I don’t think unions are always the best thing for healthcare workers. In fact, I am very much anti-union for most all industries. I believe, through personal experiences as well as experiences of family and friends, that unions cause more companies/business’ to close doors. I found this story about a strike that is being held. Read how much the CNA’s get paid. They are LUCKY to be making that much. Although I strongly wish that we CNA’s could get paid much better than we do, I think these CNA’s are being selfish. They should be happy with what they are making! I’m sure aides with more experience make a lot more at this nursing home too.

Nursing Home Workers Prepare for Strike

The licensed vocational nurses, certified nursing assistants, dietary aides, housekeepers, porters, drivers and other caregivers at the facility, many of whom have served the residents for over 20 years, do not wish to strike but feel they have no choice. Their pay is modest, with dietary, housekeeping and laundry workers starting at only $10.50 an hour, and certified nursing assistants beginning work at $12.50 an hour. In negotiations, workers have sought only to preserve the benefits they presently have and to secure small wage increases of 3% per year — just enough to prevent them from falling further behind in San Francisco’s astronomical cost of living. Jewish Home management has been unwilling to work with the caregivers, and recently ended contract negotiations by implementing an unapproved contract.

An article about Feeding Assistants:

Homes enlist feeding aides to help staff

Critics worry the workers will lack the necessary training to work with seniors.

By Brad Heath / The Detroit News

Nursing home regulators are letting homes in many states hire workers specifically to help patients during meals in an effort to ease the pinch of inadequate staffing.

But some advocates, worried the rules will put patients’ well-being in the hands of low-paid employees with far too little training, have asked a federal judge in Seattle to halt the practice.

They fear some homes could actually use the lower-paid “feeding assistants” to replace better-trained, higher-paid employees.

“I don’t think it’s true these feeding assistants would supplement staff; they’re going to replace staff,” said Toby Edelman, an attorney for the Center for Medicare Advocacy in Washington, which is working on the legal challenge. The case still is pending.

Federal regulators first endorsed use of feeding assistants last year, as a way to lessen the demands on the nurse aides who in many homes already struggle to ensure every patient gets enough help eating.

The assistants would get less training than other nursing home employees and would often work part time.

“Staffing is a critical problem in nursing homes,” said Thomas Hamilton, the director of survey and certification for the U.S. Centers for Medicare and Medicaid Services, which regulates nursing homes. “We figured it would not be responsible on our part to criticize nursing for not providing necessary staff if we were not doing our part to try to figure out the best ways by which higher staffing levels could be achieved.”

The agency is studying how well the program works, he said.

Michigan has approached the idea slowly.

Regulators here are putting together a six-month trial in a handful of nursing homes that will give researchers an opportunity to gauge its effect. Many of the details haven’t been finalized.

In addition to the federal rules permitting the change, each state must lay out its own training rules before any feeding assistants can be hired.

Other Midwest states, including Illinois, Ohio and Wisconsin, are pushing ahead more rapidly. This fall, Ohio gave about 170 homes permission to begin hiring the assistants, though most have not yet begun hiring, state officials and nursing home administrators said. Wisconsin has been using the aides longer — it was one of only a few places to allow such specialized help before the new rules took hold.

Wausau Manor, a small nursing home in Wausau, Wis., trained employees who usually run activities at the home as feeding assistants.

“Nursing staff just can’t do it all. Mealtime is probably the most intense time during the whole day,” said Peggy Jones, director of nursing at the home. “It’s just using the staff that are already here and have a relationship with the residents. It’s not a matter of cutting the staff in any way.”

But patient advocates are wary. Helping patients eat is often far more complicated than it appears because many have difficulty swallowing or other problems. The advocates contend less-trained employees could cause more problems than they solve.

“What these new rules do is enable people to come in who have even less training,” said Alice H. Hedt, executive director of the National Citizens’ Coalition for Nursing Home Reform.

Regulators say there’s no evidence that will happen. States such as Wisconsin, which have used aides longest, have reported no problems, Hamilton said.

“The criticisms have been hypothetical criticisms, and I’m not saying they’re illegitimate, but they’re theoretical,” he said.

I worked here all weekend-I call it hibernation because I work two back to back 16 hour shifts (6am to 10pm Saturdays and Sundays). Its like I don’t exist on weekends. I get up too early to see anyone, and get home too late to catch up on anything new and exciting. When I work my weekends, it’s like being LOST in the twilight zone. Come Mondays, I find myself catching up on everything going on with my family, friends and the world in general. We could be under a major attack and I seriously doubt I would know about it.

Anyway as I was surfing about the net, trying to catch up on news and other exciting things- I came across this post at the Hospice Blog. This is about nursing home residents recieving hospice services. Having worked in a nursing home with residents who were in the process of dying, I can say without question I DO think the services are needed. I was never able to spead enough time with terminally ill residents.

Should hospices be allowed to care for (read: paid for) patients in a nursing home? I can not emphasize how much I believe they should. Somewhat by definition, a hospice patient requires more care than your typical nursing home patient, and if you’ve been in an average nursing home lately you know that the typical nursing home patient doesn’t get the care they need. Nursing homes are understaffed and generally the best homes provide adequate care at best. We won’t even talk about the bad homes. Now, if the staff of the home is stretched thin on a normal day, what happens when a patient needs extra attention? Either that patient doesn’t get it, or some other patient in the building is neglected so that the special needs patient can be cared for. This is where hospice earns it’s money. They provide the care that the terminally ill patient needs with more skill than the nursing home staff could or would, and allows that staff to continue to do their job. There is no doubt in my mind that hospice is a good thing for nursing home patients. Hospice workers are experts in caring for the terminally ill. If someone with a terminal illness resides in a nursing home, they should have access to the experts.

This is a new thing I want to add to the blog. A question, from the discussion forum, will be asked here. I invite readers here to comment and reply to the question.

Here it is:
Do you routinely take B/P’s on residents/patients who are on meds for high/low B/P? Many aides feel uncomfotable with this practice- as they don’t have confidence they are doing it right. Aides get about 3 hours training on measuring B/P’s- if not less. We are expected to practice a lot, but this doesn’t always happen.
Getting an accurate B/P is vital to the patients’ health and med routines. What do you think?

Here are some links to sites that help with B/P:
Dr. Blood Pressure
Measuring the Blood Pressure
Checking up On BP Monitors

Patti

There is a growing number of medical and nursing blogs online for folks to check out. Most are authored by doctors and they have very interesting topics and make good reading.

Medpundit
Code Blue: Tales of a Nurse
Bedside Matters
Soap Notes
The Hospice Blog

There are many others, and I will post them next week. Also, there are many LAW blogs as well. These are called BLAWGS-while you might wonder how the law blogs relate to what we do, consider how many times we use the word legal in our work…

Also, of interest, Google has launched it’s Google Scholar search engine. Run a search on nursing assistants and see what you get. This is an excellent resource for medical and nursing students.

Some news articles from around the web:

Antidepressents-Questioning Whether They work:

NEW YORK (Reuters Health) - Depressed people 75 or older are just as likely to improve after an 8-week course with an inactive, placebo drug as with an antidepressant, new research indicates.

The study shows that after a short course of the antidepressant medication citalopram (Celexa), around one-third of elderly people with depression went into remission — the same improvement rate seen in people taking a placebo drug.

However, study author Dr. Steven P. Roose of the New York State Psychiatric Institute in New York City cautioned that these findings do not suggest that the antidepressant is no better than doing nothing at all.

Dental Plaques Related to Pneumonia?

NEW YORK (Reuters Health) - Bacteria in dental plaque can cause hospital-acquired pneumonia in elderly nursing home residents, according to a report in the medical journal Chest.

“The available evidence suggests that poor oral health, characterized by inadequate hygiene results in the formation of extensive (plaques), promotes oral colonization by potential respiratory (microbes) and increases the risk for serious lower respiratory tract infections in institutionalized subjects,” co-author Dr. Ali A. El-Solh told Reuters Health.

Dr. El-Solh from University of Buffalo, New York, and colleagues investigated the rate of plaque contamination by disease-causing microbes in institutionalized elderly patients. In addition, the researchers sought to determine whether these bugs were related to those recovered from patients who developed pneumonia.

Patti

Got this over at Medpundit.

Coming Soon to a Bookstore Near You: Druglords, an FDA tell-all:

Dr. David J. Graham, the drug safety reviewer who denounced his employer, the Food and Drug Administration, before a Congressional panel last week, said yesterday that he feared being fired and had sought legal help from a group that protects whistle-blowers.

‘My concern is retaliation from these people,’ Dr. Graham said in a telephone interview.

His lawyer, Thomas Devine, legal director of a public-interest group, the Government Accountability Project, said that he had received anonymous telephone calls trying to discredit Dr. Graham and that he believed the calls were from people in ‘F.D.A. management.’

Now, can he get Russell Crowe to play him in the movie?
…Read more—>

Scope and Severity

The federal government’s enforcement process requires the Health Facilities Division to assign scope and severity levels for deficiencies. After these have been determined, they are given a letter designation.

The level of the deficiency is determined both by scope, how widespread the problem is, and severity, how much potential or actual harm it has caused to residents.

Level Scope Severity
A Isolated No actual harm, potential for minimal harm
B Pattern No actual harm, potential for minimal harm
C Widespread No actual harm, potential for minimal harm
D Isolated No actual harm, potential for more than minimal harm
E Pattern No actual harm, potential for more than minimal harm
F Widespread No actual harm, potential for more than minimal harm
G Isolated Actual harm that is not immediate jeopardy
H Pattern Actual harm that is not immediate jeopardy
I Widespread Actual harm that is not immediate jeopardy
J Isolated Immediate jeopardy to resident health or safety
K Pattern Immediate jeopardy to resident health or safety
L Widespread Immediate jeopardy to resident health or safety

Scope:

Assesses how widespread the deficiency is in the nursing home. There are three levels of scope:

An isolated problem-when one or a very limited number of residents are affected

A pattern of problems-when more than a limited number of residents are affected or when the same problem has occurred in several locations in the facility and/or the same number of residents have been affected by repeated occurrence of the deficient practice;

Widespread scope means the problems causing the deficiencies are found throughout the facility and/or there are systemic failures in the nursing home that have affected or have the potential to affect a large proportion of the residents.
Severity:

Assesses how much harm may occur or has occurred to residents as a result of the deficiency.

There are four levels of severity:

Level 1: Represents no actual harm but has potential for minimal harm;

Level 2: Represents no actual harm, but potential for more than minimal harm. A level 2 deficiency could result in minimal physical, mental or psychosocial discomfort or has the ability to compromise the resident’s ability to maintain or achieve highest possible function;

Level 3: Represents actual harm that is not immediate jeopardy (i.e. life-threatening). A level 3 deficiency means a resident has been negatively impacted and his/her ability to maintain or reach the highest functional level has been compromised;

Level 4: Represents immediate jeopardy to resident health or safety. A Level 4 deficiency requires immediate corrective action because serious injury, harm, impairment or death has been caused, or could be caused to residents.
Deficiencies are cited at the highest severity level. If a deficient practice has minimal impact on most affected residents, but has a severe impact on only one of the residents, that deficiency will be cited at the highest severity level observed.

Many of the writings here are designed for use in in services and staff meetings. If you see something that you think would be good for this purpose, just click on the title above the post…it will open the entire post onto it’s own page-then you can print it.
Some of the materials worth sharing might be:
The Nursing Process and The CNA
Culture-Workplace
Being Professional
Malnutrition
Dehydration
CNA’s & Respect

Also, over at the discussion forum there is a section called “LEARNING” where all these articles are placed as well. There is more material there too. So go ahead and check them out and use them freely.

I figured it would be nice to give some explanations on how to use this site.
This is a BLOG- a weblog that anyone can use and read. Blogs make it easy for anyone to have a website, and updating the site can be done without logging onto complicated web page programs.

This is the FIRST blog for CNA’s. There are many healthcare blogs out there, a few for nurses and none for CNA’s. That is one of the reasons I decided to go to this format.

One of the cool features of this site is the COMMENTS section (see the end of this section). Click on it and scroll down the page; you can leave me or anyone else a comment. On some blogs, hundreds of comments are left for postings. (Postings are what you are reading right now).

Another feature is for those who blog. Often, readers will like certain postings and will want to link it to their blogs. A feature called “Permalinks/Trackbacks” is for that. CLick on it and a new pop up will appear with the trackback URL for the posting. Each post has it’s own page it is saved to. Archives can go back YEARS.

Everything that is posted is saved and sorted by date, category (like a filing cabinet-blog writers assign each post to a category).

One doesn’t need to have a special program downloaded onto their computer to blog. It is all done online-some blog providers are free and others cost money. Some bloggers use hosting services and others use the free Blogger site…
This site is hosted, and the program used for blogging is called Word Press. E.Webscapes is my host and they are wonderful. Lisa is the web designer and owner ofE.Webscapes- and she designed this site along with another blog I maintain.

Anyway, in the next few days I will be doing some fixing up around here: Adding new links to the side content,
writing about what I would like to do with this site (some things will be fun-like a question of the week, and a skills challenge test…) Don’t forget to visit the discussion forum! Things are getting warmed up over there too.