Need advice,Problem CNA

Nurses General Nursing

Published

I am a nursing student in school, and I am currently working on my preq reqs. My question is this, my mother in law is in ESR (End Stage Renal Failure) and my spouse is trying to assist his mom in anyway possible. The CNA that is taking care of her is becoming unapproachable to the point that everytime we ask her a question she assumes that I am after her job and instead of just speaking with me about her condition she runs back to our father in law and tells him that we undermine her and we think she dosnt know what she is doing.

Let me first state I do not want her job, I am too busy with school and my own job at a local hospital, but it has now gotten to the point that my mom (in law) was placed on too much meds her bp was dropping and she was rushed to the hospital on several occassion almost having a heart attack. When I went to look at her meds I continued to try and point out to her that her medication was incorrect, but instead of trying to look at the problem she was more concern with her job then her patient.

Now she has had these medications in her system for so long, the doctor is convince her health is warranty Hospice and my spouse dad is confused and do not want her on all these meds (being that the meds are 4-5 different psych. meds) and she is not combative in anyway.

I cant get past why this CNA is so protective about her job, to the point that she dosnt want to share information with her family members which is us?

When going to school, or obtaining your RN, did any of you guys experience this before?

If so how did you handle it?

I have not said anything to my spouse because I dont want to complicate things more, but it makes me wonder sometimes what is she hiding if anything.

I should also mention, that I believe my mother really can benefit from a RN doing quaterly vist and assesments to prevent this, but when she meets anyone she introduces herself as "her nurse" and she is not a nurse! and this impression is hindering her from receiving or asking for the appropiate care.

i'm glad you were able to make a decision to contact the nurse directly. the trips to the hospital r/t the meds were what worried me the most. there were parts that weren't clear in the first post (like the healthcare power of attorney, how long she'd been with your mil, but sometimes the family situations everything's complicated and getting it all in can be hard.)

confrontation is never fun, but remember as nurses (in the future) we're our patient's advocates, we're their last line of defense against med errors, and pretty much everything else. let it be a learning experience in communication to obtain the goal for your patients/family. plus if you are confident your mil is being taken care of properly it will enable you to concentrate on your studies.

0 Votes
Specializes in Cardiac Telemetry, ED.
To come back and tell me to butt out of my own MIL health, is out of line, she is my MIL and I have ever right to know how her progress is.

Wrong. Your MIL has the right, as long as she is of sound mind, to decide what health care information you are privy to. Just because she is your MIL does not entitle you to know her private health information.

Now to say we cant ask any information about her is crazy, if you took your love one to the hospital and you visted them on a regular basis, and asked the nurse how is she doing and the nurse told you to butt out- exactly what would you think of that RN?
It's not that simple. I can give general information, such as "she's comfortable" or "she ate all her breakfast today", but I cannot divulge protected health information just because a family member wants to know. It's illegal. Protected health information consists of diagnoses, lab and imaging results, medications, etc. That information is for the patient to decide who gets to know. If the patient is incapacitated, then the MPOA gets the info. In the hospital, we require an actual legal document. So, if you were to ask me how your MIL is doing, and you are not the MPOA, you'd get a very general answer, and if you didn't like it, too bad. You can think whatever you'd like of me.

also we do have the legal right to ask these questions because we are the health proxy for her.
If your name is indeed on a legal document as her health care proxy and she has been presumed to be incapable of making her own health care decisions, then I don't understand what the problem is and why you haven't had an RN come visit and make a written care plan, and why you haven't been on the phone with the doctor to have her medications adjusted. If you are indeed the responsible party, then the CNA is only part of the problem here.
0 Votes
Wrong. Your MIL has the right, as long as she is of sound mind, to decide what health care information you are privy to. Just because she is your MIL does not entitle you to know her private health information.

It's not that simple. I can give general information, such as "she's comfortable" or "she ate all her breakfast today", but I cannot divulge protected health information just because a family member wants to know. It's illegal. Protected health information consists of diagnoses, lab and imaging results, medications, etc. That information is for the patient to decide who gets to know. If the patient is incapacitated, then the MPOA gets the info. In the hospital, we require an actual legal document. So, if you were to ask me how your MIL is doing, and you are not the MPOA, you'd get a very general answer, and if you didn't like it, too bad. You can think whatever you'd like of me.

If your name is indeed on a legal document as her health care proxy and she has been presumed to be incapable of making her own health care decisions, then I don't understand what the problem is and why you haven't had an RN come visit and make a written care plan, and why you haven't taken her to her doctor's office to have her medications adjusted. If you are indeed the responsible party, then the CNA is only part of the problem here.

Yes we have the legal document and we are the proxy on her case, we havnt had the opportunity to take her to have the med adjusted nor have we had the opportunity to have a RN come in and make a written care plan because like I have stated the CNA is stating she is the nurse, and these are her responsibilities, she has taken on the role of her nurse (RN) and that is wrong. I would never suggest that she gives us privy information, in that I would not be getting that from her I would get it from her MD, but if a family member wants to know how there family member is doing ie, is she eating well, is she going to the bathroom ok, did she have any concerns while she was with you today, that I should bring up with her MD, then as a CNA these things she must answered, the problem that we are having is that she is a CNA , not a nurse, my MIL meds we are already aware of because we have record of this information from the doctors that did the orders, but we are seeing first hand that these meds need to be adjusted that she needs a RN to come in and create a written care plan however, she is interjecting herself over us and assuming this role, and then these things do not get done without my FIL becoming more fearful by the second.

I will say this she is my MIL, my spouse comes to me, for advice, and knowing that he has this proxy document he comes to me for my opinion and of course I am going to tell him what I know- which is she needs a RN to give an assesment with a written care plan, and she needs to see about having her meds adjusted. As a family member all this is stressful enough I really do not need the added stress of having to explain to someone I dont want their job, I just want what is best for my MIL.

But like I said if the CNA would just be the CNA and stay in that scope of practice and the health proxies are allowed to play there role it would make everything easier.

I am a CNA while going to school, and I may know how to perform a certain task but I always let my pt know that is not within my scope of practice, and I will be more than happy to get your RN nurse.

0 Votes
Specializes in Cardiac Telemetry, ED.

It sounds like your spouse is actually the name given as the health care proxy. As such, your spouse needs to call the agency and discuss these concerns.

0 Votes

so, if you were to ask me how your mil is doing, and you are not the mpoa, you'd get a very general answer, and if you didn't like it, too bad. you can think whatever you'd like of me.

in my facility it is general know who has a poa during admission in that this information is taken then. in a home setting the poa is general know because that relationship has already been established as well. i hope again i am misunderstanding you, but for me to come back with that attitude to a family member wouldnt make things any better. if i cant give them information then i would simply explain that i have a obligation under hippa to not disclose certain information to you, i know that you are a family member and you are concern, however, i can tell you how she was a dinner today, did she eat her breakfast, ect..... and i hope that helps, if you have a health proxy you can express these concerns to him or her and they will come back to me, and i am able to give them that information.

we are also aware of speaking this way with family members because from a family member preception they are concern and i want things to be as smooth as possible. so i dont know about you but yes i want to make my family members happy as legally possible, without crossing the line

0 Votes
It sounds like your spouse is actually the name given as the health care proxy. As such, your spouse needs to call the agency and discuss these concerns.

yes, that was a suggestion that was given and I think this would workout the best, thanks for your comments :yeah:

0 Votes
Specializes in med/surg, telemetry, IV therapy, mgmt.

You did say your MIL is in hospice, correct? There is an RN who is in charge of her case. There must be by law. Her name is supposed to be listed on a folder of documents at the house or the chart if your MIL is in a facility. Contact that RN and complain about the CNA. If that gets you nowhere, call the hospice agency and talk to the person in charge and complain. If that gets you nowhere, call Medicare directly.

We had a horrible hospice experience with my mother. With the way the economy is they are forcing people into home health or hospice and I won't do it because of the poor services we received in the past.

0 Votes

I wanted to thank everyone for the advice, but I am going to take Virgo RN advice on this and butt out!.

my MIL is not on hospice and she still dosnt have a RN- the hospital will most likely have her placed into a nursing home and no she dosnt want to be there nor is my FIL or spouse willing to place her there. Now here is the problem, today I made arrangements putting off my school work and staying up for the last 3 days between work and helping here trying to setup and speak with my spouse about getting her a RN and having her meds adjusted. The CNA comes in and instead of staying at the home with her, she leaves and goes home early, she stated she did not see the need for these services, I have had enough with being put in the middle of all of this trying to get her help, just to have things cancel so I cant do anymore.

I thought maybe if she knew I was just giving advice to get her the services she needed and not try to take her job she would feel more comfortable about things but this is not the issue. I dont know maybe if she is in a nursing home or placed on hospice at least eventually she will get the assistance she needs. hopeful it would not be too late. The doctor, state to me when I called him back, that he would not make any changes in her plan based on the word of a CNA so he is stating she needs a nurse, and since she has gone behind us and made such a fuss about things he dosnt feel my FIL can handle her and he is recommending hospice, or #1 choice would be a nursing home, either way he states he refuses to treat her while she is in this perdictment because it is extermely dangerous. But then again at least the CNA get to keep her job, never mind my MIL - Sad I thought we were in this field for the better of the patient instead of the soul better of our pocket books.

0 Votes
+ Add a Comment