Turning q2h, any ideas?

[CNA2day]

Why would you assume that I didn't go in with someone else and turn the resident?

I have had to resort to this tactic to have proof that some of the aides were documenting what they had not done - turning - so that I could justify the write-ups that ensued. A decubitis does not happen from occasionally getting busy and forgetting *a* turn.

And I can't be there 24/7.

Well if I went to turn a resident and I saw that he was already turned why would I turn him again? if I turn say once and hour and I left him on his left side and he is now laying on his right then I am probably going to wait awhile to turn him.. sooo say you went in with someone else, turned him, and stuck some stupid note underneath him I would not find it right away and you would think I was not turning the residents... that makes absolutely no sense.

I like straightforward. Go look. If the resident has not moved in 5 hours I bet you would know it without putting a note underneath him. And if you were the nurse I was working with I would have no respect for you if you did that to me.

I understand that not everyone does their job and yes I think they should be disciplined but I do not agree with your method of "checking".

I, on the other hand, do my job and if someone didn't get turned it was because something happened and it was crazy.. and that means that all the effort you spent to place the note would make me think that you could have helped me out if you had time to sneak around and do that. Besides that if I found a note I would just throw it away. I would not play into that game.

[RGuadagna]

I agree with a lot of what's been posted. I worked as an NA for a couple years before getting my BSN, and I actually supervise co-workers that I used to work with on the same level. I attribute the fact that each one of them said they'd be comfortable working "under" me to a few things. For one thing, the power of leading by example cannot be understated. From your post, it seems that you are already interested in, if not already, doing so. Turn the residents when you can and just *let the CNAs know* that you did it so 1. they know they don't need to rush back in there, and 2. they're aware that you're aware and care about what's going on.

Anyone in the healthcare field knows that there's a pretty wide margin when it comes to "quality" of staff members. Get to know who you're working with so that you know which CNAs will need more frequent reminders. And I am all about being direct. If you want something done, either do it yourself or ask someone who is qualified to do it and provide clear directions. i.e. For CNAs you notice routinely forget to T&R, "xxx, could you please turn Ms. xxx? I noticed she's been in that position since our shift started." If it's not done in a timely manner, ask again. If this doesn't work and it's clearly due to personal irresponsibility on the CNA's part, utilize disciplary action.

Thank the CNAs who are doing their job. For anyone who thinks it's unneccessary to thank someone for "doing their job," try working as a caring and compassionate CNA for a week. It may be fairly free of "responsibility" (license-wise), but it's physically exhausting and can be emotionally draining (depending on how much your residents open up). Knowing you care that they are caring is important.

To AlmostABubbieRN, please remember that not everyone works in conditions similar to your own. On our LTC unit, we have plenty of staff available to T&R q2hrs if indicated. We utilize the Braden scale to identify those at risk for breakdown, and have a very low rate of pressure ulcer development.