ticked about evaluation!

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Specializes in geri, med/surg, neuro critical care.

I am a 2nd year Nursing student (will graduate with A.D. in May). Currently, I work as a CNA in a long-term care nursing facility. I had my yearly evaluation the other night (have been employed at said facility for over 3 years). The RN who reviewed the eval with me had no complaints except for one: an incident occurred about 2 months ago where a resident fainted, fell on the floor, and was in and out of consciousness. I watched the nurse do the assessment and helped with NA duties. When the EMT's arrived, I was the only person with the resident...the nurses weren't available. They were asking me questions "how did this happen, etc", so I told them what I knew. They asked me about current medications for this resident, and I told them I am NOT the nurse, I'm a CNA. Well, according to the eval, several nurses complained that I "overstepped my boundaries" with that situation (in other words, I was pretending to be a nurse or something of that nature). There have also been times where someone was short of breath, no nurse was around (I searched and couldn't find them), so I checked an O2 sat and asked them about their pain (quality, duration, etc.), and reported the information to the nurse so she had a "heads-up" on the situation. Apparently, I'm not supposed to do that...it's not like I was doing an invasive procedure or a full assessment or anything like that. I don't see it as a big deal; I was just trying to be helpful and resourceful, as well as using the situation(s) as a learning and growing experience. By the way, I have never pushed my duties as a CNA aside in pursuit of doing "nurse" tasks. Am I wrong for wanting to help my residents and fellow co-workers if the situation arises and no one else is there to help?

Specializes in Med-surg.

I would have done the same thing. Sadly some nurses are easily threatened... maybe that's the case?

Specializes in Rural Health.

Wow - I always thought that as an CNA, you were supposed to be the nurses eyes and ears....sometimes you'll see things LONG before they ever will because of time constraints.

Sounds like they have ego problems.

Are you going to stay there when you graduate?

Specializes in geri, med/surg, neuro critical care.

Will I stay there? Heck, no...I'm going to find a place that values the contributions of ALL employees, whether or not they carry a "title" behind their name or not.

Specializes in Utilization Management.

Maybe you were supposed to go get a nurse to talk to the EMS people. The only sensible reason I can think of is that the nurses are trained to report certain things and the EMS report can be used in court.

In other words, if the nurse suspected that the patient's H&H was out of whack because she had a problem with anemia, this wouldn't be a problem normally shared with CNAs, but it would be something that the nurse would want the EMS to write down for a patient history, so that once in the ER, they would do a complete workup instead of just a couple of X-rays.

I personally would've appreciated your input with the patient who was short of breath, but just an FYI, an O2 sat isn't going to be very accurate with certain conditions, so that's why the nurse was probably upset about that. I've had patients who were in full-blown CHF that were satting in the high 90's! Yet that patient is critically ill at that point and needs stat medications.

It seems to me that the nurses might be upset because they realize that they cannot be everywhere at once, and just the thought that a resident could be having a severe life-threatening problem and they were busy doing some mundane thing like passing pills, is enough to freak them right out.

So I wouldn't take it personally, but maybe if you find someone that's in a situation where you can't find the nurse, would it be possible to overhead page the nurse to that room? Or would you get in trouble for that, too?

Just wondering what your options are supposed to be at that point.

I think you did good. Don't let it bug you, OK?

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

I'm not going to address whether you were right or wrong about giving information to paramedics. I want to talk about the evaluation.

First of all, you should have already been informed about the above incident way before your evaluation if it had caused that much of a stir. What a bunch of cowards to say nothing until a yearly evaluation. That is poor management, clear and simple. Nothing on a yearly evaluation should ever be a surprise to the employee. Anything negative on an evaluation, like this incident, that stems from a specific action, should have written backup. If there had been written backup at the time of the incident, it should have been addressed with you as a counseling. So, whoever did the actual writing of your evaluation did a very poor job of introducing that prior incident on your eval.

Second, you have the opportunity to address that at the end of the evaluation. I would simply put down that this is the first you are hearing about any wrong doing on your part with regard to this incident.

Third, no one else in the world is going to see this evaluation except you and the file it is stored in. Unless you ask for a copy of it for your own records and decide to show it to a prospective employer at a later date, it's a closed case. It's confidential information that only a person in management or administration is ever going to see again. It only becomes "of interest" when you are up for a promotion.

Fourth, remember this incident. If you ever find yourself in a management or supervision position where you have to give written evaluations, remember that most employees ask that they are judged on a fair basis. It is not fair to bring up any kind of wrongdoing during a yearly evaluation that you weren't already counseled about. Anything an employee does that is wrong should be addressed with them as soon as possible so they know exactly what they did wrong, how they should handle the situation if it ever occurs again, as well as given a chance to demonstrate that they have corrected their actions. The appropriate way to have handled that was to mention that you were counseled over an incident where you had given information about a patient to paramedics that was felt to be outside the scope of your job authority, were counseled and there have been no further incidents since then.

If this is a good job, don't walk away from it yet because some fool doesn't know how to do an evaluation correctly.

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