Years ago I worked as a state tested nurse's aide. The nursing home where I was employed was not a nice home. I wouldn't even call it a step above the county home. It was kind of a slum/sweatshop. Unaware of conditions in the home, I'd applied there because it was in my neighborhood.
I trained for three weeks, took the certification test, and was put on the floor. According to company policy, I was supposed to train another four days under the supervision of an experienced aide. That it didn't happen should have been my first clue, but I was new to the health industry. I had no idea what was coming.
Instead, I bought into the nurse's line that we were just temporarily short handed because someone had called in sick. So, on my second day, I was sort of dropped into the regular work routine, sink-or-swim. I swam, but not with a lot of confidence. However, it was left up to me to figure it out. After my third question regarding patient behavior or conditions that were not noted on their charts, the nurse got impatient and told me to shut up and do my job. That was my second missed clue.
The third was the lack of cooperation among the aides. We had been taught in class that most residents who could not stand up by themselves were "two man lifts." In other words, the person was either too heavy or too fragile to be lifted by one aide alone. When you needed to transfer a "two man lift" patient between bed and chair, you were supposed to ask another aide for help. This prevented injury to both us and the patients. I found within the first week that most aides were not willing to help the "newbies" lift. We had to seek out and ask each other. Some of the aides were lifting the "two man lift" patients by themselves, because if you didn't get your work done fast enough, you got written up. I was written up for looking for help lifting a 300 pound immobile, nearly vegetative patient. On the form, I wrote in that I felt the write-up was unjustified because I was following policy, and couldn't have lifted the guy by myself even if I had wanted to. The nurse who wrote me up threatened to write me up for insubordination because I put that in the "employee comments" section of the page, but the head nurse told him that he could not.
There were more incidents like that, but it was a month before the worst hit. One day, I was greeted beside the time-clock with a special order from my floor's nurse. Two people had called in. No one could come in to work their shifts. We had to divide their patients among us, and instead of having the legal state maximum of 14 patients, I was going to have 21. I was not to ask the nurse for any extra help, and I had to squeeze the same care for those extra 7 people into my normal shift.
I was a first shift worker. That means it was my responsibility to get the patients all out of bed, help them bathe and dress as needed, give them their breakfast trays, feed those who could not feed themselves, take the trays back to the cart on time, transfer patients to physical therapy as needed, take them to the dining hall for lunch, give them their lunch trays, feed those who could not feed themselves (again), take the trays back to the cart on time (again), and during that time, squeeze in showers for the 1 in 7 patients (three today) whose day it was to get a shower. More than half of my patients required assistance with everything. Most of them could not walk without the aid of a walker or wheelchair. During that time, I was also responsible for answering any call-button lights, in case patients needed to use the restroom. Also, any patient who was unable to move under his or her power must be moved to change the position of his or her body a minimum of every two hours, to avoid bed sores.
Getting patients up in the morning varied from patient to patient. Several of mine were unable to feed or dress themselves, so making sure I took care of all of their needs without getting behind schedule was a nearly impossible challenge. You can't just rush through these tasks. If you are not careful, you can injure your patient, or yourself.
I got through that day without any really bad incidents, but I did get written up for not being fast enough. That is not what was put on the paper, but it is the translation of what was said. Basically, another aide needed to shower a patient, but I was still in the shower room with mine. The patient had unknowingly defecated, a common occurrence. That happens enough that I never showered him without a bucket under his chair. All I had to do was carry the bucket out of the room, in to the attached bathroom, and dump it in the toilet. Unfortunately, that was going to take both hands, because it was also full of water.
My patient also required both hands. He was a fall risk, meaning that if I didn't watch him like a hawk, he'd try to get out of the arguably uncomfortable shower chair, and fall down. I could not just turn my back to clean up the mess.
I pulled the call button to ask another aide to watch him while I flushed the contents of the bucket. We waited, and no one came. My patient began to shiver under the blanket, and fidget in his seat.
I decided that I couldn't just keep him in there indefinitely. I buzzed the nurse's station, but no one answered. So, I wheeled my patient out into the hall, where I was startled to find the next aide waiting for me. I asked why she hadn't answered the call light, and she said she hadn't seen it. She was standing right under it, and it was accompanied by a repetitive, computerized tone, so I knew that was a lie.
I told her about the bucket and asked her to watch my patient for a minute while I cleaned up. I told her that was why I had turned on the light. She refused, stating instead that she needed the room now and would just clean it up herself. Behind her was another patient squirming uncomfortably in another shower chair. We were supposed to make sure the room was open before wheeling patients down the hall with nothing on but a bath blanket, and now she was impatient with me for using the time slot allotted to my patient. I wasn't even late getting him out of the shower... I was early!
I couldn't do anything about her attitude, so I just took care of my patient. Moments after I'd finished getting him dressed and settled into his favorite easy chair, the nurse called me down to the office to write me up for "leaving feces in the shower for the next aide to clean up."
I recounted to him what had happened, but he ignored it and made me sign the paper under threat of being fired.
The next week, we had more call-ins, and more illegal workloads. I went to a supervising nurse to discuss the issue. I happened to know of a temp agency that would send aides if the company would just call them. Since it was illegal for us to be that understaffed, I figured the supervisor would be glad to know where we could get help with the problem. Instead, I was reprimanded for "rocking the boat" and told "we don't do that." The supervisor threatened to fire me if I disclosed to any of the families that we were understaffed. I informed her that I was family. My grandmother was temporarily housed in one of the rooms on another ward. That did not go over well.
The nurse assumed I would not know the system for reporting violations. I did, but I was still naive enough at that point to think I could work with corporate on fixing things. I called the human resources number and talked to one of the supervisors there, telling her everything I'd witnessed at work, and how at-each-other's-throats the aides were getting. Corporate held a meeting with all of use to hear grievances related to how things were being run at the site. Afterward, they issued a finding that there were no problems, and three of the four most vocal aides were fired. I was the only one retained, and I was written up for insubordination for statements I'd made under the assurance that they would not be held against me. Again, in the comment section of the page, I wrote my opinion of the reprimand, noting that the statements had been both true and made under the assurance of confidence and impunity from corporate supervisors. The nurse took a black permanent marker and "redacted" everything I wrote.
The last straw for me was coming in that week to find that we'd had so many call-offs that I was assigned a double group. I had 28 patients to care for. The nurse told me we weren't getting anyone out of bed. One of my patients was so heartbroken about spending the day in bed "again" that she cried. I realized that this was not an issue my employer was going to be willing to address.
At the end of my shift, I went home and called the Ombudsman for the elderly. I explained the situation, giving dates for the times when we'd been illegally understaffed, and listing several other violations of our patients' rights that I had witnessed. I gave a list of the names of the people in the company who I had alerted to the problem, and explained that I'd made them aware of a temp agency where they could bring in aides to stand in for those who were ill. I described injuries I'd discovered on my patients which were consistent with carelessness and neglect. I talked to the lady on the phone for half an hour. She was appalled.
An investigation was initiated. The Ombudsman showed up without warning on a Monday, the worst day for call-offs. Her timing was perfect. Halfway through the morning, no one was out of bed. Every aide on the shift was responsible for 28 patients, and it took her nearly half an hour to find a nurse. She wrote all kinds of things in her little notebook.
The next week, the head nurse changed the schedule without warning, right in the middle of the work week. She waited until I had two days off in a row, then scheduled me to be there for one of those days. When I didn't show, they labeled me a no-call no-show. I called the Ombudsman's office and alerted her to the retaliation. She asked if I wanted to fight for my job, but I really didn't. I was only getting minimum wage, and I'd learned that aides at other nursing homes made half again as much just starting out. I just wanted to make sure she knew that the company had retaliated against the whistle-blower.
In the meantime, my family removed my grandmother from the home a month early, and made sure to tell corporate that the decision was a direct result of living conditions there. She would have her physical therapy at home.
An employee who had worked with me and survived the whole thing stopped me at the grocery months later, and told me what happened after that. The state had taken over management of the home. There was also a huge fine. Several supervisors and a few nurses had been fired, including the man who had repeatedly wrongfully written me up. There were dismissals at the corporate level. Everyone who knew about the problem and had not addressed it was fired.
Laws were meticulously enforced. A lot of changes were made at the home, including the way fall risk patients were handled. As a result, working conditions also improved. The state kept charge of that home for nearly a year before agreeing to transfer managing control back to the corporate owners. A lot of policies were changed, including the policy of not using temps to cover for sick employees. In fact, the home went to using temps as a hiring method. Instead of hiring off of the street and training aides, they would bring in temps, and if they had the right attitude, work ethic, and bedside manner, there would be a full-time job offer.
In addition, employee concerns related to how policy was being followed (or not) on site, and whether laws were being followed, increased in priority. There was now a genuinely anonymous reporting system for on-the-job safety and patient concerns. Alleged retaliation by any supervisor was grounds for an investigation, and if it was found that there was retaliation, that was grounds for dismissal.
The company had made some very expensive mistakes, but apparently corporate had learned from them.
You can't safely assume your employees are ignorant of the laws governing your industry.
You can't safely assume your employees don't know their rights.
You can't safely assume your employees won't feel a moral obligation to protect their clients, even at your expense.
Your employees will only take so much crap from you before they turn on you. Even those who don't know how to fight for themselves will back the one who does... and there will always be someone who does.
You won't get away with illegal activity or conditions indefinitely. Eventually you will be caught.
And most of all, you can't fight city hall.
In the end, it's cheaper to do things right the first time, stay within the law, and treat your employees like the human beings that they are.
Showing posts with label laws. Show all posts
Showing posts with label laws. Show all posts
Thursday, August 18, 2011
Monday, July 25, 2011
Don't believe everything you think you saw on TV
Yet another way to prove to everyone that you are an idiot... argue with an actual, real, living, breathing, ROCKET SCIENTIST about HOW FIRE WORKS... because of course, what does he know? He's only a ROCKET SCIENTIST, right?
Now, most people are aware that gasoline is a flammable substance. Especially in Ohio, where we now have a law that says you can't light a grill within 20 feet of a building, passed in response to some guy having blown up his little hibachi grill on an apartment balcony (because he used gasoline in it) and set the building on fire, people would be well aware that gas is very, very flammable.
Most smokers are aware that the tip of a cigarette being smoked is actually burning, since moments ago they had to light it using a flame. I refuse to give anyone the benefit of doubt regarding whether or not they know that when you ignite something with a flame, it is thereafter on fire. (I do fail miserably to see the logic in setting an object on fire and then sticking it in your mouth so that you can breathe in the burning ashes and poisonous gasses from it, but that's an entirely different rant.)
So... one should be able reasonably expect that most folks would be smart enough to avoid bringing a burning object into the same space as a very, very flammable liquid, especially when there's a lot of said liquid in the ground under said folks' feet. I really think this should fall under the category of common sense. Honestly, who wants to risk being blown to bits the size of corn flakes? I think having that happen to me would kind of suck. I would really prefer to not do that.
Why, then, is it that when my co-workers and I go out to make sure our lot is clean and presentable, we find buttloads (pun intended) of spent cigarettes all around the gas pumps? Do people not realize that dropping their smoldering butts (and I've found them still smoldering on the ground) next to the pump is just as stupid as smoking at the pump?
Why, when we catch people in the act and shut off the pump, do they get angry with us? Do they really think the sign admonishing them to not smoke is just a suggestion? It's not... it's the law. In fact, we can get busted if we don't stop the pumps when we see them smoking.
My particular store just happens to be a stone's throw away from an Air Force Base. As such, we do get a lot of business from the base, including pilots, marines, independent contractors, tourists, etc.
One day, a very upset man with one of those nametag/clearance level cards around his neck stomped into the store, pointed out to the first cashier a customer smoking at the pump, then approached the manager of the store. The guy was so mad he was shaking. The cashier shut off the pump immediately while the guy quietly told the manager (who was standing next to me) about the argument he'd had with the smoker.
Apparently, when the guy had reminded the smoker to not smoke at the pump, the smoker had cited an episode of Myth Busters in which they had proved that dropping a cigarette into a puddle of gas would not start a fire. The smug smoker then continued to drag on his butt as the guy explained first that he was a rocket scientist who worked with fighter jets and had nearly a decade of schooling on the subject and multiple decades of experience with flammable substances, and then the difference between the ignition temperature of a puddle of gas and the ignition temperature of a cloud of gas fumes.
Myth Busters had not addressed fumes in that episode, nor had they stated that it was safe to smoke at a gas pump. After learning that he was talking to a rocket scientist, the smoker still continued to keep his cigarette lit, called the guy an idiot, and said that he'd seen all the proof he needed on TV.
When my co-worker shut off the pump, the smoker came in and threw a royal, screaming fit, threatened to "call corporate." The manager told him to go ahead... it's to our advantage when they know that we are following the rules. The angry customer paid for his gas, and then stormed out to his car and drove off. After he left, I calmed down our upset guest by asking the room, "What kind of an idiot argues with a rocket scientist about how fire works?" Everyone laughed, and business went back to normal.
People who think that there is no danger of setting off gas fumes with cigarettes, sparks, etc. must not know how an internal combustion engine works, something I thought was fairly common knowledge. Maybe it's not... I learned it in the 8th grade in science class, but my science teacher had taken a second job as a used car salesman, so maybe he just taught us that because he found it interesting. It's something everyone should know, but I've realized lately that there are a lot of things everyone should know which most people don't.
So, for the benefit of those who were never taught this stuff:
Don't believe me?
Read some proof:
Now, most people are aware that gasoline is a flammable substance. Especially in Ohio, where we now have a law that says you can't light a grill within 20 feet of a building, passed in response to some guy having blown up his little hibachi grill on an apartment balcony (because he used gasoline in it) and set the building on fire, people would be well aware that gas is very, very flammable.
Most smokers are aware that the tip of a cigarette being smoked is actually burning, since moments ago they had to light it using a flame. I refuse to give anyone the benefit of doubt regarding whether or not they know that when you ignite something with a flame, it is thereafter on fire. (I do fail miserably to see the logic in setting an object on fire and then sticking it in your mouth so that you can breathe in the burning ashes and poisonous gasses from it, but that's an entirely different rant.)
So... one should be able reasonably expect that most folks would be smart enough to avoid bringing a burning object into the same space as a very, very flammable liquid, especially when there's a lot of said liquid in the ground under said folks' feet. I really think this should fall under the category of common sense. Honestly, who wants to risk being blown to bits the size of corn flakes? I think having that happen to me would kind of suck. I would really prefer to not do that.
Why, then, is it that when my co-workers and I go out to make sure our lot is clean and presentable, we find buttloads (pun intended) of spent cigarettes all around the gas pumps? Do people not realize that dropping their smoldering butts (and I've found them still smoldering on the ground) next to the pump is just as stupid as smoking at the pump?
Why, when we catch people in the act and shut off the pump, do they get angry with us? Do they really think the sign admonishing them to not smoke is just a suggestion? It's not... it's the law. In fact, we can get busted if we don't stop the pumps when we see them smoking.
My particular store just happens to be a stone's throw away from an Air Force Base. As such, we do get a lot of business from the base, including pilots, marines, independent contractors, tourists, etc.
One day, a very upset man with one of those nametag/clearance level cards around his neck stomped into the store, pointed out to the first cashier a customer smoking at the pump, then approached the manager of the store. The guy was so mad he was shaking. The cashier shut off the pump immediately while the guy quietly told the manager (who was standing next to me) about the argument he'd had with the smoker.
Apparently, when the guy had reminded the smoker to not smoke at the pump, the smoker had cited an episode of Myth Busters in which they had proved that dropping a cigarette into a puddle of gas would not start a fire. The smug smoker then continued to drag on his butt as the guy explained first that he was a rocket scientist who worked with fighter jets and had nearly a decade of schooling on the subject and multiple decades of experience with flammable substances, and then the difference between the ignition temperature of a puddle of gas and the ignition temperature of a cloud of gas fumes.
Myth Busters had not addressed fumes in that episode, nor had they stated that it was safe to smoke at a gas pump. After learning that he was talking to a rocket scientist, the smoker still continued to keep his cigarette lit, called the guy an idiot, and said that he'd seen all the proof he needed on TV.
When my co-worker shut off the pump, the smoker came in and threw a royal, screaming fit, threatened to "call corporate." The manager told him to go ahead... it's to our advantage when they know that we are following the rules. The angry customer paid for his gas, and then stormed out to his car and drove off. After he left, I calmed down our upset guest by asking the room, "What kind of an idiot argues with a rocket scientist about how fire works?" Everyone laughed, and business went back to normal.
People who think that there is no danger of setting off gas fumes with cigarettes, sparks, etc. must not know how an internal combustion engine works, something I thought was fairly common knowledge. Maybe it's not... I learned it in the 8th grade in science class, but my science teacher had taken a second job as a used car salesman, so maybe he just taught us that because he found it interesting. It's something everyone should know, but I've realized lately that there are a lot of things everyone should know which most people don't.
So, for the benefit of those who were never taught this stuff:
The very thing that makes your car go is the fact that gas fumes can be set off easily. (For those readers who didn't learn about the Internal Combustion Engine in science class in school, it's explained really well HERE.)
The important thing to note for this post is how the fuel is ignited. Remember that in an internal combustion engine, fuel and air are shot into the combustion chamber together. It comes out in a mist, like hair spray from an aerosol can, or perfume from a diffuser. In other words, what is being ignited is gas vapor, not a puddle of gas as in the Mythbusters demonstration. It's not just fuel that's being ignited. It's fuel and oxygen.
Now, think back to the last time you accidentally got gasoline on you. It totally reeked, right? You probably smelled it until you changed your clothes. Even if you didn't, everyone else did. If you know anything about why we smell things, then you know that smell means there are particles of gas in the air. (Yes, when you smell anything, that means that particles of it have gotten into your nose. Think of that the next time someone around you lets a really foul fart!)
The reason why the gas is combined with air is that fire needs oxygen. When a flammable substance is mixed with oxygen, it is much, much easier to ignite. Hopefully everyone reading this learned that in elementary school science just like I did, but if not, you know now. This is not an excuse to pour liquid gas or lighter fluid into the flames on your backyard grill - you can still get burned doing that, as the jerk who ruined it for all apartment renters in Ohio learned the hard way.
It does explain why it's a bad idea to pour gas onto charcoal, let it sit a minute, and then light it... by that time there is a cloud of fumes above the charcoal and there will be a fireball when you drop in that lit match... if you get the chance to let go before the explosion.
Even a cigarette lighter works that way, only with butane instead of gasoline. As you flick your Bic, it releases vapor from inside the little plastic part at the same time as the friction created by the device's modern version of flint and steel produces a spark. Every time a smoker lights his/her cancer stick, he/she is demonstrating exactly why one does not want to have any active means of ignition around an active means of dispensing a flammable liquid which evaporates quickly when exposed to air.
Anyway, the vapor effect is why your car has spark plugs and not some kind of flame producing device, and it is what pushes the pistons and makes your engine work in the manner which moves your car. Because it is dealing with a vapor instead of a liquid, less effort is needed to produce a flame, and all of the fuel ignites very, very rapidly instead of the ignition moving slowly across the substance as with wood, coal, or even liquid fuel. This causes an explosion inside the combustion chamber. The force of the explosion moves the piston, etc.
The same thing can happen with gas fumes next to a gas pump. A small spill can produce enough vapor to make a big fireball right where you are standing. Even a single, small spark can be enough to ignite gas fumes.
The important thing to note for this post is how the fuel is ignited. Remember that in an internal combustion engine, fuel and air are shot into the combustion chamber together. It comes out in a mist, like hair spray from an aerosol can, or perfume from a diffuser. In other words, what is being ignited is gas vapor, not a puddle of gas as in the Mythbusters demonstration. It's not just fuel that's being ignited. It's fuel and oxygen.
Now, think back to the last time you accidentally got gasoline on you. It totally reeked, right? You probably smelled it until you changed your clothes. Even if you didn't, everyone else did. If you know anything about why we smell things, then you know that smell means there are particles of gas in the air. (Yes, when you smell anything, that means that particles of it have gotten into your nose. Think of that the next time someone around you lets a really foul fart!)
The reason why the gas is combined with air is that fire needs oxygen. When a flammable substance is mixed with oxygen, it is much, much easier to ignite. Hopefully everyone reading this learned that in elementary school science just like I did, but if not, you know now. This is not an excuse to pour liquid gas or lighter fluid into the flames on your backyard grill - you can still get burned doing that, as the jerk who ruined it for all apartment renters in Ohio learned the hard way.
It does explain why it's a bad idea to pour gas onto charcoal, let it sit a minute, and then light it... by that time there is a cloud of fumes above the charcoal and there will be a fireball when you drop in that lit match... if you get the chance to let go before the explosion.
Even a cigarette lighter works that way, only with butane instead of gasoline. As you flick your Bic, it releases vapor from inside the little plastic part at the same time as the friction created by the device's modern version of flint and steel produces a spark. Every time a smoker lights his/her cancer stick, he/she is demonstrating exactly why one does not want to have any active means of ignition around an active means of dispensing a flammable liquid which evaporates quickly when exposed to air.
Anyway, the vapor effect is why your car has spark plugs and not some kind of flame producing device, and it is what pushes the pistons and makes your engine work in the manner which moves your car. Because it is dealing with a vapor instead of a liquid, less effort is needed to produce a flame, and all of the fuel ignites very, very rapidly instead of the ignition moving slowly across the substance as with wood, coal, or even liquid fuel. This causes an explosion inside the combustion chamber. The force of the explosion moves the piston, etc.
The same thing can happen with gas fumes next to a gas pump. A small spill can produce enough vapor to make a big fireball right where you are standing. Even a single, small spark can be enough to ignite gas fumes.
Don't believe me?
Read some proof:
The kid's step brother was smoking while pumping gas. When the nozzle caught fire, he pulled it out and the kid got sprayed, and ended up burned over a majority of his body.
Story about a woman who started a fire by smoking while pumping gas
From Elizabeth Cohen
CNN
(This article includes an example of a fire started by a spark from static electricity at the pump during refueling.)
CNN
(This article includes an example of a fire started by a spark from static electricity at the pump during refueling.)
If that isn't enough, read This Thread from the Airstream Knowledge Sharing Forums
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