pumpkin92356

boy thats right they cant tell you what to do when you are on break!

I think its like that everywhere you go. There's always a conflict between co-workers and this creates attitudes.

I think it becomes very easy to forget that some residents still have feelings for the opposite sex. You know that old saying "Snow on the rooftop doesnt mean there isnt a fire still in the furnace" but I would definitely make sure it was documented and the families were made aware and almost pay special attention to whats going on when they are together alone. They do have privacy rights you know. Worked at a facility once where two residents male and female fell in love and they were always trying to be with each other and when they were found to be attemping sexual acts the families decided they should get married and they did and lived the rest of their lives together happy and sharing their room together.:heartbeat:D pumpkin92356

How sick!!! An artificial nail found on a patients bottom!! I think that would have made me get sick and I usually have a strong stomach being a nurse and everything! That is just sick!!!

Wow! The rush to impress the state surveyors goes on at every facility I have ever worked at. I worked at a state facility when the DON employed there was caught up with pushing the pen on the paperwork. The state moved in on the facility and stayed there for a month picking every little lit ball from under the beds! They even wrote the place up for having the ice tea to warm! So it doesnt pay to lie to the state. They have been around and know who is telling the truth and who isnt. pumpkin92356:D

Recently my facility hired some new aides to work the floor and they had those artificial fingernails that you have put on at the salon. Well my boss told them that they needed to remove them because of infection issues and potential harm to the residents. They protested saying that it was their right to wear their fingernails long as they kept them at a decent length and that at their previous place of employment they were allowed to wear them. We have a couple of patients who have MS and are scared to death of those nails scratching them as they are unable to move themselves and would have to have the aides bath them etc. This issue to me is totally ridiculous because I know personally that if I was unable to move and a nurse approached me with "CLAWS"! I would certainly be ready to scream Help!!!! What kind of facility would ever let aides wear those stupid fingernails and lord if I ever have the misfortune to be a resident in such a place. Any feedback? Thanks Pumpkin92356

From what I have observed over the years concerning nurses and backstabbing each other etc. Nursing is a very hard job period. The pay can be the *****! and most of the time the staffing is short because of money issues with the facilities and management that doesnt get involved with these issues so they continue. A lot of nurses are tired of the working conditions and demands that are put on them by management and the public. The constant pressure of the job the stress this causes makes many nurses become territorial and unwilling to accept newcomers as equals because they feel the newcomer as somebody who they have to put up with along with their other job demands. There can also be a certain resentment towards other staff who are not as educated as they are and helping to relieve their stress they lash out against that particular staff member its a way of venting their personal frustrations with their job and its workload. Nurses are constantly faced with the daily legal issues of the job and making mistakes can cost them their license. So putting the blame on others might also be their way of protecting themselves from blame should a legal issue concerning patient care come up. (med errors etc.) Its a shame that it is this way. There are many wonderful nurses out there who are caring and love their jobs if only they could be left alone to do their job they way they in their heart know how to then maybe the backstabbing would cease.

Well this can be typical when you are short staffed. But my question is why wasn't your supervisor out there helping on the floor till you got some help? Most RN supervisors will get out there and help if asked in a pinch. I know I have seen my DON putting patients on bedpans and assisting with meals so her LVN could get the morning meds passed when aides had called off or were delayed in getting to work some mornings. And calling in the troops is needed sometimes when patient care is an issue. The safety and care of the residents should always be the first priority whether you are an aide or a DON. Don't you agree? Good Luck, Pumpkin92356:D

Has this resident been diagnosed as having some form of dementia or is he depressed. Is he physically abusive or just making verbal remarks towards staff. If he is only verbally abusive most facilities will tell you to have other staff assist him if he doesnt want you. He unfortunately has the right to tell you not to go near him if he so chooses. Document, document his behavior so you will have something to show the doctor and maybe some type of medication can help him with his rude and aggressive behavior. But all I can say in my experience as an aide for many years is Grin and move on as there are always some patients that arent going to like you and some other staff member will just have to attend to his needs in your place. And most of all don't take his behavior as personal towards you he is what appears to me to be trying to retake control over his life now that he is in a nursing home he probably feels that this is the only way in which he can draw attention to himself. I don't know if this will work but you could try and talk to him and ask him (when he seems to be in a good mood at the time) if there is something you could do for him that would help him and you take care of him. Let him feel that it is all up to him and he might feel that sense of control that he is trying to get back. Because he is in my opinion a classic case of "Resident demanding Control". Good Luck you are going to need it. If this resident feels like you are trying to rule him then this could be the root of the problem. Try a more passive approach letting him feel he is the boss. Pumpkin92356:D

I have just one question, Most facilities start measures to assist residents in having regular bowel movements within 2 to 3 days. You said your resident stated she hadn't had a bowel movement for seven days. My question is why wasnt something done before seven days? I hope I didn't misunderstand you? Does she say this even though it is reported that she has went sooner than 7 days? If it isn't charted then the state is going to assume that she hasn't went no matter what you or whoever says to the contrary. Far as I know you must have orders to digitally remove feces. It is extremely dangerous if you don't know what you are doing. Thanks pumpkin92356:D

I think one of the most ridiculous sites I have ever seen in a hospital setting is the wearing of bluetooth headsets by nurses and various other staff during working hours. Most of my residents have never heard of these devices and have thought that a nurse or other staff member was speaking to them or talking to themselves because the resident didnt realize that the stupid device that they are wearing on their heads is a phone. I myself on many occasions have wondered what in the world does anyone have to say that they must wear one of these stupid headsets for 24/7!!! I know I wouldn't want a nurse or other medical professional working on me and talking to their callers at the same time!!! any comments on this subject? I hope I"m not the only one who feels this way? Phones should be left in the car or at home during working hours period! Thanks Pumpkin92356

Thanks for all the input, I appreciate the help , I will try some of the suggestions I have read. I agree that the resident should be able to use the commode when he wants as I myself would not want to sit and wait for to relieve my self. But he has been evaluated and has no physical problems that the doctors can see that would make him need to go so frequently also the majority of the time he doesnt do anything. He is very mean and demanding. We don't have a standing lift at my job as of yet. Thanks again everyone! Pumpkin92356

I'm a CNA and this kinda sounds like a form of resident abuse? I would think that knowing that a resident is sitting in his own urine would be a dignity issue that could be reported not to mention willfull neglect? If that was my father there certainly would be hell to pay! I wonder if those CNAs realize that letting this resident sit like that is a form of abuse and they could lose their certifications. pumpkin92356

Well this is probably going to sound like a broken record but here it goes. At my facility we have a male resident who rings approximately 20 or more times a shift to get up and down on his bedside commode. The problem with this is transferring him back and forth from bed to commode and so forth. Many times due to his weak legs we have asked him if using a bedpan would be okay? The lift that we have is a full hoyer and isn't practical for this type of transfer. The Licensed staff demand that we transfer him back and forth as many times as he requests. Over a dozen girls have been injured in one way or another by this resident as he weighs over 200 pounds. He is sexually aggressive and rude and yells nurse! nurse! in between using his call lite. He has three different alarms on his bed because of non-compliance with using his lite to ask for assistance. He will not wait one minute for anything. The other residents do not like this guy because of the time he takes away from them. We have approached our nursing staff with the problems we have with his care and they say that we must continue to obey his requests. I feel that these nurses need to try their hand at this resident for a day and see if they can go home without a sore back and sprained arms. What can be done with this situation before this resident gets seriously hurt or we CNA's do? Our LVN is fed up too, she has went in the room and politely informed the resident that he needs to use his bedpan if he is to weak to bear weight on his legs because he is hurting the girls and he says "Who cares" I pay their wages" Any ideas out there??? Thanks Pumpkin92356

Where I work at you have DON, MDS, staff developer etc all on the day shift and we have one extra CNA total of 4 aides and LVN for 50 patients. What gripes me is that the swing shift does everything we do on day shift but we serve one extra meal that is lunch. The PM shift does just as many baths and during the dinner time one of them has to go to the main cafeteria because some of the residents about 5 prefer to dine independently and an aide has to be observing for choking assisting with serving food etc. This leaves 2 aides and one lVN to tackle the rest of the facility during dinner. We have 11 residents on bedalarms and 2 that yell out for the commode at least every hour. The staffing for pm shift needs at least one more aide like we have on dayshift.

I am a CNA for many years and this story goes on everywhere I have worked. A lot of times some facilities are so understaffed that the workload for CNA's is next to impossible to complete in an eight hour shift. But, nevertheless its boils down to either accept your job as a cna or get out!! I'm am so tired of working along side of lazy CNA's. Most of the time its the younger ones with all the energy who are to busy taking smoke breaks and talking on their cellphones. Taking care of residents, patients is very serious business. An incorrect set of vitals could cause a patient to recieve to much or not enough medication. I would personally have a beginning of the shift meeting with my CNA's if I were a nurse and give them the report(which 99% of the time nurses I,ve worked with dont do this) and tell them you want your vitals by certain certain time. That way they can schedule vitals around their other tasks. And as for a cardiac patient, if I was responsible for the medication this patient recieves and I didnt trust the CNA I was working with I would personally do them myself. As a CNA I know who is boss and its not me. When a CNA is doing their job they are answering the call lites of all residents if they are not busy with their own residents, they are polite and ready to assist the nurse with any request within their scope of practice. Vitals signs when requested, making sure turns or done, helping other cnas without being asked. Down time could include depending on the shift stocking up supplies, spending quality time with a patient, tidying up the nurse station etc. I myself prefer to stay busy because I have found that the time goes by faster and if everyone is standing around the DON is going to think that there doesnt need to be as many cna's on duty and cut staff to save on budget. CNA's out there I hope you are listening.

CNA's do all hands on nursing care. We do vital signs, obtain speciums for the nurses. Assist with meals to patients. It really depends on the hospital policy to how much we can do. I know in some acute care hospitals CNA's do just about everything but any thing that deals with the medications.

A patient can change their code status at anytime. If they want to be full code or DNR they can change their mind when ever they want even going out to the hosptial with ivs and o2 mask .

I recently had a resident similiar to your lady. What worked for me was to make it a point to go in the room when she wasn't ringing and ask her is there anything you can do for her. Also I would make it a point to let the resident know that I was just thinking about them. Depending on how alert she is find a subject she enjoys talking about and sit with her and talk a while. A resident needs the security of knowing that they are cared for and liked and that you are sincere when you tell them so. Once the resident realizes this they usually want to please you because they want the positive response that they hope will follow. I know most of the time you wont be able to do this because of your workload but it is worth the time and effort and it will get results because once she figures out that she doesnt have to act that way to get attention then she will stop. Most of the residents want the staff to like them and you show me a resident who doesnt want all of your attention? Some residents are out to get even with their families for placing them there so they figure if they get the staff worked up enough they will have to kick them out. I have had a lot of residents who thought that acting up would get them out of there but after they settled in and realized that this was not going to happen they tried more positive ways to get attention. There is probably no way you can get this resident moved to another place or so on because she is there because she can't live at home and is considered dependent adult and no doctor is going to kick her out because she is playing these games so I hope my advice might work for you but every resident is different and has different reasons for what they do. Good Luck you will need it!

Well sounds to me that this facility is out for the buck and not concerned with level of care. I dont know what your nurse to patient ratio is in your state but this is clearly not quality care nor is it safe for you or your residents. And believe me if one of them falls and breaks a hip or starts to have skin breakdown you are going to be the one they are going to want to point the finger at. I have said this over and over nursing care hours required by the state need to be figured per shift not on a 24 hour clock. A licensed nurse is considered to be two staff in the figuring of these hours. These hours are most important to the LTC facility because this is their payment from the government medicare program. If they had to figure it our per shift there would have to be so many nursing staff on duty per 8 hour shift. As it stands in most states running short on swing shift for example wouldnt have much effect on the 24 hour clock because maybe they were fully staffed on the other two shifts. Long as they come up with the right numbers per 24 hours they keep getting paid and you keep getting overworked and understaffed.

If he makes a comment or suggestion that makes you feel uncomfortable and if he is alert then you need to let him know in no uncertain terms that this type of behavior is inappropiate and that it will be reported if it continues. Still let your Charge nurse know but letting him worry about a family member or spouse finding out about the behavior usually keeps the most aggressive resident at bay. If he does it again back up your statement to him and go immediately to your supervisor and report him. And if possible have the nurse go in and talk to him with you present to reinforce your statement to him about reporting the action. Unfortunately because he is disabled and in a facility you have to follow the facility policy on this type of behavior. Working in the field of nursing comes with its good days and the bad days. Thats why we nurses are special people.

That is got to be one of the most disgusting remarks I as an aide of 32 years has ever heard from a licensed nurses mouth. Over the years I have worked with many a nurse and have had some good ones and bad ones but this nurse needs to walk a mile in your shoes . Dont ever let anyone make you feel inferior just because you dont have the "Diploma" from nursing school. I know a lot more about nursing than most new licensed nursing grads simply because I have been in this line of work for many years. I am proud of my work and feel that I am doing a very important job. Just because we aides are not college graduates doesnt mean that we are ignorant and uneducated.

Bingo is big at my facility. Residents win candy and other stuff. Have to gear activities towards how alert they are.

Where I work its level of care an aide can have anywhere from 5 to 12 . My previous job was working in a state facility for veterans and I would have an average of 12 to 16 . Most places dont care if an aide calls in they just divide the residents up and giveyou more. And what gets me angry is the management bitching at you for not getting all the nail care done and the closets organized etc. Little things that are not possible with that many residents to care for in 8 to 12 hour shifts! I dont know who makes the ratios or if there are any but I think it is ridiculous to assume that one cna can keep 16 patients clean and dry and bathed and etc by their self. Impossible unless you have roller skates a catheter bag in to save time, and 8 arms and eyes in the back of your head hahah.

How about nurses who give patients pain creme for their shoulder or aspirin for their headache and the next day when they are off and the relief nurse is on and I as a CNA not viewing the MAR on a daily basis is assuming this resident has some kind of doctor signed order for this creme or whatever and comes up to the nurse and tells her the resident is requesting it and finding out that there is no order and the patient has been getting this medication for months!!!! Or how about signing for a medication that isnt in the cart!!!