Question for CNA's and Nurses

[Lucina11]

I am fairly new to being a CNA, so maybe this is just ''the way it is" , and I am being a wimp, but I have some questions regarding a skilled nursing facility. Please allow me to rant along. :)

First of all this facility has two aides to 30 residents. To meet regulations, they count the charge nurse, the medication aide ( who is not allowed anymore to act as a CNA), the social activities director ( who is a CNA ) and the DON...none of whom will ever, not even during a state inspection, be seen on the floor. The 2:30 ratio is for days and evenings. On nights there is only one CNA, and the charge nurse. Is this safe? I know its certainly a problem when 15 of the residents are fully dependent on aides for transfers. They need constant supervision and/or assistance. 5 residents have severe mental handicaps and behavior issues, so aides are constantly needed to prevent them from injuring themselves or other residents.

Every other day, one of the day aides is sent to transport a resident to an appointment. One day, one of the CNA's was asked to drive a combative resident 150 miles to a clinic where they had to have test. Is this right?

This facility has one sling-lift. At some time in the past it was used improperly and injured a resident. No one is allowed to use it now. All lifts and transfers are done manually. Nine of the fifteen dependent residents weigh at least 200 pounds. One weighs close to 400! The rest of them would greatly benefit from a stand-lift, to prevent injured shoulders and wrists. ( not to mention prevent many of those falls when an aide is over balanced by an unsteady resident.

Then there is the shortage of supplies. The diapers are locked up, and doled out daily. If you use more than you need, the nurses are angry, or tell you to ' beg, borrow, and steal' until more are 'found'. Many of the aides are buying hteir own to make up for shortages when not enough supplies were ordered. For instance, once they ordered five boxes of diapers in size small,

( which no one wears...) but ordered ten cases of straws and and a hundred catheter bags...when no catheters are used in the facility! Then told the aides that they went over budget and to make the diapers last a month.

The beds all sit at knee level and cannot be raised, making it impossible to follow good body mechanics.

The pads, drawsheets and linens are in short supply, yet on a surprise inspection one day, the Administrator stripped the beds and told us never to use a stained, torn, frayed or worn sheet--but to throw them away immediately. ( No replacements were ordered though.)

Aides are expected to clear the tables, mop up the dining area, do the laundry, completely scour the shower rooms, run errands, organize and oversee social activities if the activities director decides to leave early, organize closets, dust, clean toilets, water and prune houseplants, etc. Whatever task that might come up. On one amazing day when everyone was actually toileted, changed, and put to bed on time, and the aides had five minutes before they had to start showers---the charge nurse jumped them, and said that if they had that much time surely there was a toilet somewhere that needed cleaning. On good days aides are more than willing to deep clean, but on bad days the residents need us more than the toilets do. ( today at lunch we had to get thrity residents up, changed, dressed, and at the table for tray pass...in 45 minutes, and the charge nurse came down and told us someone important was coming in twenty minutes, so make sure the halls were spotless before lunch!)

The personal bath supplies are locked in a closet that only the nurse can access. The facility supplies are padlocked into a cabinet in the bathroom which no one can access. Someone locked it months ago, and no one has found the key or cut the lock--therefore, one bottle of body wash is getting shared. A big no-no.

There is tons more...but these are the biggest problems. Am I right to be thinking of changing jobs? Or should I suck it in and grow up? Oh...and did I mention the recent cockroach infestation? Or the fact that they can't afford a shower chair that rolls, ( we have to drag the old one, because the wheels are so corroded they've permanently locked) but the floors were redone, the walls painted, and new wallpaper ordered this week?

[iluvdetroit]

Sounds like a living hell and a very unsafe and lawsuit-worthy workplace. I would hit the road as soon as I could secure another job. Yikes!

[bethann27]

So sorry to hear you are working in this environment. {{{{{hugs}}}}} I've been there and done that myself. Unfortunately, this has been the norm for many facilities for many years.

But let me give you hope . . . there is legislation being proposed that will make how LTC facilities operate more transparent to family and lawyers who are concerned about this type of abuse. And communities are being built that are more home like. With that said - I would NOT recommend that you try to report this as it will usually only cause you grief when looking for employment elsewhere. Just do what you can where you are and look for a facility that operates in a way not only to make money, but also to provide good care to it's residents.

I believe with all my heart that God is calling those who are willing to this work to care for the baby boomers who will need us soon. There are many, many CNA's and Nurses working in LTC who truly care about our seniors. Don't give up!

[systoly]

You're certainly not a wimp and while these conditions exist, they should never be accepted or taken as "that's just the way it is". When you know in your heart that it isn't right - it isn't. Look for a different place.

[tokidoki7, ASN, RN]

RUN!!!

[escapebigd]

:yeahthat:

I'd report it... I know if it was my family member in that home I'd want state to know. People are going to be hurt, and if you report it you help put an end to that, or at least sleep easier at night knowing you did something about it and didn't just leave those people to rot.

[nickos]

That sounds HORRIBLE, new CNA or not. I'm impressed that you are not only trying to stick with it, but that you SEE that these things are not ok. A lot of times people sort of go with the flow and don't want to try to change anything. When I was a new CNA, I worked for only two months at an Alzheimer's/dementia facility. Luckily the supplies situation wasn't so bad as you are talking about, but the staffing was almost as bad. I bailed for a much, much better job offer doing private in-home care. I struggled afterwards with some guilt...if things were tough, and I stayed, at least I knew what WAS getting done when I was there! Then I realized that I couldn't run mySELF into the ground because of not-so-great staffing...eventually I would burn out and start to cut corners just to hang in there; and I didn't want to do that. I agree with RUN..but I also agree with TELL SOMEONE. Who to call? Man I don't know..ombudsman? BON? Someone. Otherwise the cycle will continue with people coming and going who DON'T care as much as you, and that's not fair to the residents.

[Lucina11]

Thanks for the replies. I love the elderly, and even though they are getting the best care we are able to provide as aides, it kills me to see that it isn't better care. I hate that we don't have to time to chat three minutes with them...we have to pull away from their hugs and conversations because we have so much to get done, and it has to be on a rigid schedule.

Nickos--You've hit on it exactly. I feel guilty even thinking about leaving, because it leaves one less person who cares. Also, it makes a strain on the other aides who are trying just as hard, and are just as overworked. I've stuck it out for five months, at times things started to get better, but now it is just getting worse. Today I felt so overwhelmed it was like being brand new on the job again.

I would tell someone...after I left. I couldn't live with myself if I just ignored it. But I really wanted to know from experienced people whether or not I was justified, or making a fuss over nothing.

[shrimpchips, LPN]

My-oh-my...that sounds like a nightmare!!! If the opportunity presents itself, I would leave as soon as possible!

[dannyc12]

RUN!!!

Run away fast. That facility is worse than the one I work at - and brother that is saying something!

[RNMLIS]

YIKES!

Run ASAP

Get another job and report that place

Possibly the best thing you can do for these people is to report that place.

You coud get hurt working like that or someone else will get hurt and it sounds like the staff will be blamed

What are the nurses doing

[nursel56]

I can't fathom what the stress of that place would feel like. It sounds like the schoolmaster in the movie, "Oliver". FOOD???? You want MORE FOOD?? Jeez, I hope this isn't the norm for LTCs. Not enough drawsheets combined with not enough diapers? I admire you for hanging tough for the sake of the residents, but you have to be very, very aware of the cues your mind and body give you-- you just cannot do the impossible--- I'd really be thinking deeply at this point about where you want to be in the future and start setting up a structure and preliminary plans--sometimes these things end quickly and badly. You deserve much more than being thrown into chaos unexpectedly. Hope it all works out for you. :)