Archive for the 'News' Category

This is an age old question: Should CNA’s pass meds? What if we had more training? What if the states mandated that the practice of CNAs include passing routine medications as delegated by the nurse?

Forbes has an article up about this very subject:

Frail seniors, as well as adults with disabilities, often need help with routine medical care such as taking pills, receiving injections, getting oxygen, or managing catheters. Traditionally, this assistance has been provided only by nurses. But, especially for people living at home or even in assisted living facilities, having a nurse provide this routine care is prohibitively expensive and can lead to long delays in getting assistance. As a result, states are increasingly permitting home health aides or certified nursing assistants to take on these responsibilities.

Personally I don’t see where I would have the time to collect meds and pass them. If a system could be set up that made this process very simple and involve very little time, I think it could work.

Articles like this leave me speechless. A man volunteered at a nursing home for years without any problem. One day he witnessed an abusive occurrence. He reported this. He started seeing more abuse and continued to report.

His story is here.

For the first time, he was told he couldn’t visit the nursing home, that it constituted trespassing. Feeling that the residents had the right to have visitors, on January 26, 2011, Edmund disobeyed those orders, and found himself arrested. He spent time in jail at taxpayer expense. He had never been arrested before.

It’s too bad this gentleman had to experience all of this. Doing the right thing can be difficult when you’re up against big corporations and especially nursing home chains. We need to support those who have the guts to speak up. Support can mean cheering them on, assisting with paying for legal help, etc.

I’ve been doing this work for over 20 years now and had my unfair share of injuries while performing my duties. I have often heard bosses moan and groan about worker comp rates and cost loss problems. Those of us who work in this field KNOW getting hurt on the job is almost…part of the job at times.

An article here validates this:

We’ve seen reality shows featuring dirty jobs, cops and coal miners. I wonder if it’s time for one showing a day-in-the-life of nursing home workers. Most of us don’t give much thought to what goes on inside of nursing homes, that is until a friend or family member needs to reside in one. What might appear as a quiet, slow-paced, restful setting is usually a stress-filled, physically-demanding environment for the people who work in them. Lifting and moving patients from beds, toilets, recliners, showers, and wheelchairs can cause all sorts of injuries, but then throw on top of that, the body fluids and infectious agents, staffing shortages, and violent patients and family members. On second thought, it’s probably not a tv show that would attract many viewers.

I think it would be good to have a reality show on Life in The Nursing Home. A Day In The Life of a Nursing Home Worker.

Here’s an excellent article for nurses (and anyone who works with people with AD) with some helpful ideas on communicating with this special population.

Becoming an Alzheimer’s Whisperer

Once we get the communication part down, we can provide successful care to these people.

In the March edition of Long Term Living Magazine, an article was written about nursing home and assisted living residents hiring their own staff. This is a unique development in our line of work, and one that could have wonderful implications for the next generation of people who need LTC services.

You would expect the DON to be involved in every aspect of recruiting a CNA, and Judson is indeed involved. But, at the hour of decision, she silently steps aside and the residents take over.

A team of four to six residents, their homework done and ready to meet the applicant, stroll into the conference room. It is a meeting of the ages. On one side is arrayed the accumulated wisdom of the seniors who look benignly across the table at the eager young aspirant, Angelica Riviera, 19, idealistic but nervous. The dialogue across generations goes on for 45 minutes, with storytelling, jokes, and much laughter, as each side wonders how the other side will affect its future.

Isn’t this great? Imagine being a resident, and having some power in who is hired to work with you, to take of you, help you?

The DON is instrumental in this process:

“Seeing residents hire their caregivers is rewarding enough,” says Judson. “It has also elevated my understanding of what matters most to the residents. It has made me a better leader and a better person. It is an empowering and uniting experience for us all. Sitting on the sidelines, I listen to residents tell a budding caregiver what living in a facility is all about; at each session I learn something new.”

Read the whole article HERE.

I found this web site that lists the desired competencies for those who wish to work as nursing assistants. While the list is comprehensive, I have to say that for every aide I know who exhibits these traits, there are 2 that don’t.

Summary Report for:
31-1012.00 – Nursing Aides, Orderlies, and Attendants

Work Styles
Concern for Others — Job requires being sensitive to others’ needs and feelings and being understanding and helpful on the job.
Dependability — Job requires being reliable, responsible, and dependable, and fulfilling obligations.
Integrity — Job requires being honest and ethical.
Cooperation — Job requires being pleasant with others on the job and displaying a good-natured, cooperative attitude.
Self Control — Job requires maintaining composure, keeping emotions in check, controlling anger, and avoiding aggressive behavior, even in very difficult situations.
Stress Tolerance — Job requires accepting criticism and dealing calmly and effectively with high stress situations.
Attention to Detail — Job requires being careful about detail and thorough in completing work tasks.
Adaptability/Flexibility — Job requires being open to change (positive or negative) and to considerable variety in the workplace.
Social Orientation — Job requires preferring to work with others rather than alone, and being personally connected with others on the job.
Initiative — Job requires a willingness to take on responsibilities and challenges.

And far be it from me to speculate, but the following competencies are above the education and typical training offered to CNA’s:

Knowledge
Customer and Personal Service — Knowledge of principles and processes for providing customer and personal services. This includes customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction.
English Language — Knowledge of the structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar.
Psychology — Knowledge of human behavior and performance; individual differences in ability, personality, and interests; learning and motivation; psychological research methods; and the assessment and treatment of behavioral and affective disorders.
Medicine and Dentistry — Knowledge of the information and techniques needed to diagnose and treat human injuries, diseases, and deformities. This includes symptoms, treatment alternatives, drug properties and interactions, and preventive health-care measures.

Regardless, it’s an interesting site with a lot of good info for those who are considering training to be a CNA.

Every CNA is either a stayer, a switcher or a leaver. So says a new study about job satisfaction among aides.

Sometimes, it’s not all about the money. Instead, job satisfaction and emotional well-being are better indicators of retention in long-term care facilities, particularly with nursing assistants, according to new research from Rice University, University of Pittsburgh, and Baylor College of Medicine, published in The Gerontologist.

Well better pay wouldn’t hurt retention numbers, that’s for sure.

Researchers looked at turnover rates of 620 certified nursing assistants to give administrators an idea of work-related factors that contribute to turnover. Previous studies have over-exaggerated the turnover rates, said study coauthor Vikas Mittal, professor of marketing in Rice’s Jones Graduate School of Business in press release, because previous research included data from both full- and part-time workers.

They assume that most aides have chosen the hours they work; some of us do, but many of us would prefer to work full time but it’s not an option thru our employers. Usually this is the case so benefits don’t have to be available to part timers.

Instead, they found that most nursing assistants (85 percent) did stay at their position. The study identified “stayers” as those who remained at the same job with the same organization for a year after they were surveyed, classified “switchers” as those who continued to work at least 30 hours at a different organization, and “leavers” as those who no longer worked in direct-care or left the workforce all together.

So which type of aide are you?

It feels odd to be classified like this. Once again, we’re not people with families or financial needs- we’re being labeled yet again.

We’ve written here about how CNA’s are often the victim of discrimination and racism. But this article takes the other side to the extreme:

WEBSTER — A certified nurse’s aide is charged with allegedly hitting an elderly resident at a local extended care facility after the resident, who is suffering from dementia, called her a racially derogatory name.

It’s hard to be called names. It’s even harder to be called racially charged names. How do aides ignore this and walk away? Is there a better way to prepare people who want to work as aides, to deal with these comments?

Follow the money. Really.

The nursing home industry gave at least $1.8 million to Kentucky politicians over the last decade while lobbying against bills that would require them to hire more direct-care employees, face higher fines for violations and abide by stronger precautions against elder abuse, among others.

While it’s no surprise, I was a little taken aback to learn of the political parties of those involved with this. And I suspect this is very common in every state.

For all the “conversations” this nation has regarding race issues, it seems that this should not be a concern: Residents/patients having the “right” to chose nurses, aides and other caregivers based upon their race. But it happens, often. It’s wrong. It’s discriminatory. And it’s about time something changes to end this. Indiana recognized this and have made it illegal.

INDIANAPOLIS (AP) – Certified nursing assistant Brenda Chaney was on duty in an Indiana nursing home one day when she discovered a patient lying on the floor, unable to stand.

But Chaney couldn’t help the woman up. She had to search for a white aide because the woman had left instructions that she did not want any black caregivers. And the nursing home insisted it was legally bound to honor the request.

As usual, laws are written without legislators thinking of the consequences. It usually takes a few years for the full effect of these consequences to come to light.

Elderly patients, who won more legal control over their quality of life in nursing homes, sometimes want to dictate the race of those who care for them. And some nursing homes enforce those preferences in their staff policies.

The nursing assistant in this case sued the facility:

Documents in Chaney’s lawsuit, filed in 2008, say her daily assignment sheet at Plainfield Healthcare Center always included the reminder that one patient in her unit “Prefers No Black CNAs.”

Chaney, a 49-year-old single mother who at the time was helping to put her only son through college, initially went along with the policy despite her misgivings because she needed the money.

“I always felt like it was wrong,” said Chaney, who has worked in nursing homes since she earned certification in 2006. “I just had to go with the flow.”

The nursing home said it was just following a long-standing interpretation of the patients’ rights law. “The rules say this is their home and everyone else is just a visitor there, including staff,” said McSharar.

We work in a high stress field. No one deserves to be singled out for any reason, rejected and actually written off as a “patient right” issue. I’ve seen the opposite happen as well: Black residents refusing care from white (or Hispanic or Asian) aides.

An aide is an aide. A nurse is a nurse. We all have the same basic training and are fully capable of doing our jobs. It’s about time older people understand this.