State review/my bad

duskyjewel · Apr 13, 2014

God bless you. I couldn't work LTC and have mad respect for anyone who can.

sissiesmama, ASN, RN · Apr 13, 2014

We recently had our yearly review by the state at the LTC facility where I work.
At 7pm during a state audit, the state auditor stood in a resident's room and pushed the call light. I was timed at a 17 minute reponse time. Apparently, this is unacceptable and I was named specifically in the citation for poor response time. *gulp*.
I wasn't given an opportunity to explain myself until the D.O.N asked me about it. If any of you have ever worked 2nd shift, you will know that 7pm is an insanely busy time where EVERY SINGLE one of my 11 residents wants to go to the bathroom/bed/etc. I can only assist one person at a time. It took me 17 minutes to answer the call light because I was assisting a resident (who is total care/hoyer lift) into bed and washed up.
Sorry, I didn't see the call light while I was in another room providing care for someone else....yes, it takes THAT long for this particular resident who needs everything (transfer/oral care/PJ's on/brief changed...)done for them.
We were also cited for not providing oral care for 3 (not mine) residents by 10pm and some of the residents stated they had not washed their hands before dinner.
I know these are "basic care" things. However, if they expect a call light to be answered withing 10 min during "after dinner/bedtime" hours, they should consider hiring additional aides as I RUN MY TAIL off trying to make everyone happy and comfortable a.s.a.p.
@the staff meeting, we were told that soon the state will require "specific patient care." Meaning, if a resident is use to (B4 they came to LTC)a shower just b4 bedtime, and they go to bed at 9p, then they will have that on their care plan and it will be expected that they will shower at 8:30, then assisted into bed.
.........good luck with that! we TRY, we try really hard but, we can't get everyone into bed at the time they pinpoint, especially when everyone wants in bed between 7p-8pm. I may "only" have 11 residents but I assist my hallmate with her 2 person assist residents as well.
The state auditors forget how difficult it is to care for 11 people at once. They have great expectations and they mean well, but the patient to CNA ratio needs to more like 6:1 for it to happen, and that is the real world truth.
...I just needed to vent..

Oh wow!! I am SO sorry! That sounds crazy - I can't imagine working thru all that - and state being there!

Anne, RNC

SilleLu · Apr 13, 2014

17 minutes?! Where the heck where the other CNAs, LPNs and RNs? That is where the responsibility lies. Make sure you communicate to your hall partner that you will be tied up for a while with a total assist; when providing care to that person you cannot leave to answer a call light until they are safe. Even at 6:1 you would have been in the same boat while taking care of that resident. If you are the only one who is responsible to answer a call light for your assigned resident, they need to review the policy.

Missingyou, CNA · Apr 13, 2014

Thanks for the comments. It helps to know that I'm not the "bad guy" here.

@nmsxx, I am not the only one responsible for answering "my" call lights, and I answer others lights if I have a spare minute, but at that particular time it is crazy busy with everyone wanting to go to bed/toilet etc. All the other aides were apparently busy as well or I am certain (especially with the state auditors there) they would have answered the call light for me. We are an excellent team!

If it were a chair alarm, I would have immediately made my resident safe and answered the alarm along with probably 3 other aides at the same time, but the state did not choose to pull a chair alarm to check response time....isn't that always the way?? :blackeye:

Paws2people · Apr 13, 2014

On paper a 10 minute response sounds reasonable, however in real life it is not always doable. I agree that almost every (if not all) facilities could use more CNA's and PCT's on staff. Particularly the evening and night shift are usually short handed at my hospital.

Also, I believe everyone should answer call lights. That includes nurses, and other CNA's even if it's not in "their group." You will never hear me say, "Oh that's not my group/patient." They are ALL my patients and in my group in my eyes.

systoly · Apr 13, 2014

oh my

ten minutes is unacceptable in my area

our goal is 2 minutes with a maximum of 5

everybody is expected to answer call lights, all departments

if the need of the resident cannot be met by the person answering the light, they let

someone who can know and if necessarry go back to the room and tell the resident

how long before the need can be addressed

as nmsxx6454 said, communication among staff is a key factor, especially on 11-7

Missingyou, CNA · Apr 15, 2014

oh my
ten minutes is unacceptable in my area
our goal is 2 minutes with a maximum of 5
everybody is expected to answer call lights, all departments
if the need of the resident cannot be met by the person answering the light, they let
someone who can know and if necessarry go back to the room and tell the resident
how long before the need can be addressed
as nmsxx6454 said, communication among staff is a key factor, especially on 11-7

I have found that if I answer a call light when I can't immediately meet their need...(for example, I'm passing by their room with a lift in tow on my way to assist someone else to the toilet), if I say to that person, "someone will be right with you" the reaction is almost always complete frustration from the resident. They get annoyed and upset that you came into or even near the room without the intention of actually helping them! It often leads to that resident complaining to the nurse that I walked by and didn't help!!!!

It just works better(at least on our hall) to not enter the resident's room who has a call light on unless you can give them your full attention.

systoly · Apr 15, 2014

I have found that if I answer a call light when I can't immediately meet their need...(for example, I'm passing by their room with a lift in tow on my way to assist someone else to the toilet), if I say to that person, "someone will be right with you" the reaction is almost always complete frustration from the resident. They get annoyed and upset that you came into or even near the room without the intention of actually helping them! It often leads to that resident complaining to the nurse that I walked by and didn't help!!!!
It just works better(at least on our hall) to not enter the resident's room who has a call light on unless you can give them your full attention.

part of that is, imho, because you don't have a good support system

we do get the occasional, "why'd you come in here if you're not gonna help me"

answer,'' to make sure you're safe and find out what kind of help you need so the

right person can assist you"