Being a CNA in a nursing home is the hardest job you will ever have to do next to parenting. There are so many rules and skills to remember and everything has to be done properly; for your patients safety and for the safety of your job and license. That is what this article is about; making sure that you know what rules are top on the priority list so you do not get in trouble and your patients are given the best possible care.
Rule 1: If the patients chart says to turn every two hours – DO IT! Never skip a turning. Many aides will do a sloppy job of it or skip it altogether because most patients who requiring repositioning this often cannot talk to tell on them. They simply mark the chart that the job was done and go on their merry way. I realize how difficult it can be to turn a bedridden patient. They are usually very stiff and hard to move. Pillows and wedges must be put in place just so and this can take a large chunk of time out of your schedule, but it MUST be done. Not only will you lose your job, and possibly be charged with negligence, the patient will get bed sores and any other number of ailments because of not being turned properly.
Rule 2: If you must use a lift to get your patient up and the instructions on their chart say that two people must be present to perform the task, get another person in there with you. I know how hard it can be to get help unless you are part of the elite CNA club at work, but you are not there to make BFF’s; you are there to take care of your patients and if you have to piss a few people off to do it then so be it. If you ignore the instructions and do the task on your own, and something goes wrong, you are in big trouble and your patient can be injured beyond repair.
Rule 3: NEVER EVER talk about your patients with people outside of the loop. Their information is confidential and the law frowns upon sharing of information. Do not go home and tell your friend that Mr. Jones has a penis implant or that Mrs. Jackson has an STD. Your friend may know someone who knows someone who knows one of these patients and word spreads like wild fire about “juicy” details. This can actually land you in jail in some states so think twice about gossiping about your patients – even to other staff members. And NEVER look through a patients chart. That is confidential information that is for the RN’s use only. As a CNA you have no reason to look through it. They are very tight on this with all the new HIPPA laws in effect so tread carefully and do not let your curiosity get the better of you. You might want to read up a detailed post we’ve done about Social Media Posting Guidelines
Rule 4: Never eat off of your patient’s meal tray – even if they insist. This is a huge no-no! That food is for them no matter how hungry you happen to be at the moment. If you are caught eating off a patients tray, the least trouble you will experience is getting written up. And speaking of meal trays, pay attention to what your patients have consumed. I have seen too many aides simply pull numbers out of thin air when doing their chart work. It is important for the nurses and doctors to be able to see the true amount of food and liquid that the patients are taking in. There is a good reason for charting this info and it is part of your job- so do it!
Rule 5: Never make up numbers for your patients vital signs. Usually it is at the end of the shift when these are taken and we are ready to rush out the door to sweet, sweet freedom. However, we have to take and chart them for a good reason. A patient can actually DIE if you make up a number for their BP. What if their BP is twice as high as it normally is? This can mean so many things and if the nurses don’t know about the extreme change they cannot do anything to prevent tragedy.
Pay attention to all the rules and regulations of patient care. Your license if important but the patient’s lives are of a much greater importance than your license.