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

  1. 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?
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  2. 16 Comments

  3. by   TheCommuter
    It sounds as if your daughter is idealistic and really cares for the well-being of the patients. I would tell her to avoid becoming like the other employees. There's no need to sink to the level of others.

    I would also explain to your daughter that the real world of nursing is nothing like the world that's portrayed in her CNA courses, and she will likely see things that disturb her. In addition, I have heard CNAs privately complain that they are being assigned students because they already have so many patients to make rounds on.

    This is truly a complicated situation.....
  4. by   TazziRN
    It also bothered me that one person told her she'll never make it with the attitude she has, namely "bleeding heart", that if she can't make it in LTC, she'll never make it.

    I told her it's the exact opposite, that if she can make it in LTC, she can make it anywhere, but that if she doesn't, it does NOT mean she can't excel in some other specialty. LTC is not for everyone, just like critical care or OB or OR is not for everyone.
  5. by   vamedic4
    Hi Tazzi,
    I'm with Commuter...reassure her that it isn't all roses and honey when dealing with sick patients...or with health care staff members. It does amaze me that a CNA wouldn't just jump at the chance to have some help changing/bathing/cleaning when it's offered!!!
    It sounds as if your daughter has a keen eye and a good heart...healthy attributes which will serve her well in this field. Just continually remind her that while there are those who are "just there for a paycheck"...there are far more of us who truly do care about the patients and helping them during their stay. Encourage her to talk to you about things, especially things that bother her. Perhaps you can share what you have learned in your expereinces as well.

    Good luck...and good night!

    vamedic4
  6. by   canoehead
    Perhaps that CNA had 4 others that have been waiting to be changed, or may have been working her way down the hall towards that patient. The help of a student can be more of a hinderance. I also would not jump at the chance if I had 5 other things that needed to be attended to.
  7. by   jimthorp
    This comment by Commuter pretty well sums it up;"I would also explain to your daughter that the real world of nursing is nothing like the world that's portrayed in her CNA courses, and she will likely see things that disturb her."

    Although we would all love to respond immediately to the needs of the people we care for, in the real world it's not always possible. Where I work its common to have only 4 CNA's for 50 residents.
  8. by   DDRN4me
    I usually tell students that they SHOULD do everything right..that is the best way to learn.. i also caution them that the real world is different than school and they will learn to adapt to the changing needs of their unit.
    Maybe the CNA was stressed out ; we cannot judge since we werent there. I think that her compassion and commitment will make her a wonderful CNA (maybe nurse??) Give her my best!
  9. by   meownsmile
    Although it bothers your daughter not to be able to help a patient like she described, there may be another reason the CNA didnt want to get right to her. Remind her that there are parameters that phsycial therapy and other reasons why the CNA's working with people dont jump right to putting someone back to bed. Yes if she was wet, that needed to be addressed however maybe the CNA knew if she went to change her it would be a long drawn out affair convincing this woman she shouldnt go back to bed so opted to wait to change her until last when she knew she would have more time to convince her to stay up, or it would be closer to time for her to get back to bed. There may be other issues behind it besides they just didnt have time right then. Students dont always understand those situations because they dont know the individual they are inquiring about.
    Not making excuses for the attitude of the CNA,, just throwing out some other reasons behind her actions.
    I wouldnt call her a bleeding heart,, she just has a caring heart,, just what nursing needs.
  10. by   Altra
    [quote=canoehead;1971194]Perhaps that CNA had 4 others that have been waiting to be changed, or may have been working her way down the hall towards that patient. [quote]

    It sounds like your daughter has a good heart, Tazzi. But as a student she may not yet grasp the reality that caring for multiple patients, whether it's 4 or 40, means that not everyone gets everything right now.

    I don't see this as a "don't become uncaring" issue, just a perception vs. reality issue. With the exception of 1:1 private duty nursing, no patients are well-served by a nurse/caregiver who does not organize & prioritize appropriately.

    Good luck to your dd -- sounds like she's focused on something she finds meaningful.
  11. by   leslie :-D
    i admire your dtr's ideals, tazzi.
    i've asked many cna's to change a pt., and have gotten the same reply.
    not disrespectful, but they were busy and would get to it when they had a chance.
    if able, i would check on the pt in another half hr. to see if s/he was changed.
    often, i would offer to help the cna so we could do it in little time.
    some cna's chief complaints is they didn't have anyone to help them, so i find it important for the nurse to make him/herself available.
    it really doesn't take more than 5 minutes.

    explain to your dtr that the assistants have many pts to take care of, and they all must learn to prioritize their care;
    and so yes, the pt. will be changed, in due time.
    to say the least, i would certainly hope they are.

    leslie
  12. by   sanctuary
    About a hundred years ago, when I was just starting, I worked with a woman who was curt, and sharp to the patients. Not hostile, just impatient. One of the patient interactions that I had was very tender, and I guess it showed on my face. The "ol'biddy" looked @ me & said "You just feel that way because you are young, and have stars in your eyes. You'll get over it when you have been around for a while." I thought for a minute and answered, "No, if I ever start to 'get over it', I'll find another kind of job." 43 wonderful years later, I'm still in it, still caring, still over extended and still trying to do the little bit more that will make the difference to that patient, in that moment. You have raised a warm and caring daughter , and she may see things that should not happen. Have her file it in the "Things I'll Never Do" folder. And give her a hug for me. I'd love to have her as a student (or an employee) on my floor any day. Remember when we were taught that nurses needed the three H's?
    We need heads (filled with information), hands (skilled with techniques), and hearts (filled with genuine concern for patients). She'll be a grand nurse.
    Last edit by sanctuary on Dec 15, '06 : Reason: typo
  13. by   CoffeeRTC
    Yikes. Yep..what a smack in the face about what LTC can be like.
    As the other posters posted...we don't know what the other CNA was dealing with, but her response to the resident was wrong. She could have had 4 other pts waiting or maybe that pt was unstable she needed more help or maybe if she put her back to bed, the res would have just climbed out in two minutes......

    Tell your daughter to never stop caring. Sanctuary's post coverd that well.
  14. by   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.

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