This week at the AL Facility I work at, we had a big hoopla because apparently some of the residents' families complained to the manager that their loved ones pericare was not being done. Bad, right? I'm not sure how they determined that, but it sounded like it was because their briefs weren't changed. I'm not sure, since I only work there a few days a week and just heard about it second-hand.
The way it works at that place is that 'daily pericare' is one service and 'incontinent care' is a different one. So even if someone is continent, they can get a daily cleaning to prevent UTI's. Or if they're incontinent but able to change their own briefs, they get cleaned daily by someone else. Or some people are incontinent and get changed every 2 hours, but are able to clean themselves in the shower or whatever. So pericare and briefs don't always go hand-in-hand there.
So our manager, rather than adding a pericare chart to the pericare resident's bathrooms (which I'd think would make the most sense, because pericare residents are not always incontinent), she decided that we all need to start writing the date, time, and our name on their briefs. And if we check and the brief is dry, cross that out and add the new time.
I personally feel like that's okay for our more confused/less aware residents, but the alert ones don't like us writing on them, and I don't blame them.
Does anyone else have this policy? What do you think as far as it being a dignity issue vs. being sure care is done?
We don't have this policy, but we DO have a nurse who carries a sharpie around with her. She knows which aides tend to skip their bedchecks, etc and she will actually go and write on the briefs as soon as the residents are laid down and check them again before our shift leaves to make sure they've been changed.
She only does this with a couple of aides, though.
We don't have that policy on our unit either. But once there was a family member who hid electrodes through the patient's gown, linens, and unexposed body parts. When she came in the next day, she would check for the electrodes- if the electrodes were still in the same places, she knew the patient wasn't bathed and/or the linen wasn't changed. She made a big fuss, so everyone- nurses and nursing assistants- stayed on their toes.
We don't have that policy on our unit either. But once there was a family member who hid electrodes through the patient's gown, linens, and unexposed body parts. When she came in the next day, she would check for the electrodes- if the electrodes were still in the same places, she knew the patient wasn't bathed and/or the linen wasn't changed. She made a big fuss, so everyone- nurses and nursing assistants- stayed on their toes.
Specializes in PACU, LTC, Med-Surg, Telemetry, Psych.
We don't have that policy on our unit either. But once there was a family member who hid electrodes through the patient's gown, linens, and unexposed body parts. When she came in the next day, she would check for the electrodes- if the electrodes were still in the same places, she knew the patient wasn't bathed and/or the linen wasn't changed. She made a big fuss, so everyone- nurses and nursing assistants- stayed on their toes.
I have seen evil nurses use 'secret' marks.
I have even seen family members refuse catheters on alzheimer patients because 'the aides would not check on him if he did not get wet'.
I even saw one evil nurse take a dementia patient's member out of diaper and tell them to pee in the bed because she had it out with a lazy CNA (NOT A LIE), but I digress. You see a bunch of messed up things working agency. I have good reason for some of my cynical posts.
But that is just nuts.
Who is giving the family member the electrode pads? She taking it from the cart or drawers where they keep the heart monitors? Depending on where you stick those things, it can be rough on skin. Unless the family member was in Allied Health, I guarantee there is a nurse or patient advocate who gives that to the family to terrorize CNAs. You may have a nurse who does not care about the CNAs/ thinks they are lazy/ does not care. Or you have someone rummaging through supplies.
EDIT:
A possible counter to this is to tell a nurse it is affecting the skin. Even if it is only a temporary red mark.. the nurse 'must' mark this on a skin check. If the nurse has to work with constant skin checks, the putting heart monitor pads will not last long!
I work 12 hour shifts, I arrive at 6p and leave at 6a. Normal work hours for most employees 7-3/ 3-11/11-7 not on my hall. Of course we were short staffed but it was fine because it was doable. Long story short.
I got moved to a different hall and did bed check at the time I normally do for my hours seeing as I had not worked the other halls I did what I was used to, now there are alot of residents and so by the time you start it could take anywhere from 30 minutes to an hour and sometimes depending on complete bed changes fully cleaning up people who are rank with urine smell up to 2 hours it happens unfortunately I got done fairly early and was told I got done sooner than I should have and was basically called a liar evab though the trash can said otherwise. Needless to say I got called into the office and was yelled at for not doing bedcheck because when someone decided to check them at 7 am someone had the audacity of being wet!
.... you can change someone who is wet and they will pee 5 seconds later or you can check someone 2 hours later and they are dry. Just because someone is wet doesn't mean they haven't been changed and just because someone is dry doesn't mean they have.
Bad, right? I'm not sure how they determined that, but it sounded like it was because their briefs weren't changed. I'm not sure, since I only work there a few days a week and just heard about it second-hand.
ctmed
316 Posts
I do not think 'love' is a word I use for those folks that complain a lot. :)
I am still not going to work in a facility that makes me do it. In fact, I refused an agency assignment at a place that was into that.
I am also aware of CNAs who, either by laziness or becoming apathetic due to low pay, leave rivers of yellow flowing through the rooms.
I have just seen this system abused in more than one place.