Where to begin. I'd like to keep this short not only for HIPAA reasons, but because I'd possibly spend the entire night explaining this situation. I'm a relatively new CNA. I've worked in hospital situations so I'm not a totally green but I am new to geriatric LTC. I took a job recently and I'm wondering whether I should continue. I guess I'm wondering if this is the norm for LTC or if I should just change jobs. Part of the reason why I took this job is so I could gauge if nursing is right for me, I believe I have that answer but I'm wondering if this job situation is normal for CNA's or is this an unsafe atmosphere. I took this job working with Alzheimer's patients and I was under the impression that most of them were on the higher end of functioning and that I would be working with 3 patients. This was a home situation and not a facility. Although I knew that I would be doing the cooking and cleaning for them as well, with 3 people I thought that I could handle it. It would be a slight challenge, but doable. When I got there, I found out the situation was different. There were 6 patients, 3 of which were higher functioning, 2 not as well off as the others, and one was total care. To care for this group would be one CNA (me). No LPN/RN's, no other CNA's. Just me. On top of the normal CNA duties, I would also be expected to cook and clean up for part of breakfast, lunch and dinner while trying to keep an eye on the residents - a few of which are ambulatory and wont to explore the place. The one total care does not leave his room. I would be expected to come to his room in another part of the house and feed him, while the others are in the main room. This bothers me. I'm still in training with an aide but I will be expected to do all of this, alone. One day while in training, the other aide was feeding the total care resident and went to go get something for her and happened across the main room. One of our more unsteady residents was walking around. As I was guiding her back to her chair, she almost took a spill sideways onto her chair. It scares me to think what would have happened if I wasn't there. I told the other aide about this incident, and she told me, "Falls happen. You've got to expect it." But I'm thinking, "But this is a fall that was totally preventable if one had an eye on the residents and not having to be in another room tending to the basic needs of another resident." Am I wrong in this? This is one of many problems I have with working here. I believe that this job would be great for me, IF I had one other person to help me out. As it is, it's busy enough with two people but I'm terrified of doing this alone. But I'm wearing myself out with the physical needs of 6 residents, cooking full meals, feeding residents, toileting/changing, cleaning up after meals, doing pt laundry, being sure that no one tries to leave (there is an alarm system), keeping everyone safe, monitoring physical conditions, etc. At no time have I received a basic report when I come on, and as of yet, no one has sat down with me and explained the particular problems with the residents. I feel that this is not a good situation, but if I leave, I'd miss the residents. I've already become attached to them and I'd be concerned about them after I leave. There are other problems but I don't want this post to be too long. I'm just explaining the basics here. Bottom line: Is this normal for LTC and I need to "toughen up" and give it time or is this a situation which may spell disaster? Thanks for any insights you all have. BTW, my original question to myself was answered, that is, is nursing right for me? I believe with my heart that the answer is yes. It's just a matter of saving up money to pay for school (I don't want to take out any loans). I'm sorry if this is hard to read as I'm having trouble with formatting.
Specializes in Clinical Research, Outpt Women's Health.
They can do this because it is not acute or skilled level of care. It is the hugely under regulated assisted level of care. I wish it was better regulated.
I have worked in a LTC as a CNA but not a group setting. B/c of this I don't have experience in this area but to me this place seems very unsafe. I agree with some of the other replies. If they told you 3 clients and you have 6 that is misrepresentation. You should be getting some sort of report and told about the protocols of the facility. To me it seems like you feel unsafe and that is the main point here. I would feel the same way. That is a lot of responisbilty for one person and I would feel liable for those 6 clients. If something should happen on your shift that would be horrible. To me it sounds like you might want to think about looking for a new place to work. Even though you are attached to your clients (which I do as well and is a good thing but you need to remember that they are clients and shouldn't be the soul reason to stay at a job) it is an unsafe atmosphere for yourself.
BabyRN2Be- I'm so sorry you had an awful group home experience. Having worked in group homes for several years, I can tell you that there are fantastic group homes and horrible group homes. I think you did the best thing for yourself by leaving that position... many things in your original post concerned me about that facility. It sounds like you enjoyed the clients though. If you can find a reputable group home company, you would probably love the job. It can be a steep learning curve, but what you would learn working in a group home would be invaluable experience in nursing. Frequently group homes hire CNA's because they have some of the tehcnical skills for working in a group home (ADL's etc). However group homes are VERY different than LTC , regulation wise, scope of practice, etc. However, there are specific trainings/ certifications that cover things such as med administration. If you want more info on group homes PM me... my post is already long enough. By the way, don't let your job experience change your mind about nursing. Good luck!!
I just wanted to thank you all for your encouragement, support, replies. You all are just so awesome. I was concerned about posting here but I'm glad that I did.
This home is licensed by the state to care for 6 people. I do not know if they have regulations on the acuity levels. Originally it was 3 low acuity patients. All were ambulatory and needed just a little assistance getting around. However they moved 3 non-ambulatory people over (one was total care) and that's where it got unmanageable. If it was just 3 people, that was one thing but when they moved the more sick people over, that's when it got bad. One non-ambulatory resident was over 250lbs and should have been a 2 person assist. However, had I stayed it was going to be one person, me doing all the lifting for her.
Although I miss the residents, I feel that I made the best decision. This job had "back injury" and "potential legal problems" written all over it in capital letters.
Gr8rnpjt, thanks for your concern about getting the $$ for nursing school. Currently I have another loan and I don't want to accrue more debt. I am taking your suggestion and looking at hospital-based programs. I did look at one though and a few things concerned me... that is, if you didn't pass the NCLEX the first time, you had to give all the money back - even if you are sucessful the second time. Wow... that's a lot of pressure that'd be riding on my shoulders. :) But I'm looking and hopefully a combination of a few things might come together so that I can go.
I want to work as an RN with my whole heart. This experience did not dissuade me one bit.
ETA: I'm just glad that we got my dh grandmother out of that situation. She's very close to us now and we'll be able to go see her more often.
Once again, thank you for all your help. I really appreciate it! :)
CrunchRN, ADN, RN
4,556 Posts
They can do this because it is not acute or skilled level of care. It is the hugely under regulated assisted level of care. I wish it was better regulated.