Nurse and CNA argument at the end of my shift - page 2

by zippeh 3,890 Views | 15 Comments

I have been a CNA for about two years. I have never really gotten into it with any nurse before tonight. I got into it with the night nurse and the evening nurse. It was about 10:40 PM. I was doing my last rounds and I was going... Read More


  1. 0
    I use to defend CNAs bc I was one myself. The ones I work with now are crap. Sounds like you had a crappy nurse who was only thinking of herself and not what's best for her/ur pt.
  2. 1
    I would speak with the DON of the facility. I have been working as a CNA for 10 years, and as a student nurse for 3 years. I understand both roles, as I have been working in the nursing system and also have observed the nurses role throughout my 10 years as a CNA. I understand the duties, and have practiced the duties in the capacity as a nurse. Sure it gets busy, sure things get hectic, but at the end of the day we do our best. It sounds as if both sides- yours and the nurse, could have done things a little differently. However, almost one hour to address that situation is inappropriate. I have also worked with many dementia patients, and also patients with stomas. He could have tried to eat his feces, or gotten it into his eyes. It does appear that her course of action was inappropriate, and perhaps the situation can be prevented from happening in the future if it is brought to the attention of hopefully a skilled-leader- the DON. She should have a good perspective on both sides of the situation. If your shift ended at 11:00, you are off shift. It sounds as if you were already assisting the patient off the clock, and staying even later to catch up on your paperwork, that this preventable incident clearly took you away from. As a future reference, perhaps if it occurs again, I would think about putting him to bed before it is time for you to punch out. It is annoying for the other nurses to clean him up, but it is safer for the patient as cleaning up a dirty bed is not as critical to the patient as a decubutis ulcer would be from staying in the chair. Just food for thought. On another note, as for the new night shifts ganging up on you, you spoke to the night CNA, it actually was the night CNA's duty to put him to bed, and the RN/LVN's should have asked the night CNA- the CNA who is on the clock. You were not on the clock, and if an injury occurs, the hospital may not be liable for your injuries. As RN's Im a little surprised that they were not on top of it- it is part of our job as nurse leaders... I am wondering if they did not know the situation at first, and then became defensive after you told them what happened (you were angry by that point, and anger causes the person hearing it to become defensive). If you think that this is what may have happened, perhaps in the future you can keep that in mind when you respond to a person outside of the incident, and keep that perspective that they are completely fresh. You seemed to be understandably upset, but just try to practice not taking your frustration out on the new nurses as a result of the previous nurse- if thats what happened. It is REALLY frustrating, but if you practice that it will actually help to keep you from getting too angry for your own health. All in all, I would definitely speak with the DON. The DON should be aware of the situation, and clarify the appropriate response on both sides. This situation could happen again, and I do not think what the nurse did was appropriate. She definitely will think twice in the future before brushing you off. But that is not the only reason why too. It affects your patient, and if she would do that so "easily", she most likely will do it again. If I was a busy nurse who really had no time to change a stoma bag, I would NOT be laughing with another nurse. It sounds like she wasn't focused or very concerned about the patient... Talk to the DON. As a side note, and as a CNA who does the heavy physical and mental work- therapeutic communication is exhausting for a good CNA- I think that it is important we all respect one another- Nurses and CNAs- for the duties which we do, and work together for the good of our patient. Both roles are CRITICAL to our patients, and we cannot have one without the other to properly care for our patients! What if it was us who was the patient?!
    Last edit by Mrs. Sunshine Lily on Feb 16, '13
    amoLucia likes this.
  3. 7
    I have a real problem with CNAs telling me what I need to do NOW. As a nurse, my priorities may be different than theirs, and some of them don't seem to understand that. I don't know anyone who likes sitting at a desk and shuffling paperwork, but some of it IS very important and needs to be taken care of- even if there's a colostomy bag that needs to be put back on.

    For example, I had an admission recently who was SOB, hypertensive and having seizures. He was from a nursing home and had orders to continue his nursing home meds, but his med rec had not been created yet and pharmacy was closing in about 20-30 minutes. I quickly reviewed and wrote out the urgent medications I needed that night, faxed them to pharmacy, and called to confirm that they received my fax. Height, weight and allergies had to be charted for pharmacy to process my request. I also faxed and paged RT, then waited a few minutes for their call before going to set up suction in the new admit's room. The CNA for another patient approached me about three times during all of this. She was annoyed that I hadn't replaced a dressing that had come loose on another patient. Her perspective was that I was just "sitting in the nurses station" while a patient was waiting to be taken care of. I even heard her complaining to another CNA that she "kept telling the nurse" and nothing was being done. She had no idea what I was busy with, and frankly, I get tired of feeling like I have to justify my actions to her. Most of the time, I no longer bother, because if she doesn't get it by now she's never going to.

    I also prefer to give report before tying up last minute loose ends. It's hard to get things done when you have a full load of patients still under your care. Delaying report also puts the next shift behind. And so what if I giggle because someone says something funny while I'm working ...am I supposed to spend all day crying to show how seriously I take patient care?

    OK, I'm done now.
    Pat2012, hikernurse, Boog'sCRRN246, and 4 others like this.
  4. 0
    I was a CNA and now I am a nurse. If you were off shift girl, you were off shift. As far as I'm concerned you reported what needed to be done, and the nurse dropped the ball. Takes 2 minutes to change an ostomy bag, report could have waited.
  5. 1
    Quote from Orange Tree
    I have a real problem with CNAs telling me what I need to do NOW. As a nurse, my priorities may be different than theirs, and some of them don't seem to understand that. I don't know anyone who likes sitting at a desk and shuffling paperwork, but some of it IS very important and needs to be taken care of- even if there's a colostomy bag that needs to be put back on.

    For example, I had an admission recently who was SOB, hypertensive and having seizures. He was from a nursing home and had orders to continue his nursing home meds, but his med rec had not been created yet and pharmacy was closing in about 20-30 minutes. I quickly reviewed and wrote out the urgent medications I needed that night, faxed them to pharmacy, and called to confirm that they received my fax. Height, weight and allergies had to be charted for pharmacy to process my request. I also faxed and paged RT, then waited a few minutes for their call before going to set up suction in the new admit's room. The CNA for another patient approached me about three times during all of this. She was annoyed that I hadn't replaced a dressing that had come loose on another patient. Her perspective was that I was just "sitting in the nurses station" while a patient was waiting to be taken care of. I even heard her complaining to another CNA that she "kept telling the nurse" and nothing was being done. She had no idea what I was busy with, and frankly, I get tired of feeling like I have to justify my actions to her. Most of the time, I no longer bother, because if she doesn't get it by now she's never going to.

    I also prefer to give report before tying up last minute loose ends. It's hard to get things done when you have a full load of patients still under your care. Delaying report also puts the next shift behind. And so what if I giggle because someone says something funny while I'm working ...am I supposed to spend all day crying to show how seriously I take patient care?

    OK, I'm done now.

    Okay Orange Tree,

    I understand your frustration with that. It can be very annoying. I knew she was busy with a patient's orders/status of a new admission coming in. Although, I came up to her and told her and she told me, "okay, I'll be there in five minutes", and I approached her two more times after that in five to ten minute intervals. It was not until 11:15-20 she finally told me to go home and night shift would take care of it (she thought the pt. was in bed, while I told her numerous of times that the patient was sitting there waiting). The point is, I understand nurse's get busy... very busy, and as a CNA I can't fully understand at that time how busy they really are. Although, as a nurse, do not tell your CNA's that it will be five minutes. If you are going to be longer than that, OR you don't know, tell me that. That way I can prepare the patient and get him cozy instead of waiting with him for you to come. I went up to her yesterday and I apologized if I came across rude. I reinforced that I still stood by what I said, but if my attitude was negative towards her or the other nurse, I apologize. She said it was okay, and tried to reinforce to me that I should have put the patient to bed. I understand that part, and next time I will get the patient in bed, because as a CNA, I do need to cover myself. If anything happens after I provide care to the patient, I can say, "I did what I was supposed to do, and I alerted the nurse X amount of times about the issue." MY BIGGEST COMPLAINT, is what I stated before. DO NOT tell me you are going to be somewhere in a certain amount of minutes, when you in fact know something is more important (like getting meds from the pharmacy before they close). Tell me what to do (prep the patient, and lay a towel over patient). As a CNA, I don't know and am not trained in the proper procedure of putting a colostomy bag on. Every nurse I have ever worked with has put the bag on the patient while he was sitting up (probably to save time). Furthermore I did not tell the nurse to do anything. I told her multiple times what was going on and the patient needed her. I would have left her a lone if she told me what to do and that she couldn't have made it for a while to the room. LASTLY, your example was a perfect example of prioritizing, while she had pressing matters that were also important, I alerted her before her report started(while she was attending her urgent matters). You can ask the ethical aspect as to, is my report more important or is my patient that has the possibility of having feces all over him and having a possibility of him eating it more important. She could have also delegated her task to the night nurse, as much as people don't like to do other's people's work, it needs to be done at other times. The report was already late, and being another 5 minutes late really would not make a difference. Yes, it would have been a hassel and a nag on the other nurse, but as we both know... Everyone has their nights. In the healthcare field, you rarely ever finish on the right time. (just because I stayed after my initial hours, does not mean I clocked out. Things happen all the time where you have to stay after. IF you are clocked in, you automatically are covered because you are still "working". IT is when worker's clock out and then return to their work, the facility technically isn't responsible for your actions/injuries that occur after you do that.)

    Thanks EVERYONE for their feedback. I really appreciate it. Like I said above, I approached the nurse and apologized if I came across rude, but I stood by my actions and what I did say.
    i_love_patient_care likes this.
  6. 0
    Sometimes you really plan to be somewhere in five minutes, but it just doesn't happen. Things change constantly. Priorities change constantly. A lot of tasks only take five minutes to complete, but it can often be difficult to fit all of those five minute tasks into one twelve hour shift. I don't see an ethical dilemma here (with the colostomy care delay), but I can understand why you were frustrated about waiting and ultimately getting nowhere. The nurse should have at least apologized that she wasn't able to get there as soon as she thought she would. You seem like a fairly reasonable person...not at all like the type of CNA I was ranting about!


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