Additional CNA Training: What is Punishment and Involuntary Isolation?

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No matter what facility you decide to work in after CNA training, you may notice that there always seems to be a group of residents sitting in chairs or wheelchairs near the nurse’s station. In some cases, CNA training graduates who work in the facility may not have the time to constantly supervise residents at risk for falling or wandering off. In others, the CNA training graduates  may place the residents in this position because they “need a break.”

After CNA Training: What is Punishment?

During your CNA training, you will be taught the differences between safety precautions and punishment. As a safety precaution, some residents are placed in chairs with alarms attached to their clothing. When they stand and attempt to walk away, the alarm goes off, alerting the nursing staff to the situation. However, this can sometimes be taken too far.

Punishment is defined as any situation where a resident is restricted from performing any activity due to their previous “bad” behavior. In 1987, the Omnibus Budget Reconciliation Act, or OBRA, established federal regulations to protect patients and residents from punishment through the nursing home reform act. According to these regulations, patients have several specific rights:

  • Respect- Patients have the right to be treated with respect and dignity. During CNA training, you will learn that every resident has the right to make their own schedule, including deciding when they will eat, get up in the morning, and go to bed. They also have the right to choose whether they want to participate in certain activities. They can not be coerced, discriminated against, or retaliated against because of their rights.
  • Freedom from Neglect and Abuse- Residents can not be subjected to physical, verbal, sexual, or mental abuse, involuntary seclusion, or corporal punishment. As a CNA training graduate, it’s your responsibility to report any suspected abuste.
  • Freedom from Restraints- Patients have the right to be free of chemical restraints, which are drugs used for convenience or punishment and are not used for medical problems. They also have the right to be free of mechanical or physical restraints. These types of restraints restrict physical activity and normal movement and can either be attached to the patient or placed next to the patient’s body.

After CNA Training: What is Involuntary Isolation?

Involuntary isolation is confusing for many individuals who complete CNA training, because they may not even realize they are using it. This type of isolation refers to any time when a resident or patient is place in his or her room, isolated from other residents. Unless the patient asks to go to his room, is receiving personal care, is sleeping, or has a contagious illnesses, isolation is illegal.

Many CNAs become frustrated with a resident’s behavior and place them in their room until they can “calm down.” This is similar to a time-out used for children. Often, residents have no one to talk to, nothing to do, and may not be able to reach their call button. Involuntary isolation is often used to correct behaviors. In reality, though, the emotional stress of isolation can exaggerate the unwanted behavior.

When you finish CNA training and begin working in a medical facility, keep a close eye out for instances of punishment and involuntary isolation. These illegal actions should be avoided at all costs as they can not only harm the resident physically and emotionally, but you and the facility can be fined, you could lose your CNA certification, and you could face imprisonment.

CNA Training & Careers

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