Skilled Nursing (LTC)

I have worked LTC for 22 years. I give them one verbal warning then I start writing. I report all issues to the DON, verbal or not. Unfortunately babysitting and herding morons is a part of nursing that will never go away unless you work by yourself. You are legally responsible for directing the aides.....that means you are responsible for keeping track of what they are doing all the time, not just giving them the assignment and doing your own thing.

Even when I have great aides, I keep track of what is going on all day....and I make sure they know this......not in a pushy manner, but it is clear who is in charge and who does the telling.

One thing that really motivates aides to do a good job is when they know you are listening to them, consider what they have to say, take their suggestions when appropriate, explain why this or that is important, and make them part of the team...not just some flunkie.

for example: one person did not give a shower and wrote refused on the assisgnment sheet, after telling someone once that they needed to get their showers done and they don't , how many verbal warnings do you give before writing them up.

i'm confused. i recently started a cna class and i was told if a resident refuses treatment (of any sort), legally you have to respect their wishes, and that missing one shower isn't gonna kill them cuase it's not like their rolling in dirt, lol. are your cna's doing this type of thing every day, did they at least go back and try asking again? i'm just worried now that if my residents don't want to wash up, that i'll get in trouble for it.

~michelle

i'm confused. i recently started a cna class and i was told if a resident refuses treatment (of any sort), legally you have to respect their wishes, and that missing one shower isn't gonna kill them cuase it's not like their rolling in dirt, lol. are your cna's doing this type of thing every day, did they at least go back and try asking again? i'm just worried now that if my residents don't want to wash up, that i'll get in trouble for it.

~michelle

sorry for the confusion. residents have rights to refuse their shower and other sorts of treatment, but some of the cna's say that the resident's refuse continously so they won't have to give the shower or the cna's will cross out the resident's name and write done, which in fact half the time it has not been done. most of the time they do not go back and ask again, which is a good idea. this topic is not whether or not the resident refuses, it's about the cna's not doing their duties.

I just got a job in LTC I graduate OCt 14 and start oct 17. I'm scared with being only 19, the CNA's wont take me serious and it'll all be a big mess. Any words of advice.

I have been working as a nurse for 9 months at the same job (LTC). My question is about being the only charge nurse on 3-11 shift. I have never been in a management position. I am in charge of 3 CNA's and some of their job performances are not like they use to be. My question is for example: One person did not give a shower and wrote refused on the assisgnment sheet, after telling someone once that they needed to get their showers done and they don't , how many verbal warnings do you give before writing them up. My DON said she hated to make us nurses "babysit" the CNA's, but she said that's what we are gonna have to do. I feel like everyone is an adult and knows what their job duties are and they need to do them. I know I am managing the cna's, but how can we babysit, when we have 35 residents to give meds to, tx's, charting, doctor's,etc......I don't know what to do to make my team better on my shift. Please help!

I would approach the resident and ask why they are refusing a shower and try to coax them into taking one. If they still refuse I would document the reason. For example they may have gone out with their family and are just to tired or maybe they are having pain that needs addressing. This way the cna's will get the message loud and clear that you will intervene in behalf of the resident to ensure the best possible care for them.