Where oh where have the good PCTs gone?

Nurses General Nursing

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So this is a vent. A few nights ago we had a newish PCT work with our night rotation. She normally works with our other night rotation. She's still in her probationary period.

I had one patient who was s/p CVA who was a turn q2, aphasic, contracted, the works. Blood pressures never dipped below 180. The doctor was aware and was not treating it. Anyway my 2000 vitals on him were 199/75. pretty normal for him. I wasn't concerned. The family members in the room actually told me before I saw the sheet from the PCT.

At 2200 I noticed he was not turned so I turned him. No problem he was an easy turn.

For 0000 vitals I had noticed the PCT was making her rounds and was passed his room while I had did my q2 rounding. When I went into his room he was again not turned and I had asked the family member, who by the way was sitting by his bed holing his had, if his blood pressure had went down. She had told me that they had not come to check his vitals since 1930. I thought to myself maybe she was saving him for last so she could check him to make sure he was not dirty. I turn him before I leave.

One of my other patients had just gotten out of the bathroom when I made rounds on him and had asked for the PCT to go in his room to take his vitals because he was in the bathroom when she went to his room. I called her on her phone and she said ok. I went back to the desk. She gave me my vitals about 20 minutes later. She had not gone back into my patients room who was up in the bathroom, I know this because he was across from the nurses station and I could see his room, but of course I had vitals on him. At this point I'm mad. I ask her to re-do his vitals, which she did. I then noticed that my CVA patient had a blood pressure of 131/50. I go into his room and ask the family member if his blood pressure was taken, and she tells me "no". I take his blood pressure myself and its 180/50. Now I'm fuming. I confront the PCT who tells me "I took them". I roll my eyes at her and then let the charge nurse know about it.

For 0200 rounds I follow her a few rooms apart. Pt. not turned. I turn him. Still mad.

At night it is at the nurses discretion whether or not 0400 vitals should be taken. I request for my CVA patient's vitals to be taken. The PCTs normally start vitals at 0430 so they can collect I&Os and do vitals at the same time. When I get my I&O's and vitals my CVA patient, who was pretty much comatose, had an intake of 270 and a blood pressure of 130/50. I take a deep breath before I blow up. I go into the patients room take his vitals and I get 195/50. I can also feel heat radiating off his body. His temp was 101.2 axillary, the PCT had 97.5 written down. I ask the family member who about the vitals and she tells me all the PCT did was empty his foley bag and leave.

When I look at my other I&O sheet all of my patients have intakes of 270. and most of them were wrong after I go and ask the patients myself. I don't even talk to the PCT again. I tell the charge nurse again and she makes copies of all the sheets.

When my nurse manager arrives in the morning I show her all the sheets and tell her what had happened during the night. She takes my papers and pulls the PCT in the office. Of course the PCT does not get fired. The NM tells me they are working with her because she is a "good" PCT who shows up and picks up shifts when we need her to. OMG is she serious. They are keeping someone because she shows up. What she did was falsify medical records which was ground for termination. I can not trust her with any of my patients. Especially when she says she took the patients blood pressure when the family member said she didn't.

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Specializes in Trauma Surgical ICU.

That is so wrong. I can let go of the falsifying documents but when you "lie" about vitals that can be a life or death situation. We need accurate info in order to treat/notify the MD if an issue arises..

Now I am not saying the documentation part is not important because it is but I think "safe" practice is top priority on this one.

I would not trust her. She either needs to go back into orientation or be fired.. I think fired would be a better plan of action..

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Specializes in public health.

Maybe she had a bad day or something. I like to think that we all want to work together to accomplish something. I know your goal is to treat your patient and get the vitals signs on time so you can monitor him. I know your goal is not to fire the PCT or humiliate her. Anyway, there are always two sides of the coin, no need to get upset or mad because she didn't do what you asked her to do. Next time, maybe talk to her (not tell her, "I asked you to do XYZ, why didn't you do it?") There are slackers everywhere, and there are people who like to get things done quickly and on time. Just calm down and think from the other person's point of view. Communication, communication, communication. Pointing fingers will not do the patient any good. Remember the patient is your priority, it's why you are working there.

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Specializes in ICU + Infection Prevention.

What hospital so that I know not to go there d/t incompetent PCTs and NMs with completely ****** up priorities?

And to the "two sides to every story" folks... no bad day gives PCT or anyone else a pass to make up vitals! If that patient had died because the PCT lied, "I was having a bad day" would be a **** poor excuse to the family.

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Specializes in MDS Coordinator.

I can't believe the NM didn't do any disciplinary action for this PCT. Her behavior is putting people's lives in jeopardy.

SourApril, having a "bad day" does not excuse making up vital signs and not turning patients. This isn't about humiliating somebody, it's about making sure these patients are being cared for. I know I wouldn't want one of my family members in that person's care.

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We were told that the night unit coordinator was working with her and she would be watched more closely. I still do not trust her. This is not an isolated incident. Other nurses have had the same problem with her on different occasions.

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No one individual will be"fired "for one evening of slacking. You need Repeated documentation from different nurses. You Will work this individual again. Try giving a written list of duties that you expect, and see what documentation the PCA returns to you.

Also... I don't think asking the family what duties they saw performed was appropriate.. They are sitting at the bedside of a critically ill family member,they should not be involved in this situation.

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Maybe she had a bad day or something. I like to think that we all want to work together to accomplish something. I know your goal is to treat your patient and get the vitals signs on time so you can monitor him. I know your goal is not to fire the PCT or humiliate her. Anyway, there are always two sides of the coin, no need to get upset or mad because she didn't do what you asked her to do. Next time, maybe talk to her (not tell her, "I asked you to do XYZ, why didn't you do it?") There are slackers everywhere, and there are people who like to get things done quickly and on time. Just calm down and think from the other person's point of view. Communication, communication, communication. Pointing fingers will not do the patient any good. Remember the patient is your priority, it's why you are working there.

I like people who do things on time but I also need to know that they are done right. I can't trust any of the vitals she gives me. I need to know they are right so I can make critical assessments on my patients. What if it was a ped that she said had a temp of 97.5 but was actually 104. That's a major difference.

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Specializes in MCH,NICU,NNsy,Educ,Village Nursing.

I am seeing a person who falsified patient vitals and other important information, thus potentially increasing the risk to the patients. I'm saddened that the NM would deam it okay to keep her on just because she shows up. Sounds like the OP's work load has increased too in that she has to verify everything this PCT does, due to lack of trust & the PCT's demonstration of unethical behavior.

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Specializes in L&D.

Here is my gripe with PCTs as of late...and the kicker is that I am a PCT too :) Let's just say I am glad I have the experience, as it has taught me loads about teamwork.

Anyway - if you answer a call light, you are responsible for whatever you walk into. Far too many times as of late, my fellow PCTs will answer the light of one of my patients that has to go to the bathroom. These certain PCTs will tell the patient to wait, call ME to say that MY patient has to use the bathroom, and walk out of the room. WHAT THE HECK HAPPENED TO TEAMWORK??? Not once have I answered a light (regardless of if it's "my patient" or not), and not taken care of the patient myself at that moment!!

So I don't know exactly what it is, MissyF RN, but I can guess that is just plain lazy. Please know that there are PCAs (who will someday SOON be fellow RNs!) that do their job, and do it well :) I am sorry you have to deal with that mess, and I hope that management will get it together and hire someone willing to do their job - and you know there are people lined up outside waiting to get in!!

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Specializes in Med-Swing/Rehab.

Team work. Instead of sitting on your bottom while your PCT is busting hers - why don't you help out?

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Specializes in Med Surg, Specialty.
Team work. Instead of sitting on your bottom while your PCT is busting hers - why don't you help out?

Did you read through the entire OP or are you just responding to the title?

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