Complaints about me ALREADY!

Boog'sCRRN246, RN · Feb 24, 2012

So I just started my FIRST job as a CNA January 2 of this year. I am still fairly new. I thought I was doing pretty good for starting out, until I recently had some complaints!
There was one girl who was so angry with me. It turned out that one of the residents soaked his linens, and she had to change it.
I had put the pad too far up, so the pee got on the linens, rather than the pad. I now make sure that I put at least two pads on and make them low.
Yesterday I asked one girl on the shift after mine to double check my set and make sure that everything was right.
I clock out at 1030 pm. I do my rounds at 945pm-10pm. That is when we have to check on each resident and change their brief if they are wet. I did this at 945 pm, and made sure everyone was dry and clean and asleep. The girl on night shift texted me and said that TWO beds were soaking wet. HOW?! I just did my rounds at 945, there is no way they can soak up a bed, through the bed pads, onto the linens in 45 minutes!
She told me to put two diapers on them. Am I allowed to double up on residents?
I am still new, so I am on the 90 day probation thing, and I am terrified I will get fired at the end of the 3 months. ='[
I couldn't stop crying!
Any suggestions??!

My suggestion: Let it go and keep doing your best. It is very possible that a resident can soak a bed in 45 minutes, even if they've just been changed in that 45 minute window. If the patient is taking a diuretic and is dependent on assistance to get the bathroom, well, the likelihood of incontinence goes up. I get tired of hearing the CNAs on my floor complain that patients are wet in the first hour of their shift. It is immediately blamed on the previous shift. You can't predict when a patient will be incontinent. If you stayed until the very last second making sure everything was in order, believe me, even then the next shift would find something to complain about.

nguyency77, CNA · Feb 24, 2012

Let it go! I'm relatively new still; I've been a CNA for about 6 months..

EDIT: Everyone makes mistakes. Don't double up on briefs; it's going to be a MESS trying to take it off, especially if they have a BM. Meet your new best friend: chux/pads.

I'm not saying you should leave people wet and soaking for the night shift, but when your shift ends, those patients are no longer your problem. You did your rounds, and that's too bad that your coworkers don't want to do their job.

A lot of my friends at work and I know that when people complain and nitpick in that manner, it just means they're lazy and they want the prior shift to do a lot of the work for them.

For example, I have this snooty coworker who thinks she's the best out of all the CNA. She's got a superiority complex, and is always trying to criticize other people's work. We work in skilled nursing, and sometimes people are here to recover because they had knee/hip surgery, etc. Those patients do enough with physical therapy, but that particular coworker insists that we can't give them room trays just because she doesn't want to pick them up after lunch!

Am I going to make my 98 year old hip replacement patient get up to go all the way to the dining room just so your lazy ass doesn't have to pick up her tray later? Hell no. My patients come first!

fuzzywuzzy, CNA · Feb 24, 2012

I don't get why people get mad about incontinence at the beginning of their shift. If the pad is brown and the ammonia smell just about knocks you over when you pull the covers back, then fine, get mad. But it's pretty obvious when someone's been sitting in it all shift vs they happened to pee a little while ago after rounds were done. It's like, I can check a resident of mine at noon and they'll be dry. I'll put them on the toilet for a few minutes and nothing will happen, so I'll send them off to the dining room. Then I check them at 2 shortly after they come back from lunch and they could be soaked right through everything. And I have no idea when they peed... it could have been at 12:05 or it could have been 2 minutes ago. Obviously I didn't do anything wrong but if that same situation had occurred an hour later, the next shift would be up in arms about it. And I have seen people soak a bed in 10 seconds flat. Some of them, you can change them and they'll be SOAKED. Then you go in 30 minutes later to give them a breakfast tray and you can see even the top sheet is already soaked. Then as you're rolling them over to change them again there is another waterfall and you're like, "How does this person pee like 3 gallons in less than an hour?"

I know it's annoying to have to change a whole bed because it wasn't protected enough. Usually people take extra precautions with the frequent flooders, like double-padding or tucking a brief or chux between the legs. At my facility these things are not "allowed" so a lot of times at the end of the day, at the last minute, you'll put things back to the way they're supposed to be so you don't get in trouble. Then if the following shift is crabby they will complain about the bed change; however if you decided to place 2 pads under the person they'll run and tattle on you, so you're damned if you do and damned if you don't. That's if you have cranky staff members after you. There is just no pleasing some people though.

MyMystudentRN · Feb 24, 2012

okay first of all you did your rounds!! you did what you had to do on your shift until the next person relieved you. once you are off the clock that patient is no longer "your" patient so to speak..the CNA coming on has to deal with it, why complain that's her job anyway!

im sorry but i can not stand when this happens! this has happened to me until i got fed up with it and went up to the cna and actually told her not to attack my character as a cna and stop complaining because this is her job as well as mine to clean this person up whenever we are on shift. and to stop with the complaining because if they are incontinent they are going to go on themselves whether i was there or not.

dont know if they went 20 minutes after you changed them or not then they will be sitting in their urine/bm for the rest of the time waiting for you to change them again..point being know your patients you are newbie and you will def get better and im sure she is only doing all of that complaining because she is one of those unconfident cna's who thinks her job is in jeopardy!

nguyency77, CNA · Feb 24, 2012

Then as you're rolling them over to change them again there is another waterfall and you're like, "How does this person pee like 3 gallons in less than an hour?"

I KNOW, RIGHT?

At my facility these things are not "allowed" so a lot of times at the end of the day, at the last minute, you'll put things back to the way they're supposed to be so you don't get in trouble.

Wow. Your higher-ups seem just about as out of touch with reality as mine are!

AJ_427 · Feb 24, 2012

Those are really tricky situations. This happens at my facility A LOT. Back when we used to have a supervising CNA on our shift, I would complain about things like that and nothing would slide by me.

In my opinion, before you leave, you have to check all your residents. Your changing round should be within the last 20 minutes (30 is max) of your shift. The last checking round should be 5-10 minutes before you leave. Why the last round? So you can check that none of your residents have vomited, all the side-rails are up, no one is on the floor, no one is walking around, etc. You would not believe how many residents I have found on the floor and with no side-rails, no diapers on, or those who have G-Tube feedings with their heads not elevated.

If you feel like certain residents are heavy wetters, put extra pads under them. Heck, I sometimes put 3 extra pads because I know some can pee through their diaper AND manage to get the entire bed wet. Hopefully, there is no rule against putting extra pads at your place.

There is another thing. It also depends when the aide that worked after you checked the residents. Who knows, maybe she checked them after 11 pm.

My advice is to tell the aides that work after you that you are new and ask them who is a heavy wetter so you can put extra pads under them and so you can check them the last.

Sorry, but I check my residents within the first 5-10 minutes after I get my assignment and if I see that they are wet (not a little, but a lot) then I will complain. I've worked after many aides that managed to change their residents and most were dry so I know it's possible. I shouldn't have to clean up after people who are lazy (not you, I'm actually thinking about one particular aide at my facility). Seriously, I come to the main nurse's station 10 minutes before my shift starts to get and assignment and the aides are all sitting around, texting (my annoyance level goes through the roof). Keep in mind, some of us complain not because we are lazy, but because we have to clean up after lazy aides. This puts us behind. I don't remember the last time that I got to go on break (during night shift!) because for the first 1-1.5 hour all I do is change entire beds, diapers, bedbaths, and clothes (16-22 residents, all total care). Don't take it personally, but try to get a feeling of who gets wet around what time (I know that this is sometimes impossible). Once you get to know your residents, it will get easier. Don't worry about since you are still new.

nguyency77, CNA · Feb 24, 2012

I work 2-10pm and I always start rounds at 9.

--If I start earlier, then people will re-wet themselves.

--If I start later, I might not get out by 10pm, report will be late, and graveyard will be mad.

I tend to change heavy wetters around 9:30 or so. I round again as I give report at 9:50, and I'll help whoever's on graveyard if any of the residents do need to be changed.

Once you figure out your residents' schedules, it won't be so hard. Just make sure to plan ahead and make sure people who urinate a lot have a layer or two of pads underneath.

JDZ344 · Feb 25, 2012

I accept that one or 2 people may be wet when I get around to checking them. It's not a big deal.

Double-Helix, BSN, RN · Feb 25, 2012

Sometimes the people on the next shift just don't want to work. It can happen on any shift, but I did notice it more with night shift. If they came on and there was a resident still awake (because they are A+O and wanted to stay up) they get annoyed that they have to help them get ready for bed. Sometimes the culture on night shift is to do homework, read, or just relax and talk. The workers get annoyed when this is interrupted because they actually have to change someone.

So don't worry about it. Ignore the texts from this person, or even reply something sarcastic such as, "I changed them at 9:45. They must just like you." or "Don't you know old people pee every 10 minutes?" Just continue to do your rounds like you have been. Once you leave, try to let that responsibility go too. This will come with practice.

And residents can ABSOLUTELY soak a bed in 45 minutes. They can do it in five minutes. We had these two men in particular that could require three or four bed changes every night. One of them would actually take his brief off at night, so that was part of the problem too. Putting a brief on an adult isn't as easy as it looks. It takes some experience to get it lined up correctly. Check to make sure that your brief is placed evenly (the top of the brief should be just about at hip level). Make sure it's secured, but no so tightly it will dig into the skin. Make sure it's not bunched up between the legs, or it will leak. Finally, if it's a male, make sure their member is pointed straight down into the brief, not upwards or off to the side. Just like with babies, they will leak out if pointed the wrong way.

Two pads/brief aren't allowed because they cause skin breakdown, not because the management wants to make it harder on the CNA's. Too many linens under a patient isn't as bad, provided they are smoothed out. (No wrinkles.) Two briefs, however, causes sweating and the trapped moisture leads to skin breakdown and higher right for pressure sores. So only use one brief.

Merlyn · Feb 25, 2012

This is normal. You will find as time goes by the other shift will complain about anything. The thing is to do your best.

The other shift will never stop complaining.

MikaB23 · Feb 25, 2012

Tammy I worked as a CNA for about six years, and the best way I found to get rid of this problem is to do a walk through with the CNA that will be taking over your patients after you leave. I even went the extra mile to have them sign off on my own made up charts as we left each patients room, that way they cannot complain about someone being wet, having skin tears, or anything else. In my experience I have learned that a paper trail is always your best defense, dates, times, patients, and signatures, that way you can always go back and say "well why did you sign off on it?" Being a CNA is truly a hard position mentally and physically, you have to really care about people to do this job well and unfortunately there are those who make it that much harder. Anyone can tell if someone is freshly wet or if they have been laying up in it for quite sometime, this is the best advice I can give, walk your hall with the next shift EVERYDAY before you leave......problem averted!! Good Luck!!