The nurse and patient's family yelled at me. I feel horrible.

Nursing Students CNA/MA

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I'm a nursing assistant in the float pool. I get floated to pretty much everywhere. However, I enjoy it. I do my job and leave. I always get compliments each floor I go to because I work hard. I don't take the morning breaks like others do and I take my lunch break always later after everything is done. I barely sit down to take a break. That's just how I am. Today I got floated to work on the pediatric floor, general peds that is. I finished the morning and noon vitals and put them in. None of the patients had fevers. One patient who was a baby girl had a temperature of 99.0. During my lunch break, the nurse for that baby (1 year old) who had that 99.0 temperature asked the other nursing assistant to take her temperature. I saw that the nursing assistant got a temperature of 99.4 and put it into the computer. Then a hour later, that baby is crying so hard. The mom asks if we can take a temperature. I go in and the baby is hysterical. The mom is holding the baby tight. I got a temperature of 99.4. The parents give me an attitude saying how can the temperature be 99.5 when the mother feels the baby is hot. I take it again and the temperature is 99.6. The baby is crying hysterically. I leave and tell the nurse the temperature and put it into the computer. The dad of the baby comes out of the room asking if they can get the individual thermometer, not the one we use to get temperatures for everyone, you know the ones you throw away after using it on each patient. The mom takes the temperature with that and the temperature is 103. The parents ask the nurse to go into the room and tells her it's 103. Then they take it again and it's 104.3. Within like 10 minutes, the temperature spiked up so high.

The parents give the nurse an attitude asking if the baby had a fever all this time and we didn't know about it. They said when each of us went in, it would read something lower than 100 degrees. I hear the nurse tell her our thermometer is fairly accurate and it's probably my fault and I did a terrible job. The nurse asks me to go to the patient's room and they all said I did a horrible job. The nurse and the parents both gave me the biggest attitude. I've never had a problem with this. Can this really be my fault????

Kids can change in a matter of minutes. It is up to the nurse to tell you how she wants the temperature taken. Sometimes axillary temps may not be as accurate, but not your issue. If the baby's temp was 99.4 and the baby was fussing, it should have been up to the nurse to go assess on your information (and perhaps do a rectal temp). Which for some kids, a 99 degree temperature can make them uncomfortable. But a follow up by the nurse should not have included anything about your technique. I am not a pediatric nurse, but a crusty old bat who has taken care of my fair share of kids, and parents need education by the nurse that kids can have a complete change of condition in a matter of a half hour. Sorry this happend to you.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

threads merged......:)

Specializes in NICU, PICU, PACU.

Kids can spike fast. And that nurse threw you under the bus. She should not have called you in the room..she just disn't want them yelling at her. I'd go to the manager about that.

What kind of thermometer was it? Tympanic? Are you sure you were using it right?

axillary

sometimes you need to go through steps to get an accurate picture of a situation. For some reason, the thermometer you had wasnt reading accurately, perhaps. you took the temps, and did what they requested. i know parents can be very high stress if their child is sick. Eventually they got their answer. To be honest, the only thing I can see is what you did, retaking the temp, and because the parents were visibly upset at the warmth of the baby, perhaps getting the nurse...but other than that, you did nothing wrong. I am a nurse, and my son has had surgery, and believe me, i was a nervous wreck, i would have rather it be me than my child...so sometimes you have to look at the stress family members have and learn not to take it personally, but to empathize.

Are you sure the nurses were glaring at you? Make time whe you know that particular nurse is on, and go and talk with her about it. It will help you process this situation, which sounds like its upsetting for you. I am sure you will feel better once you can talk to her.

Specializes in Med-Surg.

Dear, we went over this with your post yesterday. There are lots of different factors that could be at fault here. For one, thermometer could be having issues. Two, could be placement of the actual thermometer, because as a CNA I'm sure you took an axillary temperature. Most nurses will tell you rectal is much more accurate, but a CNA should not do rectal temps on infants due to the risk for perforation. And based on what you wrote, you are not the only one to get a low temperature. So seems like IT WAS NOT JUST YOU!

I might not have tons of experience in pediatrics, but I can tell you that children, babies especially, can either get way better or way worse really quickly. They compensate and compensate and compensate until they just can't anymore, and crash. So it COULD be that the temp really was that low and spiked real fast. Or it could be that this baby, who was crying (will make temp rise) and being cradled by his parents (sharing body heat) could have a higher temperature than it should be because of these things

Ok, so now that you can see that there are many more things that could be to blame and that you are most likely not a horrible, terrible person, take a nice deep breath. Remember that parents get a lot more frazzled than your average crazy family member, because THEIR CHILD IS SICK. They don't mean to get upset or yell (well, most of them anyway). They are just completely off because they are worried, they want to know what is wrong with their child, and they want to know how to make it better. Was it right for them to yell at you? No.

What was worse though? The one who had NO valid excuse, was the nurse. Throwing you under the bus was no OK. She could have simply explained how an axillary temperature was less accurate, and taken a rectal. For the record, where I have worked before, any child in for something fever/infection related automatically got rectal temps, of course taken by LPN or RN. Maybe you can make a point of telling the nurse that if you ever get sent back to a pediatric department.

I understand stress when your child is sick (as I have 2 kids), I think the nurse exacerbated the situation by telling the parents that the NA was doing a terrible job and making the NA go in the room to be verbally berated by the parents.

Specializes in Emergency, Telemetry, Transplant.

From what it sounds like, you basically did nothing wrong--so have something to eat and then sleep easy. You took the temp, documented it, and told the nurse about it. I am willing to give them leeway because their child is sick, but the family sounds like they had an attitude and you could not win.

Some thoughts on the situation:

1. The nurse was totally wrong to sell you out like that, and should never have asked you to go back into the room when it was clear there was tension between you and the family. The nurse's behavior made this situation a lot worse for you and that is truly unfortunate.

2. The temperature should not be taken with the family's thermometer (or any other VS taken with non-hospital equipment). The hospital makes sure all equipment is correctly calibrated and that quality control checks are done a regular intervals. Who knows how old the family thermometer is. What is the quality of the family's equipment? You would not treat a blood pressure that was obtained from a machine/cuff/manometer that had not been calibrated and/or kept in good working order. The nurse needs to step up, defend you, and she needs to politely, but firmly tell that family they she cannot chart nor treat the family's readings for temperature.

3. This is my one criticism for you (and why I used the word "basically" earlier). You cannot go back to work and look up patient information "just in case" or "just to see how their doing." This is a privacy violation and you leave an "electronic" trail each time you go into the chart. Inquiring minds may notice that you were in the chart on a day when you were not even scheduled to work. It may not turn into anything, but looking in the chart of patient for whom you are not caring is a bad habit that may cause trouble in the future.

Thank you for your feedback and advice. The thermometer that was given to the parents are the ones the hospital supplies, not the ones that the parents brought from home. I just felt bad because my work ethic was questioned and now I'm second guessing myself. Part of the reason is because I have low confidence.

Specializes in Oncology.

I hate to add insult to injury. I don't think you did anything wrong with the temp. Axillary temperatures are not that accurate and can have a huge range depending on positioning and such. However, it is a HIPAA violation for you to be looking at patient information you don't need to do to provide care, which definitely includes looking up a chart on your day off of a patient you cared for several days ago on a floor you don't even work on regularly. Probably nothing will come from it, but I'd advise you against doing it again.

If this is bothering you to the point that you're losing sleep over it, you may want to consider seeking professional help.

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