copyright © 1997,1998,1999,2000 Shari Allen. This is a documentation written by the author, and it is expressly forbidden to copy, duplicate, make changes, without the consent of the author. By e-mail, please contact me below. Thank you, Shari.

The Topics
The Goal
More Misunderstood
Agency vs. Full time Personnel
Resident Rights

The Guardian Angels.

24 Hours. 7 Days. Keep your mind on the Resident.

    Certified Nurses Assistants exist because of the demand: in general it is a position requiring knowledge of the changing needs of a patient or resident that is confined to a nursing home, Long Term Care facility (LTC) etc. It is not because the assistant has no education or lack of education. The life of a nurse assistant begins here.

    The study, usually a 6 week course to become certified can be grueling, scary and sometimes downright upsetting. In the end a reward is given. You will have the knowledge to start from ground up and go farther into Nursing, Such as Medication Aide, LVN, LPN, RN, ADON, DON or stay in the CNA area and continue to help and do a position that most people would not choose.
    There are benefits and drawbacks with either way you go, study the options and make a careful observation of the position you would like to endeavor in.

    Depending on the type of environment chosen, let's look at at Long Term Care. ie, a nursing facility, where the people in these homes overall are elderly, let's say a mother, father, grandmother or grandfather. Family members want the best for them in their last stages of life.

    Sometimes, home health just does not fit into the scheme of the life a family member has chosen, with jobs, children, daily chores and duties, taking care of an elderly person is much like caring for a child, the elderly seem to exit out of this world, basically the same way they came in. More and more people are looking towards home health care (HHC).

    There are also the problems that the elderly usually encounter much like a newborn baby and that is more commonly called bed sores, (babies get diaper rash) they can be eliminated, but only with lots of TLC (tender loving Care) and constant washing, changing, and use of certain creams designed just for that, (Sween, Zinc, Lantiseptic, etc.) Unfortunately, so many elderly realize that this is a hardship on them, and their family because some them have the knowledge that they are not able to do the things that they once could do on their own.

    Simple things, like going to the bathroom, standing up for long periods of time, dressing themselves, putting on makeup, combing their hair, taking baths or showers, cooking, driving, going to the store, dialing a telephone, reading, writing, eating, making a bed. These people need someone who will be there every day 24 hours a day to see that those needs are met.

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    More Misunderstood in the profession,
    as the "bad guys"

    Hence, the Nursing Assistant. Unfortunately, there is a drawback to the idea that the resident is not being taken care of by the assistant. This is largely due to an overwhelming amount of people at one time that the assistant is required to handle, short staffing, call-ins (for illness or other circumstances) or NCNS (no call no show) that require the assistant to take on several more residents and not enough hours in the day to fullfill the need of those residents that need the care, and do it properly. Sometimes, with added residents, short cuts are taken, even though the care is there, it tends to be done quicker, and something usually seen or noticed, begins to be left unnoticed.

    Unfortunately, there is still not enough time it seems in the day to meet the needs, and the assistants tend to "burn out" easily and more frequently than hoped. Sometimes, what we feel in our hearts is left unseen by others.

    The nursing home or facility, has much to do with the Nurse Assistant's performance on the job. When call ins are made, it should be the facilities responsibility to find a replacement as best they feasibly can, via a Nurse on duty, or calling a Specialized Nursing Assistant agency, PRN employees who are either on staff who work "as needed" but to take sound measures to restore the person missing, NOT let the floor or floors run short, and above ALL, DO NOT USE an agency to replace staff members on a permanent basis, but then again, it is also the responsiblity of the party calling in, to NOT assume the call they are making is just because they don't feel like going in, or plans were made by others that could not be resisted. and "oh well, they'll get a person to take my place" attitude.
    Remember, you are a professional as a CNA you uphold the eyes, ears, and one on one care of the patient or resident

    As an Assistant always remember to act in a professional manner. You know, and I know that we are professionals, we are at an entry level position, just like an Administrative Assistant is to her/his administrator. We have a goal, and the goal is to keep each resident we handle, as comfortable as possible. Your personal problems stop at the door of your facility. If you have happy things to discuss with a resident, by all means strike up the conversation. Residents love to see the Assistant happy, but eliminate topics of unhappiness, and "doom". My personal opinion on that is, the Resident has seen enough, and heard enough doom and gloom already What they really like is seeing their Assistant have happy days.

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    Agency Personnel vs. Full Time Personnel

    As a Certified Nurse Assistant, we all have seen how quickly at times that the personnel in a nursing facility tend to come and go . For many reasons. I intend to go into this, so as not to give a wrong impression, there are Full Time Assistants and Agency Personnel, who will go the extra mile, and some who "can't and won't" do a thing to lend a hand.

    The fact is, when you have a call in, or a NCNS (No Call No Show) You need a replacement and you need it now. This is really no different than a company like a big insurance co. downtown, say in Chicago, or even Los Angeles, who loses a devoted receptionist or claims clerical worker, they call "Manpower" and the like. You get what you get, and if that person is good, they will be called back, and if they are not, well, they don't come back. Simple as that.

    Then again, we have Assistants who are non - stop at being meticulous, and Agency personnel, who would just go the 100 mile for a resident and the Full time CNA, and Charge Nurse. This does not by any means say either party is right or wrong, it all depends on the circumstances. Decision making at the last minute becomes a very traumatic thing when you are dealing with healthcare. Charge Nurses are really depending very highly on the staff of that area, to make quality decisions, if you have one Full time regular employee working a floor, with 2 or 3 agency personnel, Assistants seem to be demanding in the care and quality of care that they want done by the agency personnel. Of course, some agency personnel take this as an insult that a Full time Regular employee CNA is "giving them orders".

    I want to make clear, that is NOT the case. A Full time Employee CNA, knows what the Charge Nurse, ADON, DON, want, expect, and will look for on that floor, and when it's not taken care of, when it is left unhandled, the CNA, the Charge Nurse, and on and on, will all eventually suffer consequences that can lead to embarrassing situations, and really, what price is it to pay to just do it, and ignore the fact that it sounds like you're being "told what to do".

    Agency personnel can make mistakes, they do not know the resident, they are sent to a different facility day in and day out, sometimes never able to stay at once particular place day in and day out. They do hospitals, Nursing Homes, Mental Health Care Facilities, etc., if the care plan book is not read by an agency personnel at time of arrival, or a list was not readily made up, what can you expect when a floor is running short handed, and becomes behind and Family members are due in to visit, and time is running out to get things done. Even the Charge Nurse, CNA, is going to over look something, and the next thing you know, if things are not haywire enough, a problem occurs, and it has to be handled.

    It's too late to fix a problem, that existed all day long due to an oversight, but the problem now, is hanging well over the Assistants head, and the Charge Nurse, and even the Administrative, and the Family members.

    To say the least, agency personnel are there to cover for a certain day, a certain illness, etc., Not as a RESTAFFING to replace permanent staff who have left for one reason or another, plus, they make about 80.00 a day, that's a huge amount to pay for a mistake also. That alone can cost a resident and the residents family many heartaches, if the permanent employee is not watching every thing they do. So, all in all the choice clearly, is not the assistants, but that problem is going to be in the hands of the Administrator.

    Something to think about.

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    The Rights of the Resident

    You cannot tell a resident who has spent his or her "life" in the nursing home eating in their room that now, they must eat in the dining room now, because if they don't want to THEY DON'T HAVE TO.

    A resident really doesn't have to do anything they don't want to do. If only, the people who were making these changes knew that they were the bad guys in all this decision making, The Nurse Assistant would have lots more time for the compassion they are supposed to give, and not be in such a rush to get to the next resident. So., I've been there, and I've done that, and I've watched Nursing Homes fall apart due to this. The Administrative changes that the Administrators do, are not always are for the best welfare of the resident. Nor, is it making the Nurses Assistant job any easier when these changes are implemented in a quick fashion.

    Change for the elderly takes time, and cannot be done overnight. I personally, can understand why administration makes the changes, But, unless the whole staff, in that administrative area that makes the changes, have had a one on one experience of each and every floor, and go right along with the Assistant, on a basis of about a week, and do every single step of the procedure, that an Assistant has to do, I really feel that some of the decisions, would bring forth a to say, "second thought" or a reconsideration as to some of the mass changes that would have normally influenced the changes in the first place.

    Residents of a Nursing Facility, do not adapt to change easily. They must be explained to very carefully what the changes are that are being implemented. If the Resident is coherent, understands what is being told to them, they may understand you, it does not mean they are willing to change with the changes. Once these changes go into effect, the Administrator, and the decision making staff can walk away, but the Assistant that now enters the Residents quarters, and begins to abide by the changes that took place, suddenly becomes a person who is trying to change them, and make them do things they don't want to do. It's hard on the understaffed Nursing Facility then, because the Resident at times, does not understand that there are 10-12 more people that the Assistant has to tend to.

    I found a website one night, that just made me mad. It regarded Restraints. I have to tell you about it. Some Restraints, are downright deplorable. I mean totally humiliating. But, it seems this site is determined to kick loose all restraints. That, may be the biggest mistake.

    I know of many residents in my facility alone, that without restraint, of some sort, a lap buddy, or the safety belt, would be part of the tiled floor in a New York Second.. Then, you have a problem, a broken arm a broken hip, a real banged up head, and what's the excuse??

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        Next set of documents: Click the next link

        Employee Unrest
        The PRN Structure
        The State Visits
        Your Resident=Our Resident