I work the overnight (11-7) shift at a LTCF. There are 2 aides(me & 1 other) plus a nurse on staff, for a total of 30 residents, many who have alarms due to wandering, Alzheimer's/dementia. Many of the residents I care for stay awake well until 3 am, asking to be toileted, etc. There is an hour of lull time, and at 4 the lights start again. I often have full bed changes on my first set of rounds, and 11 of my residents are completely incontinent of both urine and feces, and 2 of the others ring every half hour to an hour to go be toileted, one who has an alarm and cannot be left in the restroom. I am expected to get up 4 residents(varying with the therapy schedule, which does not necessarily coincide with the resident's sleep habits) plus give a resident a shower between the hours of 6-7am, and the aide on the other side is expected to do the same. (wake up anyone before 6, and there is disciplinary action.) If get-ups are not complete, there is a problem. My nurse always tells me she is on break from 5-5:45, at which point I am completing my final rounds before get-up, and she starts her med pass immediately after.
The other night, I started my rounds on the late side, because I was helping the supervisor with a project (during my 3-4 lull). I start my rounds at about 4:30, having checked if my two assists are wet, so that I will be able to get assistance from the other aide on the floor, as the nurse will not help. My coworker has more two assists to change on her side than the last time I had worked, so I am much further behind than usual. At about 5:30, one of my two assists rings, and I find her in a pool of liquid feces. She was dry until this point. My co-worker is currently in the shower room with a fall-risk patient who keeps getting up. My nurse is on break. I keep thinking how I can't leave her in a pool of liquid feces, and attempt to change her myself. (first mistake) Unfortunately, the facility where I work does not have side rails, which I sometimes forget, and roll the resident away from myself. (We had side rails in my training program, and the last place I worked) This was my mistake 2. I feel horrible, the resident fell and hurt herself. Now I am fired for breaking the care plan, and an injury happening.
I don't know what I want you all to say. I already feel like a moron, and like I don't deserve any sympathy. I guess I am just wondering if there is any chance of me finding another job as a cna, or in medicine period, or if I should just give it up. I really enjoyed my job until I had to come to the facility I was just fired from, and residents were always verbally appreciating how gentle/patient/responsive I was, even at this new facility, where many of the aides are gruff. I guess I just needed to spew at people who would possibly get it, and have some helpful input, other than, "yeah, you screwed up." Thanks for reading.
Is anyone else wondering about the nurse who takes a 45 minute break during one of the busiest times in the shift? And refuses to help with patient care when she is one of ONLY THREE people in the building?
I did! My first thought as well.
Good grief, you were set up to fail here. Very unsafe.
My mom is in an Alzheimers Lock-down hospital. There are CNA's everywhere! It is amazing and I'm grateful. Even so, these kinds of patients fall. My mom falls. All the time.
Don't beat yourself up as others have said. Just make sure your next job is adequately staffed.
How are they not required to have side rails??? That's nuts and asking for a fall to happen!
The story I've always been told is that ever since a confused LTC resident managed to get his neck through the bars and basically hang himself, side rails are considered a restraint, and in every nursing home I've worked in, forbidden. We also weren't allowed to prop people's feet up (like with a chair) unless they had a recliner, and our wheelchairs did not have seat belts or harnesses due to injuries sustained beforehand.
No physical restraints were allowed any place I've worked, period. And if someone was acting out that badly, we had to send them to a psych ER.
The story I've always been told is that ever since a confused LTC resident managed to get his neck through the bars and basically hang himself, side rails are considered a restraint, and in every nursing home I've worked in, forbidden. We also weren't allowed to prop people's feet up (like with a chair) unless they had a recliner, and our wheelchairs did not have seat belts or harnesses due to injuries sustained beforehand.
No physical restraints were allowed any place I've worked, period. And if someone was acting out that badly, we had to send them to a psych ER.
That's crazy. They make beds with side rails that don't have the bars and are solid where someone couldn't shove their head through and hang them self. I just don't get it. But then again, I don't work LTC, nor have I ever, and I really don't feel called to. Lol
I guess that's partly why it's mind blowing that you wouldn't have side rails on beds in a LTC. Especially with AMS, dementia, and Alzheimer's patients. There's no way, especially with not being staffed adequately, you can make sure your residents don't fall.
I think they made a mistake to fire you. Falls happen. As a nurse i collaborate with my unit manager to review falls and put programs in place to reduce the number. But they happen. What's more important is how staff responds to a fall. It sounds like you followed policy. If this LTC fires everyone involved in every fall they will soon find themselves with no one.
Spidey's mom, ADN, BSN, RN
11,305 Posts
I did!
My first thought as well.
Good grief, you were set up to fail here. Very unsafe.
My mom is in an Alzheimers Lock-down hospital. There are CNA's everywhere! It is amazing and I'm grateful. Even so, these kinds of patients fall. My mom falls. All the time.
Don't beat yourself up as others have said. Just make sure your next job is adequately staffed.