CNA_Coco

Michael- while I agree that the NOC shift has fewer duties (no meals, often no showers, etc.), I have to say I don't agree with you when you say that the NOC shift is easier than 1st or 2nd shift. I have worked in several different facilities, and have worked all three shifts. I would never say that any one shift is any easier than another, just because there's a "balance". Yes, AM shift has two meals. They have family members coming in, the majority of activities often happens on AM shift... but to balance it out, they have fewer patients to be responsible for than the other shifts. PM shift is kind of in-between- one meal, showers, fewer family members, fewer activities. So they have an in-between amount of patients- more than AMs, but fewer than NOCs. Noc shift would be the easiest, if a CNA had the same number of patients. Often, to keep a balance going, they are given the largest amount of patients to be responsible for. This is what accounts for a lot of the issues- It can be highly difficult to keep everyone clean and dry for the entire night when you're responsible for 30+ patients, and Mr. Johnson needs a shower because he just finger-painted himself, and Mrs. Smith keeps climbing out of bed and is going to fall if she doesn't get immediate attention when this happens. Neglect happens on all shifts, and what happened in the main post (residents being absolutely soaked, being double-briefed, etc.) is inexcusable, regardless of what shift it was. I worked PM shift at this facility for over 6 months before switching to NOCs (my five-year-old just started kindergarten this year- if I stayed on PM shift I'd never have seen him!), and I have to say that I've actually worked much harder on the NOC shift just because of staffing issues and the utterly crazy number of alarms and call lights we have to deal with some nights. To the main poster- I suggest either calling the ombudsman or talking to the administrator about what you found- AFTER pulling the night shift CNA(s) responsible for those particular patients aside and talking to them about it. It may be that they are inexperienced, or that they had bad training, or whatever. Maybe after they get a good talking-to, and hear that their methods obviously aren't working, they will try something else. If this happens multiple times, calling the ombudsman to report a violation of residents' rights, calling state (if it happens often or throughout the whole facility, if these things are not done by just one CNA), or writing to/talking to the administrator. We all face problems like this! The easiest way, nine times out of ten, to fix the problem without making huge numbers of enemies is to follow a few simple steps- 1) ALWAYS do bed-to-bed rounds. The CNA before you should go from room to room, bed to bed, with you, and ensure your residents are all clean and dry. 2) TALK to the CNA who made a mistake before you talk to other CNAs, supervisors, or management. It could be (except the double-briefing, that's just plain wrong, imo) an honest mistake. Good luck- hope things get better!!

YES!! I hate when (especially in LTC where they know us and are emotionally attached) residents ring their call lights, and casually ask as we're helping them, "Did I wake you up?" Many CNAs from AM and PM shift both like to say things about night shift CNAs being lazy, or claim that "they all sleep at night, so there's nothing to do". We've been battling the administrator, needing at least one more CNA (we often take care of 30 or more LTC patients, and only 5 in the entire facility are independent or minimal assist- it's hard work!). So it really, really irks me when they ask this. No, they don't know any better. And no, I don't say half of what I'm thinking. Normally I just respond with "Nope, I do my best to stay awake while I'm here at work, just in case you need me!" Often this kind of response helps with the confused or disoriented patients who think they're at home or in a hotel or something, but there are many a&o patients who still ask, night after night.

A comfort care patient of mine passed away a few years ago. As it was expected to happen soon, the nurse was none too surprised to hear that he was gone. She walked down the hall with me, helped me while I cleaned him (he didn't breathe the entire time, obviously) and got him all set up (took less than 2 minutes, really, as we'd been keeping him as comfortable as possible), then whipped out her stethoscope, stuck it on his chest, rolled her eyes, and said "Dumbass! He's got a pulse still! It's faint, but it's there" and walked out. ...The patient had a pacemaker. Two hours later, she checked him (again), declared him dead, and wondered why he was "so damn cold for someone who just died..."

AGREED!! Even though I'm a CNA and not a nurse, any good nursing staff should know what diabetes is and what it does to a person. Had a patient not three weeks ago who was clammy, pale, shaky, acting confused, c/o nausea... went and got the nurse, he had a BS of 43... Where was his HS snack? Sitting at the desk- because HE didn't come up to the desk to get it, the CNA said she figured he didn't want it!! *facepalm* As for the looking for the CNA for 15 minutes... at least the nurse finds the patient wet and poopy- ours mostly walk right by the call light, look for us for 15 minutes, yell at us, only to find that the stupid light was someone requesting their PRN meds, meaning they needed the nurse anyway!!!... that's my biggest pet peeve. "It's not my patient" bothers me- especially when the aide sits there on her butt while the person who has the patient in question is busting theirs!

I'm with most of you- it doesn't really bother me when people who don't work in the medical field (family members or something) make mistakes with these words, but it really irks me (and kind of scares me sometimes!) when my co-workers butcher these words! How about "anti-psycho" drugs (I'm still not sure whether the nurse was just fooling around or mistaken, but I've heard her say it several times)? "Anti-depressives"? O2 STATS really does bug me... It's kind of cute, though- I had a little lady tell me the other night, "be careful taking care of my new roommate, she's psycho-phrenic!"

Actually, I'm fine with poop, sputum, fractures... pretty much everything. Worms, I could do. Leeches, okay. But I've been a CNA for almost 10 years, and still can't handle vomit! After the patient's done, I can handle the clean-up. Having someone heaving in front of me, I just can't take. Hand 'em the basin and take off! Fortunately, one of the girls on the same rotation as me is just awesome. She can't handle open sores, so I change and turn her open sore folks, and she takes care of people who are vomiting, since it doesn't bother her.

I've had the patients-eating-leaves quite a few times! Surprising how many dangerous plants people bring in unknowingly! Family members once brought in a HUGE poinsettia plant and put it on the desk to brighten things up around Christmas-time. I think we sent out three or four of our patients that evening before someone finally decided to toss out the plant. Several times, I've noticed things like foxglove in bouquets. Just goes to show you, even a CNAs job isn't always as straightforward as people might think! Okay, for another gross one (really isn't too bad, but still.) On the rehab hall, we have a healthy-sized man (about 6', 220 lbs or so) who is recovering from multiple strokes. He just switched from the g-tube to solid food not long ago, with good results. That is, until he had his flu shot. It floored him! We were cleaning vomit for hours on end, and struggling to keep him sitting up in the bed. In the end, we all decided that putting him in the chair would be the best bet, and while he was up about six feet in the air, swinging in the Vanderlift, the nurse decided to unfasten his brief and give him a suppository for nausea. Good in theory, bad in practice. He started heaving just as she was giving the suppository. He peed all over her, just bathed her from her lower back on down (as she was kind of kneeling/bending over beneath the sling of the lift). She hurried up and finished, and stood up quickly, trying to reassure him that we'd get him cleaned up and in the chair. As she started talking, he turned his head toward her and vomited all down the front of her. Needless to say, she went home to change. Sucks to be her! She was a good sport, laughing about it, but I can definitely say I'm more than a little relieved it was her and not me!

Years ago during my time at a LTC facility, there was a little lady I knew I'd never forget. In the middle of a (for once) pretty quiet night shift, this poor old girl walks up to the desk, and complains of lower abd pain. There was a little swelling in the area, and the lady was in obvious pain & getting a bit tearful. Chg nurse notified the patient's MD who said he'd see her in the morning... about two hours later she walks back to the desk, still crying. I'm sitting behind the desk, talking to her over the top, and start to hear (the only real way I can describe the noise) a sound like something cracking and popping as it hit the floor. This sound is accompanied by the worst odor I have EVER smelled, in my whole 11 years as a CNA. THREE FULL MONTHS ago, during Easter time, the grands and great-grands came to visit our little woman. They'd given her easter eggs to hide for the young'uns. Guess where those eggs ended up! After a good clean-up, she was sent off to the ER for the raging infection... Yours truly got to clean up those eggs from the floor... Blood, stool, vomit, snot... body fluids and gore don't bother me, but those eggs... *gags* Anyway- that's the only downfall with being independent (ADL-wise) in a facility- no matter how confused you might be, if you use the bathroom and shower yourself, in many places you will NOT get checked out properly on a routine basis. After that experience, ALL my independents are checked several times a shift!!