ok, here's another gripe. In the LTC facility that I work at, which has 42 residents, the aides start getting residents out of bed and into their wheelchairs and out into the halls at 4am starting on one wing. I have asked the DON what is an acceptable time for this and she skirts around the issue. She really won't state what time the residents should be getting up.
We have residents that can get up on their own and usually around 5-5:30am I see them moving around in their rooms ready to start the day. I saw a nurses aide take a spray bottle of water and spray it at the faces of several of the residents who were already in their wheelchairs in the halls. I almost blew a gasket. This is outright abuse. DON fired the aide because she had been looking for some reason to get rid of that aide for months because of the constant bruises, skin tears and other complaints, but she could never catch her doing anything.
Anyway, just another rant from me. I am currently looking for a different job. Working in LTC is just not for me.
res sleeping in the hallway is a heartbreaking site. when i became unit manager i stopped it. it wasn't easy, as the cna's weren't used to it. i worked it out with our activities director to have our leisure center opened early, that way, the residents that are up early by choice, can go down there and socialize with other residents until it's time for breakfast. believe it or not, some do like getting up early. for those who want to sleep, we let them sleep, we have what's called open dining, which means the resident can get something from the kitchen between the hrs of 8:00 a.m. and 7:00 p.m.. if someone wants to sleep in, they can get a bagel, toast, some cereal or a muffin when they get up.
i've been in my position since march and it is only now that the cna's are starting to automatically take the residents to the leisure center instead of just parking them in the hallways. i do the same thing all day long, i don't want to see residents just parked in the hallways staring into space, in my opinion it is depressing and a dignity issue. we also got a facility dog (a puppy really) who the residents just love. i love my residents and for the most part work with good cna's and nurses, but it is a challenge every day to break bad habits.
don't give up on ltc, it can be the most rewarding part of nursing. good luck.
that's too funny...not funny hahaha, but on friday in class we were just talking about this. the ltc in our areas serve breakfast around 7:30 or so and therefore all the residents have to be up and ready for breakfast early in the morning. our discussion on the subject was that the generation of residents right now are probably for the most part early risers. however, it won't be long before most of the residents in ltc will consist of people who used to sleep until noon or used to work shift work when they were younger. ltc's will have to change to meet the demands of these particular clt's. i like the idea of open dining!!! about the residents lined up in the hallway...it would always break my heart to see that when i'd go see my grandma. the residents looked so pitiful and bored. good for you on the leisure room...
We have about 100 residents and every single one needs an aids help to get up, be toileted and brought to one of 5 dining rooms they are served meals in. Breakfast trays start at 6:45 and the last try is usually out by 7. Breakfast takes an hour and nurses can't really begin their duties until after everyone has eaten.
So the aids start getting residents up at 5. I know it's early but considering most patients are in bed sound asleep well before 8, and some by 7 - it makes sense. Many are groggy because of sleep meds they are given, and one problem is when a resident asks for a prn medication at 3 in the morning; of course they don't want to wake up at 5!
We don't have the luxury of allowing residents to order food between meals, so it's 7 or never for breakfast.
A large facility has to be run with many rules. That's just one reason why we all hope we never end up living in one!
that's too funny...not funny hahaha, but on friday in class we were just talking about this. the ltc in our areas serve breakfast around 7:30 or so and therefore all the residents have to be up and ready for breakfast early in the morning. our discussion on the subject was that the generation of residents right now are probably for the most part early risers. however, it won't be long before most of the residents in ltc will consist of people who used to sleep until noon or used to work shift work when they were younger. ltc's will have to change to meet the demands of these particular clt's. i like the idea of open dining!!! about the residents lined up in the hallway...it would always break my heart to see that when i'd go see my grandma. the residents looked so pitiful and bored. good for you on the leisure room...
i work on a skilled unit and the idea of open dining sounds like a nightmare to me. there are so many duties that have to done during dayshift, between treatments, meds and charting - then add physical, occupational and speech therapy, and there isn't time for patients to sleep in or eat whenever they want to.
the ltc facility i work at, and i was on the ltc floor for well over a year, mostly has patients with dementia and alzhiemers. they can't make reasonable decisions about their care or else they wouldn't be there. so unfortunately schedules like meals, sleep, showers, etc., are made for them.
when you have a situation like that,where a pt rises at 9 and misses her 7am...just ask the doctor to change the order to reflect the pts requested schedule. Thereby the 7am becomes 9 and the rest is adjusted accordingly. We have some pts self medicate and it goes well, when they are no longer capable, they happily hand over the reins to us but it helps that they have built up trust with us from before. One pt gets all his daily meds in the morning every morning as we are afraid he will take too many, most get meds for the week and we keep count. I sign on the count.
Our DR don't set times we do... they Say BID, TID, HS Etc. we set the times on the MAR (RN) I manage 4 units. I meet with staff daily, we discuse this daily, I care plan each residents wishes and rising Times. (new culture.) There Rising time has just started being careplanned. Each unit is 17 resident. they also have 1 main LPN daily, It has been going very well.
We start getting ours up @ about 5. There are only so many of us CNA's to go around and breakfast is @ 7. I think it's ridiculous personally, but, I don't make the rules and I don't think the DON would care about my ideas anyway. LTC's are about the bottom-line.
It is the same time for some of the residents in my LTC facility. We have 88 beds and three shifts. Third shift is required to get some residents up and first shift ( which starts at 6:30) get the other residents up. Third shifts start getting residents up @ 4am. Do I agree with this? No but I do understand the neccesity of it. If third shift started any later they wouldn't be able to finish there work and first shift does not have enough time between start time and breakfast to get everyone up. So what do you do? I don't know. Working in LTC is very fustrating just because you see what happens to people when there to ill to care for themselves and theres no one to do it. It's even more fustrating when you see individuals working in the feild simply because it's a job but don't care about the residents.
I care about the residents and want what is best for them. But, working here is merely a paycheck while I get myself through nursing school. When I came to work here, I was excited about making a positive difference in peoples lives, how naive, I've come to realize that CNA is just a fancy way to say "orifice-wiper" and that you are not appreciated.
How does an employer show appreciation to the CNA? Better staffing and better pay. Mostly better staffing. It wouldn't hurt also, to make LTC's democratically run, so that CNA's could have a say in decision making.
Specializes in Gerontology, Med surg, Home Health.
No work place is a democracy. There are always people making decisions based on many things. In my facility, the CNAs are valued. We have 5 for 41, if the unit is full. They are a part of every meeting which has anything to do with patient care such as the falls and restraint meeting and skin rounds.
As far as getting people up, there is no regulation which says everyone has to be up, washed, and dressed in street clothes to go to breakfast. If we have people who want to sleep in a bit but want to have breakfast with everyone else, they are the last on the list...they are toileted, teeth washed, bathrobe on and off to breakfast they go.
We start getting up our residents at 5am....any later and we have a problem. On most days, we have 5CNAs to 102 residents with 56 REQUIRED to be up by 7am. Breakfast trays hit the floor at 7am everyday.
I do not agree with getting people up that early (I would be the resident that punches anyone trying to get me up before 8am) but I completely agree with the necessity of it. If anyone is not up by 7am, the morning shift, unit manager and DON all hit the roof and start threatening pink slips. If a resident refuses to get up, I the nurse have to go in there an 'talk them' into getting up. If they still refuse, the supervisor has to come and do the same. If they refuse *3, then we have to document on their chart and on 24hr book and personally inform the unit manager. I mean......seriously!!! It irks me to no end.
There is no way everyone can be dressed, groomed, good AM care done, teeth brushed etc etc etc if we started any later.
oh...and the new thing now is the shower aides are starting their showers at 6am. That means,, not only do the people on the get up list have to be up and ready for the day by 7am, anyone that gets a shower on that day must be up in wheelchair and ready for the shower aide by 6am.
No work place is a democracy. There are always people making decisions based on many things. In my facility, the CNAs are valued. We have 5 for 41, if the unit is full. They are a part of every meeting which has anything to do with patient care such as the falls and restraint meeting and skin rounds.
As far as getting people up, there is no regulation which says everyone has to be up, washed, and dressed in street clothes to go to breakfast. If we have people who want to sleep in a bit but want to have breakfast with everyone else, they are the last on the list...they are toileted, teeth washed, bathrobe on and off to breakfast they go.
Yours sounds like a pretty decent LTC. But, I beg to differ regarding you assertion that no work place is a democracy. In fact, there are places right here in the US where everyone has a say in decision making, from the CEO to the person that sweeps the floors. They all have a say and profits are delivered more equitably. In these types of companies, workers are more motivated and production is better than the dictatorships that define so many American employment "opportunities".
I actually posted this awhile ago. I loved the facility I worked at, small and homey...except for this! We had to get 4 residents up at 5am everyday. These were residents that we WOKE up and then would fall asleep waiting for breakfast. I have no problem getting people up that early risers, but these residents had no say, because they were unable to speak for themselves! I had mentioned it to everyone, and like another poster wrote, everyone skirted around the issue. So much for resident centered care.
sunkissed75, CNA
252 Posts
res sleeping in the hallway is a heartbreaking site. when i became unit manager i stopped it. it wasn't easy, as the cna's weren't used to it. i worked it out with our activities director to have our leisure center opened early, that way, the residents that are up early by choice, can go down there and socialize with other residents until it's time for breakfast. believe it or not, some do like getting up early. for those who want to sleep, we let them sleep, we have what's called open dining, which means the resident can get something from the kitchen between the hrs of 8:00 a.m. and 7:00 p.m.. if someone wants to sleep in, they can get a bagel, toast, some cereal or a muffin when they get up.
i've been in my position since march and it is only now that the cna's are starting to automatically take the residents to the leisure center instead of just parking them in the hallways. i do the same thing all day long, i don't want to see residents just parked in the hallways staring into space, in my opinion it is depressing and a dignity issue. we also got a facility dog (a puppy really) who the residents just love. i love my residents and for the most part work with good cna's and nurses, but it is a challenge every day to break bad habits.
don't give up on ltc, it can be the most rewarding part of nursing. good luck.
that's too funny...not funny hahaha, but on friday in class we were just talking about this. the ltc in our areas serve breakfast around 7:30 or so and therefore all the residents have to be up and ready for breakfast early in the morning. our discussion on the subject was that the generation of residents right now are probably for the most part early risers. however, it won't be long before most of the residents in ltc will consist of people who used to sleep until noon or used to work shift work when they were younger. ltc's will have to change to meet the demands of these particular clt's. i like the idea of open dining!!! about the residents lined up in the hallway...it would always break my heart to see that when i'd go see my grandma. the residents looked so pitiful and bored. good for you on the leisure room...