Refusing to change/toilet pts - page 8

I am not sure if this is in the right topic... I have been working with an increasing amount of nurses who FLAT OUT REFUSE to change or toilet their patients. Is this a thing? Do your hospitals... Read More

  1. by   Sour Lemon
    Quote from Ellie G
    I stayed to help the CNA because being expected to clean a patient that large by yourself is ridiculous.
    Agree 100%!! Still think it was extra nice of you, though. I guess I believe you if you say "desk nurse" was horrible. You seem credible enough.
  2. by   bikegirl
    Ohhhhhhhhhhh!!! This is a HOT topic for me. When I was a CNA:

    1. I was walking a patient when the nurse I was assigned to came out of a patient's room, and told me to put that pt on the bedpan. By the time I got the
    walker pt back to bed, guess what? The nurse couldn't put the pt on the bed pan and then tell me 'B6 is on the bed pan." Nooooooo she was "a
    professional and didn't do those things". Incidentally, the nurse was a new grad and had 3 pts on a Med/Surg floor. She was off perceptering.

    2. I was in an isolation room giving a bariatric patient a bath. I was actually paged to to toilet a patient. My pt was on her side and holding on to a bedrail
    so I could clean her back and bottom. Now, what would you do?

    3. A pt had soiled herself and was sitting in the shower' while 2 nurses and the nurse manager where debating in the hallway about what to do about the pt.
    I was coming out of another pts room, having done a blood draw. It was SNF floor. Hallelujah!!! I can save the day. My heart hurt for the pt: she was
    humiliated at having soiled herself, cold, and kept apologizing. I gave her a big hug when we finished.

    4. Another bariatric patient. This time it was a physical therapist. PT called me in to get patient up. PT didn't want to help or do it because she "didn't want
    to hurt " herself. I leaned out the door and called "Can someone help me in D3? I need to get this patient up and the PT doesn't want to hurt herself".
    That PT henceforth became kryptonite.

    Moral of the stories: CNAs are expendable at 7 bucks an hour. Also? When I got my RN I vowed NEVER EVER to become THAT NURSE and respect my CNA.
  3. by   Jory
    If the patient simply needs minimal assistance to the room, I take them. If the patient is sitting on the pot and is a high fall risk (due to more than age, due to weakness, etc)...and a code or emergency is called the nurse HAS TO GO.

    That's the only reason I get the CNA.
  4. by   hopefulRN'17
    Quote from operations
    Sorry no, you aren't going to play the "get my degree card" as if I don't know what a nurse does. I'm not a teen thanks. I have 10+ yrs experience in a variety of clinical roles, from ER to Critical Care, even ones in working directly with surgeon. That's absolutely incorrect of you to say I don't know what a nurse does. In fact, plenty of people in other careers know exactly what a nurse does. Another card RNs like to play. Actually yes a CNA is a nursing assistant... meaning that they don't have a seperate role that cannot be done by a nurse, it is completely under the RN scope and expected of the RN if a CNA is unavailable. I am not saying you specifically are going ask me to move the pt by myself. Mainly I was saying that if you are RN you must understand that CNA has many pts... Also, it is not other CNAs responsibility to take care of your patients. I'm sorry if you can't get what you need done because workload is high, but it is not other CNAs responsibility to provide care when you are the designated caregiver and there's no way you can argue around that. If you don't understand that a CNA also has other things to do for other nurses, and abuse delegation that is treating them like a slave. I wasn't saying you specifically do this, but you sure got defensive like I was saying that you were. I do think you are quite insensitive however. And starting to dread employment as a nurse if this is the way other nurses expect me to also treat my CNAs, which I won't.

    Also, I don't consider RN school "significantly" greater education than a CNA. ADN is a two year degree that doesn't required hard math or sciences. It is very condensed, but I know people with PhDs in stem areas that make less than rn. I would say they are "significantly" educated. Even so, I believe minimum wage for CNAs doesn't reflect the amount or importance of the work they do. As well, part of your RN pay is assuming you are participating in at least some cargiving measures that the CNA is doing and please don't tell me it's not true because I know for a fact it is.
    First .....Actually a CNA is NOT a nursing assistant. One is certified and one is not...

    Second, ADN/ASN DOES require hard math AND sciences. Unless I imagined the program that I just graduated from?!

    Your view on RN's are very askew at best. Especially your last sentence.
  5. by   tamdmoss2
    Tuesday morning during my med pass my hospice patient on continuous tube feeding vomited EVERYWHERE. My tech was in the dining room feeding so I cleaned him up, gave him a bed bath, changed the sheets, changed him and went back to my med pass. It took me at least 45mins, but I was NOT going to leave him laying in vomit so I could pass meds, and I had 30 patients. Were meds late? Yes, yet I'd do it again.

    If a patient comes by me and I can SMELL that they need to be cleaned up I'll tell the tech. If I'm doing a bolus feed and they need to be cleaned up, I'll tell the tech. Will I ALWAYS do total care during my med pass? Nope. But I will make decisions based on their well-being and if that means cleaning up puke and giving a bed bath I will. The truth is, when I see nurses taking 4-5 smoke breaks before lunch, you can't tell me you're too busy to do any kind of care. What it does tell me is that you DON'T WANT to, and those are the nurses I can't stand.
    I was a tech 15 years before becoming a nurse and it has afforded me the privilege of having techs say to me "I'll do whatever you need because you're my favorite nurse." Truth is, passing MOST meds isn't rocket science, THAT'S why med techs exist, so please don't act like you're doing Neuro surgery and can't stop for a moment.

    Yes we get HELLA busy and a GOOD tech can see that and doesn't ask us to do things they know take an immense amount of time. But good nurses also know they can get off their asses or miss a smoke break and clean someone up if needed.
  6. by   redhead_NURSE98!
    Quote from 2018nursewi
    I work as a CNA and currently am in nursing school, and I cannot think of a time at my facility when the nurse asked me to do something (toilet or change a patient) and I felt as though she should do it herself. On my psych unit we have one nurse to 40 patients and 4 CNAs. My nurse is busy, skips her breaks, and stays sometimes over 2 hours after shift to finish charting. It is my job to do what I can to help her so that she can do what I cannot.
    Same here when I was an extern. I never once had a nurse ask me to do something just because she didn't want to do it. I have witnessed it out of RNs at my current job; however it is far removed from my extern days at another hospital and the environment is different, as are the expectations of the patients, family members, and Disney-fied, Studer-ized senior management whose jobs are being threatened because the reimbursements aren't coming in, because whoever completes the patient surveys didn't feel that we ALWAYS did EVERYTHING in the exact way and exact time they wanted us to.
  7. by   redhead_NURSE98!
    Quote from operations
    I'm sorry if you can't get what you need done because workload is high, but it is not other CNAs responsibility to provide care when you are the designated caregiver and there's no way you can argue around that.
    No, really. It literally is. I don't have to argue at all about that. Read your job description. I'm willing to bet that any accredited facility specifies that your duties are performed under the direct supervision and direction of a licensed nurse. That doesn't mean you're a slave but it does unfortunately mean you should do what is asked of you, and if you have any questions or criticisms of those supervising you, they should be shared with the director of your unit, or whoever hires and fires you. I mean, if my director is told by the CNO to audit 20 patients for telemetry lead placement and the director brings me, an RN, the audit sheet and asks me to do it, then goes to her office and engages in a personal call for two hours....what choice do I have unless I'm willing to go over her and discuss my duties versus hers? What do you think the CNO's answer would be if I raised this issue? Think I'd work there very long if I bittered up and refused to do it more than once? Same thing. Actually it's even more critical for UAP to do what a nurse asks of you or explain why you can't, since the delegation is proper and it's in the best interest of patient care.

    Quote from operations
    Also, I don't consider RN school "significantly" greater education than a CNA. ADN is a two year degree that doesn't required hard math or sciences.
    Eek! Have you taken physiology. And micro. And pharmacology yet? Maybe you're a genius. I survived law school prior to taking the courses I mentioned, and I still feel that these are "hard."
  8. by   Beatlefan
    Nursing and healthcare is a game. I get to work, meet in change of shift huddle, then my co-workers play games to see who can get out of taking a higher acuity patient or admission. Then we get report and learn about how busy the shift before was- even though they didn't miss the pot luck party in the break room. We inherit things they were just too busy to do. Then we hit the floor running and may get a post-procedure on frequent vitals, new admission, etc- and scramble to find CNAs to do their jobs so we nurses can do our jobs.
  9. by   Julius Seizure
    Quote from tamdmoss2
    I was a tech 15 years before becoming a nurse and it has afforded me the privilege of having techs say to me "I'll do whatever you need because you're my favorite nurse."
    I've always felt uncomfortable with this idea. I mean, it's wonderful that some techs and nurses have such a sense of camaraderie that the techs are happy to help with whatever is needed. But on the flip side, techs are responsible to help assist patient's even if they don't like that particular nurse. It isn't right or okay for a tech to refuse to assist or to avoid work because they don't like a particular nurse. In the same vein, it isn't right for nurses to let personal differences between staff affect THEIR care of the patients, either.

    Its about taking care of the patient, not about if the nurses and techs are friends.
  10. by   DawnadonRN
    We have a thing at the facility I work at where all members of the staff answer call bells. If they aren't able to help, they find someone. I will help my CNAs clean up a resident, pull them up in bed. Whatever they need as long as I'm not in the middle of another task. They all know I will help them so when I do ask them for help, they are more than happy to help out.
  11. by   Orion81
    Quote from Julius Seizure
    Guys, we found NOADLs!
    Bahaha!!! I was thinking exactly of NOADLS
  12. by   nursemike
    At the end of my most recent shift, I needed help to get a patient off a bedside commode, but the aide didn't come because she was giving report. The nurse I was going to give report to came to help me. I've heard stories like the OP's a bunch of times. I've experienced stories like mine too often to feel as sympathetic as one might wish. Every aspect of keeping a patient safe and comfortable is part of my job. Doing your job for you is not. I learned an important lesson as a patient. I want to be nice, and I want to be heard. If you make me choose, I will be heard.

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