Monday, March 29, 2010

Can't see or hear- and that's just the staff

It's pretty much the same old at the old age home.

Last night I worked with the aide that I "harassed." All night, she ignored call bells and bed alarms. I stood my ground and told her to answer them. She rolled her eyes, sighed, cursed me. In the end, the safety of the patients had to prevail and I ended up answering most of the bells and alarms while she sat there glaring at me. Amazingly, nobody fell. Nobody ever does fall with her. I do not want someone to fall or get hurt, but I am waiting for the night when one of the patients on her assignment does fall and I get to write on the incident report, "Bed alarm sounding. Aide sitting outside room. Nurse responded to alarm and found resident on floor." I have never written an incident report so as to assign blame to an individual, but this is what administration wants. This particular aide has advised administration and the night supervisor that she has no intention of performing the duties required of her job, yet they keep her.

One particular bed alarm highlights the issue. I went to another floor to obtain forms. (Only one floor has a system to keep papers in order. One out of three is not too bad, I guess. No, computers are not used at all. Every record is handwritten on paper. I have to use my own laptop to file death certificates, which now can only be done online in my state. But that's another story.) That floor had a urine specimen for the fridge to await pick up. The fridge is located in the beauty parlor (which disgusts the beautician, but that's another story), which is inconveniently wedged on the floor I was working- in between the oxygen closet (you guessed it- I don't have a key) and the air vents. I brought the specimen down with me to place in the fridge. As I opened the door to my floor, I heard a bed alarm sounding. The aide was seated in an arm chair, looking quite bored. I said, "Can you go see who that is?" (I wanted to scream, "What the hell is wrong with you? Answer the damn bed alarm before somebody is on the floor, you stupid bitch." But I restrained myself.) Her eyes rolled. Sighed. Arms fell to the sides as her entire body collapsed into the chair more. Head shook back and forth. The fill-in supervisor was nearby. She looked for her keys, then for the key to the door of the beauty parlor, then we went in, found the light, placed the specimen in the fridge, turned off the light, locked the door. I washed my hands. I heard the alarm still ringing and saw the aide meandering through the hall, casually looking at (not even into) each room, as if she was window shopping on a too-long lunch break. I went down the hall towards the sound of the alarm, quickly bypassing her. The resident had not fallen. She made it from her bed to the bathroom. This particular resident is slower than molasses pouring out of a fridge, as another resident described her. She finishes breakfast as lunch arrives, finishes lunch as supper arrives, and is still eating supper when night shift arrives at 11 p.m. Yet it took her less time to get out of her bed and walk ten feet to the bathroom than it did the aide to walk the forty feet to her room.

Although this aide is the extreme version, most of the other aides are similar in nature. They do some work, ignore the rest, and go berserk if they are told to complete their assignment. I can't work like this. This isn't team work. It's me taking care of sixty frail, elderly people with three employees actively rebelling against me. The response from administration: The nurse is responsible for the actions, or inaction, of the aides, but has no authority over them.

Tuesday, March 23, 2010

Who's in charge?

The aide who complained of my "harassment" was written up by the Director of Nursing himself for lying about the incident and disrupting work while she ran all over the facility trying to drum up support for herself.

I don't consider this a victory. If she is really viewed as a poor worker and a risk to the facility, she would have been fired and not merely written up again.

I saw that she rides in a car with three other aides. One of them acted up last night, hollering at me, "Don't start so early" when I directed her to care for a resident. I reported her to the supervisor. I added that I was tired of being screamed at by the aides when I gave them the tasks of the shift, as if they were in charge instead of the nurse. I said that administration was well aware of the situation, that certain aides act as if they are supposed to tell the nurses what to do, and most nurses go along with it. I told her that it's unprofessional and a risk to the residents and my license, and that I can't continue like this. She agreed and said she doesn't see what she can do about it, other than leaving the company.

That's a shame.

Tuesday, March 16, 2010

Roughing it

Because of recent heavy rains, we had no electricity in the facility for three days. The generator gave us lights in the hallways and power with a few electrical outlets in the halls. That's it. All the food spoiled. I won't speculate about the refrigerated meds.

The residents handled the situation pretty well. Anyone with an electric bed couldn't adjust it. The power cords and few outlets were reserved for the trachs, the specialty air mattresses, and the feeding tube pumps. Somehow, the call bell system worked. No televisions. Thank goodness I had enough flashlights to give each CNA one so that they could halfway see the people they were changing. No elevators. The stairwells are alarmed and I was afraid that they would shut down, rendering the doors stuck shut, but that never happened.

The arrangement was nicely prioritized. The supervisor supported me in not rearranging the electrical supply to accommodate individual demands for electrical supply for bed adjustments, cell phone charges, and lamp lightings.

Friday, March 12, 2010

Job duties optional

More problems with a particular aide.

She doesn't take care of the residents well. Leaves siderails down, bed sky high, diapers on the floor, call bells looped onto the wall, etc. Denies everything, rolls her eyes, sighs, disappears. States she doesn't have to listen to me, I can do it myself, stop checking on her.

I had written her up last month. The behaviors continued. Doomsday supervisor told me that I couldn't write her up again because she would call it harassment; furthermore, it was pointless because they fired her a few years ago, she fought it, and won.

Last night, she kept hiding the call bells. Again, denied it, even when showed her work. A resident must never be left without the call bell because they can't seek help if they have a problem. They may try to get up by themselves and fall, or will report it in the morning to administration. I told Doomsday. The aide blew up when Doomsday spoke to her. Doomsday told me to write it up.

Later, at home, Doomsday called me and said that the aide was still in facility, bawling her eyes out, that we are harassing her, and that she has already filed complaints with the facility and the union.

What amazes me is that she is so damn brazen. She does a terrible job. I don't think that anyone would say otherwise. Yet she pursues this formally, as if she does a great job.

I don't know how this is going to go. I didn't "stay under the radar," as Doomsday tells me each night. According to her, corporate doesn't like me and she's the only reason why I'm not fired. I don't know if this is true. I do know that the Director of Nursing doesn't know me well, only speaks to me when there's a problem, and considers issues to be "cat fights" caused by female jealousy.

I guess it's a rite of passage to have to fight for a write-up, but administration has never had my back.

Tuesday, March 9, 2010

Things that go bump in the night

We are troubled overnight by three residents. One gets in and out of bed constantly. When she's lying in bed, she moans, "Help me out. Why won't you let me get up?" and then tries to get out of bed herself. As soon as you help her into the wheelchair to prevent her from falling as she does it herself, she says, "I'm so tired. Why won't you let me go to bed?" This goes on all night. Come morning, she tells the incoming shift that she was removed from the bed, not allowed to return all night, and physically abused, usually by being thrown across the room. This is followed up with, "So will my daughter take me home now?" Social services interviews her daily and documents that she is oriented in all spheres. So the implication is that she is telling the truth. A lot of time is spent on writing her daily incident report where the staff claims that she is not telling the truth.

The other one awakes at any moment and screams for attention. As the staff enters the room, she pretends to faint. She wants to be carried to the bathroom, moved in the bed, dressed in a different outfit, etc. If touched, she screams, "The pain! The pain!" and pretends to bawl. If you leave the room, she won't stop ringing the call bell, which is extremely loud at night and wakes others. The roommate will also get involved and start calling people on her phone. This can go on for hours. In the morning, she tells the incoming staff that the night shift stole things from her. Nevermind that she never had a diamond ring or a million dollars with her. Statements must be written daily.

The third one sleeps all night. She barely wakes up to take her 6 a.m. pills and immediately succumbs into sleep. She is forgetful. Around 7:30 a.m., she wakes up enough to telephone her daughter to state that she asked for help all night and was ignored. The daughter phones the supervisor, the director, the floor, etc., to start the accusations and suspicions all over again, as if the previous day's performance just didn't do it for these people. Again, more daily statements about how we paid attention to her all night.

This is a total, utter waste of time by three people who love to manipulate others. Instead of caring for the other 57 patients, some of whom are very sick, I have to spend most of my time documenting what each of these residents is doing every fifteen minutes. And at the end of the shift, it doesn't even matter because their families and administration believe them and not us. Yet if their families were so concerned, they should have pulled them out of the facility. And administration could come in before 9 a.m. to see what's going on. But they don't.

Monday, March 8, 2010

What to do next?

I haven't been posting in a while. I'm job hunting and house hunting, which are both time-consuming and tiring.

The good thing about nursing is that I could probably find work in any geographic location. So in a way, I don't want to commit myself to a long lease or even a purchase because that would limit where I would want to work next. I don't have warm and fuzzy feelings about my current job (as you probably inferred from this blog). Yet I've gone elsewhere twice and have returned both times. The grass was not greener on the side I went to, but I still think that the grass must be greener somewhere.

Monday, March 1, 2010

The last stop for everyone

A resident finally told me more of her story.

She's a strange bird. She sits up most of the night in her wheelchair at the nursing desk. She nods off every few hours. She refuses to go to bed, stating that she is homeless and has only her wheelchair to live in. Supposedly she is wealthy, has no children, but has a few nephews and nieces who can't wait for her to die so that they inherit what's left of her money. They visit her on special days, such as major holidays and her birthday, but that's it.

She told me that her younger sister accidentally killed their baby sister by burning her to death while playing with matches. The mother was never the same. Then the father was killed in a car accident. The mother eventually died and the resident came home one day to find herself locked out of the house with a note posted that she was not to enter or to remove anything. She blamed the sister for the lock out.

I don't know if the lock out was the fault of the sister or of creditors seeking to collect on the estate, but it does show why she carries the "homeless" feeling to this day. She married, but continued working throughout the marriage. I don't know if this was by choice or because they needed the money.

The overall theme is that every resident of the nursing home came from a different background, yet they all end up in the exact same place.