QuigRN

Hi. I am a disabled RN due to a lung disease. I am on oxygen 24/7 and have a part time job teaching CNA students. I do the classroom stuff and don't have to do anything strenuous. It's a great job and I get a lot of satisfaction knowing that I have a part in sending out well trained, caring CNAs. Good luck with whatever you find. Your knowledge is valuable!

I agree! Document, document, document. Follow your policy because this is a dangerous situation, and if it should happen again the DON will blame YOU and say that YOU did not follow the facility protocol for elopement!!!! Go to the administrator with this. If no one listens, go to Protective Services. (In MA we don't have ombudsman programs in ALFs). This resident might not be an appropriate candidate to remain there and need a more secure facility. Good luck and keep us posted.

Thank-you so much for your replies! You guys are the greatest! Because I'm an RN, I've always believed that the more we give away, the more we have to worry about techies coming in and usurping licensed positions. But I have no problem if CNAs are taught these things in a facility, for that facility only. The CNAs being allowed to do technical things is a blessing and a curse for us. I certainly understand why we need them to do some of these things, because it's getting really hard to manage our own work load in surroundings that keep cutting back on nursing positions. Heaven knows we need help from all of the team. I appreciate all of your responses and I think I'm going to have our program continue to teach the basics (no messing with orafices except the mouth), and no nursing procedures that don't fall within their scope of practice. I will tell them that if they want to do more, seek out places of employment that will train them. Thanks again, your answers were so enlightening for me!

I was wondering if there is any circumstance wherein a CNA would be allowed to do an accucheck? Is this something that they would ever be allowed to do if trained? I oversee a nurse aide training program and boy, those students ask a lot of guestions! Thanks!

I'm 56 and thought I'd be nursing forever. I've worked over 30 years in most areas of nursing, and the last 15 years or so I've been an ADON and a DON and loved it for the most part. The stress is killer in LTC, however. My body finally made the decision for me to leave nursing full time. I have a bad back from years of abuse and now I have COPD and am on oxygen. I felt lost and useless after resigning in O5 and I'm now teaching CNAs at our local community college. There is no stopping a determined nurse! This fits right in with what I'm physically able to do and it fills me with a sense of pride to be a part of a program that I know sends good caregivers out to the community.

Thank-you all for replying. Daytonite, those are great links and will be a good resource for me. I know that positioning is key when you can't get air in and some people just don't even think of that as an intervention. And I have tripped more times than I can count over my darned tubing! Lol and I have moved too quickly sometimes and yanked my portable tank, slamming it onto the floor from my kitchen counter. That doesn't help the shelf life of the tank at all!:uhoh21: Fear is another issue that needs to be addressed. Knowledge is power and so much fear could be eliminated with some good sound facts. KellieNurse06, I hope you have better luck getting good home care staff! My heart goes out to you for all that you are dealing with. Thanks for your support and I hope to hear more ideas! This is a mission from the heart for me and I am so grateful for your input!!:kiss :redbeathe

I am an RN who also has COPD. I have worked in all areas of nursing; the past 15 years in LTC, going from supervisor to nurse manager to Director of Nursing. I recently had to resign my position as a DNS due to my illness and of course, the extreme stress of the job. In the past 8 months I have improved tremendously, and while I still wear oxygen, I am now teaching, which I love. I would like opinions from nurses, CNAs and students (and anyone else who would like to offer an opinion) about their experiences with oxygen. Do you think you got enough training prior to working? Was there anything that you learned on the job that you wished you had been taught? Do you have special tips on how to help someone breathe easier when they are "panic breathing"? Did you understand all of the oxygen equipment when you started using it? Do you think your orientation was adequate? I am researching and am going to write a training module to offer to LTC facilities, oxygen providers, and CNA programs to help address some of the issues that I have come across both as a nurse and an oxygen user. I have personally felt the desperation of "panic breathing" and wish that when I had been hospitalized, there were nurses who knew how to focus me to bring my breathing under control. I wish I had known myself what to do for others. I feel there is a need for more education around breathing issues and oxygen issues. Thanks in advance for your help!!

By regulation, any suspected or witnessed sexual abuse of a resident by "anyone" has to be reported, thus including resident to resident. It can also be considered a form of exploitation of a resident. Usually an investigator doesn't go to the facility to investigate unless it involves more than one resident or looks like the facility isn't dealing with it appropriately.

I resigned my position as a Director of Nursing late last year because I felt like you. I had been the DON for 7 years in a small SNF and the stress was unrelenting. I was awake at night trying to figure out how to keep us in compliance and how to motivate nurses and CNA's along with activity director, food service and heaven help us, the housekeeping staff. The administrator was 85 and could care less, as a matter of fact, he was a hindrence because he thought we should operate circa 1970....you get the idea. I had my hands full and I wanted it to be run professionally and provide the highest level of care. My constant attempts and worries exacerbated health problems. And bam!! I was too sick to work. Please don't let this happen to you. Find a job where what you do truly makes a difference. Nursing has so many opportunities and not all of them are in LTC. I fought for good care in nursing homes for the last 20 years of my career. I don't regret resigning from LTC because now I am a director of a CNA training program and loving it. It makes me feel good to be sending out caring and competent caregivers to the community. The Cape is a GREAT place in the summer!!

that's a good idea, i will. thanks!

Last year I quit my job as a director of nursing and I am now the director of a CNA training program. My question is this: how do you reconcile what we teach them about bathing the correct way as described in their books, to what reality in a nursing home dictates? I don't want them to get a job and be blasted for using all the wash cloths for a bath but I can't teach them that they'll be lucky to get one wash cloth per person bathed or worse yet, have to use the corner of the towel. How can I keep it real for them?

Happy to oblige!!! Keep up the good work.:cheers:

Try a google search. I came up with several like this one: http://www.skillpath.com/ and I'm sure there are lots and lots to choose from! Good luck!!

As a DON in the Massachusetts LTC system, I would have had to report this incident to the state Department of Public Health and THEY would have to come in to investigate the allegation of abuse. (the facility is also required to do their own investigation). In this way, the facility and staff are SPARED the opportunity to play favorites. If they didn't report an allegation of abuse, and it was discovered say, during survey, they would be investigated anyway and in addition, reported to the Attorney General for possible prosecution. I've been a DON for 15 years and we ARE mandated reporters to our state's reporting agency which in Mass is the DPH. Every facility must have an abuse policy that addresses pre-employment criminal record checks, on-going education of abuse/neglect, and clear policy that states who is responsible for reporting, and what is reportable. Very good reading!! Please keep us posted, HHC_LPN, you are an employee I would love to have on my staff!!

Hi TIA, I've was a DON for many years and it seems to me that they are protecting you from her. The DON is mandated to investigate any allegations brought to her/him and if they are not telling you, and not investigating, then they do not give her allegations any credence and consider "Jill" a threat to you. I would be very glad that she's leaving and not too soon enough! Good Luck!