SO YOU WANT TO BECOME A NURSES AIDE part two

The job itself....at a health care center

It depends on which shift you work.
There are three shifts. Depending on
which facility you work at, what the
times are. But it averages, 6am...day shift
2pm...Eve shift... and 10pm...Noc shift.

If you work the 6am. You go in and get
a report from the Noc shift aides. You
want to know if there are any changes
that happen in the last 16 hours since
you left. That can be anything from a
behavior change to, physical change
(stroke, raised temperature and etc.).
You get your supplies to start your shift.
That is linen's cart, dirty linen barrels
and etc. It differs from facility to facility.

Then there is the start of the shift.
If you are working the day shift, it is
your duty with your partner, to get the
residents up, dress, and groomed in
time for breakfast. Some facilities have
the Noc shift help get some of these
residents up. As in the previous blogging,
you have about 5 -7 minutes to totally
get this resident ready. As you have an
average of 20 resident between you and
your partner to get up.

You always knock on the door before
entering the room. Giving a little bit of
time to adjust to you entering. Then
address them by name, and say good
morning, and why you are there. If you
have a person who can respond to you,
you ask them what they would like to wear.
If they don't know, you ask what color
they like for that day. Some of these
residents dress themselves. But they are
in the 10% of the residents. Another 10%
of them can dress the top half or can do
the grooming themselves. The other 80%
you have to totally dress and groom them.
Grooming is washing their faces, brush teeth,
and brush their hair.
Because you are running on a clock
situation, the fastest way to do this is
the following. Pull the curtain around
the bed, so you have privacy.
Put their socks on, then their pants,
and then their shoes, from the bottom
of the bed. Talk to them while doing
this. These are human beings, not logs,
in a bed. Treat them as you would
want to be treated. With dignity. Then
change their Attends (or what ever
brand they use) Be sure to clean that
area well before putting on the fresh one.
After the Attends is in place, pull
up the pants to the waist. Some
who can't move at all, you will have
to roll them over back and forth
until you get this done. Then sit
the resident on the side of the bed.
Place the gait belt around their
waist. Explaining what you are
doing and about to do. Placing
your feet well, so that you have
a solid foundation, you count and
lift, and turn and place the person
in the wheel chair. Put their foot
pedals on the chair. Then start to
change from gown to shirt. This
is easier if you have them placed
in the wheelchair, than it is in the
bed. After getting the upper part
dress, start with the grooming.
Combing hair, rinse off false teeth,
and making sure the person looks
good. If they can do their own teeth
and hair, then set them up with the
side table and you can make the bed
while they do that. Get the call light
where they will be able to reach it.
Make sure their water glass is within
reach and refreshed. When they are
ready to go, then turn on their TV so
they can watch their favorite show,
while you get the rest of the residents
up. As it will be a while before they are
taken down to eat breakfast. Then you
continue on. If the person is a two person
lift, you do the same until it comes time
to get the person up out of bed. Then
you get your partner to help you lift that
person, with gait belt on. Or a Hoyer if
needed. Then continue on. You will also
be called on by your partner to help
them lift their resident that they are
dressing.

Some facilities have a bath team.
Some don't. If you have a bath team,
then there might be some residents on
your floor that you won't have to get
dressed. As the bath team will after
they bathe them. There is a daily list,
and you are to always be aware of who
and when. Even it is you who will have
to get the resident bathed. If you have
to, then you will know which ones will
get their baths before breakfast, and
which ones after. Their beds are to have
a total change if it is their bath day.
Clean body, clean linens. In the larger
facilities it is on a 4 day rotation
.
After you have gotten the total floor up
and then into the dining room in the
hour and half that you have had.
Then it is time to get the meals in front
of the resident in a timely fashion.
Some eat by themselves, some need
encouragement to eat by themselves,
some need a limited help, with cutting
food and then there is the restorative
resident who needs help. And then the
ones who are to be fed.

This time is a social like time for
the residents. The more sociable ones
will talk among themselves. If you are
a restorative aide, you talk to your resident
to encourage them to eat, and to
encourage their effort in feeding
themselves. If you are an aide who
feeds a resident then you talk to them.
This is not the social hour for the aides.
You don't talk about what party you went
to last night, what happen at the bar
you were at, the fight between you and
your husband, the fight with your kids
or friends. All of this is inappropriate.
By talking over the resident you are
making them feel like they are not there,
and you don't care about them.
If you want to relate a funny story about
your kids,husband or friends, to the
resident themselves, that is fine. They
want to feel like they belong. And they
can always use a good laugh.

After everyone is done in the dining
room, then it is time to make sure those
residents who need reminding, to go to
the bathroom. The ones who can't go by
themselves, then you take them. Lifting
from the wheel chair to the toilet. And
then there are those who have no control
over their bladder or bowels, so you lay
them down and change them. This has to
be done in about an hour's time, as activity
time comes up about an hour after meals.
Also thru this you and your partner, rotate
to take a quick 15 minute break.

After activities then you get the residents
ready for lunch. Some of your residents
didn't go to activities and were laid down
instead. So this is the time you get them up.
Also thru this time you and your partner
rotate a lunch half hour. Usually getting
the residents you can by yourself, and
leaving the two person lifts to when your
partner returns from lunch.

Lunch pretty much goes by the same as
the breakfast. After lunch it is time for all
the residents to lay down, with the exception
of the more alert ones. You lay down each
one after you toilet each one. Removing
their pants, and getting them under covers.
And if you are the one who bathes the
residents, then you do so and laid them
down. If there is a bath team, they will
do it for you.

If you are the Eve. crew, you start your
shift the same way as the day shift. Report,
supplies and then going to get the residents
up. You have it a little easier as you have
a lot of the residents half dressed already.
Then you get them ready in an hour time
for afternoon activities. During this time
you and your partner rotate your lunch.
Then there is dinner. Same routine as the
day shift has for meals. Some facilities
have an after dinner activities. That is
when you and your partner rotate your
15 minute break. Then there is the rush
to get all residents, clean up, teeth brushed
(false teeth removed and soaking), in a
gown, while on the toilet in hopes the
bowels will move.Otherwise enema's
are given,if it has been more than 3 days.
After they are laid down for the night.

Noc shift starts off like the other two
shifts. Report, supplies, and then going
to check your residents to make sure
they are all ok, and no one has fallen.
Then you get the ice and replace glasses
and pitcher, ice and water at each bed
that each resident is able to have water.
As there are some who have trouble
swallowing, so are not allowed glasses
of water. We do have thicken water
that we can give instead.

Then it is time to make your round.
Rounds are every 2 hours. You check
each and every resident. If they need
changing, you clean and change. If
they need help getting to the toilet, you
help them go. If they just need reminding
then you wake them and remind them.
All the time you are doing this, there are
buzzers going off. As there are those who
are mentally alert, who will turn on their
call light/buzzer(this happens on all shifts)
and want to have something. Anything from
being put on a bedpan, to a drink of water,
or the nurse and etc. You are to answer this
call light as soon as you possible can. Even if that
means you have to stop your round, to answer
those call lights. If you have a good nurse,
they will answer the light while you are on
rounds, if they aren't busy.

Around 1:30am you have a lunch break.
Being the Noc crew does not have two
person per floor, there has to be someone
from the other floor who will watch your
floor while you are on your lunch time.
Also if you have a good nurse they will also
watch over the floor. And then when you
get back.. you watch their floor.

Some faculties require you, at 5:30am,
to start getting some residents up for the
day. It is a harsh time for the elderly as
they have to be occupied for 2 and half
hours before breakfast, and usually fall
asleep in their chairs. So you need to start
your 4 o'clock round and get thru it, do
your paper work and hand in anything the
nurses require of you. So you can start at
5:30am with the getting up residents.

Which brings me to the fact you have
paper work to do, lots of it. There is
documentation for bowels and bladder,
for every shift. There is documentation of
vitals (blood pressure, temps, and pulse)
for each shift. There is I and O's (intake
and output) sheets to fill out for each shift.
These are all extremely important for the
health of the resident. Any which one of
these can fore see a problem before it gets
bad. Bowels, it is blockage, if they aren't
moving at least every other day. Bladder
could be a shut own of the kidneys or liver.
Vitals, will show a raise in temp or blood
pressure. I always like to get the vitals done
as soon as possible into the shift, and give
it to the nurse, so they can be on top of things.

If you have a good partner, and with Noc's
crew, a good crew, your life as an aide is
doable. It is never a picnic. But it goes well.
There is good days and bad days, like with
any other job. Some days are fast but smooth.
And other days, everything that can go wrong,
does. When the flu or virus goes thru the
building it is hell. Not only because of the
residents, being sick and cleaning up after
them, and the extra work that goes with that.
But also the crew gets it as well, and you will
work shorthanded, and it is no ones fault.
That is just life. The difference between an
office job and being an aide, is that in the
office, things can come to a stand still, and
be made up later. Hard but can be done.
In the nursing dept. you have lives that
depend on you. Not just the crew, the
residents have to have some one there
24 hours a day. Many of times, I as well
as a good many others, worked sick.
You knew they had no one else to pull from.
And at least you were still standing. Slow,
but still standing. So you went in and you
got thru the shift. You knew you weren't
going to spread it, because that is where
you got it from. I remember years ago,
there were 3 of us working. One of the girls
went home Her family came and got her.
The other girl and myself, did our rounds
and hers. We didn't have an lunch time.
We didn't care, we didn't want to eat.
We stood against the wall, hoping the
building would stop, moving. But we got
thru that.. there are nurses aides who are
like that. That same aide had a heart attack
one night. One aide went home an hour
earlier, because she was sick to her stomach.
The aide didn't want to say anything, and
had hoped she could last the shift, because
she didn't want to leave them with one aide
and a nurse. Finally she said something to
the nurse... the nurse told her to go, she
would call some one in early. The aide drove
herself to the hospital, and 45 minutes later
a helicopter was taking her to Spokane.

The old time nurses aides are a tough
bunch. And always worried about the
residents or letting their crew down. We
have seen a lot over the years. We have cried,
we have mourn the dying of our residents
as well as some of our fellow workers.
We have laughed. Some times for relief.
Some times because the residents have
been humorous. Some times the times
have been humorous. Maybe I should do
a blog on the humorous times. Have to
gather up some of my former workers,
and start some writings. We have
watched as God kept residents alive for
their family to make it there, to say
good bye. And we have held family
as they cried. And those who didn't
make it in time. And we have hugged
our fellow workers who have gone
thru some bad times themselves.
You also have to remember that it is
good team work that makes the job
go smoothly. It is a team of your nurse,
your partner, and yourself. There are
others who are involved. Restorative
Aides, Physical Therapist, Activity
aides, all of you...You are a team.
Work together. Try to keep a positive
attitude, negativity drags everyone down
and it not in the best interest of the resident.
And that is who you are there for..foremost.

I retired December of 2003, so
some of this has changed. But I doubt
very much has.
Tomorrow... part 3...
"what you need inside yourself to be a good aide."