Nurse Aides: Weed Out the Bad, Dangerous Ones

I’m a nurse aide. The hospital may need the Nursing Director, but the patient needs me. I am the low man on the totem pole, but I am a hero. I am cannon fodder; a grunt, but I am the backbone of the facility. I am the foundation of patient care: the water fetcher, the bile cleaner, and the person who gently wipes away the sweat of fever and waits anxious for the signs of remedy.

Nurse aides are turners, we’re lifters and we’re always on the front line. And when ten patients metamorphoses into twenty because the other nurse aide working the hall vanished at the first sign of real work, it becomes clear that one can divide nurse aides into two categories: good, and bad.

The blessing and curse of nurse aides, is the amount of schooling we’re put through. I’ve seen crash courses in nursing assistance that lasted four weeks. That’s four weeks to learn how to insert a Foley catheter, how to make the beds, how to feed needier patients, what to say and not to say, proper hand washing technique, proper lifting, proper charting, and how to take vitals signs, not to mention the time the class eats up on what should be common sense.

Even the longer classes ensure that there’ll be a steady line of grunts looking for work. The good ones are awesome. They love your patients as much as they love your money, and they work hard. The bad ones… well, they love your money, at any rate. We live in a society where the poorest people are getting poorer, and Nurse Aide classes are a cheap way to break into the nine and ten dollar per hour bracket. The nurse aide position attracts people from every level of society, but the classes are not strenuous enough to filter out the uncaring and the lazy.

A girl I met in my own nurse aide class told me repeatedly, that she felt “whiney patients” deserved to sit in their own urine and feces if they had a bowel movement immediately after being cleaned up. This woman passed the course. She got certified as a nurse aide. This doesn’t horrify you? It does me! And however well hospitals and nursing homes filter their new nurse aides, the bad ones still slip through the cracks. They nap when they should answer lights, they watch TV when they should be cleaning up, and they let their hands grow filthier from room to room.

If the classes aren’t going to filter the students better, then the hospitals and nursing homes need to pick up the slack. Bad nurse aides can and have caused hospital-wide epidemics. They’ve let life and death call-lights blink away because they were chatting on cell phones. They aren’t just a liability to the company, they’re an active, persistent danger to the patients.

But how can you keep the bad ones out? The hiring process includes videos – always videos – but any nurse aide past his first job has seen them already, and if they’re a bad aide, it just won’t help. And there are 90 day trials; but everyone has those. These are substandard measures.

Pair nurse aides up. Consider a hospital wing with the capacity for forty patients. Normally, in the day time, during the highest census, one nurse aide will have eight to ten patients. This gives you, on average, four nurse aides on the floor at any one time (give or take a few depending on how many patients need a personal aide). Through the pairing method, you’d only need to have one extra nurse aide on the clock – considering the fact that a pair of aides working the day shift could easily handle a fourteen patient group.

Your working staff will be slightly larger, but nurses can always use the extra help! Two nurse aides together will catch things one nurse aide might miss; a team working together is not only more efficient, but they will make the hospital safer for the patients – AND the workers. Good nurse aides pull muscles and damage their backs all the time because they’re trying to lift or move a patient on their own. The other staff members, including nurses, aren’t always available to help. Pairing nurse aides together removes this problem entirely.

And if you pair a new nurse aide with one you already know you can trust, you’ll find out if they’re good or bad at the end of a few shifts – not at the end of a full month. Nurse aides are painfully aware of how much work they have in queue, and if their partner vanishes without the workload decreasing, they’ll complain, and then you’ll know too.

Furthermore, the persistent presence of another nurse aide will encourage good habits: they will remind each other about hand washing and about not marching into the hall with used gloves.

This method might cost more, but balancing the patient load to accommodate paired aides would help stabilize the budget problem of hiring extra staff. Furthermore, it ensures that the individual workload is more evenly divided and provides a better safeguard against lazy aides.

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