep me awake on third shift!) and I just gave it to one of my residents, she loved it -- albeit she picked out the same ones over and over again. :) * Kickball. Great for exercise, too. Put all your residents in a circle sitting down, buy a nice-size ball and kick it. You'd be surprised at how active some of the residents get. The combative ones will get their mini-workout if you're lucky. * Nail care and massages. Some of the more patient females will love a little manicure with nail polish and everything, and it might also spark some stories. I love when all the little ladies on my unit have their nails painted. Plus, this activity is so cheap, one bottle goes a long way. We also buy bottles of lotion and give some of the residents hand, neck, or arm massages at night in the dining room before they go to bed. * Outside visit. I don't know if your unit has a little deck (maybe they all do, I don't know), but some of our residents absolutely love to just be outside. Just to sit out in the breeze once in a while is like a dream to them. Just make sure that you don't make the same mistake a stupid aide here once did and let them out alone: two residents flagged down a car and had someone buy them cigarettes and coffee. * "Handy work" activities. We have a resident that used to be on a farm, like many, but this guy will just wander the halls in his geri chair and find the smallest details and "work" on them. He gets combative at nights but he'll just stop if he finds a screw in the wall -- he'll have to "work" on it. One day they brought blocks, Legos, and some other connecting toys and he just goes to town on those. It keeps him busy, interested, and calm. If you have any "handymen" it works perfectly. I hope some of these might work for you. I love working on my CCDU because I get to do these activities and, as Jolene Brackey says, help the resident "find their greatness." It really is so rewarding! Good luck.

You corrected yourself -- it's not like you walked away and left it on for the resident to freeze, or left her naked, or forgot to pull the curtain! Please do test again, skills tests are intimidating but your job will be rewarding in the end. You sound like a caring person, we need those around in the nursing world. :) Besides, in my opinion, your evaluator should've given you a break. At least around here, if you correct anything you do from any skill before your test is over, you get the credit. Oh well, you'll have next time to do better! Sorry about your uncle. You and your family will be in my thoughts.

As far as I'm concerned -- you want your residents taken care of properly, you keep your employees happy. I'm a CNA, and when I'm feeling up to it, I help out however I can -- sometimes I work 70 hrs. a week as we're understaffed right now (but, of course, I'm only nineteen and no husband or kids!). But on days where I can't, I say no -- I care a LOT about my residents, but I'm not going to wear myself out over ANY job. In a healthcare job, you need to keep yourself enthusiastic AND healthy!

OMG, do not worry about being a "tattle-tale." This is real life and this is work, not kindergarten. These people are paying to be taken care of, and it is your job to make sure the effort is being made and the job is being done. Are you saying that if someone was soaking in urine and reeking of BM and their aide refused to do anything, you wouldn't tell your highest supervisor immediately? That is so, so wrong. I'd rather apologize to my own patients and vaguely explain the situation and take care of MANY and work my butt off, than deny a lazy aide's patients all care. I'm sorry, I'm here for the people needing care, not making sure my feet aren't sore at the end of the day! I'll work 'til I can work no more for my patients or residents.

I would say just the same as others, clock in, do well, clock out. But if her attitude is affecting residents in the place they live and expect good care, I think it's another aide's job to bring it to someone else's attention. If the other aides are too cowardly to speak up like they were before, I would just call or pull this aide aside and tell her why everything was being said and whatnot. Even if this meeting takes place with you, her and the DON. It needs to be resolved, IMO, and it's not fair if it isn't. If "firm but friendly" is offending residents and staff, guess what -- it isn't friendly. I don't think these residents should have to live somewhere and put up with people who act like they're just there for a job. On the other hand, this poor girl who may have been just trying to do well, is now crying all the time, probably hates coming to work, feels like all of her coworkers hate her, and probably feels like she's being watched constantly. If I were in the same situation, I'd talk to her, explain what's going on, show her how you do things, and tell the other aides (since they seem to be better with you than her!) to do the same.

I took my class and put it off for a year because I was so nervous, haha. Stupid decision on my part. But I got a job at an LTCF to refresh a bit and then took the test a month in. Did well, and the LTCF will reimburse me for it, score.

I've only been a CNA for four months, but I've had a few good and bads. One of my bests has been with a resident I'll call Maggie. Maggie had COPD and so many problems. She was only an Ax1 and continent when I got there, but a couple months in started to decline fast. She could barely stand, needed to "take a breather" more often. I knew she was giving up. She had such a great sense of humor, though, it was hard not to get a laugh out of her in even this state (towards the end, she would get room trays for breakfast and we would laugh at a big ol' plate with just one stupid egg rolling around, haha). She was incontinent all the time, and always made fun of herself for it. One time though, I was standing Maggie up to go from toilet to chair, and she just started to collapse out of weakness. Adrenaline and instinct took over and I just threw her back onto the toilet to save her from falling -- with such force, I bruised both of her underarms mildly. She became an Ax2 soon after. Maggie became so weak, she never talked to anyone but her daughters that came to see her daily. She moved to the hospice home, and a few days later I heard she'd passed away. Her whole family, just the nicest people ever, were cleaning out her room. I went in and said, "I just want you to know I'm so sorry for your loss, and it was a real pleasure taking care of your mom. We're all going to miss her." They just looked at me, blinked -- for a second I felt like maybe I'd been out of place -- until one of them said, "Oh my God, you're the only one who's said anything like that, thank you so much, you have no idea..." And we just hugged and cried. I got hugs from ten or eleven different people then, and I wished them the best and clocked out for the day. It felt really great to just be there, it was then I finally felt like an aide and was really ready to be a nurse. Bads, there's a few, but they aren't the worst. My favorite, absolute favorite resident, I'll call her Anna has Alzheimer's. It's just bad, she barely eats or drinks now. When I first started, she would walk next to me with her gait belt around her, simple Ax1 and just a short sweet thing. Her husband Mickey would tell me about how she used to sing, so I always get her to sing Jesus Loves Me with me. We would have endless conversations about whatever, and when you talk with someone with Alzheimer's like hers, it really does end up like whatever. Her husband Mickey always came to see her and was very dedicated and great, would sit with her, sometimes cry alone with her, as she sat staring ahead. One day I heard a PSA sounding, and our SW got there first -- Anna had tried to get out of bed and fell. I could hear her screams as the nurses tried to move her and knew she'd broken something. As she was walked away on the stretcher, I gave her a kiss and told her to be good, and she said, "Of course, dear!" and just smiled away, forgetting the pain, I hope. She'd broken her femur and will probably never walk again. The day she fell we found Mickey in bed with another female, and quite confused, resident. It broke my heart double time. Anna is now an Ax2 w/Hoyer and her Alzheimer's gets worse all the time, though Mickey still vows he's a great man and has always loved her, I don't look at him the same, sadly. Another resident, I'll call Charlie, was an Ax2, skinny, frail old man. Everything hurt, he would call you every horrible name in the book, be absolutely terrible, hit you, whatever. But I took a liking to him, because when he was sweet, he was sweet. Other aides told me that sometimes when he was in pain he'd yell out my name even if I wasn't working. He never got married or had kids (said he didn't want a b***h or brats around). He yelled "Help me, help me" and whimpered all night long in pain, wouldn't eat or drink, was on the call light constantly. He told me he was an aide for forty years until he retired and volunteered for ten more until the hospital just told him to stop coming. He had to have had a wonderful heart his whole life. He started to go down hill, his limbs were swollen but his face was sunken in. He told me to pray for God to take him away, and I told him I wouldn't. In the back of my head, I was torn though -- he was in pain all the time, I wouldn't want a life like that. He started refusing all meals. One day I came to work and they told me Charlie would die that day. Right around my break time, they were waiting for it, and I was hoping I'd get to be in there before he went to say goodbye and then help clean him up. I clocked out, came back, and he was gone. I was so, so heartbroken, but when I went in to see him, I was relieved. And so was he, the poor man had been so weak and so ill, he'd been ready to go long ago. I know wherever he may be now, he is the happier man he used to be, and completely pain-free, and if there is a God, I would thank him for taking Charlie when he did and not a minute later. Still, watching him being finally taken out was a little heartbreaking for all the staff, no family to see him out, no one to comfort him but the few aides and nurses that didn't despise him. Everyone says they miss him now, and every time our wings are call-light crazy we say Charlie's fooling us. But I know that, sadly, only a handful of staff truly valued him, but I guess I can be glad to say I was one of them.

From what you're telling us, I say get the heck outta there. You just started, it's early, give them a good amount of time for notice and politely end your time there. You would have GREAT reasons for leaving when your next employer asks! Very few facilities just flat-out fail state inspections! And, you never, ever want to work for a supervisor who doesn't treat employees well, especially in health care. My DON asked me to work third shift, and I said I would do it for a month to help out, but then I wanted back to days. She tried to push it on me after that month and I told her no way -- I absolutely hated the shift and if I hated the shift, I hated my job, and then I wasn't there for the residents but just pushing through misery for a paycheck. That is NOT why I got into nursing! She appreciated the answer, and even though she was short an aide on nights, they had gained a good and enthusiastic aide back on days! You just have to find somewhere good and comfortable to work in. Don't stay too long and have your future employees see a closed facility on your references list!

Moral support being sent your way! I was insanely nervous. So nervous I put it off for a year and worked at a low-paying ice cream store where I made just enough to pay for car insurance and gas and still have some fun with my friends. What a great waste of time that was, worst decision ever. My boyfriend's sister worked for a LTCF and it helped me get a job there, after a month I tested out easily, it was actually kind of fun. I was still nervous as anything, but I survived! The great thing is that I treated my "resident" as I did my real residents, and cracked all my cute little jokes with them and made it fun, and made it comfortable. Soon the evaluator, my "resident," and myself were all giggling and having fun. Don't be afraid to be sweet and nervous, trust me -- they will appreciate it!

Good job sticking it out, Dreamy. If you have a bad feeling about facility and you've heard the same from around the community, they tell you to go with your gut. The good thing is that you're willing to try another workplace. I'm like you, I love working with Alzheimer's or dementia residents so much, but a lot of people are really, really happy at ALFs so good luck. :)