The response we have received from Patti’s Tips and Timesavers article has been unexpected! I thought we should re-cycle some of the other articles here that are similar, and readers can email us for an easy to read/print version of these.

Everything You Want To Know About Being a CNA

Workplace Culture and CNA’s

Being Professional

Horizontal Violence

A Call For Action

Shift Wars

The Nursing Process and CNA’s

Legal Issues for CNA’s

Observation

There are many other articles too- see the CNA Education Section to the left. These are free to use.

Those who don’t want to be represented by a Union are finding it difficult to have their voice heard.

A group of employees at Cedarbrook nursing homes told Lehigh County commissioners Wednesday that they want a secret ballot to determine unionization and raised concerns about the bargaining committee now in contract negotiations with the county.

Gone are the days when a group of employees had to VOTE for union representation. Now, it’s a simple matter of getting enough union card signatures. Many people do not know this; they will sign these cards under the guise of having an interest in learning more about a union. The cards are being used as “signatures” now, replacing the voting option.

In October, County Executive Don Cunningham asked the state labor relations board to certify Local 1776, based on a count of pro-union cards from 56 percent of the employees in the prospective bargaining unit.

But a group of employees, concerned the cards were solicited under pressure, filed a petition with the state board to call for an election, as had been done seven times before. The board set an election date but last week rescinded it after the union appealed. It concluded that based on labor statutes, Local 1776 legally represents the workers, and that a previous decision in a 1984 case to grant an election to petitioners was incorrect.

Still, anti-union workers circulated a petition asking for a secret ballot that had 163 signatures and was given to Dougherty Tuesday.

I think ballot votes should prevail in all union based activity. Using the cards is deceptive practice. A vote is the voice of so many. I also believe many unions know they cannot get the votes they need so they’re resorting to abusing these cards. 163 people are forced to work with union representation they do not want. This is fair isn’t it?

On September 16 2003 a nursing home in Tennessee burned down, and 16 residents died. Recently some records have been released regarding the investigations. Fire safety isn’t something to joke about. It’s not something to be taken lightly. CNA’s have an important role in all of this: When we see frayed wires, report it IMMEDIATELY. When we hear the alarms for a drill, ACT immediately.
Take it seriously.

Long shielded from public view, thousands of pages of court documents filed in connection with a deadly Nashville nursing home fire were released Wednesday by a judge’s order.
[...]
Documents filed by the plaintiffs describe what they say was an array of fire-safety hazards and deficiencies at the NHC facility that raise questions about government oversight of nursing homes statewide.

Attorneys for NHC have blamed the Nashville Fire Department for the high death toll, and filed an expert analysis of what they say were the fire department’s mistakes.

From what I read, it’s not just the fire departments who hold some responsibility here. The nursing home management has a lot of explaining to do. When they know of problems, it is their responsibility to fix it. Allowing things to remain in poor condition just because a life safety code inspection was passed is criminal.

From falsified fire-drill records to electric beds so poorly maintained they were fire hazards, many of the plaintiffs’ claims involve NHC’s maintenance man at the facility, Scott Hansen.

Those suing NHC claimed that by putting an untrained person such as Hansen in charge of fire training, the nursing home company set the stage for disaster.

Hansen also routinely repaired electrical beds and other medical equipment at the nursing home, although he stated in a deposition that he had no formal training in electrical repair.

In sworn statements released yesterday, Hansen and other NHC employees said the bed suspected of causing the blaze had been malfunctioning and was scheduled to be repaired.

Many nursing homes have these Jack-of-all-trades people working in maintenance positions…those who have a little experience in the trades- plumbers, electricians, woodworkers, ect. Experts in nothing, yet they are expected to fix broken electric beds and other equipment. Often this means simply placing electric tape over the frayed wires; often it means geri-rigging fire alarm systems that aren’t working correctly. It’s the cheap way out of things.

NHC attorneys have said that maintenance problems with the beds, if there were any, had no bearing on the deaths and injuries resulting from the blaze.

They also insisted that fire-drill records were not falsified, but were simply inaccurately dated, and that the facility’s fire plan was made simple so all employees could easily understand and remember it without formal training.

Much of this has been countered with staff testimony. Fire drills were not conducted. Staff were not exposed to the safety plans; no one knew what to do.

Lessons: Have a comprehensive fire safety program in place. Educate and train staff in what MUST happen when an alarm occurs.
Test their knowledge with regular, unannounced drills on all shifts. Cooperate with local fire departments and listen to their concerns; call the Fire Marshall in for consultation if needed.

When staff report wiring problems, remove the equipment. Stop using it. Utilize the services of a professional- not a handy man.

Links to Nursing Home Fire Safety Web Sites:

NFPA: Nursing home safety

Employee Emergency & Fire Prevention Plans

Fire safety: is your facility legal?

There’s been some heated conversation about the infamous Heart Attack Grille in the southwest and it’s raunchy “nurse” waitresses.

One of my favorite medical blogs has an interesting string of comments about this….

It goes without saying that this kind of place would never survive in Boston or indeed anyplace east of Minneapolis. (I hope! Tell me if you think I am wrong.) Even accounting for the free spirit of the wild West, I am having trouble with this one. Beyond the obvious pornographic aspects, it is demeaning to the profession and the people in it. The guy’s comments just add to the insult.

Some comments:
Some people have fantasies about secretaries, nurses, teachers, “stewardesses,” you name it, and can’t keep their fantasies in their heads - they start thinking or hoping their fantasy will come true.

Arizona’s libertarian lifestyle, which sometimes drives me up a wall (I’m anything but libertarian) emphasizes a sort of personal responsibility which begins to explain why it’s likely that the AG and Maricopa County will get involved, if nothing else to shame him out of business; this is an affront to Western values as much as it is to ours.

When you denigrate a group by creating a stereotype, it is really insidious and nasty. See how you as a Westerner felt? That’s the way the nurse who came to me felt when she saw what was happening in this restaurant and especially when she read the owner’s comments.

When my co-workers and I read the article written in the Standard Times we too were appauled. We one, worked far too hard to earn the credential attached to being a nurse and two, are more than “eye candy”! We are professionals and deserve to be treated with respect…..

The personification of nursing in media ect-tends not to reflect the true nature of what a nurse does in a day. This incongruence can be incredibly frustrating for a nurse. Maybe this is what the fuss is about- Lets face it there is a significant nursing shortage and many talented people are leaving the profession.

I might even have laughed at the concept of the “nurses” serving vats of grease to “patients” in the restaurant. But now I see too many sick and dying people being taken care of by people who have devoted their lives to healing.

Regarding the naughty nurse situation: the larger problem ,of course, is how most people accept, and often do not recognize, behavior demeaning to women in general,regardless of ones profession.All these unmindful,insulting actions insidiously filter into our perceptions of what is accepted in our society.

This, from FOX news:

EVANSVILLE, Ind. — A resident of a long-term care facility had maggot-infested wounds so advanced that skin peeled off her legs when a hospital emergency room nurse removed her clothing, state inspectors found.

Riverwalk Communities, which has a history of violating nursing home standards, could face state action for the woman’s care, said Jennifer Dunlap, a spokeswoman for the State Department of Health.

Let’s look into this a little deeper.

According to the state’s investigation, the woman, whose age was not released, had refused treatment for her wounds and to be bathed for five days at the licensed 113-bed health-care facility before she was taken Nov. 3 to Deaconess Hospital.

The hospital’s emergency staff found festering sores on both of the woman’s legs and maggots emerging from wounds infected with treatment-resistant bacteria, according to the state’s report.

An emergency department nurse told the state surveyor the woman’s right slipper and pants legs were stuck to her skin, the report said.

“He indicated he soaked her right foot in warm water for 45 minutes and bugs/cockroaches were crawling out of the house slipper. Upon removing the house slipper, he indicated the skin came off of the right foot and toes,” the report said.

When the nurse removed the woman’s pants, the material pulled the skin off the woman’s legs, from the knees to the ankles, according to the report.

Bugs and cockroaches? This is hyperbole. Peeling skin, yes. Wounds, open? Yes. Maggots? Yes. But cockroaches? NO. This has to be a false statement. There are wound care therapies that involve the use of maggots for treatment.

Christine Goad, Riverwalk Communities’ administrator, defended the center’s performance in caring for the woman, whom she said Wednesday had returned to Riverwalk after her hospitalization.

Goad said that in late October, an aide noticed sores on the woman’s legs when she was bathing her and immediately contacted a physician, who prescribed an antibiotic, an ointment for the sores and specified regular dressing changes for them.

The woman agreed to the medication and treatment for four days, but then began refusing all medications and the treatment and refused to be showered, Goad said.

Residents refuse treatments all the time; they become sicker or wounds grow worse and become infected. Normally the doctors are called and orders for restraints can be obtained, as a worst case thing, to ensure these residents get the needed care. If the woman had dementia, that would complicate matters even more.

“I contacted a wound specialist and an ordinary house fly could have laid an egg on those dressings and it would develop into a maggot in 24 hours. He said he’s seen it many times,” Goad said.

The state’s survey report found, among other things, that Riverwalk officials had failed to notify the woman’s physician when she refused his prescribed treatment.

While residents can refuse treatment, “that does not absolve the facility from protecting the resident,” said Michelle Motta, Vanderburgh County’s long-term care ombudsman.

Goad said that under a compliance plan approved by the state Dec. 5, Riverwalk staff must now contact a doctor immediately if any resident refuses medication or treatment specified by their physician.

When a resident refuses treatment, they or their legal guardians can charge nursing staff with assault and battery when care is provided against their will, as well. The Ombudsman knows this. The Ombudsman would be the first person to recommend these charges as well. It’s often a no win situation. Simply notifying the doctor of refusals of care don’t usually amount to much. Orders for restraints can be written but these are only good for 12 to 24 hours. A call every few hours, to an MD, from a nurse, asking for an order to hold down a non compliant, combative and demented resident won’t go over too well. I don’t have an answer for this- but punishing the nursing home isn’t one of them.

This sounds promising.

WASHINGTON (AP) - Needing a wheelchair isn’t always the biggest complaint of people left paralyzed by spinal cord injury - it’s also the loss of bladder control. On Monday, Michigan doctors began a unique experiment to see if rerouting patients’ nerves just might fix that problem.

It’s a delicate operation: Surgeons cut open a spot on the spine and sew two normally unrelated nerves together - one from the bladder to one from the thigh - with a single hair-thin stitch. It will take months for this new nerve bridge to heal, an anxious waiting period for the first volunteers.

But if it works, merely scratching the thigh should signal the bladder to empty, allowing patients to ditch their despised catheters and restore a longed-for degree of freedom, as well as fewer bladder infections and other serious complications.

“I’ve got nothing to lose by doing this,” is the way a cautiously hopeful Kevin Bryant, 19 and paralyzed from the waist down by a car crash, approached the experiment.

It’s a technique pioneered in China that is starting to garner international attention - and surgeons at William Beaumont Hospital in Royal Oak, Mich., hope their new U.S. study will prove if the approach really is a solution for at least some patients.

“We’re very excited,” says Dr. Kenneth Peters, Beaumont’s urology research chief, who headed a team of doctors that traveled to China last February to watch Dr. Chuan-Gao Xiao operate at the Huazhong University of Science and Technology.

“We said, ‘This is something we need to study … to see if we can reproduce this in the U.S.,’” adds Peters, who in turn invited Xiao into Beaumont’s operating room Monday. If the results hold up, “it would allow us to treat those patients who have no other alternatives.”

Monday’s first volunteer: a 49-year-old paralyzed from a car crash, Kevin Conkey of Fenton, Mich. On Thursday, Bryant, the 19-year-old paraplegic, undergoes the procedure - in addition to a child with spina bifida, an improperly formed spinal cord that can cause similar bladder dysfunction.

If this works it will change the lives of SO many people. And will change the work of those who take care of them.

Across the pond they have identified a new strain of MRSA. It’s only a matter of time when we will see this in the US.

A healthy hospital worker died after contracting a deadly new strain of MRSA that had never before been reported as a cause of death in hospitals.

Four other workers at the same hospital also contracted Panton-Valentine Leukocidin-positive (PVL) MRSA, with two of their friends, said the Health Protection Agency. An investigation subsequently found that the strain had killed a patient at the hospital earlier this year.

The strain, which is particularly virulent, attacks healthy young people and can cause symptoms ranging from minor infections in the skin and soft tissue to a form of pneumonia that can kill in 24 hours.

The outbreak, which has only just been reported, was identified when a previously healthy female healthcare worker, named only as “Case One”, developed a severe MRSA infection and pneumonia and died after emergency surgery in September, the agency said.

The bacterium that she had contracted, PVL-positive MRSA, had never been found to cause a death inside a hospital. It was contracted by at least three other workers in two wards in a West Midlands hospital, and two of their friends.

It was also found to have caused the death of a patient at the hospital in March.

A statement from the agency said: “Eight cases of PVL- positive community-associated MRSA have been identified among individuals in a hospital and their close household contacts in the West Midlands. Four of these individuals developed an infection, two of whom subsequently died.”

Doesn’t sound good- these new germs keep mutating and turning into things we cannot treat.