No Respect

[haziee 0]

Hello all. I just need to vent and see if any other AD's out there have experienced the same things that I have. I work at an 80+ bed skilled nursing facility. One of our nurse aides drives the van when there are doctor appointments. The doctor appointments are out of control, even though administration has asked numerous times to try if at all possible to schedule them on certain dates. Course this leads to me, the AD, to take residents to their doctor appointments when the other van is gone or when our driver has to stay on the floor cuz they are "short". Which is often. I have asked so many times for help, help from the staff and help from administration. All i hear from my administrator is that is common for me to be frustrated and that she has heard the same complaints many times at previous places where she has worked. That is no help for me. The nurse aids do not help me with activites either, such as getting residents to and from activities or getting them up. All they do is complain or hide when asked polietly to do so. I also hear from Nurses that they are only one person. Yet when they need something from the store or a resident has to go to the doctor i have to drop everything im doing to do what they ask. A nurse actually told me to my face that activities just arent as important as everything else, after i told her that i am missing my schduled activity. when im gone to the doctor with a resident, my activity does not get done. I feel i get NO respect from anyone there. Activities i feel isnt a concern of anyones until state shows...all the while i am bustin my butt to make the residents happy. Yet no one even cares to see the amount of work ive been doing.

Im very tired and feel i need to live this home..but im worried that i will encounter the same thing else where.

 

Who do ya'll have as a van driver? Do any other AD's drive the van?

How is staff participation?

 

Can things get better?

 

thank you in advance and for listening to me.

[StacieO 0]

WOW!

 

In answer to your questions, I am oriented to drive our bus as well as another one of my staff members. I have volunteer drivers (we do not need a special lisc.) We are fortunate in the situation that I am in, in that our facility is attached to a clinic & has a dental office attached (dental office will soon be moving to an off-site location). In the occassion that a resident has an appointment somewhere other than in our building, we first & foremost involve the family in getting the resident to the appt. Also - we have a city bus in our community that will pick up residents (we supply a volunteer or staff person to accompany them if needed). There are a few other resources in our area such as Medi Van, People's Express, etc. to take them to appt. out of town. Most of these services can be billed through a resident's Med. Insurance or the county pays for MA residents.

 

A few questions or thoughts maybe that I have:

How is your social worker involved? Our social worker generally lines up transportation.

 

Do your physician's do "rounds" at your facility? Even though we are attached, 3 of our 5 MD's will do monthly rounds, which takes an enourmous stress off of our Ward Secretary (who generally takes them to the clinic - also - it allows us to have our Nurse in the room, which wouldn't happen at the clinic, the doctor gets terrific input from OUR staff person & in turn, we don't have to wait for days/weeks for a written progress note from the MD.)

 

I would definately keep track of my time spent running to appointments & total up for your admin. how much time/money is spent on this. I only take residents to appt. on an emergency situation (no family shows up, ride is cancelled, etc.) That only happens about 1 -2x per year.

 

 

As far as Aides helping get residents to the activity. It is a battle & you may have to point out to their supervisors that the federal regs state that it is NOT only the job of the activity staff to get residents to & from activities, but everyone who works in the facility. It's a long, tough battle, though, I've bent over backwards for staff & kissed alot of butt, but we're getting there. It is a subject that the NURSE that does the orientation of new staff touches on, explaining the importance of group activities & that it is EVERYONE'S job.

 

Good luck to you!

[Guest Tinki]

The battle with the Aides is a overwhelming problems all AD's face. I been brainstorming for years on how to get the aides on broad with no avail. I have resorted to abosolute butt-kissing and unbelieveable brown-nosing to get the care staff to hop on board the AD train. :roll: I have heard that within the new revision of the reg's it will plainly state that it is the part of the caregiver's job duty to escort residents to activities. Let's hope they get adopted and put into place soon!

 

Many AD's are faced with an Administrators who does not realize the importance of activities and think about money before the quality of life. It would be nice if Administrators would realize that it is a necessary to hire a full-time van driver if not, at least part-time. I don't think the bosses realize just how irritating it is for a resident to come to an activity and it is re-scheduled for a van drive. That is one resident versus 15 that might attend your activity. :-x

 

I like Stacey's ideas of documenting. Documentating all your problems can only help your plight when you go to your administrator for a solution. Maybe through the documenting you will come up with your own plan.

 

I personally have run into both problems and every facility is different, as an AD you have to be creative. The best system is a full time driver, but it does help if the drives are scheduled on designated days. You can plan your calendar with the drives in mind.

[kimberly 0]

Here's what we do at my IL/AL 125-room facility. We have 2 bus drivers. They are the only ones that take the residents to and from their scheduled appointments. AND we only have those scheduled appointments on Wednesdays and Thursdays within a certain radius from the facility. Then we do a shopping day on Saturdays. I plan my calendar around those days. If the resident wants to go to the doctor or run errands on a different day at a different time, then the bus driver comes in on that day (as long as the resident gives us a 24-hour notice) and we charge the resident a fee. That really cuts down on the special trips! I am the activity coordinator at my facility with no assistants or any volunteers. I am it! I could no way be running my residents all over town. Who would call Bingo?.......

[haziee 0]

Thank you all so very much for your input and ideas.

 

It's good to know im not the only one struggling with staff and the lack of teamwork. I know some areas are blessed with volunteers and helpful employees, i just wish we all were so lucky. I guess the only thing to do is keep on fighting the battle and try to get everyone to open their eyes.

 

To answer your questions Stacie

the social worker is not involved with the transportation..when needed the nurses try to line something up with families if at all possible, some families are willing to help with doctor appointments, others refuse and want no part of it.

 

as for the doctors, yes, most do come in and make rounds monthly, and it does take care of most residents but a large group remains that need to be taken for whatever reason.

 

Thank you again for your advice

[Guest tigger]

I would just like to throw in an Idea that we came up with in my facility for getting help getting residents to activities. 15 min. before mt activity starts I get on the intercom and say Time out and say what the activity is. Time out in my facility means All staff except the kitchen gets up from what they are doing and brings at least 1 resident to the activity. My administrator is great and supports everyone helping me,. including her. Now if I forget to call time out the staff will ask me why it was not called. Food is always a good way to get help. Candy for those who bring residents, The word gets out that you get candy today for bringing residents to activities, you start getting some help. And Im from Oregon and have worked in a few different facilities and the social worker has always done transportation for Dr. or other appointments. There incurance pays for it anyway. Try out my Idea I would like to know if it could work somewhere besides my facility. Thanks

[haziee 0]

Hi Tigger

 

Thank you for your input and ideas. I have actually used our intercom at the job to annouce the activity and for all avaliable aids to please help. The times when i got to the intercom, i got little to no help. It was as they totally ignored it. I've gotten to the point where i as someone in the main off to announce the activity for me, cuz it seems when they ask they'll get a better response with help, NOT always but sometimes. The problem at my place, which i believe has to do with the office and the DON. The DON preaches alot about what she is gonna do, what she expects and plain and simple its ALL talk and no action. The office is about teh same way. I've about given up on it all, because no matter where i turn for help i run into walls. The idea is a good one, but it works only when people want to work together.

As for the candy. It works the same way.... the word would get out and then some would get jealous and feel they deserve it regardless.

just the way it is at someplaces, i guess.

 

But Tigger, they are excellent ideas, and im very happy that they work for you and that some places really care about their employees and residents.

[Wilkesrose 0]

Hello! I feel your frustration, and I know how it feels! When I was first hired, it was nothing but resentment all the way from the secretaries to the kitchen staff to the aides and even the housekeepers. But I am more stubborn than they are rude. I did as many others have done--------I kissed butt and was so sweet, butter wouldn't melt in my mouth! And, slowly but surely, they are coming around. I live and work in an area of the country that is somewhat backward in their thinking. They are a resentful, clannish group. Most of them were born and raised here, and have never been anywhere else. Their education is lacking, as are their social graces. Now, I'm not being critical, just stating facts. I idenitified the problem and adjusted my way of communicating. We had to meet on common ground. I think it has finally dawned on them that I do not have horns and I'm not going to turn them into toads. I praise them daily. I leave "thank you" notes in their communication files. I give them treats. I bring them flowers. I help them with their duties when I have a few free minutes. I no longer take anyone to the doctor, nor do I assist the kitchen staff with daily chores. I no longer run to the store every time someone says so-and-so needs something. I explained to them that my first responsibility was to the Activity Department, and I would be pitching in to help any time I had a few free mintues but that it wasn't part of the daily process. I now have shopping trips scheduled once a week. The nursing staff have been instructed to make a list of what the resident needs, including all preferences and sizes. I take the list, get the money from the office, and go shopping, sometimes alone, sometimes I'll take up to 3 residents with me. We schedule once a month shopping trips, and an outing, that are done by bus so we can take as many as 18. The bus comes on Mondays and Fridays, and that's when I schedule outings, and doctor appointments are rearranged if needed, the bus takes the residents to their doctor appointments also. The nursing staff are a bit more eager to help me these days. I still get frustrated some days, but not nearly as often. :-D