fastwalkslowtalk

Worksource Oregon (through the Oregon Employment Department) has opportunities for grants for both CNA1 and CNA under the HOPE Grant which is a partnership between Portland Community College and Worsource Oregon. This is a link to the application for CNA2: http://www.workforceallianceonline.org/WI12CNA2HOPEApplicationPacket.pdf Article detailing what the grant is all about: PCC awarded $4.8 million in federal grant money to help train health care workers | PCC News

In my area (Portland, OR.) the average wage for a CNA1 is around $12.00/Hour. Typically, RCF/ALF pay on the low end at around $10/hour with SNF between $10-12/Hour. Private Pay facilities (ones that do not accept Medicare) pay between $12-15/Hour. Private Duty is about the same. Working for an on-call agency with travel is between $14-20/Hour. In the Portland area, Hospitals and Medical Clinics only hire CNA2's so those wages are not reflected here.

I started out fresh out of High School working as a roofer for Fleetwood Homes of America. The construction industry was at that time in an economic decline at the plant was eventually shut down and never reopened. Over 300 hundred people were displaced from a job. The work was very hard heavy labor although looking back I was probably the most physically fit I have ever been in my life. I jumped around a few jobs after that working in a furniture manufacturing plant and then as a Class B CDL Driver/Warehouse Dock worker. In the course of these positions I was injured and had to spend a couple days in the Hospital. The CNA's and other staff left a deep impression on me and I really wanted to work in a clinical setting someday but I also lacked confidence in my abilities. My first brush with health care was when, out of work, I applied for a position working as an advocate for people with disabilities for an MR/DD Alternative to Work program. It blew my mind at the time that there jobs actually existed where all you did was pick people up from their homes and spend the day going to parks, movies, activities, walk around the mall, and still got paid as much as I did doing physical labor. There was also a certain amount of respect that people gave you which was desirable. This all happened back in the late 1990's when government funding for social programs was at it's peak. My wage at that time was $10.80/hour when minimum wage was $4.75-5.80/hour. Looking back, the 90's was pretty awesome for social work. i actually got paid $100.00 cash just for showing up for an interview one time - recruitment for qualified applicants for MR/DD programs was high and there was a lot of competition at the time for staff with companies offering Direct Care Professionals good benefits and perks. This was also the time when the Forever Home concept was in it's infancy and just starting to get implemented. I worked for a number of MR/DD group homes serving that populace before at the peak of my career in that field I landed a job as a Habilitative Training Tech II for the State Operated Community Program, DHS, State of Oregon. I loved the position, but it was hired on as a temp for 6 months. I decided to make the leap and applied and accepted a position at an ALF/RCF. I started out there as a NA and then was promoted to MA. They also paid my way through a Basic Nursing Assistant program at a local community college and I received my BNA certificate and then took the OSBN CNA 1 exam and became a CNA1. I was then later promoted to the position of Resident Care Coordinator for the facility. I love working with people in geriatrics. The stories!, the History! the Characters!. I found my niche in the world and in this career path and have now served as the Shift Lead/Nurse Supervisor for a couple of ALF's, but my passion is actually in Hospice work. I decided early on that I did not desire to be a RN. To be honest, my math skills are a barrier due to a learning disability that I was diagnosed with. However, I decided that I could be the best nurse support staff I could be and in that regard, due to my knowledge and experience, I have always commanded top wages within my field and have thus supported my family very well through out the years. I went back to school and later got my CNA2 (acute and dementia), HHA, and then struggled through the CMA program but made it. Working as the RSC/RCC in facilities is a very dynamic position with interaction from residents, their families, staff, outside vendors, and Healthcare Professionals requiring strong inter-personal and communication skills, flexibility, the ability to coordinate and multi-task. My day is never the same. I work on the floor providing personal care and assistance with ADL's. I train staff and run daily meetings. I pass medications, implement Physician Orders, am delegated for skilled nursing task's such as d/c folley caths, adm injections, and wound care. I coordinate resident care with outside healthcare professionals and tasked with making sure residents are receiving quality care. I perform MAR audits, cycle med fills and review, clarify orders and make sure that residents are receiving quality medication management. I handle resident and family complaints, address the issues and implement plans of correction. I have two bosses that I report to: the Facility RN and the Community Manager (we do not have a DON or the classic Nursing Hierarchy - I am technically third in command after the RN and second after the Community Manager with my next logical promotion being the Community Manager (who is also the RN's boss). Wages are good where are work - the average CNA/PCA makes $15 an hour and my position pays up to $22 an hour. We have good benefits and perks. Overall, I am very satisfied with my position and love what I do. Just for those who are wondering, I am employed for a facility that specializes in Memory Care and is Private Pay Only - we do not accept Medicaid/Medicare which is why our staff are paid such high wages. The average resident pays $10,000/a month for services with the highest being $15,000/a month. We are a very high tech, upscale facility.

Without being there to personally observe and stand as a witness to the events described by the OP, I am going to have to play the devils advocate here. Just for the record, I do not and will not condone abuse performed by any of my staff, but to the inexperienced, untrained eye, what you may construe as abuse may actually not be. If every single healthcare professional was turned in on abuse charges, I doubt that there would be many left in the field today. The truth is, there is not a single healthcare provider who has done everything they are supposed to all of the time. Even RN's and Physicians make mistakes that could be career killers. Blatant disregard for a patients safely in the form of negligence/neglect is a very serious issue but things do happen. From my experience, staff to patient ratio's, time constraints, staffing issues, training or lack thereof, level of experience, resident points on service plans, wages, hours worked and overtime, personal life problems are all factors that contribute to the level of care we provide. You may want to revisit the scenarios you spoke of and determine if what you observed was a clear cut case of elder abuse. For example: Dirty Socks: The truth is, many residents do not have adequate clothing provided to them by family members. Laundry is often only done on a weekly basis and is only washed as needed if clearly soiled. Speaking Rough to Residents: Some residents have behaviors that require staff to be more direct and firm with in order to gain cooperation or else the resident will become more difficult. They may have hard hearing or difficulty processing verbal "commands" because of disease processes. This may be done as an effort to effectively communicate with this particular resident. Banging legs while transferring: There are going to be times in your career when you are going to have a resident that is going to be a hard transfer, despite doing your best within your capabilities to provide good technique. Dropping Residents on the bed: Without seeing it firsthand I really can not offer a determination here. In my opinion, the facility should be allowed to determine whether or not these stated concerns of yours are issues that could be addressed through staff training or handled within the facilities disciplinary process. Your eyes are you own and I encourage you to make the right decision. If what you observed feels like abuse to you, then by all means make your report as stipulated by the Law as a mandatory reporter. On the flip side of the coin though, keep in mind that there may be circumstances where in your career that you may find yourself in the same scenarios.

I would be more concerned as to why the resident fell in the first place. As for responsibility, as long as you did your bedroom checks per your facilities policy and and made sure the resident was safe and secure on your rounds then it's not your fault that she fell - especially if this resident was not a known fall risk which would require more frequent room checks. Failing to report and document the fall (charting, writing an incident report, etc) would put you are risk for disciplinary action. Typically rounds are done once every two hours with call lights answered as needed. Unless there was a specific reason or concern to go back to that particular residents room I can not see how the nurse could find fault with you. With residents who are fall risks, checks could be as frequent as every 15 minutes to an half an hour. Tab alarms and "bed bugs" should also be used with other precautions such as a floor mat on the side of the bed to cushion and absorb any impact for patients who are severely at risk for falls. Just make sure that your residents have the call light within reach and follow you policies regarding room checks and walking rounds.

At my facility peri-care is performed using disposable wipes. In the event that cloths are used, as well as any clothing or linens that are soiled with bodily fluids including urine or BM, it is washed separately in a designated washer with bleach after being pre-cleaned/rinsed in a hopper as per our policy. Clothing and linens that have been contaminated is always double bagged and removed from the room and goes straight to the laundry. This cuts down on odor and keeps the residents living space sanitary and presentable.

At $40 an hour your income is approx $76,800 Gross annually. Seriously!? Quit the job after securing another position with another company that pay's the equivalent to what your making now with better terms and hours. Let the scholarship go into collections. Simplify your life and downsize. Pay off the collections in one year while living on an income approx of $30k and use the remaining $20K to either bank roll or pay other existing debts off. If the suspicions regarding fraud are true, you do not want any part of this!

That's why you make the report ANONYMOUSLY to an OUTSIDE agency with the capabilities to conduct an investigation upon the authority of the State or County, such as calling that number on the back of your MANDATORY REPORTER card that pretty much all Professional Healthcare Workers, Police Officers, EMT's, School Teachers, and any other member of society who is considered a "Public Employee" are given when they hired. I kinda thought we all decided to work in the health care industry because we wanted to make a positive difference in people lives.... I don't understand the ethics here in some of these post's. The authors seem more concerned about protecting their own careers at the expense of someone else's pain, discomfort, dignity, and health. Someday your health and well being is going to be in another's set of hands. Think about it - would you yourself tolerate this kind "care-less giving?"

I'm not understanding what the problem is here. Those actions of the Surgeon clearly fall under the categories of Abuse and Neglect. The witnessing nurse made a statement of allegation of potential abuse and negligence. Is there not a state or county agency to make your report to outside of your clinical setting? Are you not a mandatory reporter? A paraplegic is by legal definition a disabled person who is protected under the mandatory reporter law. Mandated reporters are required to file a report whenever there is reasonable cause to suspect or believe any resident of a care facility has been abused or neglected by a staff member of a public or private institution or facility that provides care. Whenever the results of an investigation leads to the conclusion that there is reasonable cause to believe that that there has been abuse or neglect perpetrated by staff, then the institution, school or facility must provide records concerning the investigation to the appropriate investigating agency and/or to the agency that licensed the facility. Your State should have a Adult Protective Services, Department of Human Services, or a Seniors and Adults with Disabilities agency where you could file a report anonymously to. Also, your State Board of Nursing should also have provisions as well. In most states, if not all, failing to report abuse is also a criminal offense. It is your duty and obligation as a Health Care Professional to protect the safety and well being of your patients. It is not your obligation to conduct an investigation or gather evidence.

It's pretty simple. I let all of my calls go to voice mail if I don't recognize the number. It's not like you can't call them back.

It's pretty tough stuff. My first experience with death in a professional/clinical setting was actually while I was attending my CNA clinical's through the Tri City ROP CNA program in Whittier, CA back in 1998. The Nurse Instructor brought the class in to show us how to make hospital corners while an elderly patient was passing away. It was a very awkward and somber experience. I moved back to Oregon and started working in MR/DD group homes for a number years up to the State level before landing a job at an RCF as a Nurse Assistant working in the Health Center (the assisted living ward). I was promoted to Med Aide and then again to the Resident Care Coordinator after obtaining my Oregon CNA1 where I worked very closely with Hospice. The first time is never easy, and it does not get much easier after that. Just remember to be the professional that you are and to do what you were trained to do with compassion and respect.