CNAs "making up" vitals.

Nursing Students CNA/MA

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Specializes in PACU, LTC, Med-Surg, Telemetry, Psych.

Now, all of us since we read forum boards know better than this (I HOPE!), but I have a little story from my time of working agency as a CNA back when agency was a going thing and a valid way to get work as a CNA.

One CNA I knew was a 5 year veteran of a local area hospital. After years of working the floor on a med surg unit in a hospital, she finally got a decent raise and moved to a prestigous ICU unit. Now, compared to the hustle and bustle of med surg, ICU is much more cilled out at this particular facility. All the nurses are much calmer because they have at most 2 patients. The workload is also much lighter on the CNA as all she had to do was assist the RN with baths, take vitals, and of course poo and pee removal.

One day, the CNA went on her rounds to take vitals. After she was through, she turned in her vitals sheet to all the RNs. As she turned it in, one of the nurses turned to her with a puzzled look. "You got vitals on Mr. J. Mr. J has been dead for 3 hours and they are waiting on the funeral home to pick up his body!".

Needless to say, tha CNA got fired. Probably because there where other issues I did not know about helped. But still, this is a pretty dangerous thing. I think the patient would want someone to know if his pulse rate was 150 resting. Last i heard of our CNA who made up vitals, she had to work for a nursing home well known in that area for being not too good of a place because she was blackballed in that town from working other hospitals.

Anyone else have any stories of gross incompetence like that?

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Just last night my tech reported to me at 0600 that one of my patient's BP was 198/86 during her 0400 vitals. I immediately jumped up and did a manual pressure and got 152/84. When I went to chart it, I saw that her comment for the 0400 BP read "nurse aware". Seriously?! Not to mention that when I came on I had to tell her to change out a small adult cuff to a larger one on a 300 pound patient to get a proper reading. Sheesh!

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Specializes in PACU, LTC, Med-Surg, Telemetry, Psych.
Just last night my tech reported to me at 0600 that one of my patient's BP was 198/86 during her 0400 vitals. I immediately jumped up and did a manual pressure and got 152/84. When I went to chart it, I saw that her comment for the 0400 BP read "nurse aware". Seriously?! Not to mention that when I came on I had to tell her to change out a small adult cuff to a larger one on a 300 pound patient to get a proper reading. Sheesh!

"nurse aware" seems kinda unwarranted. Of course, the nurse is going to be aware. You jumped up to double check and your notes are what they are going to read over what the CNA put.

Manual is always the best way to do it. Also, sometimes the blood pressure machine can read a unusually high number if the patient jerks or if, like you said, you use a smaller sized cuff. I always get a manual if I get something messed up from the machine.

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Specializes in ER, progressive care.

CNAs aren't making up vitals, but what irks me is when they record a BP like 130/99 and think it's okay, or they take a temperature and two hours later (when it still isn't in the computer) they say, "oh I forgot to tell you, so&so's temperature was 102.2" :banghead: Most are good at reporting things right away and we also have our monitors that have our BPs, HR, RR & SaO2 on them but I can't sit and watch monitors all night or sometimes the monitor techs are too busy chatting to be paying attention to them...

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Specializes in ER, progressive care.
"nurse aware" seems kinda unwarranted.

Another thing that irks me is when the CNA charts, "nurse notified of vital signs" when they never notified me of anything. They expect me to just see it in the computer. Which I do, but when the vitals are charted like 2 hours after they were taken, it's irritating....because then it makes me look bad when I have a really high BP or something and it looks like I didn't do anything to fix it.

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Specializes in PACU, LTC, Med-Surg, Telemetry, Psych.
2. CNA co-worker sped up a drip that was dripping to gravity to max because they "kept asking for water so they must be dehydrated" and sent a patient into full blown plum. oedema.

Sped up a drip? I think the only time I have even heard a CNA was even allowed to touch those things is when you have a continual bladder irrigation (CBI) because it is a pretty repetitive process that involves hanging many VERY huge bags of sterile water or saline over a quick period. The RN does need two eyes on that. Even then, even that rare case may be a just a VA thing. Eeek!

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Specializes in PACU, LTC, Med-Surg, Telemetry, Psych.
We are absolutely NOT allowed to touch drips except to d/c a finished bag and throw it away. We are not allowed here to hang the irrigation bags for CBI, only an RN can.

When I worked the VA, the facility had the CNAs do it. But, then again, CNAs put in foley catheters, ran tube feedig machines, and did all non-surgical dressing changes. But, yeah.. you are right for 99 percent of all facilities.

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Sped up a drip? How many years ago was that?? Most hospitals use pumps for everything now.

I go to a clinic fairly often for my various issues. I have noticed less and less competence in the MAs who take my BP. I have had to tell them to get a larger cuff, or where to place the stethoscope. And recently, one of them did a palpapted BP because she couldn't find her stethoscope. And she managed to palpate the lower number. Go figure.

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Specializes in PACU, LTC, Med-Surg, Telemetry, Psych.
Sped up a drip? How many years ago was that?? Most hospitals use pumps for everything now.

I go to a clinic fairly often for my various issues. I have noticed less and less competence in the MAs who take my BP. I have had to tell them to get a larger cuff, or where to place the stethoscope. And recently, one of them did a palpapted BP because she couldn't find her stethoscope. And she managed to palpate the lower number. Go figure.

CBIs are never pumped. It has a little apparatus to control the flow. It better flow because if it runs out and the patient clots, a doctor will be after some tail. So, some things still are not pumped.

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One thing I'll never do is make up or change vital signs. They are what they are.

I dont think I've ever heard of any aides just completely making up a set up vitals, at least not in a hospital, but I do know some aides probably fudge a couple numbers, like counting respirations and getting 24 but just putting 20 because their 02 sat is fine and they arent in any distress and anything over 20 might set off some protocols.

I wont do it though, the one time you do might be the one time you get hung out to dry because something really was going wrong and the patient's deteriorating, but all your vitals show everything is normal.

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I hate when CNAs chart temps of 94.8 or something. I swear, one day I'm gonna gather up all those stupid tympanic thermometers and throw them in the garbage.

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We had this CNA that was going to school for his EMT. Not only was he on his 4th attempt of passing the EMT test but one day I came in to check his vitals and he had a patient at 209/130. I burst out laughing and asked if the patient was stroking out and he said, "no he's just watching TV". I went back in and did a manual and his B/P was 109/76. I couldn't believe it. I went back and checked all the vitals he had done for his shift and everyone he had vitals on should have been dead or stroking out. I asked him to let me know when he passes his EMT where he'll be working so I know to NEVER need his assistance.

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