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?
