Blood Pressure Meds

  1. I have a question! I am a cna and I work at a nursing home and my charge nurse is an LVN. When I come to work, I have to take all of my patients vital signs and chart them on a computer. I have to do this before 4:00 pm. At 8:00 pm my lvn charge nurse asks me to take 3 blood pressures and heart rates. I ask her if she wants me to chart them in the computer and she says she will chart them. Now...the policy at this nursing home is that the licensed nurses must take the blood pressures of patients who they are going to administer blood pressure medication to. I have asked her, lol, and if course she won't tell me anything. If she charts that these blood pressures, it would look like she took them, but she did not. I did. Can anyone relate, or elaborate any knowledge in this area?
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  2. Visit Sickandtiredcna profile page

    About Sickandtiredcna

    Joined: Sep '17; Posts: 4; Likes: 2
    from CA , US

    8 Comments

  3. by   Sour Lemon
    Quote from Sickandtiredcna
    I have a question! I am a cna and I work at a nursing home and my charge nurse is an LVN. When I come to work, I have to take all of my patients vital signs and chart them on a computer. I have to do this before 4:00 pm. At 8:00 pm my lvn charge nurse asks me to take 3 blood pressures and heart rates. I ask her if she wants me to chart them in the computer and she says she will chart them. Now...the policy at this nursing home is that the licensed nurses must take the blood pressures of patients who they are going to administer blood pressure medication to. I have asked her, lol, and if course she won't tell me anything. If she charts that these blood pressures, it would look like she took them, but she did not. I did. Can anyone relate, or elaborate any knowledge in this area?
    That would be an odd policy. Vitals signs may be required in advance of some medications, but there's no legitimate reason why the task can't be delegated to assistive personnel.
    If that is truly the policy and it's not a misunderstanding, the nursing home is basically saying that the CNAs are unreliable. If that's the case, they should be fired and new ones should be hired.
  4. by   dbuy3
    I'm only a few days from finishing my LPN program, I've completed all my tests and studying for the NCLEX now. More to the point, the last part of my program dealt with management/delegation.

    Most of my last few tests had to do with delegating appropriate tasks to assistive personnel. Taking vital signs would fall under a task that we could delegate out to a tech/CNA. I have to agree with SourLemon, that seems like an odd policy if that really is the case.
  5. by   Sickandtiredcna
    The CNA should be fired for not being "reliable?" No no no it's the lvn who should be fired for false documention. She did not take the vital signs herself, but charted them in the computer under her name, like she took them and then administered the medication. The state department will be coming to our facility very soon...I will ask them. What's funny is that I questioned her about me taking them and her charting them under her name. She told me that's just the way it is. But she knows she is in the wrong because she asked a new cna to take the vital signs instead, not me. See she is very bossy, she speaks with authority and is kind of loud, but then quietly goes and asks the new cna to do her work. I'm not stupid, she will be told on!
  6. by   caliotter3
    Most nurses take the vital signs before giving a blood pressure medication. Delegating the task and then telling the CNA not to chart the findings tells you something. Be careful when you report the nurse. Management may already be aware of what she is doing.
  7. by   OpinionatedCNA
    I am not sure if your facility is just different but here only the nurses chart the vital signs. It doesn't mean you didn't do it, it just means they charted it.

    About CNA's being unreliable... Some are. And they will continue to be unreliable because some facilities will never fire them just because of how understaffed they are. I had a nurse once give me a hard time for measuring BP's manually (every single one of our facilities automatic cuffs are broken/stolen/never replaced). She then told me she asked another CNA to get her vitals before this and she just wrote a bunch of random numbers down instead of just telling the nurse she didn't know how to take manual BP.

    To be honest, I can't think of anyone else to blame except the current culture in these facilities. These nursing homes pay minimum wage and then people get upset because the CNAs are as reliable as walmart employees. They pay you bare minimum; reliable people will get another job and gtfo, and they're still there scratching their heads wondering where all their hard workers went. It's not rocket science
  8. by   Missingyou
    If she delegates taking vitals and that is a part of your job description, then do it because your supervisor asked you to. You should not be questioning a nurse or LPN over something like this. You will be labeled a trouble maker who doesn't understand how to take direction. It will go badly for you. Truth is, they need nurses more than CNAs, and any management you complain to Will side with the nurse with something like this.
  9. by   lindseylpn
    The only place I've ever worked where the nurses exclusively took the vitals is a group home and that's because, the support staff aren't CNAs. That's not the norm in most places though. CNAs almost always get routine vitals, it's probably the most delegated task. Usually the CNA gets the vitals, gives them to the nurse and the nurse charts them, in my experience. Just because the CNA got the vitals instead of the nurse doesn't mean it wasn't the nurses task to do, the nurse just delegated that task to the CNA which is legally within her right to do. If your facility is different then that's their policy and not a state thing. If you question the state, I doubt they are going to know your facility's unique policies. The appropriate place to ask the question would be your immediate supervisor. You should probably look up the rules of delegation in your state too as a refresher. Also, if a CNA is delegated a task (within their scope of course) and they refuse then that is insubordination and can result in a write up or even termination so, I'd definitely find out your facilities policy for sure before you were to do that. Your facility should have a policy and procedures book laying around that might give you the answer you're looking for. If you can't find the answer there then ask your supervisors.
    Last edit by lindseylpn on Apr 28 : Reason: Grammar
  10. by   Hygiene Queen
    Quote from Sickandtiredcna
    The CNA should be fired for not being "reliable?" No no no it's the lvn who should be fired for false documention.
    You're missing the point. The point is that the policy was likely made due to unreliable aides in the past. If that was indeed the case, then those aides should have been fired. Not only that, but if the facility continues to deem their aides as so untrustworthy as they cannot be expected to do their jobs properly, they should be fired.

    Quote from Sickandtiredcna
    She did not take the vital signs herself, but charted them in the computer under her name, like she took them and then administered the medication.
    If she trusts the BPs given to her and she wants to go against policy, that is on her.

    Quote from Sickandtiredcna
    The state department will be coming to our facility very soon...I will ask them.
    The state isn't going to know about something that is uniquely facility policy. This is unique and not anything mandated by the state.

    Not only that, but there is something called "the chain of command" that needs to be followed. Going to the state without following the chain of command is a low blow and may end poorly for you. If you feel something is unsafe then address it with a supervisor.

    Quote from Sickandtiredcna
    What's funny is that I questioned her about me taking them and her charting them under her name. She told me that's just the way it is.
    Every facility is different, but where I have worked, the vital signs were taken by the techs and then the unit secretary (or whoever had time) placed them into the computer. This meant they were placed under the name of whoever put them into the computer-- not who actually took them. This is a common practice.

    However, if this is not acceptable in your facility, then so be it. Again, it's on her. Not you.

    Quote from Sickandtiredcna
    But she knows she is in the wrong because she asked a new cna to take the vital signs instead, not me.
    Great! Now you don't have to worry about it anymore.

    Quote from Sickandtiredcna
    See she is very bossy, she speaks with authority and is kind of loud, but then quietly goes and asks the new cna to do her work. I'm not stupid, she will be told on!
    It doesn't matter if she's bossy or unpleasant or whatever. If you have a concern and it bothers you so much, take it to management-- not the state. Don't blow this all out of proportion.

    I'm going to ask you, why is it that you want to "tell on" her so much?

    And before you toss that first stone, make sure your own work ethic is impeccable.

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