Hey CNA’s, did you know your residents’ units are a reflection upon you?
Sure, the resident usually gets to decide where their personal belongings go, and some of them get really mad if you tamper with anything. While we need to be respectful of our residents preferences, we can do much to keep their unit, their home, neat and organized and safe.
When you’re giving care, it’s helpful to have all your supplies ready. Basins, soap, linens, powder and lotion and all the other items should be on hand so you don’t need to leave the room once you begin giving care. Most of us use an over-the-bed-table for all these items- it’s perfect for the tasks at hand. The table can be raised and lowered to suit people of all heights, and it’s pretty portable. Often, we make a mess on this surface: water, soapy residue, wet linens are placed here. When you’re done, clean off the table with wet cloths and then dry it. If possible, use a sanitizer.
When we’re giving showers or baths, we need to think NEAT as well. Counters next to sinks, shower rails and other surfaces should be cleaned up after the tasks are finished; personal care items should be put away and not left on the shower stall rails…if a bottle of shampoo tips over and spills we have a created a HUGE fall hazard, not to mention the waste. As for the bathroom itself: Think neat and orderly. Most nursing home bathrooms now have drawers where each resident can keep their personal care items separate from the roommates’ items. Look at the belongings: are hair brushes and combs and toothbrushes and other things dated and labeled? Can you tell who owns what toothbrush? Look at the basins and emesis basins especially! Rinse them out and make sure they are CLEAN. Keeping the counters clear of clutter reduces the chances of mix ups and loss of items.
When your resident is up and out of bed, and hopefully out of the room to activities, go back and make sure the unit is neat, clean and hazard free.
The Bed: Clean linens, wrinkle free, lowered to it’s lowest position and locked. Always. Make sure the linens have no holes and are fray free. One thing most of us know but a few do not: USE YOUR BARE HAND to check sheets, pads and blankets for wetness. A gloved hand cannot always FEEL wet linens; sometimes we cannot SEE urine stains (especially when they’re wet). Sadly, we also need to check UNDER the pads…often the sheet is wet under and for the same gloved hands reason, aides from previous shifts don’t know the sheets are wet. This leads to the famous brown stain syndrome; and odors. Finally, step back and LOOK around the bed. Under the bed. Up around the headboard…look for objects, pillows, missing items (how many times have we found a set of false teeth or a pair of eye glasses under a bed?) Look for hazards- sharp objects, frayed area rugs, broken wheel parts to the bed.
The Bed Side Table: Clear off YOUR junk. That means the lotions, wipes, foam sprays, ect ect. Find a place for these items that is out of sight yet easily accessible. It is always OK to leave a box of gloves out though- we never know when we will need them. One box is good for most of the unit though. Briefs, blue chux pads and the like do not need to be laid out either. Put them all away. Show your resident some dignity. And clean off the surface with a wet cloth, again sanitizing is best.
The Dresser: Again, like the Bed Side Table, keep this area free of YOUR STUFF. This is the residents space, not yours. Remember that. If they have knick knacks and other personal items here, be extremely cognizant of this. Treat these items with the highest respect- be careful. Be thoughtful. DON’T BREAK ANYTHING! If you work for a facility that offers consistent assignment, chances are you will have the same assigned residents every shift you work. This affords you the opportunity to gently clean off the dresser top every so often, weekly if not more often. (Yes, this might be the housekeepers job, BUT, you know as well as I do that they will not do a thorough job out of fear of breaking things). To make your job easier, you might want to keep the contents of the drawers neat and orderly. Some families do this too. If this is the situation, follow their lead and keep it all the way THEY have it. Same with the closet.
Speaking of closets, we’ve all seen messy, coat hanger infested PITS known as the resident closet. The mess, like it or not, is almost always OUR fault. When we’re working short of staff we rush through cares and dive in and out of drawers and closets looking for the easiest outfits to dress our residents in…we don’t have time to go back and clean up after ourselves. A few days of this means totally out of control, awful chaos behind those doors. It’s always up to us to clean it up, to wade through the endless empty hangers and weed out the stuff that doesn’t fit. Or is in disrepair. Talk with the charge nurses, but most nursing homes box up clothing and items that no longer fit and call family to come pick it all up.
Resident Clothing: More and more we see family taking care of these items. That’s fine and it’s often a big help. But we’ll always have those residents who have no one to do this. At some nursing homes the laundry staff put clothes away; in others, the aides do it. Either way, on a day where things aren’t so crazy, it would save a lot of time for you if you organized entire outfits: In the closets and drawers. An aide I know folds up an outfit into a neat semi ball and places many of them in a drawer: Pants, shirt, underclothing, stockings. So all she has to do is grab the ball, so to speak. This can be done with closeted outfits as well: Everything can be placed on a hanger.
ODORS: A big problem in many nursing homes. Even the cleanest rooms can have strong urine odors. Once there, it’s hard to get rid of. Carpeting is a big factor here…urine soaked rugs are almost impossible to totally clean up if the accident has been left to dry…as soon as an accident occurs try to get it cleaned up. Some aides spray the foam peri cleaners directly onto the wet spots to alleviate much of the smell. Another source of odors comes from laundry: If family does the resident’s personal laundry, wet clothing placed into hampers will smell, and the scent will get worse as it spreads to the other clothes… It’s best to bag up wet clothing and tie the bag tight in an effort to separate them from dirty but dry clothes. Some facilities don’t allow urine soaked clothing to be “kept” in hampers and insist the laundry department take care of these clothes.
One final note: Usually it is up to us to report things that need repair. We’re part of the safety chain…we often see problems before anyone else. Take this seriously. When stepping back to look at your residents units, have a critical eye and LOOK for hazards, potential hazards and other unsafe things.
Check the outlets for overuse- sometimes family bring in extension cords and overload them. Check the electric cords for fraying, loose connections Bed: Work the siderails. Hard. Make sure they lock. Make sure they are sturdy and not loose. Check the mattresses. Headboards and foot boards. Check the side pads if resident uses them; make sure they’re usable and not ripped, torn or otherwise jeopardized of the intended purpose. (And do they need to be cleaned?) Look up and down and all around. The privacy curtain: Make sure it’s all UP and parts of it are not down, loose, with missing links. A falling curtain can cause an ambulating resident to fall. Look at the walls for signs of leaks and other problems. Check to see if these things could use a good cleaning. Window: Look at the locks. Test them. Screens? Holes in them? In warm months check outside for bee and hornet nests. Do the curtains work properly? Are they clean? Lights: Are they working properly? Are the bright enough or is a bulb out? Carpeting: Is it all tacked down tight? Any places where it’s coming up? Same with tiled flooring. And wood floors can be very hazardous if they dry out and cause slivering. Area rugs- these are often a big risk for fall prone residents. Make sure the team is aware the resident has one of these rugs. The nurse might want to consider talking with the resident about the safety of this. An area we tend to ignore is personal furnishings. Recliners and the like can be a real comforting thing for our residents. We want to make sure they are safe for use though: Ask your resident for permission first, then actually sit in it. Test it. See how it works and if it needs any repairs.
