shocked at what I saw!

Posted

I recently started at a new facility. We average 16 or 17 residents a piece. If it's real bad you have all 34 to yourself. We just have enough time to meet the clients very basic needs and that's it. I was changing a man last night for bed and I undid his diaper and I'm like what in the heck is a towel stuffed down in there for? It was soaked with urine and poop towards the back. I seen this done on other clients too. I guess they do this on daylight to save time so they don't have to change them as often. But unlike the diaper absorbing some of it and congeling the towel just presses against their skin and makes everything red. I'm not going to go against the tide this time but just make an effort to do the job and correctly myself. I try to change them often, cleanse the skin apply any necessary ointments or powder to protect the skin and keep it dry. They said they were having a staffing problem right now and newcomers come in from other facilities and just can't keep up and leave. I spent 3 hours giving pm care minus my 15 minute lunch break. I can't imagine having the full load of 34. is this the norm for a CNA? Also I might add this is a skilled nursing unit, few can even walk, most are in diapers, and all pretty much need complete care. We don't even pull basin, we just wipe them off , slap a gown on, and change the diaper.

Marie_LPN, RN, LPN, RN

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER. 12,126 Posts

All 34 to yourself SHOULD be illegal, not to mention DANGEROUS. I NEVER had that kind of load in 11 years!

csushi

csushi

18 Posts

i have never heard of such an insane amount! it is more likely than not illegal for anyone to be responsible for 34 pt's. there is absolutely no way that proper care can be given. the facility should be reported, that is someone's mother, father, sister, brother that is NOT being taken care of. the facility that u work in should also have better incentives to attract more staff b/c they r obviously in a desperate situation!

Mithrah

Mithrah

262 Posts

I hope the person who assigned one CNA to all those patients gets old and has to sit in his/her urine and feces all day. And then gets a towel scrunched underneath.

During my CNA training I was at a private skilled facility. These people were paying $4,000/month for care. Yet many had pressure sores, one requiring surgery to close the wound and then put on a special bed. What happens to all that money? Even hiring just one more CNA would make a world of difference.

Cherybaby

Cherybaby

Specializes in Derm/Wound Care/OP Surgery/LTC. Has 10 years experience. 385 Posts

Disgraceful. I have done more than my fair share of surgery on patients who need debridements of bedsores, ulcerations and non healing wounds. It kills me. It really does. And sure, pressure ulcers happen. But, when you are getting seven or eight patients from the same facility, same unit...you have to raise an eyebrow.

34 patients??? You need to have a talk with the DON (sounds so mafia-like, doesn't it?? *L*) and let them know that this practice is unsafe, not only for your patients...but for YOU as well. With that kind of workload in a certain time constraint, you are optimizing your chances for a work related injury...

I think stress qualifies. Read your employee handbook!! :chuckle

reprise

reprise

38 Posts

Disgraceful. I have done more than my fair share of surgery on patients who need debridements of bedsores, ulcerations and non healing wounds. It kills me. It really does. And sure, pressure ulcers happen. But, when you are getting seven or eight patients from the same facility, same unit...you have to raise an eyebrow.

34 patients??? You need to have a talk with the DON (sounds so mafia-like, doesn't it?? *L*) and let them know that this practice is unsafe, not only for your patients...but for YOU as well. With that kind of workload in a certain time constraint, you are optimizing your chances for a work related injury...

I think stress qualifies. Read your employee handbook!! :chuckle

First of all I need to declare an interest here. I am not a nurse. I am a licensed health educator and a state approved community visitor (which basically means I have a badge which allows me to walk into certain facilities - public or private - which are licensed and regulated by the government at any time of the day or night without warning and cannot be refused entry). In the time I have been a community visitor I have learned to spot the difference between a facility which just happens to be short-handed on a temporary basis (which happens in every facility from time to time) and one in which tolerance of departure from basic licensing standards has become the norm and is excused and justified at the highest levels.

While I'm aware that the legal issues involved are slightly different in the US than here, my understanding is that the duty of care issues are not and that "junior" staff can be held legally responsible for not taking their concerns to the highest possible level (which in my nation is the state and federal ministers for health). Unless I have totally misunderstood US laws, your legal duty to the patient totally trumps any other consideration every single time and in the event that something goes very wrong and you say that the DON or the facility administrator or somebody else told you that they would handle it and didn't it is YOU who will be called to account for not going over their heads.

Document everything. 34:1. You've got to be kidding. We demand better ratios here for assisted living facilities and those are mostly old people who want to maintain their independence but want the assurance of onsite medical care being available in an emergency. High school classes aren't allowed to be that large here (and they're full of young, healthy people), and much as I think that you have some odd standards and benchmarks for medical care over in the US, I very much doubt that they include that kind of ratio under either state or federal laws.

While I appreciate Cherybaby's comment, any DON who doesn't know that ratio is unsafe and who isn't actively protesting against it on a daily basis probably isn't going to be of much assistance.

ADS RN

ADS RN

38 Posts

Holy cow! Unbelievable!! I thought back in 1985 when I did my CNA clinicals I'd seen a lot. It was bad the aides stood around talking while the residents were given breakfast in bed for some ,one was blind a tray was in front of her she didn't know where anything was and when my instructor and I walked into her room the smell of urine and feces was awful. How could you expect anyone to be able to eat under those conditions? A fter we helped those in the dining room we answered a call light that seemed to go on forever. Someone was stuck on the toilet and no one but my instructor and I bothered to check it out. The Home where I worked the DON said "does it pay to make sure that everyone has been cleaned up, room picked up bed made etc. etc. brefore they serve breakfast ?" The clinical sight was beautiful but when you walked in the door the urine smell all but gagged you! Thank heavens things have changed there since. Can you imagine what would have happened if State had come in? Boggles the mind what [eople will do out there or in some cases the lengths they'll go to to avoid doing something!!!!

Larry77

Larry77, RN

Specializes in Trauma/ED. Has 10 years experience. 1,158 Posts

Most, if not all states have a hotline for reporting things like this. I would check into the department of health in your area to find out. In Wash St we have to post the number to the hotline all over our facility, and us nurses would be out there changing people and my DON would be passing meds if we were THAT short staffed.

NurseFirst

NurseFirst

614 Posts

Most, if not all states have a hotline for reporting things like this. I would check into the department of health in your area to find out. In Wash St we have to post the number to the hotline all over our facility, and us nurses would be out there changing people and my DON would be passing meds if we were THAT short staffed.

I know it is designed for the residents to be able to make complaints and have them investigated--but I don't see why an ombudsman couldn't work off an employee complaint.

NurseFirst

reprise

reprise

38 Posts

I know it is designed for the residents to be able to make complaints and have them investigated--but I don't see why an ombudsman couldn't work off an employee complaint.

NurseFirst

I don't think that Larry meant staff couldn't use that number to lodge complaints. I read his post as saying even if you don't know the "right" number to complain to at least you can use that one as a starting point and they should be able to refer you to the most appropriate body.

Here, calls made to the number which is posted on every wall in the facility (or which should be) are logged in a manner from which it might be possible to identify the original complainant and staff are encouraged to use an alternative number to report matters which do not require immediate intervention. Ideally, your state will have a toll-free number which is printed on the back of your license which you can call to report your concerns. In truth, if the incident you are reporting involved only a handful of people then it's likely those who are present will be able to work out who lodged the original complaint, but if you're reporting a systemic problem within your facility which could have been observed by anyone then I'd definitely go the "professionals" hotline rather than the "general" one.

Blackcat99

Blackcat99

2,836 Posts

Yes call your ombudsman and other officials. If that doesn't work perhaps you can notify your local newspaper about it. It seems that the nursing homes in my area hire more people when they have a negative story about their facility in the local paper.

erShocker

erShocker

30 Posts

This is insane. I certainly hope your nurses are in there, pitching in, and documenting everything. I am an RN, but have been and LPN and CNA. I always help out and I think that if nurses and CNA do rounds together, everything can be done at once and a usefull assessment accomplished.

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