If anyone has any tips/tricks/hacks for care givers, please let me know! No tip to common so feel free to suggest and don't assume I've already heard of the technique. I want this job to work. God put me there! But really need some advice due to the severe minimum staffing level on how I can work faster! Thank you for any advice you can provide.
3 caregivers:
Supervise against elopement/inappropriate behavior
Notify the nurse's assistant in writing when a resident if off kilter
Notify the nurse's assistant when a resident does not have adequate supplies
Assist the nurse's assistant as needed
Assist the activities director as needed more days than not
Set/clear tables for a meal
Serve one hot meal and choice of hot or cold drinks in the dining area
Serve dinner to the rooms of residents who don't come to the dining room
Make fresh sandwiches to those who don't like the dinner offered
Provide on-demand additional snacks
Toilet and dress about half the 57 residents
Wash and put away dishes, cups, mugs, flatware and some pots from dinner
Put everyone to bed, put on pajamas
Serve on a shower team
Wash, fold, and return residents' laundry on a team
Chart
Tidy-up inadvertent messes
Forage for emergency supplies when families don't stock enough
Update lists
Try to impress visitors
Take out toilet trash immediately for each resident
Take out a 33-gallon garbage
Take out trash from a couple restrooms and a break room
Do other tasks as assigned
Remove dog waste from the exterior as needed
Can 3 people really do this for 57 mentally incapacitated elders? Any reasonable person knows it's impossible. If there any serious neglect or abuse worth reporting of course it will get reported, so I don't want readers to worry about the elders. Everyone I work with has a huge heart & wants to please the residents. But it's impossible to serve 57 people with 3 people. I find myself getting shorter and shorter with residents. I don't have time to look at their lovely photos or listen to their problems! But when I did care giving in people's homes, we always had time to listen because companionship was just part of the job. But not when you are caring for 19 people by yourself! One care giver generally could probably serve 10 people but certainly not 19! Washington State allows ANY staffing level as long as the job gets done.
The job does not get done! Because we are low staffed there are bugs in the kitchen, things are chaotic, residents shoelaces are hazards since we don't have time to un-knot them, meals are not truly served hot, sometimes a waste basket with a brief in it does not get immediately emptied., fruit gets microwaved on some dinner plates, caregivers are not as sanitary as they should be (caregivers have provided toileting care with no gloves, soap runs out of dispensers), paper towels run out, floors are not as clean as they should be, laundry is often a terrible chaos, caregivers are not truly familiar with emergency procedures/equipment. There are many gaps in service.
After most shifts, I am ready to die in horrible pain, can barely walk or stand up straight, and am kicking myself because of gaps I left in service. My coworkers do not even take their short breaks & we all work charting when we are supposed to be on break or lunch. Whenever anything goes wrong, the care giver is blamed, not the staffing levels. There is constant staff turnover. Why is skeleton staffing legal? Is the government accepting kickbacks? Why doesn't the health department check our kitchen after hours?
"The New Jersey bill calls for: 1 CNA for every 8 nursing home residents during day shift (typically 7 am – 3 pm) 1 CNA for every 10 residents during night shift (typically 3 pm – 11 pm) and. 1 CNA for every 16 residents during overnight shift (typically 11 pm – 7 am)"
IMO this home is running illegally. They need to hire other aides if possible or shut down. Residents are paying for care and not getting it. I am surprised the State allows this.
Are many of your residents 2:1, though?
But as I said yes you do have my heartfelt sympathy. There is no time. There is too much work. There are standards we aspire to and are held accountable for which are impossible to achieve in reality. There are common practices in the sector, including gaslighting and double binds, which are so blatantly abusive of workers that the fact we don't even consider reporting them itself shows that the gaslighting is successful. Take your gloves issue as an example.
You MUST wear gloves.
There aren't any gloves.
Why didn't you order the gloves?
We did order the gloves, they haven't been delivered.
You can't provide personal care without gloves. Now, why hasn't Mrs Muggins had her shower this morning?
[Credit where it's due - when this came up with us once, mid-Covid, our Service Manager got in her car and drove to God knows where to get PPE which she paid for herself.]
Why can't we get the staff... Is it the pay? Is it the profit? Is it the government? If you ask me, it's the negative social status. Why aren't people with a decent standard of education and domestication and moderate personal hygiene - which is all you need, really, to make a start - prepared to engage in a career that is unparalleled in terms of fulfilment and social value? Because... I can put it in a nutshell. My children are embarrassed to tell people that I'm "a carer."
And the clients' attitudes?
"So, S, why are you doing all this dirty-work?"
"You can't be from [team]. You look much too professional."
"I couldn't do your job. I don't know how you can do your job."
"Can you girls make sure you put the cream on" - this one does bring on my red mist, because it's always from District Nurses who are young enough to be my granddaughters and who apparently haven't noticed that quite a lot of us are boys.
Anyway. The next time I hear anyone whining on a radio phone-in about failure to recruit to the social care sector I'm going to call in and ask what they're doing about it. "If not you, then who?"
What should we do? How can we help?
No way can one person care for 19 people.
This situation is criminal but, Washington state is corrupt to the core.
understaffed. The SNF my mom was in had 40 patients, 2 RN's & 2 CNA's. I'd call the nurse station nobody ever answered the phone. Couldn't reach my mom by phone one weekend, called the AL building&threatened to have the Sheriff Dept do a welfare check. I felt terrible for the staff, patients and especially my mother.
I have no way to know, OP, how old you are or how long you’ve done this VERY NOBLE and ESSENTIAL WORK, OR (very important) whether your geographic area was effected by COVID (mine was a hotspot, with ongoing devastation).
Instead of having a central, scientific, well ordered approach to wholistic care, we as a country had…….what we had.
Some areas didn’t see any of this as a problem.
Some suffered, from hands on personnel to medical staff to “government” inspectors. Our “family” residence did.
I apologize to you OP, and applaud you for wanting to make things better. You have described what I have seen.
In my geographic area, there are not enough healthy, able, well trained people to meet all of the demands currently needing to be addressed.
No obvious solutions around here.
It's so hard wearing a mask. I have my own health conditions like asthma and more. For 40 years, the industry made us get TB shots because "You'll never, ever be able to wear a mask while working, especially in summer! You couldn't do it!" But, suddenly we all had to do it, and are still doing it, thanks to Covid. I guess there's no need to get the TB thing now because we all have to wear masks anyway lol. "I'll wear the mask" ha ha, I wonder if they still accept that. We do have a shortage of workers right now.
"Hello. There is nobody available to take your call at the moment and you can't leave a message. Please call again later."
The client arrived home about two hours later to everybody's delighted surprise (yes, including his), but without his medication or discharge summary and with the wrong night bags for his new indwelling catheter, and only four of those. And without a two-person assist, despite the OT's request, which made getting him up the nine steps to his front door interesting.
It isn't just us, it's murder on the dance floor for all areas of health care right now.
CM,
How many accidents do you see with the elderly dealing with stairs?
My uncle ended up living in his basement before entering a facility because he could no longer go up and down the stairs in his 90’s.
It doesn't matter if it's wrong all you can do is report these things to the proper agencies. More than likely nothing there will change.
All the money they charge for this is truly sickening that most are not held accountable with required staffing.
As people are living longer and longer with dementia and incontinence and being bed ridden I dont see this getting any better only worse with an aging population.
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