Staff eating with residents

Specialties Geriatric

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:uhoh3: How are CNA supper breaks scheduled in other facilities? At mine, residents supper is from 5p-6p. After their meal, residents then want to be toileted, changed, put to bed etc..... Many alarms sound and falls happen. CNA 30 minute supper breaks start at 6 pm so typically the units are running with less staff at this crunch time. Changing CNA supper time would impact the kitchen staff since most CNA's opt to buy their meal from the facility and kitchen staff need to punch out by 8 pm. Have any facilities tried having CNA's eat their meal with the residents and then take their actual breaks later in the shift? If so, how does this work out? How does staff, residents and their families feel about this? Are their infection control issues? Any input/ ideas appreciated.

Donofmine, could you elaborate on your spa program? Is this a more personalized bathing program? How does your staff feel about eating with the residents? Resident focused care is a great start in deinstitutionalizing life in long term care and treating our elderly more humanely and I'm all for it. Sometimes it can be difficult changing things just because of the age of some of the facilities.

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Our central bath was remodeled into a beautiful spa! We have designated "spa techs" who do the bathing experience with our residents. They use aromatherapy, dim the lights, and play music while the resident soaks in the tub. The resident has nail care during their spa time and a nice scented lotion massage after drying off. (The skin assessment is done at that time by the spa tech as well). Our residents love this experience!

I don't know how staff feels about eating with the residents. Some of them already have in the past and they got in trouble for it! :nono: The times they are a changin'...........;)

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Specializes in LTC,Hospice/palliative care,acute care.
Our central bath was remodeled into a beautiful spa! We have designated "spa techs" who do the bathing experience with our residents. They use aromatherapy, dim the lights, and play music while the resident soaks in the tub. The resident has nail care during their spa time and a nice scented lotion massage after drying off. (The skin assessment is done at that time by the spa tech as well). Our residents love this experience!

I don't know how staff feels about eating with the residents. Some of them already have in the past and they got in trouble for it! :nono: The times they are a changin'...........;)

Isn't your facility doing the Eden Alternative?

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Nope. We are being inspired by the Institute for Caregiver Education. We are also being assisted by Quality Insights of PA (CMS). There is so much going on out there in the world of culture change (resident centered care) that any steps taken in that direction greatly benefit our staff and our residents!

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Specializes in Day Surgery/Infusion/ED.
It is sad that long term nursing is in such a state when we have to go to these kinds of extremes to cover up the real problems--lack of staff. I adamantly disagree with letting staff eat with patients. There may be a few independent patients in nursing homes but in my experience most are really dependent on staff. When I worked long term care I had to feed 2 people at the same time--I dont know how I would add myself to the mix. If I did eat it would be rushed and wouldnt be very pleasant.

I say that but there is no way I would eat in that environment. Hospitals and nursing homes are full of germs--despite the care that the patients recieve along with housekeeping there is still VRE and MRSA floating around. I bet OSHA would have issues with feeding yourself then feeding someone else without washing your hands. Also what about foods such as hamburgers or fries that you generally do not use utensils for?

Even ignoring all the other problems, I have seen many bad things in my life. Still I dont have the stomach to eat in that environment. God bless our patients, dementia and strokes are cruel, these are mothers, fathers, sisters, brothers and spouses but those disease processes are horrible. Coughing and sneezing are frequent and they are no longer capable (mentally or physically) of covering their mouth, they drool, they grab and touch, etc. They cannot help it but it really isnt an environment that someone should eat in if they dont have to. And I may very well be in this situation one day, if so I would not want my caregiver to have to eat with me.

Of course it will depend on the patients and facilities, assistant living may not be that bad but in most long term facilities I dont think this would work. If I were you though I would call the long term surveyors and get their input on this.

Absolutely agree. I'm sorry, and I know I'll get flamed for this, but if I were working in LTC, the last place I would want to eat would be in the dining room with pts.

And how many people really buy the mgmt. line "You'll still get your break." Uh huh...and if you believe that, I've got a bridge to sell you.

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Specializes in LTC, Sub-Acute, Hopsice.

Our shifts are a bit different...6-2 2-10 10-6, so the evening shift comes in at 2, so they take dinner break before the residents eat. We also have what is called desk duty. The cnas take 15 minute turns at the nurses station between 6:15, when dinner usually is done and 7:30, manning the phones and answering the call bells (we have an intercom system) This seems to help keep the behaviors down (as the lights are answered quickly and an aide can be paged to the room if someone is in need) and lets the alert and oriented residents know that some one is there and sending some one to them, which stops falls due to someone needing to pee RIGHT NOW, and not willing to wait to see how long it takes for someone to answer the light.

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My facility is also "experimenting" with culture change. I think some nurses cannot imagine residents and Staff eating together because they have not been provided with the "vision" of the future of long term care. I, for one, cannot wait until the day that my facility truly becomes a home and my staff can sit with my residents and share a meal as families do. I am so tired of seeing patients sitting in wheelchairs around a nurses station with alarms sounding and staff rushing back and forth trying (without success) to adequately take care of everyone. If Sally slept in until 12n everyday at home, why should that change now that she lives in a long term care facility? If John took his bath everyday at 8am, why can't we accommodate him? I want staff turnover to cease. I want my facility to become a home to both my staff and my residents. I want my "home" to sit together and enjoy a meal. I want my residents lives to be lived how they want to live them. The long term care industry has a long way to go, as nurses I hope that we can push this change forward. Unfortunately, it seems that the nurses are often the very ones that fight it. Let's stop seeing our residents as what type of care they need and start seeing them as the people they are. Instead of fighting change, lets embrace it and take part in shaping the future of our calling.

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Specializes in Day Surgery/Infusion/ED.

Sorry. I would not want to interrupt my meal to wipe drool, wipe a nose, etc. There is a reason why staff are supposed to have a meal break. It's no break if you have to eat with the pts. Nurse have enough on their plates (pun intended) without having to be forced to give up their meal breaks.

That doesn't mean I care less about pts., and I resent the implication. :angryfire

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Amen and amen!

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Specializes in Long Term Care.
My facility is also "experimenting" with culture change. I think some nurses cannot imagine residents and Staff eating together because they have not been provided with the "vision" of the future of long term care. I, for one, cannot wait until the day that my facility truly becomes a home and my staff can sit with my residents and share a meal as families do. I am so tired of seeing patients sitting in wheelchairs around a nurses station with alarms sounding and staff rushing back and forth trying (without success) to adequately take care of everyone. If Sally slept in until 12n everyday at home, why should that change now that she lives in a long term care facility? If John took his bath everyday at 8am, why can't we accommodate him? I want staff turnover to cease. I want my facility to become a home to both my staff and my residents. I want my "home" to sit together and enjoy a meal. I want my residents lives to be lived how they want to live them. The long term care industry has a long way to go, as nurses I hope that we can push this change forward. Unfortunately, it seems that the nurses are often the very ones that fight it. Let's stop seeing our residents as what type of care they need and start seeing them as the people they are. Instead of fighting change, lets embrace it and take part in shaping the future of our calling.

The future you are talking about requires that Administration open their pockets and pay for additional staffing or to get creative with staffing. I sincerly doubt that is going to happen anytime soon. Personally, I do not want to eat with the residents. They are good people, but I need my half hour away from them and the CNAs.

As I read your scenario, I see this as the residents being mostly ambulatory, and able to care for themselves. I tend to agree with the home theory, and I see it as an ideal. I just don't think it is practical for most nursing homes as they are currently set up.

Now, there is a nursing home that has an age in place program. The elderly resident comes into the facility still able to mostly take care of themselves. They go into spacious apartment like rooms that have a nice private bath. They age there until they pass away. The aids and Nurses do no more than administer meds at the appropriate times until the resident is unable to do things for themselves. At that point, the resident stays in their room, but is started on a more nursing home like routine.

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I agree that it will take Administration opening their pockets, changing the current structure of our LTC's both physically and developing a new staff structure. But it can be done. We should be the advocates for these changes not those who sit back and say it can't be done. We need the attitude that not only can it be done, It has to be done! Not only do our residents deserve these changes, our staff deserves it also. My scenario can work with all levels of care...we need to make the changes that are needed to make it work!

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Specializes in Long Term Care.
I agree that it will take Administration opening their pockets, changing the current structure of our LTC's both physically and developing a new staff structure. But it can be done. We should be the advocates for these changes not those who sit back and say it can't be done. We need the attitude that not only can it be done, It has to be done! Not only do our residents deserve these changes, our staff deserves it also. My scenario can work with all levels of care...we need to make the changes that are needed to make it work!

I respectfully disagree. I do not believe the "home" atmosphrere is appropriate for all levels of long term care.

I think you must have either a much stronger stomach than I, or you have not worked shoulder to shoulder with the kinds of residents I have, the ones picking their noses, hands down their attends, playing in their excretement, not to mention the infections. MRSA of the urinary and respiratory tracts ect. I have seen a confused resident soil themselves, then begin to play in their attend before the aid could get them to the bathroom. It was neither the Aids fault, mine nor the resident's fault for having loose bm that afternoon.

I see several flaws in the vision that you presented. Not the least of which is the burnout rate that would and does occur when staff has to be constantly in the prescence of the residents. Not being able to escape for that half an hour is akin to torture when you are having a bad day.

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