Nikki69

Where I work the CNA's use a computer system called Care Tracker. No more paper for them but the nurses are still writing a book every day. Our social worker has a very frustrating job when it comes to matching up the behaviors that the CNA's chart on the computer to what the nurses write in the team notes. Everything is suppose to match but things just couldn't be that simple.

My sister almost went to school to be a MA. I'm so relieved she didn't. I am a staffing coordinator at a LTC facility and I have had several Medical Assistants apply for anything they can get. I always have to turn them down because they are not certified as a Nurse Assistant or a licensed nurse. It's sad because schools lead you to believe that it's a demanding career when it's certainly not. The best of luck to you!

StarNurse: You are communicating with Your Assistants. Good Job!

Hi Everyone. I'd like some advice and/or input about what I can do to try to raise the morale in my LTC facility. I work in a non-union 114 bed nursing home. I worked at the same facility as a CNA for four years, and now I do scheduling for the nurses and nurses assistants. I always try to keep the peace around the building and try to help others "see the other side of the situation" when things are stressful but I'm running out of things to say and do. I'm wondering if anyone else has issues with low morale in their work places and what would make it better for you or your staff?

Agreed. Or at least hire the ones that want to come to work.

UH-OH. NOW WHAT ARE THEY GOING TO DO? Do you think they will use agency to cover open shifts? I hope people don't lose their hours because of refusing mandation! We got tired of the mandation at our facility a couple years ago. It just wasn't fair or in some cases safe. We came up with a better, more do-able way to get shifts covered and it is employee-friendly. We made a grid that divides up the schedule into four hour blocks. Then we divide up the nurses (separate one for cna's) into three tiers (greatest seniority is tier 1, then tier 2, and the least seniority tier 3). We take the number of four hour blocks and divide by the number of full and part time nurses. That determines how many blocks each person needs to sign up for during the schedule. Tier 1 gets to sign up first, then 2, then 3 (I usually try to give them 3 days each tier to sign up which gives me a deadline to have the schedule out nine days before it begins). Each nurse or cna gets to choose which hours they would like to work IF they are needed-before their shift, after their shift, or their day off. Of course, it's more beneficial for the ones that have been there forever but in healthcare, there is usually a big turnover so it doesn't take that long to move up a tier. In the beginning I had a minor problem with some not signing up or not signing enough spots but they started to comply when I had to choose their spots for them. This system isn't better than NO mandation, but it sure beats getting psyched up to go home and at the last minute get hit with having to stay for another 8. It's a heck of a lot easier to be a good caretaker when you have at least a little bit of a say in when you work.

I was a CNA for about 4 years before I was asked to take the job as Staffing Coordinator. I make the nurse's and CNA's schedules, and assign where they work every day(among loads of other things). When I have nurse's constantly complaining to me about certain CNA's that don't do their best, or leave their work uncomlete or sloppy, I have to keep reminding them that they are the supervisor and one small role of their job is to make sure their CNA's know what they expect from them. I know that this may be difficult for some people but it's necessary. That's not to say you should get out the write ups at first but I think the CNA's should realize that what they do and don't do reflects on you and the image of the whole facility. Last week I had to attend a veeeery long meeting on "better management". The biggest message the speaker wanted to get across to us all is that if the employees under us are not succeeding, it is our job to do everything in our power to make it so they can. If they fail, we fail. We can make sure most of them succeed not by writing them up every chance we get, but to encourage and nurture them. This can be done with a passing smile, a "good job", or a "don't forget to___________ before you go". It doesn't take up any time at all, and it might make the CNA's feel recognized because that's one thing that they probably don't feel very often. One thing I think might help (even in my facility) is to take a personal moment when you're at home or whatever and write down the most important things that you expect to be done by your CNA's-no matter if it's as simple as brushing and soaking the dentures or floating the heels and discuss them with the CNA's at the beginning of your shifts during report. If you don't give report to your CNA's, start. Call them all up there and do it even if they other nurses don't. They will respect you more if they know a little bit of what you know. If you're uncomfortable "telling them what to do", you could always say something like "we've had some complaints about_________, or the DON is going to be checking _________, so can you please make sure you pay special attention to that". That way it will take the focus off you and on to the management or hopefully, their own work ethics. Good Luck!!

Carol, I know EXACTLY what you are talking about. I read your post and had to look at your name and location because I also have that resident. I am one of the CNA's that get the short end of the stick when it comes to one particular resident. She is only 48 years old, and honestly the meanest, rudest, most miserable person I have ever met, seen, or heard about. Her parents are her POA and she is completely sane. Her parents tell her that she needs to treat us with respect, and they have been called a million times about her behavior. She is 4'11" and 375 lbs. She cannot walk, but she sure can order everyone around, threaten to call state every other breath, and SCREAM at the top of her lungs every single day, evening, and night. She has hit us, threw things at us, and she verbally abuses her roommates. She refuses her diet that could save her life, she refuses psych, she refuses just friendly conversation unless it is about food. I have worked with her for 3 years, and last week I snapped. I just couldn't take it anymore. I told our DSD that I can no longer be assigned to her. Other aides are just as frustrated with the woman but they do nothing about it. After 3 years of charting behaviors every day and pleading with our DON, ADON, and administrator, there is still nothing being done. I don't understand how a company can allow one person to run off their help and literally abuse us like this. I asked why we accepted her in the first place and the reply was that cencus was low. That is just ridiculous. They say that they can't "kick her out" either. They know how terrible she treats us all but still nothing can be done? There's got to be something!!??

I don't know about any of yours, but my fiance is the hardest person to get to the doctor. Must be a man thing. He wont go unless he feels like he's going to die i swear. So no, he has not been to the doc. I'm just trying to investigate, not look for a dx. thank you very much Commuter, that is helpful, but still, the only thing that swells is his uvula. I will definately try to talk him into going to the doctor.

what is anaphylaxis? i am only a CNA right now and my knowledge is limited. Like I said before though, we don't know what triggers it.

First of all, I don't know what the little thing in the back of your throat that hangs down is called. But anyways, my fiance's keeps swelling up to the point that it touches the sides of his throat and when he blows out a breath, it slaps back up and lands on his tongue. I've had to rush him to the emergency room 6 times in almost 6 years for this, and all they tell him is that it's an allergic reaction, and they give him a shot of steroids, and it shrinks back down to normal. He was doing different things, and he ate different things before each occasion Any ideas about this? I was wondering could it have anything to do with snoring?

This is very interesting. I've always been "into" these kinds of things. Before I had my first son, I had just started to do some meditation and yoga, and really study what it's all about. Then, I got so busy with family and work that I kind of put my interests on the back burner (where they remain). When my sister started to build her house, her and I smudged the land on the east,west,north, and south sides. I'd love to hear more from you.

my 3 year old just started having these also. i didn't know if i should call them night terrors or not. but he just starts screaming and crying, sometimes saying no, no, no. his eyes are closed and when you try to wake him up he gets more upset and kind of stiff like. but as steph was saying, either me or his daddy just holds him until he's calm again. he is very hard to wake up in that state.

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I have a certain lady resident who has a rhyme for everything. Like when I whistle, she says: "whistlin' girl and a crowin' hen, always comes to some bad end", or "goodness gracious caught a skunk. goodness gracious, how he stunk. Recently, while I was taking her to the bathroom and bed, she started reciting this long poem that I thought was very charming. I asked her to say it one line at a time so I could write it down, but before I could finish writing a line, she would forget where she left off. It's strange how some of our older citizens can't remember 2 minutes ago, but they remember every detail of 50 years ago. So, I went and got my cell phone because it has that voice recorder on it. Maybe I'm just sensitive, but she almost made me cry. Well anyway, here's that poem. THE WOMAN WAS OLD AND RAGGED AND GRAY AND BENT FROM THE CHILL OF THE WINTER'S DAY THE STREET WAS WET FROM THE RECENT SNOW AND THE WOMAN'S FEET WERE AGED AND SLOW SHE STOOD AT THE CROSSING AND WAITED LONG ALONE UNCARED FOR AMIDST THE THRONE OF HUMAN BEINGS THAT PASSED HER BY THEY HEEDED THE GLANCE OF HER ANXIOUS EYE THEN DOWN THE STREET THROUGH THE LAUGHTER AND SHOUT THERE WERE THE CHILDREN THAT SCHOOL LET OUT HERE CAME THE BOYS LIKE A FLOCK OF SHEEP MAKING THE SNOW FLY LIGHT AND DEEP ONE PAUSED BESIDE HER AND WHISPERED LOW I'LL HELP YOU CROSS IF YOU WISH TO GO HER AGED HAND ON HIS YOUNG STRONG ARM SHE FACED THE STREET NO FEAR OR HARM HE GUIDED HER DRAGGING HER FEET ALONG ON ACCOUNT THAT HIS OWN WERE FIRM AND STRONG THEN BACK AGAIN TO HIS FRIENDS HE WENT HIS YOUNG HEART HAPPY AND WELL CONTENT SHE'S SOMEBODY'S MOTHER BOYS YA KNOW FOR ALL SHE'S POOR AND AGED AND SLOW AND I HOPE SOME FELLA WILL LEND A HAND TO HELP MY MOTHER YOU UNDERSTAND IF EVER SHE'S POOR AND OLD AND GRAY AND HER OWN DEAR BOY IS FAR AWAY

Thank you everyone for all of your comments. Today went alot more smooth. There are just days when you want to just walk right out of there because you are just so overwhelmed ya know? Don't get me wrong, I love my job, and I don't know of any other profession that would allow me to be so involved with other people's lives. It really is sad that our elderly who at one time lived just like us have to give up everything and come to a place where there aren't enough workers to give them enough TLC. But, I guess until I get back in school and further myself, I'll be one who tries to make a difference in the days of my residents. This is such a nice place to come and unwind. I'm glad I found it. Thank you.

Alright, I just need to vent for a bit about the place that I work. I am just a measily little aide in a 116 bed facility. I am so tired of being over-worked, understaffed, and under-appreciated. Our company "rules" don't seem to apply to anyone but us aides, and even though they stress "team work", the upper-management does not participate with the phrase. I stay on the hall for both breakfast and lunch while my two hall partners go to the dining room to feed residents. My hall is very busy with demanding residents, and I have alot of people that are fall risks down there. Today, I had one of my men who is in extreme pain up on the sit-to-stand lift getting him off the toilet, when I heard an alarm go off. At the top of the hall, there are three offices, with three chairs, with three butts planted on them chairs. I finally got my man on his way back to bed when I heard those damn high heels clunking down the hall. That alarm is still screaming mind you..She(our risk management woman) walked right past the lady who got up out of her chair and pulled her alarm loose, to come and find ME to go shut that alarm up and help that resident. What the.....? She couldn't stand by while the lady used the bathroom? Put her call light on? Called for me? At least make sure she didn't fall? I don't know, that just really irritated me. I usually always have a positive attitude about work. I know that I try my very best to go above and beyond the the expectations, but my goodness!! I already have 10 people to get up, cleaned, dressed, beds made, etc. in an hour and a half in the morning. And ALL of those people have to use lifts to get up. More than half actually use the toilet, and then our dietary people get all ticked off and snotty at us when we don't have our people down there on time. That is very very time consuming. We are always working short, and I am so tired of it!!!!! Yes, yes, I know, get my rear back to school and quit breaking my back huh!?! It's probably the same way wherever you go too, that's the bad thing about it. These residents pay 1000's of dollars/month to share a room and get told when to eat, toilet, sleep, etc. It seems that they can afford to fully staff a darn place, ya know? Oh well, It'll be better tomorrow, right? aahhh, thank you for this place to vent. I feel like I can get a good nights sleep now:cool:

Becky-How is everything going? Are you a little bit more comfortable now? I am a CNA too. I know what you mean about the aides that don't seem to care. I am fortunate enough to work at a great place that usually gets rid of the ones who don't. I have orientated alot of new aides, and i can tell within the first half an hour which ones are keepers and which ones aren't. You sound like a keeper. I always make sure my residents look nice, are clean at all times, no food on face, clothes, etc. The one thing that I am obsessive about is taking the residents to the bathroom as much as possible. In this job, there is no reason to be taking a break unless its your break time because somebody is always going to need to go potty, or at least be cleaned and changed. Make sure you always apply protective ointment after every incontinent episode. While in the residents rooms with them, I talk about my life, or the weather, or just something goofy with the residents who are upset all the time, or who just plain don't talk at all because it seems to make them more comfortable. I always smile and try to take the focus off them while doing care, and tell them what I'm doing and going to do before and as I'm doing it. Also, even when I'm working with the less desirable aides, I answer their call lights too. Not just my own. I hope you continue to enjoy the way you make a difference in these people's lives because these places need more aides like us in them!

How about your aides? Every day at the beginning of the shift, emphasize the fact that you really want them to push the fluids.

One day, one of my lady residents was pretending like she was snoring with her head hung down, and I said "Jeannie, what are you doing?" She said "practicing for activities"! Everyone got a good laugh out of that one. I would have to agree that bingo is always a big deal. Some other ideas are having an older volunteer come in to read for an hour once or twice a week about your towns history(stuff to make them remember how it use to be), also, for your fundraisers-we have a little portable oven that our activity dept. bakes cookies in on tuesdays. They charge $1.00 for three of them and sell to staff and residents. Of course, you can do an annual bizarre to make money (have some of the residents decorate wreaths and pine cone ornaments, etc.) We have a monthly trip to Wendy's for lunch. We have a local school's jazz band come in and play. Also, as Harleygirl mentioned, a monthly birthday party. We have a pastor come in and do room visits, volunteers with pets, children, and church.

Hi everyone. I'd just like to get some information about hypothyroidism. My TSH level was 301. I guess that's pretty high-it freaked my doctor out. I am currently on 200mcg of synthroid daily. I take it in the morning on an empty stomach like I was told to, rarely skip doses, and I still feel like crap. I've always been a little bit overweight, but now I just FEEL like a stuffed pig. My hair is thin and brittle still, nails the same way. My face is puffy and I cannot stand the cold weather-it's like it "hurts" to be in the cold for any length of time. I've been on the med. for five years and I still can't take any weight off and I still have all the symptoms. My TSH goes up and down like crazy. If I do miss a dose, I can feel it. My energy level is sky high for a day or two, then the next day I can hardly get up. Does anyone have any suggestions about any natural thyroid enhancing vitamins or anything to comment on about this? Thank you Charnell

I would take the job if I were you. Try not to care what they think of YOU. Those residents deserve to have good professional care. And if the DON is leaving, maybe the one that replaces her will pay more attention and help you turn this into a better place. Maybe you could give your DSD some suggestions on what to inservice about to the CNA's. Where I work, we have a turn schedule, such as 10:00am, left side, 2:00pm, right side, and they actually walk around the facility and check. We have stickers with the schedule that are on the back of our name tags. As for the weights-if there is a significant difference, make them re-weigh when you are present (if you have time), or send someone you trust. Keep on working for the greater good, and look at this as an opportunity!!

I don't mind being called "girl". Come on, some people might think you are uptight. You said you "cannot allow" them to refer to you this way. You may want to think about this because if you let them know that you do not wish for them to refer to you this way, they might not think of you this way anymore. I do think it is rude to refuse this compliment.

I had a resident named Annabelle who came to my LTC home last year. She had been an active part of her daughters life until she suddenly had a stroke. She then was very still, didn't talk, and couldn't eat or drink. She would follow you with her eyes, and if I asked her a question, I told her to blink once for yes, twice for no, and that's how we communicated. Her daughter came in every day, but was unsure how to talk to her mother. And even more unsure that her mother knew what she was saying. I would spend all of my free time in that room, moistening Annabelle's mouth, lotioning her skin, washing her hair, just trying to pamper her. Annabelle went 21 days without food or drink, and the day she died, her daughter and I were both with her. I was stroking her head, and her daughter was saying mommy, I love you, mommy, I love you. After she took her last breath, I held Annabelle's daughter, and we cried together for a few minutes before I reported to the nurse. A couple days later I had a great big bouquet of wild flowers in a very nice flower pot sent to me at work. It was a great feeling. I also have a resident, Bertha, who is 97 years old, who has been chewing tobacco since she was 4 years old. All she takes for meds is a daily vitamin. Since she is old, and crippled up, she has a hard time getting her spit in the right places. It gets all over the floor and her clothes. Some of the other residents complain about it when she wanders out of her room, and our housekeeping department complains when they actually have something to clean up, so our social worker said we have to limit Bertha's chew to certain times, and certain amounts. The tobacco has to be kept in the nurses cart, and is only to be given in in the med cups when she can have it. Well, I don't think so. This woman has lived 97 years, has chewed for 93 of them, and I make sure I come to work prepared with a package of chew in my scrub pocket for my little lady.

I have a particular resident that calls me in the room every day after she gets done sorting her newspapers and ads which she throws on the floor for me to pick up and throw away. She is a very large woman and can't get up or even move an inch in the bed so when she drops her ink pen by her side she calls me in there to search for it. She's got three bed side tables just heaped full of her "necessities" and when she can't find anything in the mess, or can't reach, she hits that call bell. I just finish up what I'm doing before I answer her light because unless she is screaming at the top of her lungs (like she does every other hour-no exageration there), I know I will just be picking up after her or organizing her important stacks of week old newspapers or re-arranging her closet. Every day at breakfast and lunch there is ALWAYS something wrong with her meal. She calls me in there after I make sure everything is ok, and has me run to the kitchen over and over again to argue with dietary about her meal. Her portion isn't big enough, or she wants to know if everyone else got what she got, or,... it's just endless. They should have one aide assigned solely to that room. You would really have to work with this lady to know how frustrating she is. And she is not nice.