I use to work on an Alzheimers unit for two years as an aide before I started school. My average 12 hour shift consisted of:
-Having 10 residents
-6 needing to be woken up, dressed, and have basic hygeine performed (brushing teeth, hair brushing, etc)
-2 showers
-4 vital signs to obtain by 10am
-3 meal times where I along with another aide had to get half the unit into our diningroom (30 people), serve them, feed 4 of them (while watching the other 26 Alzheimers residents and trying to get them to focus on eating), escort them all out, collect plates and trays to put back onto dietary cart to wheel back to dietary
- Take 30 minute "shifts" with other CNA's where I had to stop my CNA duties to more or less "babysit" the activity aide while she did activities with 10-15 residents at a time because she could not be left alone with them because she was not certified.
-Walk several (2-10 depending on the day) on my residents for x amount of time because they were in wheelchairs and cannot walk on their own.
- Chart I/O's, ADL's on my 10 residents
All in all, I loved my job. As you can see I was really busy, so my days went super fast, and I got to spend a ton of time with people who truely needed me.
My problem is that the nurses on the unit generally did nothing. This is not true for all of them, but most of them did nothing. The shift started at 6am and ended at 6pm. My day started right at 6am, sometimes I'd come in 15 minutes early to get a jump start. The nurses, their job started around 6:45-7:15 am because the first hour they generally spent sitting at the nurses station drinking their coffee and talking to the other nurse. Breakfast was at 7:30am and the nurse was suppose to be in the dining room helping me and the other aide. Their job duties in the dining room were the same as ours, and legally they needed to be in there because if someone choked and they were not there they could lose their lisence. But instead they would start their morning pill pass around 7:15 am when they were done with their coffee and be in and out of the dining room passing medication instead of helping us. And I do know for a fact that their med passes were scheduled around the fact that they needed to be in the dining room when meals came. After breakfast, they resumed sitting on their behinds behind the nurses desk, but generally they had charts in their hands and were doing whatever they needed to do with the vitals that were due at 10am. Then they would start their med pass again... conviniently about 20 minutes before meal times so again they were not in there to help but to pass a medication. And by the way, that was against policy. You weren't suppose to pass medications out in the dining room. After lunch they resumed being on their behinds, and did a couple dressing changes and treatments if need be, which there weren't many on our unit anyway. They never put ointment on residents behinds because they assumed that I would do it. Legally, the ointments were medications so I could not do it and would not even though most aides would. I use to tell the nurses that all the time and remind them several times who needed it, sometimes they would get around to some of them. And when dinner came, you guessed it, med passing. That's just how it went.
My true problem here is why do these nurses not want to do their job? Why not do your med passes when you're suppose to so that you can have that little resident interaction at meal times? Don't you want to spend any time with your patients? How are you ever going to know if something is wrong, how are you going to know that the doctor should probably lower soandsos dose of blahblahblah because it's making her too lethargic at meal times and is compromising her nutritional status? Doctors are using you as their eyes and ears and I don't see how it's very effective when you're sitting behind the nurses station all day.
I tried to keep nurses as informed as I could as an aide and have even once been told "mind you're own business, I'm the nurse". Are you? Your title says so but are you really a nurse? (I was certainly thinking that but never said it).
I've told managers before and they've spoken to a few about it. It generally helps for about a week... suddenly the nurse is in the dining room, woah! Like I said, it lasts about a week and then it makes the nurse dislike you and complain about how you didn't clip soandso's finger nails to the unit manager (For one, soandso would punch me in the face if I tried so that's why I haven't and if you would have come to me and asked before running of to the unit manager I could have told you that :) ).
Oh well. This is clearly a rant. I just want to know how does this ever change? Have you ever worked in a nursing home as bad as what I've described and seen it slowly turn around? What did they do to make it better (besides fire the nurses, because I do think these nurses are good if they want to be it's just they can get away with not and they clearly think all their job requires is giving a medication)... blah
