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Most of u know I mostly work weekends. Sat. I went in and listened to report, went to start meds and was called to res. room. On her bottom was a bedpan shaped area. It matched our bedpans to a tee. Some of the top layer of the skin was beginning to come off. I was horrified. Figured that it must have happened over night, but the aides said no, they had heard about it before. After much investigation I discovered that most remembered they had heard about it Thursday. Many had seen it. NO ONE had charted or reported anything about it. Our CNA's are able to chart. It had been mentioned in report once but no one wrote it down. Nothing had been done about it. Of course I ordered her turned every hour side to side, peri care every hour and began my documentation on a seperate sheet of paper. A 3-11 lpn remebered being told about it and had seen it but FORGOT to chart it. :angryfire I spent the entire weekend talking to people, along with my meds, patient care, staff problems and everything else. The skin care on this wing must have been bad all week there were so many red bottoms that I took to carrying barrier cream in my pocket. The nurse manager on this unit is a pain, a know-it-all and pretty much worthless. I called her yesterday to find out what kind of tx she thought we should do, answer was barrier cream! She used to be our skin nurse. When I asked her if she remembered hearing about it she said no. I had already had 1 cna tell me he had reported, to her, on Friday about it. Another CNA verified it. An LPN going off shift on Thurs. remembers hearing about it but didn't work the next day. This poor patient has ms, a g tube can't move herself and is the sweetest woman. When I explained to the manager that the top layer of her skin was coming off, she said what do you mean? "Well the woman is black, the skin is coming off and it is pink underneath." Her sister came in after I left a message that the res. had a sore. A new CNA showed her the ulcer(is this what it would be called?) and told her how we thought it had happened. I worked 7-3 Sat. and came back in at 11 that night to work til 3p. I was so behind all day Sunday that I wrote myself up for not getting 3 patients their am meds given. A res. was upset about an aide they thought was mean and cried all weekend. Another was very angry because he knew the med aid during the night hadn't given him ativan but something that looked like an aspirin. Well after investigating that I discovered that she hadn't signed one out and that count was on so, obviously she didn't give him his scheduled one but tried the PLACEBO effect. At this time I decided this was all going to hit the fan so I called the DON to forwarn her. I figured she scream at me cuz I called a nurse in an hour early to help me finish up and everything else that went on, by now it was 6pm. She was very nice and told me to stop and go home. I said I still had charts to do so she said get out as soon as you can. At 730pm I was walking out the door when someone said don't forget u need to sign out all those 11am meds. A med tech I had written up 2 weeks prior had to pass these and didn't sign them out. I don't know why. But I left the "nurse manager" a note that I would be in Mon. to fill sign them. I documented everything that happened all weekend and put a copy in our don's box. What else could I have done? How much trouble will we get in for all of this? Know what? I still love my job! :rotfl:
:angryfire It happened again. Different resident. A 3-11 aide that I had to write up twice last night, left a pt on a bedpan, went home at the end of her shift and never told anyone that she was on the bedpan. A 11-7 aide discovered it on first rounds. I think that the aide that did that will get fired because I had to write her up for sitting at the desk when there were 2 call lights beeping. She said about one of that, "He can wait, he probably doesn't need anything anyway" about a pt. who is on his light alot. I told her that it didn't matter about his attitude he was still a resident with rights and u never know when it might be something serious. Later I found her at the desk, resting her head in her hands with eyes closed. Both the bedpan and sleeping on the job is grounds for dismissal. I will not be sorry to see her go, she is one of those aides that work as little as possible, making the good aides have to carry her weight. I hate disciplining people usually but in this case I had no problem.
:angryfire It happened again. Different resident. A 3-11 aide that I had to write up twice last night, left a pt on a bedpan, went home at the end of her shift and never told anyone that she was on the bedpan. A 11-7 aide discovered it on first rounds. I think that the aide that did that will get fired because I had to write her up for sitting at the desk when there were 2 call lights beeping. She said about one of that, "He can wait, he probably doesn't need anything anyway" about a pt. who is on his light alot. I told her that it didn't matter about his attitude he was still a resident with rights and u never know when it might be something serious. Later I found her at the desk, resting her head in her hands with eyes closed. Both the bedpan and sleeping on the job is grounds for dismissal. I will not be sorry to see her go, she is one of those aides that work as little as possible, making the good aides have to carry her weight. I hate disciplining people usually but in this case I had no problem.
Dinkymouse is this the same person who may have left the other resident on the bedpan?
This person has no business being in a position where residents are dependent on her care (or lack there of). I'm glad you wrote her up and hopefully they will let her go.
If someone left this poor dear lady on the bed pan, lets say they just forgot to come back, they would have at most left her on it for about 1hour & a half...She would have to have been turned in that amount of time. I see this as not a single incident, but evidence that thoses folks are not being turned on a regular schedule. I just literally cant stand this! NOTHING gets me madder than this stuff. I remember reporting pressure sores and the like to nurses, and some of them just plain hated to see me coming. Sometimes I think that might intimidate the CNAs from reporting. Also, there really needs to be some inservices on the need to turn and reposition folk, and staffing needs to be adequate to make this physically possible for the nursing assistant....
:angryfire it happened again. different resident. a 3-11 aide that i had to write up twice last night, left a pt on a bedpan, went home at the end of her shift and never told anyone that she was on the bedpan. a 11-7 aide discovered it on first rounds. i think that the aide that did that will get fired (:yeahthat: ) because i had to write her up for sitting at the desk when there were 2 call lights beeping. she said about one of that, "he can wait, he probably doesn't need anything anyway" about a pt. who is on his light alot. (must be a talented mind reader!) i told her that it didn't matter about his attitude he was still a resident with rights and u never know when it might be something serious. later i found her at the desk, resting her head in her hands with eyes closed (probably meditating). both the bedpan and sleeping on the job is grounds for dismissal. i will not be sorry to see her go (i'm shocked at you!), she is one of those aides that work as little as possible, making the good aides have to carry her weight. i hate disciplining people usually but in this case i had no problem.
let me explain that i added smilies to this quote for comedic effect, so don't blame the op---daytonite
why am i not surprised at this aide's behavior! just wanted to let you know how much i empathize with your situation because i've been in the same position a number of times. look on the bright side! you are going to really hone your writing skills! who would have thought that an aide would help you out with that? after awhile you may find it easier to mock up a form letter to report bad cna behavior. "_____ was observed doing the following: ___ sitting at the nursing station while patient lights were ringing, ___ making personal phone calls on the facility's phone, ___ forgot about patient she put on the bedpan resulting in red indentations on the patient's skin, ___ shows absolutely no remorse or intention to correct these unacceptable behaviors. signed, nursey nurse, charge nurse.
ha! ha! :rotfl:
once you get this kind of deadwood cleared out, things go much more smoothly. then, when you get a new aide who pulls this kind of stuff you will be able to focus all your attention on either helping her learn to do things the right way (for all those who haven't hardened up about these substandard cnas) or get her booted out the back door. i'm glad to hear that you are getting these aides written up. i know it's time consuming, but it's the only way to get them dealt with. it also gives you more confidence in dealing with misbehavior and makes you feel like the charge nurse that you truly are. :yeahthat:
:angryfire It happened again. Different resident. A 3-11 aide that I had to write up twice last night, left a pt on a bedpan, went home at the end of her shift and never told anyone that she was on the bedpan. A 11-7 aide discovered it on first rounds. I think that the aide that did that will get fired because I had to write her up for sitting at the desk when there were 2 call lights beeping. She said about one of that, "He can wait, he probably doesn't need anything anyway" about a pt. who is on his light alot. I told her that it didn't matter about his attitude he was still a resident with rights and u never know when it might be something serious. Later I found her at the desk, resting her head in her hands with eyes closed. Both the bedpan and sleeping on the job is grounds for dismissal. I will not be sorry to see her go, she is one of those aides that work as little as possible, making the good aides have to carry her weight. I hate disciplining people usually but in this case I had no problem.
Do the PM and Noc CNA's do a walking round together at shift change? This might help with the "forgetfulness".
NRSKarenRN, BSN, RN
10 Articles; 19,195 Posts
:thankya: For all the care and concern you've showed this patient....Be glad to work with you anyday.
dinkymouse ROCKS!!!!
:balloons: