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  • Oct 29 '12

    Thread moved to nurse colleague/patient relations forum to elicit further response. One question would be is if it is imperative that another staff member know about the condition? That would change the rules. (of course I can't think of an example now...aside from suicidal/homicidal ideation, potential medication adverse effects, a condition such as PTSD due to work trauma--i.e don't assign nurse X chest trauma patients right now, she's having a difficult time due to X.) and whether it was done in the open (announcing to the break room) or in confidence (that you happened to over hear).

    And it would NOT be a HIPAA violation unless the supervisor was providing treatment to the coworker and billing insurance for the services (for example if the coworker was a patient of the facility and that is how the supervisor found out about the condition, or if the supervisor also provides counseling services and the coworker was a client). Employee-supervisor is not covered by HIPAA unless there is a provider-patient relationship.

    Some HIPAA resources: Health Information Privacy

    It would be a potential confidentiality, ADA, Section 504, privacy violation but not HIPAA. This is like an issue to be discussed with human resources, but then again it should be discussed by the person affected directly (i.e. the patient/coworker), assuming s/he is aware of the discussion of their confidental information.

  • Oct 29 '12

    But there is confidentiality issue with privileged knowledge of the employer and employee rights to privacy.

    I say call your corporate compliance officer/HR or your manager and discuss your concerns. We cannot offer legal advice here as per the Terms of Service but another resource for employee rights would be the EEOC.

    EEOC Home Page

  • Oct 8 '12

    [/QUOTE]I can pretty much guarantee after you've grown a few greys and are a little crispier around the edges, you'll welcome any aide work for RN pay you can get![/QUOTE]

    I love helping the CNAs, but working in LTC I just can't do as much of the transferring, turning, etc. as I used to. I do fine helping, and answering lights, but absolutely couldn't do a few 12 hour shifts of it, especially in a row. My poor old body isn't what it used to be.

  • Oct 8 '12

    First, don't be so hard on yourself! When you are starting to learn a job/task, of course you will make mistakes. Examine what you did wrong, vow not to make the same mistake again and go one. I'm going to move this to the general nursing forum for more answers. Take care.

  • Oct 8 '12

    You already have one of the qualities of a good nurse. You are able to recognize and admit the areas where you need improvement. You are not pointing fingers at someone else, you are concerned for your patients safety. There are many licensed nurses who do not have this ability but continue to practice and pat themselves on the back for doing a great job and who continue to blame others for their mistakes and continue to put their patients at risk.
    So, don't judge your own self.......take a step back....deep breath. Nursing may not be for you......but you are worthy and deserving of a job you love.
    Hugs and keep on moving forward!

  • Oct 8 '12

    Quote from DogWmn
    What a rare opportunity you had, to sit and observe the patient for a whole shift. I worked as a patient sitter for a year. Often when I needed a break it was the RN who filled in and they were glad for it.
    Having done both the sitter/1:1 and the CNA/tech role...I'd rather be the CNA/tech. 1:1s are a nice change, but most of the time it's too boring for me to do for more than a couple of hours. I'd rather be kept busy because it helps time pass faster.

  • Oct 8 '12

    I work in a medical ICU, we do not have any nursing assistants most of the time. I was a CNA for 5+ years before going to nursing school. The term "CNA" work is really really insulting. NURSING begins with the basics. This includes being a sitter, or feeding someone, or bathing, or even, heaven forbid, wiping some poo. It is repulsive to hear any nurse make these types of statements. No I do not personally like doing a lot of the things that I do, but it is all part of promoting dignity for the patient.

  • Oct 8 '12

    Seems like a foolish waste of resources.

    Frankly, if this is how they're going to divvy up staff, I'D offer to sit with the 1:1 patient and have the CNA do her job as normal. Seems you should get your preference, if you're not going to be functioning as an RN that shift, what YOU'D like to do: sit with patient or be floor CNA.

    There were times as a floor nurse I would've KILLED to sit with a 1:1 patient instead of running a full patient assignment!

  • Oct 8 '12

    It was the nightmare every long-term care nurse manager dreads: the exit interview with a state survey team that has just inspected every inch of the building and every piece of nursing documentation produced over the past year.....and found it badly wanting.

    I tried to keep what I hoped was a neutral expression on my face as the lead surveyor read off the sixteen citations they had levied against my assisted-living facility. Two of them were classified as serious......and six of them were my fault. In the vernacular of the day, (stuff) just got real, and I was faced with the knowledge that I could no longer hide my inattention to detail, my inability to focus when there was too much going on around me, my impatience with the mundane and the routine. And until I came clean with the reasons why these were issues for me, I was in danger of losing the best nursing job I've ever had.

    As many readers know, I have a mental health diagnosis that makes playing well with others extraordinarily difficult at times. I am also very good at what I do when my head is 100% in the game, even though I can be loud, sloppy, anxious, profane, and witchy by turns. However, while my immediate supervisor---who is arguably the most decent man on the planet---knows about my "nonconformity", I was terrified that Corporate would find out and then chop off my head.

    Who would have guessed that NOT disclosing my illness would have handed them the axe? Our new director of clinical operations is not only smart, but intuitive, and she urged me to 'fess up so that we could problem-solve. That was how I wound up not only admitting to having a disorder that affects my ability to function on the job, but winning the accommodations I need to perform at my best....and probably saving my behind in the bargain.

    "I was wondering about that," she said, smiling. "Your work habits are definitely consistent with your diagnosis." Dang, I thought, this woman is GOOD!

    Now we all know that there are unscrupulous employers who actually look for reasons to get rid of people. I've worked for companies like that in the past, but when I ran across it I always kept my resume polished. Sometimes, however, you've just got to take a chance and ask for help. Here are a few suggestions for getting what you need so you can give the job your best, even when you aren't feeling your best.

    Have a solution in mind before you bring your boss a problem.

    He will appreciate your foresight, and may even be willing to meet you halfway if you don't waste his time. For example, if mornings are hard on your arthritic joints and it takes you three hours to be fully functional, offer to switch to evenings or a hybrid shift like 11A-7P. You'll probably get extra points for explaining why this would also be an advantage to the company, e.g., they get you during your most productive hours and you're covering parts of two shifts.

    Avoid invoking the Americans with Disabilities Act unless you absolutely have to.

    Employers really don't enjoy feeling threatened, and frankly, if you hold the ADA over their heads to try to bully them into complying with an agenda, they'll probably find some way to make life so miserable for you that you'll end up quitting.

    NEVER use your disability as an excuse for poor performance!

    This is a guaranteed career-killer, and deservedly so. There's a big difference between acknowledging a physical or mental condition that makes work more of a challenge for you than the average person, and blaming the condition for everything that goes wrong in your life. Disabled or not, you still have to take responsibility for what you do, and your employer has a right to expect you to perform to the best of your abilities.

    Blessed are the flexible, for they will not be bent out of shape.

    Sometimes an employer is unable to accommodate requests for a private office, more work space, different hours etc. At my workplace, there isn't even a broom closet that could be converted into a separate office for me, even though a good portion of my discomfort is due to the fact that the office I share with my floor supervisors is like Grand Central Station.

    Being easily distracted and struggling with short-term memory loss makes it all but impossible for me to stay on task in this environment.To make matters worse, I lose my place in a process when I'm repeatedly interrupted and then I can't remember where I left off. So I'll be spending a part of each workday shut up in the private dining room or an alcove when they're not in use, protected by my fellow managers so I can complete those soporific audits I'm supposed to do.

    Use your strengths to remind your company of why they hired you in the first place.

    You probably have at least one special talent that makes you the best in a given job skill; don't be afraid to show it off! My own boss told me recently that while I'm not so hot at the routine (read: boring) stuff, there's no one in the entire company who's better than I am at handling a crisis. I've rescued other buildings from stop-placement determinations, administrator walk-outs, narcotic diversions, and other disasters---that's why they offered me the position I turned down last year, which is now held by the woman who's working with me to put my own department back together. But our regional manager knows that if one of the properties is having an emergency, he can give me a call and I'm all over it.

    Working in a fast-paced healthcare environment isn't easy for anyone, let alone those of us with disabilities. But with the right kind of assistance and mutual respect between the nurse and the employer, anything---and everything---is possible.