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The PRN Structure
The State Visits
Your Resident=Our Resident
The Guardian Angels.
24 Hours. 7 Days. ONE GOAL TO ACHIEVE. Keep your mind on the Resident.
I have noticed something, just lately, that I really never thought of before,
but it seems to be becoming more noticeable with all my friends and people I am
associated with, regarding working doubles. You know, it's one thing to
encounter a situation, where you have to work a few doubles, to get some bills
squared away, or when the need occurs to put in some extra time.
What is the PRN Structure
But, on the other hand, consider the scenario of actually doing it
straight working 16 hours a day. Now, I have myself been in that
when I worked in the office of a major company, putting in 12-14
hours a day,
and coming home to things I still have to take care of, and
eventually, you become
unaware of your actions.
You really don't realize that you're quite
cantankerous but try to imagine how your co-workers can see it when
the person they
once worked with becomes somewhat irritable and a little more bent out
than usual. Short tempered and the like. If an employee can see and
sense the strain, I believe a resident, or
a visiting family member will be able to sense the same.
Fact is, Nursing Homes, Hospitals, rely on the added help.
But, they should also be aware
that whether the employee needs the extra time, there is a time to put
a foot down, and say
enough is enough.
This is not to blame on the Facility. It's a
by the employee to realize when enough is enough.
When blow ups begin happening in
places like hallways, resident's rooms, someone needs to intervene.
It's unfortunate that these things happen, but they do. They happen in every
workplace. I'm not singling out Nursing Homes, nor Hospitals. But, this by far
is the worst of all places for a employee/employee problem to be hashed out. Residents
hear it see, it, and to make matters worse, the Resident being as aged as
they are, hears it, (or parts of it ) and for some reason, they immediately think the
situation is regarding them.
I admit, I have some residents, that I have to spend
alot of time with. I am not speaking of 15-20 minutes. I'm talking about close to
an hour. There are little people that sometimes are very meticulous, and want it
done just a certain way. Whether or not I am taking too long is not up to an employee
who has acheived getting up 5 people in the time I had to do one, to make an issue
of it. But it happens.
Put the shoe on the other foot.
I had one person tell me a while back, they refuse to take care of a certain resident.
My demeanor at that time was indifferent, but months later, I took care of that same
resident many many times.
I would never, be so bold as to tell someone
I refuse to take care of a resident, no matter what the circumstances were. I don't think
that's a thing to tell any other working assistant.
Unless, and only unless, that resident,
or the family member requested that a certain assistant not handle a resident, due to
and then, it becomes a law in that case, but, just because a resident makes a derogatory
comment, or just takes too long to deal with, is by far the worst excuse any assistant
could rendor. That person, should not even be a part of the force, that deals in healthcare,
especially of the elderly. That person, to me, should seek a new line of work.
Back to Topics
This is a topic, within a topic. I like this because of my own personal needs. I believe
every Nursing Facility should offer this. The reason being, PRN's, or at least where I
have been affiliated with. It's not quite agency, where a temp comes in and does not
know the Nursing Facility or the residents, but it's a position which is being on that
Facilities payroll, but, not on the medical plan, etc., (except workmen's comp being the exception).
First, PRN or known to the layman as "As Needed", seems to solve alot of problems some
facilities have with call ins, unexpected NCNS. They call the PRN to come in, she/he pretty
well has been affiliated with the facility, and comes in to cover on a basis of need. Yet, in
another way , PRN's can work as they want to also. For instance, take myself for an example only.
I have ALOT of obligations I have to meet, I can't be on a full time job, with what I do for a living.
I have to be off for Christmas, Thanksgiving, a week for an out of town wedding, I must attend.
I have many weekends that I need to not be at work. That's just what things handed me, so because
of all this, I cannot afford to call in like so many people do just about every weekend. I have
the consideration and I do hate to put this so boldly, to the facility, and my co workers to not
be one that comes up with excuses every 5 minutes. This way, can work at the facilities needs,
and also my own. Also, switching with another employee, is a headache too, who wants to switch
when you've put in 6 weeks with no weekend, and now, a 7th?
I personally don't care if I touched a nerve here re: what I said about call ins. Some are legitimate,
but, the one every weekend I heard that shortstaffed us all the time was, "My cat pulled the plug from
my alarm clock" OH PLEASE!!! Every weekend? 2-3 hours late?? I agree, tho, if you have to work
on some schedule of facilities, 4 on 2 off, you are not going to see a weekend but every 6 weeks.
That, is the Facilities fault. I worked at a facility like that, and the call ins are incredible. But, then again,
I worked in a facility also that guaranteed every 3rd weekend off, Friday, Saturday and Sunday.
Having a choice, if there was one, I'd rather work in the facility that gave me every 3rd weekend
off, but, having another choice, to fit my needs and the facilities, PRN is more inviting.
Back to TopicsHospice
This is an area, truthfully, I am not familiar with. But, beginning to
want to learn more and more about. I'm treading lightly here, only
because I'm considering this as an option to my CNA training and field,
I'm thinking seriously of devoting my time to it.
When the State Visits
If this is an option to be considered by you, and you know little about
it, finding out is really easy. I will install the hospice ring below,
and you can go from there. You know I'll be visiting there, to see what
hospice has to offer.
Back to Topics
I'm sure you've heard that old saying, company is like fish, it starts to smell
after about 3 days. Well, in this case so does the State visits. Face it, they have
a job to do. We have a job to do.
Your Resident = Our Resident
Nobody likes state visits, not even the Administration
but State agencies have a title to live by, and that's this. When they walk in a facility
they're not there to be your friend. If I were anything, but a Nurses Assistant in my
lifetime, I would want to be a part of the crew that does this job. Hate me for saying
this, but here's why.
I would be able to look back and say, I was once the person we're going to look at the
most, the CNA. I'm going to look at each of those folks running around trying to do six
things at once, because six State Officials, noticed 6 residents that need tending to,
and they all want it done now. Not 10 minutes from now, not 1/2 hour from now, but now.
It can't be done, but TRY to tell a state official that. You do, and you're part of the
little piece of paper they're carrying on that clipboard called a big fat defiency, you
are now the cause of the facility getting a bad mark. You are going to make your charge
nurse very upset with you. The facility not to mention, is not going to give you a gold
star or a paid day off.
What happened here, is alot of grief. The CNA is totally beside themselves as it is, because
you have enough people running around loose in the facility trying to do 6 things at once, and
no matter how well you think you did it, unless you have a very nice
State Official, who at one
time really does remember back if they were a CNA, things are going to
be a little easier.
(some of them) really do try to be level headed. I've met a few that are responsible enough
to understand you are not an octopus. Then again, I've met some who have their head so swolen
with authority, that they can't see straight.
I find that the best solution with them, no matter who it is as far as a State Official, say
very little to them. Hold no conversation, except with your resident. Answer only the question
asked, do not go into alot of detail. The more you give them, the more they hang on it. Why am I
saying this knowing full well a possible State Official could be reading this, because, it's
They tend to be bears, and I for one don't intend to be their bait. I let it happen once
to me. They misconstrued everything I said, did, and tried to explain. They left me feeling like
I was totally helpless, they made me feel like I was a total incompetent. That's why I say, if I
ever worked for the State, there would be one difference. I would put aside how I got up to that
level, and treat each and every person with the dignity I would only want bestowed upon myself.
Someday.... but for now, I'd much rather be right where I am now.
State officials get called into facilities, by numerous means, Family of Residents, previous employees
Oh, just many other reasons. They have to investigate it. Believe me, alot of the calls tend to be
a little exaggerated, and some are not. So, back to the part of they have a job to do, and so do
you. Unfortunately, when they are there, there is always going to be more salt in the dinner than
they like, or not enough.
**But a note here: CNA's are not Private Benjamin's, and this is not the Army or the Military, where
you can reprimand and embarrass in front of the whole staff. I've seen it happen, it is totally
humiliating, and if this is how a CNA, being entry level, is to be handled, I would well consider
taking a thought here.
Back to Topics
Some facilities, not all (some) have a job description they work by. It's called, "your resident needs to......" Well actually, that's not a job description, they just think it is.
If that were true, then, every assistant would be feeding their own residents in the dining area. In our training, it was clearly understood, that all the residents are yours, once you go in, yes, you will have your own set of residents to maintain, and get up, and get started. But, once they are all up, and taken care of, I've heard this lovely tune mentioned over and over,
"um, your resident needs to go to the bathroom."
Now, if that assistant knew that, why didn't she/he tend to it? In one situation, it's because they didn't want to, the other is because, they didn't have time, they didn't know how to handle that resident, and the most famous one of all, it's not my resident"
I have my own to tend to.
Actually, to be honest, I never tried that one on another aide. I thought about it many times, just to see the reaction, but, I got a better reaction, when I went and took one of theirs, and handled it, and let them know about it, the thanks seemed to be more of a reward, because deep in my heart, I knew that they knew, I did it intentionally, to show them, and remind them of the training, they are all our residents. It's amazing how quickly that resident turns into an ownership of assistants.
What I'm trying to say here, is that under no circumstances, unless it is actually part of the facilities rules, do you adhere to the my resident only procedure. I'm quite sure that there's an unwritten rule that is made in some facilities, but, it's a rule I only came across once, in one nursing home. They stuck to it, I didn't. I've been in the middle of a very tedious chore, and low and behold, here comes assistant B with resident A, "your resident needs to go to the bathroom", and leaves the resident there.
I'm not going to finish this, because there is no need to. You and I both know it's wrong.
Back to Topics
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