From doing this 14 years or so, I have some thoughts on this...
1) Being left alone: We should never, ever be left alone during an activity with either an assisted living or traditional nursing home crowd. Too many things can go wrong and its not our responsibility to correct them. Fact is, we're not technically allowed to even push a wheelchair. When I'm left alone, I make sure to alert the AD that I'm not comfortable with it. In the few cases where it persisted, I dropped the account.
2) Inattentiveness of Activity Staff: Residents will get up and wander, especially in secured Alztheimers Units. Awareness is key...Memory Loss patients are erratic, quickly agitated and at times physically violent. Always pay attention when your playing on these units. For the average nursing home jobs, usually I'll just calmly announce over the mic that "Joe" needs a hand getting back to his seat, can you help him?" Usually does the trick...
3) Attendees talking loudly/interrupting the show: If its work related that's one thing, if its just two employees gabbing rudely with each other, I'll point them out and invite them to come up front and help me out. They usually quickly pipe down or leave, lol...(Family members can be a big pain in the ass. Too often they'll come in and try and visit with the resident in the middle of the program and their conversation distracts the other residents. This is a touchy one to go after, so I usually just let it go...)
4) Serving of food: Doesn't bother me in the least. If you've got some big dramatic ballad or hymn or something, save it for when they're done serving food. My biggest problem related to this is when the residents drop their drinks to clap along or something, lol...Likewise, taking a resident to the restroom for example also doesn't bother me at all.
5) In the US, we have something called "HIPPA" which protects patients privacy. You should know that it is a violation of the HIPPA code for a nurse to administer any meds to a resident during an activity. If a state surveyor witnesses it, it will certainly be noted.
6) Billing: Yes, this isn't nearly as efficient as it should be. Any payment rendered within 30-45 days is very reasonable. The important thing for me is an awareness of how a particular client processes check requests. If I'm told it'll be in my hands in 30 days, that's great-I'll plan accordingly. If the standard is to hand it to me that day, and then you tell me "Oh by the way, I don't have your check, because XXXXXXXXX...." Well, I'm not happy about it. Contracts can help sometimes. In my area, most clients will throw up on their shoes if you start asking them for contracts. In other areas, like where Mr. Diamond is, contracts are common.
For most of the issues you mentioned, a cordial chat with your activity director should help...
Cheers-
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Bill in Dayton
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Bill in Dayton