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I do some part time work in a skilled nursing facility. After seeing the patient, I always (and I can't stress always enough) talk with the direct caregivers (CNA's) and ask them their opinions as to what is going on with the patient. They see the patient everyday and many times know more than the DON or RN's on the units. I have built a great rapport with the CNA's and feel I've had increased success with treatments because I've made them part of my team. They have been more than willing to try anthing I ask to keep patients safe, using restraints as the last measure.
CNA's do most of the work and they don't usually have any say in the decision making process. I understand their frustration and have turned it around and allowed them to help me understand what is going on at times. We definitely have a mutual respect for one another. Suzy Schlegel
-------Original Message-------
Date: Sunday, June 22, 2003 01:47:00 AM
Subject: Re: [OTlist] I have to do an inservice 6/26
In a message dated 06/22/03 12:04:54 AM Central Standard Time, [EMAIL PROTECTED] writes:
No, although I see how I made it sound like that. The inservice is to cover two separate topics. ie
1. Restraints when to use them, when not to use them, the law,
( although CNAs are not really allowed any input into these decisions at this facility, the DON wants me to sell restraint reduction and let the CNAs know that we don't discontinue restraints because we want residents to fall or we want to make the CNAs life harder - a tough sell, , since CNAs tend to feel that they do all the work and get to make none of the decisions. Nevertheless, my job at this inservice is to remind the CNAs that the restraint committee doesn't make the rules, the government does in the form instructions for surveyors, and the restraint committee has to play by those rules.) And finally how to correctly use and apply the restraints which are used, a few soft waist restraints, lap buddies, desk arm lap buddies, pommell cushions, ischial step cushions.
and B Splints, why we use them, what are the goals of splinting, how to perform PROM before applying a splint, how to put on the splints we use, and splint precautions.
Of course a lot of the CNAs already know the rationale for restraints/restraint reduction, and splinting, or at least they know which patients are supposed to have what devices without knowing the rationale. Sometimes they don't follow the orders and policy because either the correct equipment cannot be located, or the correct information doesn't get to the CNA, because they don't get around to it, because in the CNA's opinion the splint/restraint/lack of restraint is not in the resident's best interest, because the CNA just plain doesn't feel like it, because the nurses don't check on these things daily, or because the CNA is new and doesn't know how to use the equipment. I guess the DON wants me to correct all of those reasons and get all of the CNAs to follow through with the written orders all of the time.- but my personal goal will be to raise awareness and compliance a little. -- Jody
Hello Jody:
Is the primary purpose of the inservice to demonstrate that splints are
not restraints?
Ron
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