I'm taking my nursing assisting class, a pre-nursing requisite. I started clinicals yesterday, and I'm dreading going in again tomorrow. Not because I'm doing a bad job, I'm doing a good job, and the CNAs I'm shadowing love me. The patients who I got to know love me too, and the charge nurse loves me for volunteering to come in this weekend to play piano. It was terrible because I hated the way these patients got treated... and because no sanitation is used!
It's an assisted living facility, I worked on a unit for those who needed daily care, who were dealing with dementia. The day started okay, I helped with breakfast, I helped with feeding and cleaning and all that. It started when I had to assist in helping with a bed bath. This woman was completely bed bound, unable to speak. My guess is it was alzheimer's at a very late stage.
The CNAs I was working with decided to let me and another student take over for this, which was fine because I needed the experience. They sat in chairs. But then they turn on MTV, and banter back and forth about this woman's family, and how horrible her sister is. This was after they removed her clothes and left he laying there completely naked on the bed, no bath blanket or anything. I asked for a bath blanket and they said "oh we don't really do that... I guess you can check the linen closet." They threw towels on the floor... one of the CNAs didn't even wash her hands or wear gloves.
This type of insensitivity went on throughout the day. After lunch is "down time" because everyone takes a nap, so the CNAs literally do nothing. They sit in the work station. I wander the halls looking for things to do, I see a call light on (I haven't gotten used to checking for those yet... but the woman claimed it was on for 30 minutes, and I believe her). She was sitting in her wheelchair, and said she needed so many things and I wouldn't be able to help her. but she said she was cold, and wanted to be in her bed. I told her that her needs were very important to me, and that I would go find a CNA and we would help her. I finally find the CNAs in the work station, they tell me, "oh she's always confused after lunch. She'll give you hard time if you let her..." "Is it really a problem to move her to a bed when everyone else is in a bed?" "She doesn't know what she wants, just turn her call light off."
My unit wasn't nearly as bad as a unit down where some other students were (leaving patients on standing lifts for 15-20 minutes, who can't hold themselves up because it's 'easier to clean them that way.' Not cleaning their bottoms, or under skin folds, or even their legs... where they constantly smell like poo and urine).
I go in again tomorrow, and I don't know what to do. I know that for my standards I need to provide the kind of care that gives dignity, but I can't dictate to a CNA, when I am just the student who will be here for a few weeks. What can I do? Is this kind of thing normal? I work as a vet tech... and I treat dogs better than this...
This experience in all honesty has made me want to die in a car accident tomorrow, before ever getting old and being in that situation. I would rather lose the rest of my life now, than to end up being in that situation later.
I'm glad that you had a much better day and that you were able to be so thorough with the bed bound patient. I can't help but think that obviously that won't be the norm and sadly, our influence on CNA's only goes so far. I have seen them complain to someone higher up who then agrees with them. Nursing homes are about making money - less staff + more residents = higher profits; they flat out don't care about quality care. I remember being like you - ready to take on the big, bad world of nursing. 14 years later and I'm jaded and apathetic...I just can't do it anymore. I hope you find it in you to keep your current attitude. Best of luck.
OP, don't let the bad habits of others become your own. Even if you don't see the other CNAs keeping the patients covered while doing bed baths, grab a sheet and cover them yourself. I, too, remember during my CNA block clinicals in nursing school that hardly any of the CNAs gave bed baths the way we learned in our fundamentals book. They would at least close the curtains for privacy, but they would just strip the residents completely naked and then pour water on them while they were still in bed. That kind of burned my bottom, however, being a student and a guest in a facility.. you have to be careful about what you say to the staff. A few of my classmates broke down in tears after seeing the way a few of the CNAs handled the residents. And this facility is actually one of the nicer ones around this area.
Treat people the way you would want to be treated if you were in their shoes. You'll make a great nurse someday. :)
I saw some horrible stuff when I worked in aged care.
One resident did not like being toileted by male carers and rather than getting myself or another female to assist this 'brave' guy decided to force the resident onto the bed and kneel on top of him to hold him down.
Little old ladies with dementia being forcibly held down and having their lip waxed because their 'families don't like seeing their facial hair'.
Incontinent residents left in a chair all day long and not cleaned when being put to bed, you can imagine the smell.
One lady kept asking on Christmas day when her family was coming to get her and an RN shouted at her 'NO ONE IS COMING FOR YOU!'
One lady fell over and the 'brave' guy who liked to wrestle with the dementia residents ignored my advice and hoisted this lady up. She had a broken scapula and his rough treatment made her scream.
The list goes on and on. I reported several of these incidents and nothing was ever done about it.
I saw some horrible stuff when I worked in aged care.
One resident did not like being toileted by male carers and rather than getting myself or another female to assist this 'brave' guy decided to force the resident onto the bed and kneel on top of him to hold him down.
Little old ladies with dementia being forcibly held down and having their lip waxed because their 'families don't like seeing their facial hair'.
Incontinent residents left in a chair all day long and not cleaned when being put to bed, you can imagine the smell.
One lady kept asking on Christmas day when her family was coming to get her and an RN shouted at her 'NO ONE IS COMING FOR YOU!'
One lady fell over and the 'brave' guy who liked to wrestle with the dementia residents ignored my advice and hoisted this lady up. She had a broken scapula and his rough treatment made her scream.
The list goes on and on. I reported several of these incidents and nothing was ever done about it.
Oh my god. That place sounds like something ripped from a horror movie. Are there a lot of facilities out there that are that bad? I'm just curious, as I am going to be on the job hunt pretty soon.
THIS...is the truth. It's not about turning a blind eye it's about you won't be able to keep track of your cnas because you will have a hard time keeping up with the workload. The ABC's: airway, breathing, circulation will always take precedence over tracking a lazy cna. It's very difficult to get a bad employee fired. As a cna I had reported a few cnas over the years fo negligence to the charge nurses and DNS and nothing ever came about it one single time. You complain too much and you will be blackballed. It can be a small world in the healthcare indusyry and word can travel.
This is the reason I would never choose to work LTC. In my hospital it's mainly primary care nursing where I have more control over pt care and I know it's being done the right way.
Wanted to fallow up -
If the nurses are overworked that's a different problem entirely than what I was seeing here. What I was seeing here is that there is no delegation from the top down. The charge nurses are in charge of the world, and beyond stressed. They do not delegate their stress down to the nurses, who in turn casually hand out meds and make rounds. There was absolutely no sense of urgency in their work, and several times I saw one of the LPNS or RNS hanging out in the nurses station (which I mean, they were charting and making phone calls, but again... there was no sense of doing this quickly or needing to get it done, which means that they clearly had enough time to walk the halls and check on the CNAs, which as far as I'm concerned, is apart of their job). The CNAs then have absolutely no supervision, they work on their own terms.
Each CNA has maybe 5 patients tops. This IS a very high end facility, that's what makes me so angry. It's one thing to have horrible care in a medicaid facility, but this is something like $8,000 a month for the same humiliating care. The difference here, is that the CNAs have 2 hours of complete downtime after lunch before shift change. I mean COMPLETE downtime.
Which is the entire point - the entire point is, they have enough time to show the kind of care needed, which means the PROBLEM is their lack of hummanity. This is what I find disgusting, is that this care is done by choice and no other factor. This is the jaded healthcare world we live in, the jaded precious USA we live in, where the "free" are so selfish, and self centered, that even the hurting and needy go suffering despite the tools to change this. Why the hell are we becomming nurses, or CNAs, or doctors... when we aren't invested in making the world better, or giving hummanity back to people?
And why are we even bothering to keep our elderly alive when we give them this kind of care? What is the point? i'm paying dearly for this government care every year when I can't afford health insurance, and I can promise you the elderly would rather not be around than to recieve this care.
So yea, sorry for my public break down here, but reality just hit me like a ton of bricks and you all are witness to this. I'm going to journal this as recommended by a friend, because in 10 years... I don't want to be apathetic like many of you. I will be stopped at every turn, defeated in every way, to fight the fight of human dignity, and I promise that I will need a reminder of what I'm fighting for. I'm more than capable of becoming apathetic and not caring, and I know it's very possible that it can happen as quickly as before these clinicals are over. But someone has to give a crap right?
If the nurses are overworked that's a different problem entirely than what I was seeing here. What I was seeing here is that there is no delegation from the top down. The charge nurses are in charge of the world, and beyond stressed. They do not delegate their stress down to the nurses, who in turn casually hand out meds and make rounds. There was absolutely no sense of urgency in their work, and several times I saw one of the LPNS or RNS hanging out in the nurses station (which I mean, they were charting and making phone calls, but again... there was no sense of doing this quickly or needing to get it done, which means that they clearly had enough time to walk the halls and check on the CNAs, which as far as I'm concerned, is apart of their job). The CNAs then have absolutely no supervision, they work on their own terms.
Each CNA has maybe 5 patients tops. This IS a very high end facility, that's what makes me so angry. It's one thing to have horrible care in a medicaid facility, but this is something like $8,000 a month for the same humiliating care. The difference here, is that the CNAs have 2 hours of complete downtime after lunch before shift change. I mean COMPLETE downtime.
Which is the entire point - the entire point is, they have enough time to show the kind of care needed, which means the PROBLEM is their lack of hummanity. This is what I find disgusting, is that this care is done by choice and no other factor. This is the jaded healthcare world we live in, the jaded precious USA we live in, where the "free" are so selfish, and self centered, that even the hurting and needy go suffering despite the tools to change this. Why the hell are we becomming nurses, or CNAs, or doctors... when we aren't invested in making the world better, or giving hummanity back to people?
And why are we even bothering to keep our elderly alive when we give them this kind of care? What is the point? i'm paying dearly for this government care every year when I can't afford health insurance, and I can promise you the elderly would rather not be around than to recieve this care.
So yea, sorry for my public break down here, but reality just hit me like a ton of bricks and you all are witness to this. I'm going to journal this as recommended by a friend, because in 10 years... I don't want to be apathetic like many of you. I will be stopped at every turn, defeated in every way, to fight the fight of human dignity, and I promise that I will need a reminder of what I'm fighting for. I'm more than capable of becoming apathetic and not caring, and I know it's very possible that it can happen as quickly as before these clinicals are over. But someone has to give a crap right?
I hope you know that the above mentioned ratios are not the norm. There is no excuse in my opinion for the behaviors that you described. It's not a terrible thing to care and to report wrong-doing but you will find out how difficult it is to change the culture at some organizations you may be employed at in your career. There are lazy, uncaring people all over the world and it's no different in healthcare (although you'd think it would be). Do what you think is right but don't let the negativity consume you, it will burn you out quicker than anything.
That kind of burned my bottom, however, being a student and a guest in a facility.. you have to be careful about what you say to the staff. A few of my classmates broke down in tears after seeing the way a few of the CNAs handled the residents. And this facility is actually one of the nicer ones around this area.
leslie :-D
11,191 Posts
i'm in total agreement with the op...
and can understand the "drama" in wanting to die versus being treated like **** when i'm old.
and even though i have tons of life experience, it still amazes me that people need to take classes...
to learn how to treat others with dignity and respect!!
totally blows my mind.
and it's not just cna's...
it's (many) people in general, that are just so damned ignorant.
but yeah, it kills me when i see hcws treating pts with such disrespect.
*shaking head*
op, when you're a nurse, you may or may not, be able to change certain behaviors...
but, you can certainly share your expectations and get the staff developer involved.
'maybe' some will learn something constructive out of all this.
leslie