Nursing Home
Nursing Home:
A place where CNA’s make a difference
Kristina Bratkov
College of Sothern Idaho
1

Nursing Home 2
Abstract
Sometimes individuals are no longer able to care for themselves. They are faced with making some serious decisions. For some people nursing homes make great homes. The nursing staff take care of all the needs the person may have. While living in a nursing home people are called residents out of respect. Certified Nursing Assistants do the bulk of personal cares like vitals, dressing, and feeding. Residents and CNA’s develop a professional bond among each other since they are giving care to the resident. CNA’s put aside their struggles to give residents the best care possible. The environment is fast paced, but CNA’s manage to work hard as a team and get resident cares done. A memorial should be given to CNA’s by pointing out good qualities they have. This kind up memorial is uplifting and creates a closer bond with coworkers.

Nursing Home 3
Nursing
There comes a time in a person’s life when they no longer can take care of themselves.
They are sometimes forced to find different living options they may not want. Nursing homes are considered a great way for the elderly or even young individuals to reside in. Some perks about a nursing home are that there is always a certified nursing assistant or nurse to provide the resident with patient cares or just to sit down and visit. Another perk is that there are cooks for breakfast, lunch, and dinner. Housekeeping helps keep the rooms and environment clean. Not to mention there are other residents residing that the person can visit and make friends with. The nursing staff and Certified Nursing Assistants in particular help residents in nursing homes with all their personal needs, while putting their needs aside.
Most of the time elderly occupy nursing homes, but there are even younger generations that also live in nursing homes. A nursing home is a place for individuals to come and live for a couple months or it’s a place that is long term for some. Some individuals get lonely being home by themselves and want to live in a place where they can communicate everyday with others and have friends. While other individuals have to make a heartbreaking decision to leave their homes and come to a foreign place. It may seem so foreign and unwanted partly because this decision was not made with happiness, but rather a more forced situation. There are many reasons an individual has to make this design, because they had broken bones and cannot care for themselves or there is no one else in their house that is able to care for them as they cannot take care of themselves any longer. There is an option for in home care, but sometimes that is also not an option for the person who is struggling.
While residing in a nursing home residents expect the nursing staff to take care of them in a caring and compassionate way. The nursing staff includes doctors, Registered nurses, and

Nursing Home
Certified Nursing Assistants. The first step a person needs to do in order to be able to care for
4 residents is to get proper training. Nursing homes do hire nursing assistants, but do require the aides to complete the short certification class. The College of Southern Idaho offers a certification class for two months. The student must be able to pass the skills test, which demonstrates the knowledge of performing physical tasks the proper way. The student is able to make some mistakes, but to a certain amount. Critical mistakes result in an automatic fail. If the student is able to pass the skills test they advance to taking a test on the computer. The test asks about sixty questions about rules and regulations to being a Certified Nursing Assistant. This test also allows the student to miss a certain amount of questions. Once this test is passed the student officially becomes a CNA. Aids are another name that CNA’s are called by the nursing staff. In becoming a certified aid, they play a crucial part in assisting the residents with their personal needs in their “home” whether it is for short term or long term.
While getting certified students learn how to be professional aids. Aids learn many rules that they have to abide or could result in losing their certification for good. Residents are to be treated with respect and dignity no matter what mental state they are in. Every resident is protected by the “Nursing Home Reform Act 1987”. The nursing home must be able to provide many amenities to their residents. Federal Law and Regulations… state a couple of laws that come from the “Nursing Home Reform Act 1987” “The law states that each facility is to "care for its residents in such a manner and in such an environment as will promote maintenance or enhancement of the quality of life of each resident”, and they continue to state that “The law states that "A nursing facility must have sufficient nursing staff to provide nursing and related services to "attain or maintain the highest practicable physical, mental, and psychosocial wellbeing of each resident in accordance with a written plan of care." The nursing home must have

Nursing Home certain criteria set in place by the government. I have listed a couple examples of what is required such as a dietary plan, daily activities for residents to participate in, physical exercises,
5 hair and makeup is also a must. These amenities are important for the well-being of the resident and the aids help residents perform many of these activities. Aids need to be able to keep all the rules in mind while performing tasks.
There is another rule that aids must follow in order to provide privacy to the residents they are caring for. Anyone who has worked in the nursing field are well aware of HIPPA and it stands for Health Insurance Portability and Accountability Act of 1996 omnibus rule. There are two sides the HIPPA act. The first perspective is about the residents’ rights with the law, and the second perspective is from the nursing staff. The one I would like to focus on is from the nursing staff. They have a professional duty they are required to maintain while working as a nursing assistant. The nursing staff such as the aides need to follow the Hippa regulations. Residents’ wishes come first, if it is safe for their health. Aides are required to keep all health information private from anyone that does not care for the resident. Family members are concerned for their relative and want to know what is going on with their health all the time. The aid is not able to tell the family members anything about the resident’s record. It is a very big violation, because sometimes residents don’t want to tell their family members everything about their health. This law keeps the aid on their feet and always thinking about what is appropriate to say and what is not. It can even make a new time nursing aid feel very stressed on what they are able to share with others that are not caring for the resident. There are hefty fines and even getting fired from work if HIPPA is violated.
People join the nursing career for many different reasons. The Certified nursing assistant is the lowest position in the nursing field. The salary of an aid is significantly much less than

Nursing Home those of Licensed Practical nurses or Registered nurses. Idaho is a lower paying state nationally
6 and Aides get paid much less than in other states. The CNA Salary in Idaho states “There are some CNAs in Idaho that earn an average of salary of $22,650 annually. Also, some CNAs make a good amount of $30,420 yearly”. It is calculated from a low to a high salary an average equals about 25,000 dollars a year in Idaho. Every nursing home pays its employees differently. It depends what kind of facility it is and what they offer they residents. Their salary is also based on how much work experience the aid offers. I used to work in a nursing home in Buhl that accommodated for the geriatric unit as well as a behavior unit. P. Acuna (Personal interview,
November 18, 2016) explained, “Working at Bridgeview Estates my starting wage was at eight dollars. I get paid so little and work so hard, this job is for someone who is passionate about helping people and not about their paycheck. I mean I love helping residents, but I make so little that I am currently struggling from pay check to pay check”. Back in 2010 I made more than she did for my starting wage by a couple dollars. It was enough income for me considering that I lived with my parents and didn’t have a family to support. With today’s prices on homes and prices for food, it is very hard to live off a salary that is just above minimum wage. Other facilities such as hospitals pay much better than nursing homes do. Higher paying positions in the nursing field pay much better than the nurse aid positions. Every salary is based on how much school was completed. That is why aides have a harder workload that they have to complete versus the nurses. The salary has an effect on how the person works. The reason I am stating this is because if aides feel like they are working very hard with little pay they can start not caring about how their work is done. Salary should not affect the work and how care is given to the residents. Salary does boost confidence or it can lower it, which affects the personality of a person. It doesn’t affect every person, but in this profession salary should not affect confidence

Nursing Home 7 but rather the good deeds done. The residents do not see the aid’s salary, but rather they see how the aid responds and takes care of their needs. It is very important to concentrate on being timely and respectful to residents rather than worrying about salary.
Certified Nursing Assistants have a variety of scheduled hours they must comply with.
Every facility requires different hours to work a day. It does depend on what position an aid is working such as full time and part time. St Luke’s Magic Valley Hospital in Twin Falls, Idaho has their aids working 12 hours a day and some positions that work eight hours. The nursing home I worked at had three shifts that worked eight hours a day. From a nurse’s aid perspective that was a good thing because that was a normal work day and the other half of the day was free.
From a resident view they would see three aids that all cared differently, but a tired aide most likely would not do as well as a non-tired aide.
The nursing staff have many duties that they must do especially the CNAs. They have the biggest workload by far in helping residents with their needs. Such as taking the residents’ vitals and correctly documenting it for the nurse. Aides help the nurses with many tasks that way the nurse can focus on charts and treatment plans. Certified Nursing Assistant (CNA) explain that.
“Certified nursing assistants (CNAs) provide basic support in medical environments, performing duties such as dressing, bathing, feeding or transporting patients in need. Unlike licensed practical nurses and registered nurses (LPNs and RNs), nursing assistants are not qualified to provide direct care to patients, such as administering medication, drawing blood, or performing diagnostic tests”. The aid must constantly keep the phrase “The residents come first”. When I first started working as an aid I was told that the resident needs come first. Gibbs K. (2014) states
“Speak to the person in a polite and courteous manner. Good honest, and thoughtful care enhances the person’s quality of life”.

Nursing Home
While working in a nursing home regardless where they are located, one thing that is
8 common between all nursing homes is how aids get their breaks. Some work days aides skip their breaks in order to complete their tasks. Without breaks the day may seem long and hard, because there are so many residents compared to the ratio of aids. There is no time to sit down, because call lights can be calling all day and every call light must be answered and responded in a responsible manner. Nursing homes are not highly sought out as a place for employment as other places such as hospitals. Every resident is counting on an aid to do their job as if it were for themselves. Many nursing homes do not always have enough workers, and need to call in for someone to come in to work. When they cannot find someone they just put the workload on the aids to complete. It makes life very stressful and chaotic, sure time flies but without break an individual gets very tired and exhausted. In a hectic environment a burn out can happen and no matter how much a person loves their job and the residents, they quit. It is so important to take fair breaks within the group when there are not enough workers.
Day shift in my opinion is the hardest shift, but it flies by the fastest, because it is so fast paced. The aide must come in the resident’s room in the morning and help them out of bed. Next they must help with toiletries and dressing the resident nicely, and brushing their hair. There are about ten to fifteen residents that are shared between two aides. Once everyone who wants to be up is directed to the dining room where breakfast is served. Not every resident is able to feed themselves and aides help feed the residents that need help. The aides then help escort residents to their rooms or into the common area watch television and communicate with other residents.
Once lunch is around the corner the aides need to help with toilet breaks and dress residents and brush their hair once more. Residents are escorted back to the dining room, where the same events happen as did at breakfast. Around 2 o’ clock a new shift comes on and report is given.

Nursing Home
This shift answers call lights and helps with snacks. Also before dinner starts activities are played such as bingo. Around 5 o’ clock to six o’ clock dinner is served and residents come for
9 dinner. The dinner routine is the same as both breakfast and lunch. After dinner some residents choose to go lay down in their room, while other choose to talk with each other and watch television. Before nightshift comes most of the residents are washed up and in bed. Night shift answers call lights and checks up on every resident they are assigned to. It is much quieter in the night time, but sometimes there can be hectic nights.
A nurse’s aide has a reflection how residents feel and act overall. The aid needs to have a professional compassionate manner. Sometimes aids and residents can form a bond between each other from knowing each a long time. It is not recommended to have an outside relationship with the resident. It is not healthy for the resident because they would start to depend on that nurse’s aide only. Their whole mood can change and act out if they are not able to spend time with the aid. Another action that can happen is a resident can be withdrawn from everyone and not want to participate in daily activities or eat. Both actions have many effects that are not desirable, being malnutritioned contributes to health problems, and being anti-social contributes to very low self-esteems. A friendship with a resident can result in breaking the professional barrier which results in breaking the rules or having injuries. This results in a lot of lawsuits and possibly getting fired from work. Having a professional attitude and doing everything by rules helps the residents feel cared for. This makes them look forward to seeing all the aides every day, it keeps residents going from day to day and hopefully having better health.
There are times when the resident is very unhappy on a particular day and can lash out at anybody that approaches. It is very important not to restrain the resident as it is against the law, and not to get very close in order not to get hit. The resident needs to be approached in a calm

Nursing Home manner and speak to the resident and see what is going on, and what the aide can do to help the
10 resident. The aide must not take anything to heart if mean things are said. There are times people are mad and they take out their anger on the wrong person. The nurse needs to be notified immediately to further instruct on what to do. The nurse also needs to document behavior like that in order to track it and have medication prescribed if needed.
The nursing staff in particularly work very hard in their environment. I propose a memorial that would honor aides and make them feel special. Sometimes it’s hard to get recognized for work, because aids are hard at work working to make a better life for people who are having trouble doing it themselves. It can even become a grueling task when an employee doesn’t feel appreciated by others. When there is a welcoming atmosphere people tend to have better relationships with each other and their residents.
There are a couple ideas that came to mind the first idea would be if every nursing home in America would have nice things posted on the wall about every nursing aide. Of course it could come from coworkers or even the residents if they choose. It would be a must from the other coworkers to write nice things about each other when they would have little free time. The residents would have a special table that they would be able to reach and in privacy write anything they would like such as concerns or nice things about their aids. This memorial shows what your coworkers or residents find amazing about you. It is also inexpensive way to show appreciation to someone who works very hard.
The next memorial that would honor nurse aids would be having an employee of the month. It wouldn’t be necessarily based on how hard or the accomplishments made. Every nurses aid would get a chance to go on the wall through a drawing. Their picture would be hung up on the wall in a chosen place where everyone can see and read. It would also have a little

Nursing Home story that would explain the aide’s life or any accomplishments that were made. It would be
11 whatever the aid wants everyone to know about, but nothing very personal. This memorial gives one aid a month the spotlight they deserve. They also can feel proud sharing something they enjoy about work and their own life. This helps everyone around get to know each other much better.
Nursing homes are for people that can no longer take care of themselves. There is a nursing staff to help with all their personal needs, as well as cooks and housekeepers. It takes some burdens off residents so they can have a nice life. Some residents are lonely and come to nursing homes for help as well as making friends. The nursing staff in particular CNA’s are close with residents and help with all their personal needs as well as communicating with them.

Nursing Home
References
Acuna, P. (2016, November 18). [Personal interview].
Certified Nursing Assistant (CNA). (2016). Retrieved November 20, 2016,
from http://www.rntobsn.org/careers/nursing-assistant/
CNA Salary in Idaho. Retrieved November 20, 2016, from http://www.topcnaclasses.com/cna-salary/idaho/
Federal Law and Regulations on Nurse Staffing Issues (as contained in the Nursing Home
12
Reform Act of 1987) Retrieved November 21, 2016, from http://theconsumervoice.org/uploads/files/issues/Federal-Law-Regulations-Final.pdf
Gibbs, K., & Sorrentino, S. A. (2014). Workbook and competency evaluation review Mosby's essentials for nursing assistants, fifth edition Sheila A. Sorrentino and Leighann N.
Remmert. St. Louis, MO: Elsevier. 12.

Nursing Home 13