What if CNA won't work?

sherichance · May 11, 2006

I dont understand some CNA's either. I was a CNA for sometime and yes I will admit, sometimes my job was yucky or stinky. But I would never leave someone in a wet brief or abuse them. I treated the residents with the love and compassion that I would want in their condition or age.

My grandfather is in a home in Illinois and its a state home so its not the best of places. The CNA's only get around $5.50 and hour there. They leave him sitting in his own feces, let his colostomy bag fill up until it pops and still lets him sit there in it, his stoma gets infected constantly and he has been in the hospital numerous times for dehydration. One of the main things my CNA instructor told me was, always offer a resident water, they need it. What is the deal? If you do not have the heart for this job, then dont waste the schools time by training for a job that you will not take seriously. The worst thing at my grandpa's home is that the LPN's or DON's dont take this seriously and do something. My father showed me pics the other days of my grandfathers arm, he had purple and black hand and finger prints all over him. It looks as if someone was handling him roughly and abusing him. My father has filed complaints with the state atleast 10 times now, there has been no resolution.

My grandparents cannot afford a upscale nursing home for him and none of us can take him on every other day, its just too much.

As for CNA's not doing their jobs, I see it alot. I am not an RN yet but I have made suggestions to the CNA's to either do their jobs correctly or find another job.

chadash · May 11, 2006

I dont understand some CNA's either. I was a CNA for sometime and yes I will admit, sometimes my job was yucky or stinky. But I would never leave someone in a wet brief or abuse them. I treated the residents with the love and compassion that I would want in their condition or age.
My grandfather is in a home in Illinois and its a state home so its not the best of places. The CNA's only get around $5.50 and hour there. They leave him sitting in his own feces, let his colostomy bag fill up until it pops and still lets him sit there in it, his stoma gets infected constantly and he has been in the hospital numerous times for dehydration. .

OH! colostomy care is a real obsession of mine (strange but true) and a real opportunity for a nursing assistant to do something beyond diaper change. There is no reason his stoma should get infected! Do the nurses teach them how to care for this properly? I am so sorry for your grandad.

oktravelnurse · May 11, 2006

I work in a hospital and asked an aide to put a diaper on a pt that had just had a seizure. The team I had that night was very difficult. I had pts trying to climb out of bed, yelling, taking their clothes off, wondering out of their rooms, etc. This aide was standing there and the assignments had not been made. The aides response was its not my patient. I said please just put a diaper on her while you are waiting for the assignments, you never know she could end up being your patient. The aide said I don't know anything about this pt. I said what do you have to know to put a diaper on a pt. and walked away. I later went in the room and the family told me she still didn't have a diaper on. I got a diaper put it on the patient and apologized to the family for the wait. I went to the aide who was at the computer charting her vitals and asked her about it. She never stopped typing, never looked at me, and said I told you I didn't know anything about that patient. I asked her to please stop typing so we could discuss this problem. She once again ignored me. I removed her hands from the keyboard and told her we can talk about this or I can write about it. I told her we are a team here and we help each other. I asked her to do something for this patient because she was not busy at the time. I told her the next time I ask you to do something I don't want to hear its not my patient, or I don't know anything about this patient. If she did not do what was asked of her I would writer her up. We had an understanding!

chadash · May 11, 2006

I work in a hospital and asked an aide to put a diaper on a pt that had just had a seizure. The team I had that night was very difficult. I had pts trying to climb out of bed, yelling, taking their clothes off, wondering out of their rooms, etc. This aide was standing there and the assignments had not been made. The aides response was its not my patient. I said please just put a diaper on her while you are waiting for the assignments, you never know she could end up being your patient. The aide said I don't know anything about this pt. I said what do you have to know to put a diaper on a pt. and walked away. I later went in the room and the family told me she still didn't have a diaper on. I got a diaper put it on the patient and apologized to the family for the wait. I went to the aide who was at the computer charting her vitals and asked her about it. She never stopped typing, never looked at me, and said I told you I didn't know anything about that patient. I asked her to please stop typing so we could discuss this problem. She once again ignored me. I removed her hands from the keyboard and told her we can talk about this or I can write about it. I told her we are a team here and we help each other. I asked her to do something for this patient because she was not busy at the time. I told her the next time I ask you to do something I don't want to hear its not my patient, or I don't know anything about this patient. If she did not do what was asked of her I would writer her up. We had an understanding!

You silly! You fell victim to one of the classic blunders! The most famous is, "Never get involved in a land war in Asia", but only slightly less well-known is this: "Never go in against a NA when It is not her patient"! :smokin:

Retired R.N. · May 11, 2006

You silly! You fell victim to one of the classic blunders! The most famous is, "Never get involved in a land war in Asia", but only slightly less well-known is this: "Never go in against a NA when It is not her patient"!

Chadash,

What would you suggest as a way to get an aid to follow a direct order?

buildingmyfaith57 · May 11, 2006

i don't know about the rest of you but to me i see no team work here at all. there are a couple of places i know that would write that cna up for telling the charge nurse that not her patient.

chadash · May 11, 2006

I imagine this is difficult to do in hospitals where hiring is more a function of HR than the actual departments, but I think the issue begins there, in the selection of employees.

It is important to hire NAs who are sincerely interested in giving good patient care. Also, it is imperative that the NA be informed of her responsibilities to the patients and to the nurses. She from the onset needs to see herself as your ASSISTANT, not a free agent. If she is reassured that the nurses respect her contribution, and will not take advantage, she will probably be less resistent to direct orders from you. The best nurse I ever worked with in a SNF always kept us aware of the big picture, and how essential our seemingly mundane contribution was. We saw how what we did contributed to a positive outcome for the patient. Does this NA value her job?

I was joking with the poster about not going up against the NA in the "It's not my patient senerio". They are ALL our patients, and that NA was totally out of line.

Our first concern is: that patient is having seizures, as a NA what can I do to help? I can help by responding to the nurses request to diaper the patient, so if they have an accident, they will be more comfortable and less humiliated. I don't care if it is my patient, I am there, I can help. It is not about me.

Retired R.N. · May 12, 2006

I was joking with the poster about not going up against the NA in the "It's not my patient senerio". They are ALL our patients, and that NA was totally out of line.

Chadash,

I missed the joking in that "Not my patient" scenario, and I was truly puzzled because in all your earler posts you seemed to be such a caring person. I have always had wonderful NAs working with me, and I tried to keep them informed about what was going on with the patients. Thank you for your prompt answer

to my question.

chadash · May 12, 2006

Chadash,
I missed the joking in that "Not my patient" scenario, and I was truly puzzled because in all your earler posts you seemed to be such a caring person. I have always had wonderful NAs working with me, and I tried to keep them informed about what was going on with the patients. Thank you for your prompt answer
to my question.

I slip into Monty Pythonisms, Princess Bride dialogue and Shakespearian Speak, just to be silly sometime, just to stay sane. This is a quote from the evil genius in Princes Bride (who kidnapped Buttercup, no less) , but it was really "don't go up against a Sicilian when death is on the line"....Equating the NA to the evil Sicilian genius. If you have to explain 'em, they ain't funny.

cschmill · Oct 13, 2006

the welfare of the residents comes first, you are their advocate. sadly enough, some people take the CNA classes just to make better money and could care less if their residents are taken care of or not.

noone likes to be labeled as 'the harda**', but sometimes that's what it takes to get the job done.

if the aides know there will be repurcussions if they don't do their work, then it is more likely to be done. make sure you know where the aides are assigned and if you have to, go behind them and check to make sure they are doing what they are suppossed to be doing. again, noone likes to have to babysit their staff, but the residents come first.

thsnursluvsgeriatric · Oct 14, 2006

just curious, why did someone's bad stay dangling? I've been known to say okay, then go up to the HCA and say Let's go. There has never yet been a refusal. But a person that can refuse to help someone in those circumstances, well I'd question their motivation for working in a long term facility. I have a feeling that that wet pad is just the tip of the iceberg in the neglect department.

1st edition · Oct 15, 2006

I sent out a memo to all my CNA's. VS must be done by such and such time, I & O must be properly recorded, etc and that I would be making rounds at such and such time, about an hr before end of shift to make sure all rsd were reasonably dry and clean and if things weren't done on time (unless there is an emergency) then they would be written up before at end of shift. It is working great! All the CNA's support me and understand I just want the rsd taken care of and that I depend on them to be able to do my own job. I cleared the memo w/ the DON ahead of time. I never spoke to the admin about it but he came to find me the day I handed out the memo and thanked me. He said this was the leadership he had been looking for and that it could mushroom "into bigger things". I have never been in a leadership position before so this was a scary step for me. But w/ 3-7 women working in one hall someone has to lead and it is our job as charge nurses on the unit to lead.