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That is sooooo terrible. I do commiserate with you.
There are many of us "idea people" out there who experience the "ying yangs" of
the world ... and heaven forbid that our ideas create improvement in the
residents!!!! Please don't give up yet.
Gail Neustadt, NHA
----- Original Message -----
Sent: Wednesday, April 07, 2004 2:53
PM
Subject: Re: Nursing rehab
Great ideas Gail, thank you. I am so
tired of tying to get clients to develop meaningful programs--and constantly
hearing that I just complain. Not true, I have recommended programs,
seminars, books etc. I have stopped, they think I have mellowed--not
true, I just decided that they were not worth all of my effort.
I
helped one DON develop a 4'x 8' board with all types of handles, locks,
faucets, doors, drawers and various other devices residents could manipulate.
[her husband worked at Home Depot]. Therapy used it a lot and demented
residents spent hours manipulating the devices.
The administrator
became angry and said that they didn't need to be taught how to get out of the
facility and into places they shouldn't and removed the board.
So much
for that program
Delores
Delores,
I completely agree with
you.There are very few programs that include communication or for that
matter ADls except for toileting. Restorative communication programs will
obviously be social in nature and as such, the best folks to carry out
theses individualized or group programs (no more than 5 in a group) are the
folks in activities. This can be done as long as it remains under the
supervision of the licensed nurse and is properly documented. Additionally,
if you go with the RNA concept, be certain to NEVER pull them to the floor
for regular CNA duties. I also have established a different approach - I do
not label the trained CNA an RNA, but rather an RNM which stands for
Restorative Nurse Mentor. These "mentors" maintain a reasonable caseload and
when a resident is stabilized on the program, trains the floor CNA who then
becomes a "restorative nursing assistant" or floor RNA. As the floor CNAs
become trained and carry out their duties with appropriate documentation,
they are awarded with pins or prizes of some nature. Also, this prevents the
inevitable expansion of the caseload which may then become too unwieldily.
Hope this helps.
Gail Neustadt, NHA
Delores L. Galias, RN,
RHIT
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