My daughter's asking me questions I'm not sure how to answer

[TazziRN]

Recap: she's 17, taking a CNA class through ROP, and last week started her clinicals. Almost every day she's telling me about things that she's observing that bother her, mostly about how the employees at the LTC treat the residents. Today she told me about a woman who wanted to get back in bed but also needed her Attends changed. DD and her classmates are not allowed to do things on their own quite yet and she went to the CNA assigned to that resident. Answer: "I'll get to it when I can." DD, with her CI's permission, offered to help and the answer was, "I said I'll get to it when I can." She's getting scared: she's a typical student who wants to do her best by the world and has the attitude of "I'll never treat my patients that way." But then in the next breath she asked me "But what if I do? What if I become like them?"

I don't know what to tell her. Any ideas?

[Lucyinthesky]

I understand the difference between how you're taught in nursing school and how it is in the real world but I know i too have been really disapointed in how I've seen some patients treated during clinicals. For the most part the employees have been great but there have been a few (especially one particular CNA) that has no respect for the patients. I asked her for assistance once in cleaning a patient who had been incontinent of stool and was extremely hard to turn on her side and while we were cleaning her up she started to 'leak' again and the CNA just said in a disgusted voice " ugh, she is going again!" right in front of the woman. This patient was mortified that she could not control her bowels and my heart about broke from her embarrassment. I later reassured her that it was ok and that she shouldn't hesitate to ask for anything as I was there to help her.

The CNA also referred to the patients husband as a big d**k and that he was always complaining about something. Gee, I wonder why....

By the way, this same CNA who rolls her eyes if you ask for help sits at the nursing station flipping through catalogs during our clinicals while we run around like crazy people.

[TazziRN, RN]

I did bring up to her that the CNA probably had other things to do at the moment, but she said that the CNA was at the end of the hallway laughing with other CNAs. Sorry, that's no excuse in my book. I worked LTC, I know all too well that things can only be done one at a time, but if you have time to be sharing jokes with your buddies, you've got time to get your a** in the pt's room and clean him/her up.

I told her that there's not a lot she can do about it, being a student, because the students are guests in that facility. All she can do right now is vow that she will never do that herself.

[sister--*]

There seems to be plenty of "those" kind of employees in every facility.

On the other hand it's important to keep things in perspective. When things get harried a short positive interchange with co-workers in the same boat can refresh the mood and regenerate the energy. This to the benefit of all.

I'm not saying it's ever right to ignore and procrastinate good pt. care. Only that there are times when you have to take a minute to get a second grip.

BTW, I'd be proud to work with your daughter! Nursing, IMHO, is more than heads and hands. It's the heart that makes a difference.

Anyone that has the heart can learn the heads and hands of it. Not every nurse has the heart. I see that your daughter has. Hugs to both of you!

[nursemike, ASN, RN]

I told her that there's not a lot she can do about it, being a student, because the students are guests in that facility. All she can do right now is vow that she will never do that herself.

I hate to agree, because that kind of neglect shouldn't go unreported. But I do agree, because a student has enough on her plate without taking on that kind of trouble. If the facility really wanted to know about it, they already would.

On the other hand...as a nurse, I am accountable for the actions of the aides I work with. If a student came to me to ask for help changing a patient because the aide wouldn't do it, I'd help, and I'd have some pointed questions, later, for the aide. (Of course, I'm in acute care, with a maximum of 6 pts. A nurse in LTC might be too busy to help. I might, too, at times. But it wouldn't be the student I would be annoyed with.)

In all my months of nursing experience, I've learned that real world nursing and textbook nursing aren't always the same. As much as I value human dignity, it's pretty high on Maslow's scale, and more fundamental needs take precedence. Still, I would far rather change a soiled brief than dress a bedsore. Count me among those who would love to work with your daughter.

[TazziRN, RN]

On the other hand...as a nurse, I am accountable for the actions of the aides I work with. If a student came to me to ask for help changing a patient because the aide wouldn't do it, I'd help, and I'd have some pointed questions, later, for the aide. (Of course, I'm in acute care, with a maximum of 6 pts. A nurse in LTC might be too busy to help. I might, too, at times. But it wouldn't be the student I would be annoyed with.)

Unfortunately the nurses don't seem to like the students either. My daughter told me she offered to help a nurse do something and the nurse told her "No thank you, I want to make sure it's done right."

Talk about a morale breaker!

I understand that nurses and aides in LTCs are busy as all get-out, but come on guys......everyone was a student at one time!!!! How are these kids supposed to learn if no one gives them the chance? What would it have really cost the CNA if my daughter and her CI had gotten that pt back in bed and changed?? It may have taken DD longer since she's learning, but that's one less pt the CNA would have had to worry about and the student would have gotten a little bit of experience.

I have students in the ER frequently, both CNA and nursing students. I tell them in the beginning that unless it gets busy and something needs to be done now, we'll let them do what they can within their scope. Any place that is used to having students should be doing that.