Keeping your back healthy is very important. We all know this. And yet, at every long term care facility I have worked at, I have seen aides cheat the systems and policies and rules when it comes to LIFTING. Aides will lift heavy residents by themselves; they will also refuse to use mechanical lifts designed to save our backs.

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What is stress?
Stress is the psychological and physiological response to events that upset our personal balance in some way. When faced with a threat, whether to our physical safety or emotional equilibrium, the body’s defenses kick into high gear in a rapid, automatic process known as the “fight-or-flight” response. We all know what this stress response feels like: heart pounding in the chest, muscles tensing up, breath coming faster, every sense on red alert.

There is little doubt that our job is stressful. On any given day you might be asked to take on extra residents due to call outs; you might be confronted with an aggressive resident; you might need to comfort a family member or calm down a angry co worker; the bosses might be on a very public rampage about overtime costs or some other concern. You might feel under the nurses’ gun for paperwork or some other request. These are emotionally difficult situations.

Add to this the physical part of the work- the lifting, tugging, moving of residents. The constant walking and rare breaks can and do take their toll on our bodies. So, when we’re working short and the residents are feeling OUR stress, we GET MORE stress tossed back at us. It’s almost like a vicious cycle.

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I see a lot of aides (and others) use these terms all the time. They get the two mixed and up and this causes much confusion for many people.

“Right To Work” is about union membership.

Each state has statutes on their books about whether a union can require ALL unionized employees to be members of the union, regardless of what the employee wishes at any given place of employment.

A Right to Work law guarantees that no person can be compelled, as a condition of employment, to join or pay dues or “fees” to a labor union. Such a law also reaffirms and strengthens the existing federal labor-law provisions that bar hiring discrimination against union members. Section 14(b) of the Taft-Hartley Act affirms the right of states to enact Right to Work laws. Currently 22 states have passed such laws.
Alabama, Arizona, Arkansas, Kansas, Florida, Georgia, Idaho, Iowa, Louisiana, Mississippi, Nebraska, Nevada, North Carolina, North Dakota, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, and Wyoming.

“Employment At Will” Is About Employment Terms
This term means that employment is presumed to be voluntary and indefinite for both employees and employers, under the Doctrine of Employment at Will. A employer may fire an employee for no reason, for fair and unfair-but not ILLEGAL reasons, and layoff people with no reason.

On the other hand, employees may quit a job for no reason, for fair and unfair reasons and give no notice. The doctrine works both ways. All states adhere to this doctrine; however each state mandates what are legal and illegal reason for termination. Of course, being fired because of your age, sex, your religious affiliation, sexual orientation and race are illegal. You should know what your states stance is on this- there are no lists online that I can find that detail all states.

Everything You Need To Know About Being a CNA

A lot of CNA’s ask what their rights are regarding breaks, meals and getting paid for such. Here are two lists of state statutes about breaks. Usually, rest breaks are paid; meal breaks often are NOT unless one works through it.

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Each state is able to mandate it’s own CNA:Resident Ratio. Only 8 states have mandated actual numbers…the rest either have no numbers, or use some formula of hours of care to be given and most allow the care of nurses to be included.

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In our article TIPS & TIMESAVERS FOR CNA’S, we advise new aides to keep a small notebook on their person. To write down answers to questions; to write down phone numbers and other info needed for the job.

Seasoned aides can also make use of a small notebook. They’re cheap, can be bought almost anywhere and come in so handy for CNA’s. A great resource, the little notebook.

I have one…pocket size that fits nicely in my scrub pockets. What do I do with it? A lot. When the nurse asks for VS on a resident/patient, I have paper to record the results. When a weight is needed; when a height is needed; when intake and output need to be recorded- these little pads come in real handy.

At the top of the page I write the date…day, month, year and shift I am working.

*I record the times I clock in and out- so if there is a discrepancy in my pay I can go back and check.

*I record what unit I’m working on, and the initials of the staff working with me. Even the nurses. And I note who is agency.

*I record my assignment- residents names. No need for more info; names are enough.

*Any falls or other incidents are recorded in my notebook as well…the vital stats are documented. Who. What. When. Where. Witnesses.

Some aides will go to the effort to write in certain info about their residents: BM’s, voids, showers, turning and the like.

Many aides use their assignment sheets to record all this info…and that’s fine. But I like to keep a personal record of these things. It can help you keep a clear record of your daily work and one never knows when this information can become necessary to defend one’s actions. Some aides prefer to write notes about their workday at home, away from prying eyes and nosy bosses. No matter where you do this, it’s pretty important to DO IT.

The legal environment in today’s nursing homes demand we keep clear records of the care we give. Most nursing home management can be trusted to not alter records, but not all. Aides can and have gotten into seriously hot water over issues and incidents that were not properly documented; flow sheets have been “corrected” to suit the best looking picture. Since aides are the lowest people in the chain of command, it’s way to easy to blame us for problems, issues, accidents and the like.

Who hasn’t been called at home, by the DON, demanding to know details about some incident that occurred last week? And who among us has a truly clear recollection of the events? If we had written down all the details, it would certainly help us during this call.

A little notebook can keep a lot of vital information. I wouldn’t go around telling everyone I have one though…management often doesn’t take well to such things. And we have to be extremely careful to respect HIPAA rules, but it is within our right to keep notes about our workday. I strongly advise all aides to do this.

Looking at last months archives of Nursing Homes Magazine, I found this article:

Striving to be employers of choice

Quality resident care that enriches quality of life and independence is the primary service of senior living communities. What most senior living employers have known for years is that the employees are crucial to this mission. Our employers believe that the best way to help employees care for their residents is to care for the employees. To accomplish this, senior living providers believe in maintaining and enhancing positive, direct, and meaningful relationships with employees.

Hmm.

So what do they list up?

We will adhere to the highest ethical standards in all aspects of our operations, including our relationships with employees.

We will comply with the letter and spirit of all federal, state, and local laws.

We will maintain and enhance excellence in resident care and services.

We will maintain a positive, direct, and meaningful relationship with employees by providing rewarding and meaningful work, individual recognition, career development, fair wages, employer-sponsored health insurance and other fringe benefits, open communication, effective problem-solving, and an environment fostering mutual respect and dignity.

We recognize the right of employees to engage in union and other protected concerted activity, to make an educated and informed choice about representation, and to express that choice through the time-honored process of National Labor Relations Board–supervised and valid secret ballot elections.

Okkkay…that last part mystifies me. WHY would any organization come out and proclaim to be employee friendly YET speak of unions? If a company strives to be the best employer yet panders this union talk, then we know the company isn’t all serious about being the best.

Here’s a reason why we don’t want to see private equity ownership of nursing homes: Using nursing home funds to start up other ventures.

HARTFORD, Conn. (AP) _ The state has begun investigating the finances of a nursing home chain owned by a Nashville recording studio executive.

Haven Healthcare, which provides about 1,800 beds in the state, has been sued by at least 12 creditors since 2005, the Hartford Courant reported Sunday.

That is about the time that Raymond Termini, Haven’s chief executive, launched Category 5 Records, which has signed artists including Travis Tritt.

Should we write letters to Mr. Tritt informing him that his career comes at a high cost?

Termini has acknowledged that he used assets from Haven to finance the record label and buy a house, but said none of that money had come from government Medicaid or Medicare payments.

Haven Healthcare received about $130 million in such funding last year.

It also was not improper to use cash from refinancing Haven homes in other New England states to invest in “non-health care companies,” which he hoped would someday generate a return to the nursing-home chain, he told the Courant.

It’s not illegal or against laws to use “profits” and other incomes from nursing homes- to buy and finance other companies. But we have to question the ethics of it. The fall out is bad and sadly not to many people seem to care. The neglect of nursing home residents on the back of these so called investment opportunities needs to be re-examined. Health care and profits do not mix.

An article that tries to have a look at both sides of the Manor Care/Carlyle buyout debacle.

It’s hard to know who to trust in the latest tussle over a private equity company going billions into debt to buy a nursing home chain. With nursing homes, it’s probably best to trust no one. If you’ve been in one lately, as a visitor, worker or patient, you know what I mean.

Like most people, I find it hard to trust the corporate giants that seem determined to treat nursing homes as commodities. In this dispute, Goliath is the Carlyle Group, which owns Dunkin’ Donuts and Hertz and promises to deliver a quality nursing home product.

Interesting perspective; make sure you read it all.