Category: Advice For CNA’s

We have seen high turnover for years in Long Term Care; not just CNA’s, but nurses, Administration, housekeepers. The work is brutal and there are few benefits to sticking it out. CNA’s in particular have a very high rate of turnover. It’s not uncommon to hear of aides leaving a facility to go work down the road at another nursing home for a dime more per hour. This is leads into this topic of this article: Giving proper notice.

In most lines of work, across all the various industries, people give 2 week notices. They do this in order to give the employer a chance to replace them. In Long term care facilities, there are often several openings for aides to begin with. When another aide leaves, it just compounds staffing issues even more. If an aide is scheduled to work many shifts but suddenly quits, it leaves ALL those shifts open and often unfilled. Who suffers? The residents, patients, clients fist and foremost. Then the aides left behind to do the extra work. Management has to fill the position and do all the human resource things associated with this: Background checks, abuse registry check, hiring, orientation, mentor-ship if there is any, and on the job training.

I understand the reasons for wage shopping in jobs in this field. Money is tight and people need to make a living. Some people would laugh at a dime an hour increase in pay but when you’re living paycheck to paycheck every dime counts. Still, it is so important to leave on good terms. When an aide or anyone else quits without a notice, they almost always end up on the “No-re-hire” list- which is important if one wants to get a decent reference. Trust me- a bad reference is not a good thing in this work. And very often, the DON of one nursing home is friends with many DON’s of many local nursing homes- they usually have a network. They warn one another about staff who quit without notice as well as staff who are placed on LOA pending an abuse investigation.

Some other reasons for two week notices:

• In the future at another agency, you might end up working with some of the nurses and aides  of the facility you left. One of those nurses could be a DON of a nursing home you want to work at, or hospital.
• You may want to come back to this facility in the future. Now you think I’m truly crazy. You’d never want to work for this horrible nursing home again! Well, remember that whole turnover thing? 5 years down the road, the new management of the nursing home may very well increase pay rates and offer better benefits. You would love to go back now. But you can’t because there’s that “No Re-hire” comment attached to your SS number.
• There are financial benefits to giving notice. If you have any vacation time accrued you may lose it if there is a policy about giving two week notices. Also, consider any health insurance facts as well. You will lose coverage.

As well there are some valid reasons to NOT give any notice:

• An employee has been physically abusive.
• A supervisor has sexually harassed you.
• Your mental health is being seriously endangered by job stress.
• You have not been paid the agreed-upon wage or wages have been withheld for an unreasonable length of time.
• You have been asked to do something which is clearly unethical or illegal.
• Personal or family circumstances are such that you need to leave the job.
• A crisis has happened in your life, and there is no way you can continue on the job.

Remember it WILL be the residents who suffer the most when you leave. If you have relationships with them, cutting out without notice will be especially painful for them. It will feel like a death in their family. Only you can decide but it seems to me there are better reasons to give the 2 week notice than there are to just walk off the job.

 

 

The work we CNA’s do is HARD; some say brutal. The stress we put upon ourselves while performing our duties takes a high toll on our bodies. We have to take care of ourselves. And I mean that- especially at work.

Some of the things I do to make sure I’m ready and physically able to do my job are pretty mainstream, or so I thought. Lately I’ve noticed newer aides not bothering to do simple things that can make such a difference.

1) The usual items we hear about are par for the course: Eat right, exercise and get plenty of sleep! Easier said than done in today’s busy world. Family, friends, commitments, kids’ games and activities all keep us, at times, TOO busy to care for ourselves.

2) We use our legs, arms and backs for the vast majority of the tasks we perform. It makes sense to stretch these muscles before we use them. Before I go to work, each shift, I do some simple little stretch exercises that really have helped me stay limber, and I believe they help me perform the lifts and other harsh aspects of this work without pain, and without injury. Please seek your doctor’s opinion before attempting these. The links take you to a site that illustrates how to do the stretches.

3) One thing I always have on my person is my own GAIT BELT. I don’t use the ones work provides; I prefer my own since I take care of it. Actually I have three belts- and it’s important to wash them between shifts. Think of all the germs that come into contact with these things! I have a small can of Lysol spray in my locker and every so often I use it on the belt…to kill the germs.

4) When I am working, I ALWAYS CARRY a small bottle of hand sanitizer. The stuff comes in sprays and pen form now too. I use it A LOT. I work with an aide who will rub it all over her face every so often- and she never gets sick! I use it every time I touch a door knob, or answer the phone. Some of my peers think I’m a little crazy about this- but I rarely get sick. I use it liberally and purchase several trial size bottles at Wal Mart.

5) Staying hydrated. A big one for me. Where I work it’s dry and the air is filtered, so little fresh, outdoor air comes in. I used to not bother drinking water because I didn’t think I had time. I always felt thirsty and my throat hurt due to the dryness. I don’t care for straight water; but I do like Vitamin Water- which comes in many flavors, is very low in calories and tastes good. I get them at Wal-Mart for less a dollar each and only buy them for work; I bring two or three bottles with me.

6) Eating at work can be challenging. We all know that our breaks are often interrupted, or short to begin with. It’s important to bring your own meal with you unless the facility provides them. Even then, I would opt to pack my own lunch. I know a lot of aides who skip meals altogether. That isn’t healthy. I pack a small lunch: A sandwich or pita wrap; some fruit, a granola type bar…keep it simple. Yogurt with nuts is good; a medium size salad can fill me up as well. I try to incorporate the major food groups: Meat, veggie, fruit…protein and the like. Premade pasta salads are very good as well.

7) Vitamins. A lot of people take them. Many or a few or even one. We each have our own needs and desires with this stuff. I take a multi vitamin AND lots of extra Vitamin C: We are exposed to a lot of germs and viruses every day. It’s important to stay well-nourished and the food we eat should provide us with all the daily requirements…however, there are some vitamins that don’t absorb well due to medications or lifestyle habits. It’s important to seek medical advice before embarking on any vitamin regime.

 

Finally, I always have on my person, a bunch of things that might be needed (and from experience, have indeed BEEN needed!)…A small bottle of Tylenol/Advil/Bufferin or whatever pain reliever works; some TUMS, a little bottle of IMODIUM; band aids…all travel size bottles or packages- that fit neatly in my bag or in the glove compartment. One never knows when the headache from you-know-where will come along; it’s good to have some relief on hand.

 

In our article TIPS & TIMESAVERS, 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 and agency staff as well.
• I record my assignment– resident’s 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.
• Any family visits and any issues/concerns arising from visit.

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, its way too 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.