Residents are human like the rest of us, and certified nurses’ aids naturally need to treat them the same way they want to be treated decades from now. To be sure that residents are not neglected, take a few moments to think about all the needs that a resident has that must be met.
Residents need to have call bells within reach so that they can call for help when needed. Never walk past a blinking light over a door. Go in and see what needs to be done and take care of it. Water must also be within reach unless the resident has an order for fluid restriction. Elderly people in fragile health can become dehydrated easily and a residents’ suffering thirst would be a clear indication of neglect. A resident’s missing a meal would also be a form of neglect. Sometimes a resident will miss mealtime at your facility because of going away for a procedure at an acute hospital. When that happens, ask the kitchen to send another tray when the resident returns. If the kitchen is closed check to see what snacks are available, as long as they are in keeping with the resident’s diet.
The resident’s room should be as clean enough so that the resident will find it livable. Certified nurses’ aids are not expected to scrub the floors, but they should clear away clutter. If something falls onto the floor, pick it up promptly to prevent falls.
Hospital beds are designed for the mattress to rise into a comfortable position for changing linens, and for making patient transfers from gurneys to beds. After you have finished working with the bed, always lower it. If the resident is in bed, put up the side rails before leaving the bedside. This will prevent falls and injuries. Injuries from falling out of bed are preventable, and leaving resident in a dangerous situation is neglectful.
When incontinence is a problem it should be cleaned up promptly. None of us wants to lie on our own waste, and doing so can break down the skin, particularly in older people with fragile skin.
Residents who are unable to move in bed should be moved at least every two hours to prevent pressure sores. Pressure sores are signs of neglect.
Abuse can be a serious problem that damage residents, their families, the care facility, your career and the entire profession. If you feel that you are under too much stress, and have feelings of hostility, talk things over with your supervisor before you do something you will regret. Abuse can take the form of assault or battery. In assault, a person is threatened, either physically or verbally. Threatening to put a resident into restraints or raising your hand as if to strike would be forms of assault. Battery is even more serious. Battery involves using force against a patient. The only time when force would be acceptable would be to prevent the resident from harming him or herself or others.
Q. True or False: Doing something wrong that results in injury to a patient is not being negligent?
A. False. Making an error that results in an injury to your patient or a worsening of their condition can be the result of negligence even if the mistake was not intentional.
Explanation: You can be considered negligent if you perform a nursing assistant task incorrectly even if you do not realize and are not intentionally doing things wrong. You are also being negligent if you purposely cut corners or leave out steps of nursing assistant tasks to save on time. The same is true if you truly do not know how to complete a certain task and do not ask for help. If you intentionally complete a task wrong, such as working with a patient online on a task where it is required to have at least two CNAs, you are also being negligent.
Q. How should a nursing assistant respond if they see another nursing assistant or nurse, abusing a patient?
A. If you see a patient being abused by anyone, you should take immediate action to stop the abuse. If you are witnessing abuse in “real time” you must enter the room where the patient is being abused and put a stop to it. You must then report the abuse (or suspected abuse) to your supervisor. An incident report should be filled out as well.
Explanation: You are just as guilty as the person abusing a patient if you see abuse occurring and do nothing. You are legally and ethically required to take steps to stop abuse when you see it occurring. Take steps to help the patient avoid being abused at the time it is happening and then take steps to make certain it does not happen again.
Q. What are some of the ways in which a patient can be abused?
A. There are many ways in which a patient can be abused. One of the most obvious is if a patient is being physically abused. A patient can also be mentally, sexually, verbally or financially abused.
Explanation; Some forms of abuse are not as easy to recognize as physical abuse. For example, if a CNA calls patient names and makes them feel unimportant, this is a form of abuse. It is also abuse if a nursing assistant (or anyone else) is taking money or personal property from a patient. Neglecting a person by purposely ignoring their needs is another form of abuse.