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
Employee Unrest
The PRN Structure
Hospice
The State Visits
Your Resident=Our Resident
The Guardian Angels.
24 Hours. 7 Days. ONE GOAL TO ACHIEVE. Keep your mind on the Resident.
Employee Unrest 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.
But, on the other hand, consider the scenario of actually doing it 5 days straight working 16 hours a day. Now, I have myself been in that situation before, 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 of shape 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 responsible action 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.
What is the PRN Structure 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.
Hospice 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.
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.
When the State Visits
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.
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.
They, (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 simple.
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.
Your Resident = Our Resident
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.
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