Personal Care Duties
FHB – we’ve all heard or will eventually hear this term. FHB stands for “Face, Hands, Butt,” which isn’t a polite term, but in this field we deal with behinds every single day. When an aide says they need to take care of FHB – it means they are working with a short staff and they are doing their best to take care of what is referred to as the basics of personal care: cleaning the face, hands, and behinds of residents in order to avoid taking the time for full bed baths and showers.
While it may seem that this is the best thing that an aide can do in order to give, at least, the basic care to all of their residents, it is not fair to the people they are in charge of. How would you feel if you were left in pajamas several days in a row with only your face, hands, and your private parts cleaned? Not only that, but the cleaning may not be up to par because in some cases the washing involves only a wet washcloth with no soap.
You would be angry, sad, or even fall into a depression. There is a reason that sub-par nursing homes have a smell to them! They are short staffed all of the time and the aides run on FHB thinking!
There are some key personal care duties that you need to be aware of:
ADL
Known as the activities of daily living, the CNA will usually be responsible for bathing, grooming the patient, dressing, assisting the patient with food and drink, ambulating, toileting, exercising, etc., all of which will be required on a daily basis.
Toileting
If you are running behind, you can still provide good personal care. Every room should have a basin with soap and washcloths stocked. If they are not stocked, put washcloths and soap in the bathrooms at the start of your shift. Come in to work a few minutes early if you must to ensure that your shift runs smoother. Keep a spray bottle of peri-wash in your uniform pocket at all times! Plain water is not enough to kill germs left behind by urine and feces.
This brings us to another point – urine left on the skin, not properly washed away, turns to ammonia in a brief or underwear. This chemical will literally eat away skin! Once the skin is raw, the urine and feces can introduce bacteria, causing an infection or even bedsores. Either result is very painful for your residents.
Oral Care
Oral care is another area that must not be neglected during morning or bedtime care. It does not take long to give oral care and should be incorporated into your routine. This can be performed while washing your resident’s face, helping them toilet, or when brushing their hair. It takes one to three minutes to perform good oral care – there is no excuse for cutting it short. Bad oral care results in mouth odor and even decaying teeth. For residents that still have their own teeth, the lack of care can result in an abscess which is excruciating.
Dressing the Patients
Before taking your resident from their room, check their clothing and hair. Clothing should match and be flattering. Dress your resident as you would dress yourself if you were in a hurry. Would you match your clothing or just throw on anything? As you would like to be seen in public, remember that your resident deserves that same sense of dignity. Do not just slick back hair for women, spend a moment or two with the brush to provide a flattering look or if you must, pull into a smooth ponytail.
Shaving
Personal care doesn’t stop when we enter a nursing home. Men still grow beards and women still have hair in areas they would prefer not to. Quite a few residents will be unable to take care of this part of personal care on their own. This is the domain of the nurse aide. All aspects of personal care fall under the job description for aides, so why do we see so many men and women with long body and facial hair? Perhaps men will not have full beards, but it isn’t odd to see men in nursing homes with quite a bit of stubble.
Part of the reason is that some aides are afraid to shave another person. Some men will refuse to be shaved as they have been doing it themselves for years and do not want to give up this last portion of their independence. If you have a resident that won’t allow you or another aide to shave their beard, ask their family to purchase a safe electric shaver. These can help avoid nicks and cuts.
For aides that are afraid of shaving, it really isn’t that hard. You must remember that the face is more sensitive than legs, if you’re a female nurse aide (men are already aware of this!). The proper way to shave with most electric razors is in small circles. Use an electric shave lotion before shaving, if possible. Electric razors can still cut or nick if the skin is not pulled taut under the blades. Moisturize the facial skin after shaving.
Disposable or reusable razors should be sharp, dull razors can nick or scratch. With shaving cream, pull the skin taut, and shave with the direction of the hair. Clean the blade often, run under cold water. Hot water dulls razor blades. Again, use a moisturizer after shaving.
Female residents may ask to have their legs and arm pits shaved. Do this as you would do your own, if you shave. It can be safer to shave with the direction of the hair unless directed otherwise by the resident. A good shaving cream for legs should be used or a very moisturizing body wash. Rinse well and as with men, moisturize after shaving. For armpits, do not use deodorant right after shaving. Allow to dry and use powder if possible.
Remember, your residents depend on you to help them look their best. Shaving is just one of the many ways you can help them retain a high quality of life. Don’t neglect this essential part of resident care!
Infection Control
Another of the areas that will be covered in a CNA training class as well as by the employer, is that every CNA should follow strict procedures to prevent the spread of infection in a healthcare facility by washing hands properly, properly caring for and handling contaminated objects, following proper isolation procedures and being aware and reporting on any areas vulnerable to the spread of infection.
Resident Monitoring and Taking Vitals
Patient or resident monitoring and measurement including but not limited to taking patient vitals such as temperature, blood pressure, respiration, and pulse. A CNA will also be taught in CNA classes how to take patient weight and height as well as how to apply patient restraints as required, how to collect lab specimens, how to measure and report on the patient or resident’s condition, the consumption of meals, etc.
Performing Various Tasks
The CNA will be required to know how to perform the various procedures set forth in the procedures manual for the healthcare facility and will be supervised by the nurse in charge while performing tasks such as admitting and discharging patients, transferring patients, applying dressings that are non-sterile, the application of ice packs, etc.
Lifting and Moving Patients
A CNA will be taught in CNA training classes how to properly lift and move patients from one room to another or from one position to another. Proper procedures are necessary in order to prevent injury. Assisting with patient exercise will also be necessary in many cases to ensure that the patients or residents maintain musculoskeletal function as well as overall wellbeing since exercise in very important.
Ensuring that patient and resident living conditions remain in impeccable condition is another of the duties of CNAs to ensure that patients and residents remain as safe and comfortable during the duration of their stay. The nursing assistant should ensure that the patient rooms are clean, at a comfortable temperature, the furniture in the room and other odds and ends are neatly organized, getting rid of trash in a timely manner, ensuring that there are no objects on the floor or other instances that could qualify as safety hazards, knowing how to perform CPR or how to evacuate patients and residents in the event of a fire, etc.
Effective Communication
Effective written and verbal communication is necessary for a CNA. This will enable him or her to effectively communicate with patients, staff, as well as family members. It will also ensure that the CNA knows how to properly document patient care information as required as well as take messages when he or she answers the telephone.
Other CNA Required Tasks
1. Being aware of and protecting patient rights.
2. Taking necessary steps for self-improvement through various educational and training programs.
3. Maintaining patient and resident wellbeing and safety.
4. Being aware of and following the healthcare facility’s policies and procedures.
5. Being aware of and following all safety rules as well as ensuring that ethical standards of care are maintained. The CNA should also avoid anything that would result in legal ramifications.
6. Being a team player.
7. Following proper post-mortem procedures as required, etc.
These are some of the general duties of a CNA that will be covered in CNA classes as well as learning how to properly perform these functions. This is a very rewarding career as you will be able to make a difference in the lives of those that desperately need care. A CNA training class will show you what to expect if you are interested in following this career path.
Our residents deserve the very best care we can give them – they are not the cause of our lack of organization or time management skills. Even the most harried aide can learn to give proper, by the book care in a fast, yet quality manner.