is this a case of Lazy RN, OR Over productive CNA??

[josebeltran88]

Ok so this is the issue.

Lately I've been reporting a lot of observations that I think are worth reporting to my charge nurse. This entire week I've reported everything from pt. vomitting their dinner, to pt. fighting with room-mate and creating a dangerous situation. Take into consideration that I work in a lock-down, where things can get nasty in an instant. And, everything that can go wrong, will go wrong.

In adittion to verbally reporting to my nurse, I also write down everything I report on the back of the flow sheet that belong to the pt. that I'm making a report on. I do this in order to "cover" myself, and to set a record of my observations and reporting. Since not too many RN's in my facility stand up for their CNA's, we have to "cover" ourselves.

Here's the problem. Last night, as I filled out my flow sheets, I wrote down an observation and recorded it, as usual. The problem here was that the RN REFUSED TO SIGN WITH HER INITIALS. She said, in a very distressed tone of voice that she was fed up with my annoying notes, and that she had had enought of me wanting her sign for my observations. This was something that totally caught me off guard, and we proceeded to argue, I argued that I was only doing my job as "eyes and ears" of hers, and that I was trained to do what I was doing.

After she was adviced by an LVN to follow through with my request, she did.

Now there's a very tense envireonment in the unit because of the "altercation" that happened.

Wasn't I just doing my job as a CNA??

Your opinion is welcomed.

[caliotter3]

Your demand that she initial off on your observations is perceived as a threat on her part. She does not feel that she needs to be supervised by you.

[DolceVita, ADN, BSN, RN]

What you are doing sounds OK to me but I am just a student. It is important to know if a pt vomits as it could be a sign of medication toxicity or something else. If you are in a psych ward they may have ingested something they shouldn't. Certainly I would evaluate the patient/resident.

Is she an LVN herself or an RN?

Who is your supervisor? I would ask her specifically about this. I would not, however, say that you had a problem with the nurse.

Also, I would be careful about labeling anyone lazy or anything else. If you are thinking negative thoughts about someone it will be apparent in your interactions with them -- people just are not that good at hiding their feelings.

I would keep reporting what you are reporting about patients until someone in a higher authority tells you to stop.

I would be interested to reading what a proper nurse has to say....

[caliotter3]

Are you implying something with your last statement?

[DolceVita, ADN, BSN, RN]

Are you implying something with your last statement?

Who me? If so, no. So steady on. It was my tongue in cheek way of saying someone other than a student nurse.

[eveningsky339, LPN]

Your demand that she initial off on your observations is perceived as a threat on her part. She does not feel that she needs to be supervised by you.

I think this makes the most sense...

I would approach this RN and explain that you are just trying to cover your butt.

[CoffeemateCNA]

Just want to add that the timing of giving these observations makes a HUGE difference in how well they are received by the nurse.

If possible, notify the nurse as things occur or are observed. Don't wait until you are filling out your CNA charting.

Nurses may get slightly annoyed if you wait until they have finished all of their charting very late or at the end of the shift. Your observations are additional charting, some of which requires the doctor to be notified, etc., which means the nurse runs the risk of having to stay late. So basically it equals MORE work for them to do. I'm not saying anyone's right or wrong, I'm just saying how it often is.

I'm not sure when you give your observations, but just a thought for you to keep in mind.

[annacnatorn]

When I worked in a LTC, I always had the C. Nurse sign my notations. I would tell her, but then write it. I started this after an unfortunate incident.

I was working a split triple..what was I thinking! I dunno..anyhow, in my bargaining If they wanted me to work that shift, I wanted the same run period. I got it, plus extra money..anyhow, I left work at 3 pm, from starting at 11 pm the prev night., any how, I came back at 11 pm, got the same run, discovered one of my patients who had a contracted R arm now had broken arm, dark bruising red etc, when I went to the Nurse to report, she blamed me as the prev cna mentioned nothing..um I told her when I left at 3 pm, there were no signs of anything wrong, I CALLED the Admin to exp the situation, luckly for me the Admin was also an RN BSN, she came in to examine the pt, found the bruising to be "fresh"...the prev CNA of course made no notation, She got fired, I got questioned, but was not found at fault. So from that point, forward, I made notation on the back of all notes, then reported to CN, IF I found anything wrong with the patient, I would also make notation is Nurses notes, my admin liked that, this way the CN can't say that they were not told!

remember the first rule of nursing is C....Y....A......

[josebeltran88]

"I CALLED the Admin to exp the situation, luckly for me the Admin was also an RN BSN, she came in to examine the pt, found the bruising to be "fresh"...the prev CNA of course made no notation, She got fired"

This is exacly what I'm trying to prevent for myself! And as you posted, C. Nurses don't really go through the work of trying to find out which CNA really is responsible for incidents, they just pin it on the CNA who is presently assigned to the pt.

Nice work!

Keep that "cover" on yourself ALWAYS!