When did cutting corners become acceptable?

corbinRN · Jul 12, 2008

I KNOW! That made me mad when I started my job at a retirement community/nursing home. The person who oriented me just said that he liked to do everything fast so he could get done.

He was just so proud of how quickly he finished his residents.

But all he did was go in the room and slam on the lights (at 2230 hours while the residents were asleep) and say I got to do my last check and check their depends and change if necessary and leave.

No "how are you feeling?". Even during the "awake" hours he doesn't even really talk to the residents.

I would rather rightly get paid for the hours I work and talk to the residents and spend time with them (many who never have family come to visit).

Anyway....

[steps off soap box]

So, to answer your question: it NEVER became acceptable to cut corners. Just do it the right way and you will be better off (especially if you ever have to go to court for anything).

suanna · Jul 12, 2008

You work the graveyard shift? One of the priorities is getting your patients a few good hours of uninterupted sleep. If I have to cut a few corners to get my patient some real sleep I will. Sleep deprived elderly patients don't do well. Perhaps this is the reason your coworkers are rushing things to finish thier rounds.

NewbieLPN2011 · Jul 12, 2008

:banghead:I also work the night shift and rounds are not rushed. Its the last hour and half that is HORRIBLY RUSHED and MANY MANY corners are cut because each hall has 4 get ups all of which are 2 assists and one aide assigned to a hall. They do as much as they can by themselves then run to try and find another aide, who by the way also needs help, to get these people out of bed. Not to mention call lights going off and NO FREE HANDS. EVERY SINGLE PERSON IS BUSY but makes time to answer the light, which in turn means they have to make time somewhere else, which means residents do not get quality AM care. Everyone thinks night shift does nothing and 4 get ups per hall with one aide is nothing. I did the math. Thats 22 min per resident. Thats if everything is going RIGHT and there is no call lights. That does not factor in time trying to track down another aide to come help you transfer all of these residents in turn means they also need help transfering their residents. Its a very very vicious cycle and if families saw what goes on between 4:30 and 6 in the morning, I DONT think they woudl be very happy at all. But this place gets away with it because noone is there at that time of morning. I don't know. Maybe this stuff goes on at every facility. This is the first one I have worked at. And believe me I have no intentions of staying there.

I don't believe it is ever ok to cut corners, but when management, who have no idea what its really like on the floor, want you to perform miracles, something has to give somewhere, and unfortunately where I work, its care of the residents. :banghead:

casi, ASN, RN · Jul 12, 2008

I claim there are three ways to do things: The wrong way, The way you learned in school, And everyother right way.

While I don't like the idea of rushing through patients, I also know you need to haul butt to get your work done. I'll be the first to admit I do rush through some work so I can get ahead of myself as I never know when the poop will hit the fan. I also know that I'm a darn good aide.

When you are fresh out of school you want to do everything by the book, but as you get experience you'll learn what corners you can cut and what tricks work for you.

cnaeva99 · Jul 12, 2008

I agree with the others who say you figure out what works in different ways. When I started I was very idealistic too...I had all these conceptions of the kind of care to give pts. But not every pt is the same, and CNAs are different too. There are great girls who work with me and others that I know will get NOTHING done. The best advice I can give you is keep your pts dry and don't worry about the piddly stuff. It is more important that they sleep well, eat well, and are changed. Also removing trash is important too....we get written up if we leave briefs in trash after we change. So do that and practice infection control, but changing the bedsheets for every bed q 2 hours? Not going to happen....:nuke:

DreamyEyes · Jul 12, 2008

I claim there are three ways to do things: The wrong way, The way you learned in school, And everyother right way.
While I don't like the idea of rushing through patients, I also know you need to haul butt to get your work done. I'll be the first to admit I do rush through some work so I can get ahead of myself as I never know when the poop will hit the fan. I also know that I'm a darn good aide.
When you are fresh out of school you want to do everything by the book, but as you get experience you'll learn what corners you can cut and what tricks work for you.

Exactly. Not trying to mean, but you will learn quickly that you can't do everything by "the book". Too much stuff to be done with little time and barely any help. As long as you are caring for your residents, and treating them with respect and dignity, I don't see anything wrong with getting work done a little quickly. If people are "cutting corners" by not cleaning a resident properly, or not cleaning them at all, then that's a problem. But you will soon find out that you need to do things quickly, unfortunately, because you have 20 other residents' call lights going off, residents who are fall risks trying to get out of bed, all whille you're trying to keep an eye on the residents who tend to wander.

nightmare, RN · Jul 12, 2008

:banghead:I also work the night shift and rounds are not rushed. Its the last hour and half that is HORRIBLY RUSHED and MANY MANY corners are cut because each hall has 4 get ups all of which are 2 assists and one aide assigned to a hall. They do as much as they can by themselves then run to try and find another aide, who by the way also needs help, to get these people out of bed. Not to mention call lights going off and NO FREE HANDS. EVERY SINGLE PERSON IS BUSY but makes time to answer the light, which in turn means they have to make time somewhere else, which means residents do not get quality AM care. Everyone thinks night shift does nothing and 4 get ups per hall with one aide is nothing. I did the math. Thats 22 min per resident. Thats if everything is going RIGHT and there is no call lights. That does not factor in time trying to track down another aide to come help you transfer all of these residents in turn means they also need help transfering their residents. Its a very very vicious cycle and if families saw what goes on between 4:30 and 6 in the morning, I DONT think they woudl be very happy at all. But this place gets away with it because noone is there at that time of morning. I don't know. Maybe this stuff goes on at every facility. This is the first one I have worked at. And believe me I have no intentions of staying there.
I don't believe it is ever ok to cut corners, but when management, who have no idea what its really like on the floor, want you to perform miracles, something has to give somewhere, and unfortunately where I work, its care of the residents.

This sounds just like us.The only tip I can give is work smarter not faster.I've never seen fast as part of a job description in Elderly care!

What we do is,on the first and second round,if you know you are getting them up in the morning,make sure that everything you will need is in the room .Towels,clothes for that day,gloves ,wipes etc.Get toiletries ready so that you are good to go as soon as you start and don't have to run around looking for things.

You don't have to cut corners but what you do need is organisation and team work.

shy_wolf101 · Jul 13, 2008

I know I went in too idealistic. I guess I just thought things were going to be a certain way and when they fell short of my expectations I was disappointed. I do understand the reason and the need to try to go as quickly as possible through your round, I guess my problem is is that when you go through your clinicals and you get to do some seriously cool patient care because your only responsible for maybe two patients, when you get thrust into a situation where you have at least 20 incontinent residents you feel a bit cheated and lied to lol. I will get the hang of this, it will just take me a few days to adjust. I know I was a bit harsh in the beginning, and i now concede that I understand that time is a key player, but I am still going to try to get through my shift without cutting corners. I am hoping that maybe if I am organized enough and plan ahead enough I will be able to deliver the level of care I want to. And if I fail, then at least i know I tried, and I can at least look at myself in the mirror and not hate what I see.

NurseCubanitaRN2b, BSN, RN · Jul 13, 2008

I used to work in a LTC facility at night and let me tell you, it's not hard regarding patient care because most of my patients were alert and oriented.....We were in the rehab section of the LTC facility....But having to do vital signs on all 32 patients and pass out water does take time....plus you would start your rounds around 12:30 and then be done by 2am....With all the call lights going off, it looked more like Vegas at nights.....You still have to answer the call lights while all of this is going on.....Then by 2am one aide goes on break and then at 3am the other aide would go on break....4am rolls around and you're getting ready for your last rounds at 5am....then you're done by 6:45am....and inbetween the shift you do charting when you can do it....It's tough, but hey sometimes you have to do short cuts.....It all depends on what the short cut is.....but there are times where I've witnessed short cuts where they don't give oral, or pericare and THAT CHAPS MY HIDE!!!!!....As a nursing student I see it done all the time, and it makes me want to slap the aides silly.....The basic care for a patient is oral, peri, axillary, and footcare...which doesn't take long....as long as those are done, then a patient is taken care hygenically.....Emotional needs are hard to meet as an aide because you have so many patients and when you're giving care in the AM they're usually slower than a turtle and you have call lights going on everywhere and you have the nursing staff chapped at you because you're not answering the lights because you're with that slow patient....It sucks being an aide at times....but I love working with the patients when I do work in the morning.....

Word of advise for the new CNA working nights.....embrace yourself, you're in for a long rideeeeeeeeeeeeeeee....you will see a lot of things that can be shady....but as long as you're providing excellent care that's all you can do....Patients will notice the care you give them and then family members will be asking for you on off shifts...But if a patient complains about a certain aide and you hear it from several patients...do not ignore it....encourage them to voice their concern to their family members that way they can do whatever they need to do to have it taken care of....becareful because there's a lot of gossip in these types of places (in the acute care too)....watch your back....don't gossip to others there because they will rat you out like no tomorrow....keep yourself squeeky clean....Good luck and let me know how you're doing!

kcochrane · Jul 13, 2008

I think cutting corners became acceptable when we all learned we had do to what we could to survive the real world of nursing. Nurses have it the same way. We pass meds on 2 people in school and have 8 hours to do it. Real world, I have 15-20. When I worked days, I had to do patient care and I know how hard it is to get everything done.

We are supposed to turn people every 2 hours. Well after you get your 8 people up, its time for lunch - for them. Than all the aides/nurses have to rotate lunch. Its probably 2ish by then. Back to bed for some, tolieting for others, time to leave.

Its one thing to hurry and cut corners to set on your butt...its a whole other to cut corners to do the best you can with the time you have. And like someone else mentioned, it really depends on what short cuts you are using.

Keep plugging, you will figure out what you can do, and what you might have to modify.

shy_wolf101 · Jul 14, 2008

I got to work with a different CNA last night, and I finally get it. With the workload you have you have to come up with some system to get it all done, but she showed me how to manipulate the system without sacrificing patient care. She made me feel like I can actually do this. Thank you LatinaVNStudentRN2B and kcochrane! Your right, I will figure it out. I am just glad I got to see that you can do it without sacrificing your self respect.