A long story then a delegation questions

[Graduatenurse14]

I was floated to another unit yesterday and had a situation with a Nursing Assistant that I am still upset about and need to vent then get advice on delegation.

A little background: I've been working an RN for a little over a year and prior to that was a Nursing Assistant in a different system while in school for 3 years.

So, I was floated to another unit from 3:30p - 7:30p. I had 3 patients for most of the shift as one was taken for a diagnostic procedure just as I was getting report. At about 6:00 I was told that I was getting a new patient from the ED (Given to me since "You get a lot of patients like this on your unit." I'm sure it wasn't because I was the float! I honestly didn't care though. Seriously. He was my fourth patient on a Dayshift 1:5 unit like mine.)

So, as the life of a nurse goes, at about 6:30p one of the patients called out to go to the BR and she had lower leg weakness and didn't do well walking with PT that day per the alert and oriented patient. I noticed right then, my new patient being wheeled up the hall as I went into the patient's room to assist her and remembered her leg weakness and determined that a bedpan was best (which I told the patient and her family) so looked in the bathroom to see if she already had one, she didn't.

I was trying to hurry as on my unit the arriving patient's nurse is always part of the transfer from stretcher to bed and helping to gather people to help- no, the transport/escort people do nothing but leave the patient at the nurses station or sometimes by their room. I walked out of the room to try to find the supply room with the bedpans and the nursing assistant was right there so I asked her to put the patient on the bedpan and she asked me why I didn't put the patient on when I was just in there so I said that I just got a patient and had to help.

She was putting the patient on the bedpan (which she could locate immediately) and I was going to get my new patient in bed with whoever I could find. People were already helping when I went in and right then, the secretary buzzed in that they were on the phone to give me an update for my patient who was off unit. The nursing assistant buzzed out that she needed help with my patient so I got the update and then went help her.

When I walked over and the Nightshift Nursing Assistant is standing in the doorway and I hear the one who was helping my patient very loudly complaining about me and how she's about to go off on me and how I wouldn't help her as she was pulling her covers up. I was so shocked at her outburst that I stammered out as forcefully as I could muster at that point that I had just gotten a patient (but not about the patient update on the phone) and she proceeded to chastise me saying that others could help with the new patient.

Turns out, she had walked the patient to the bathroom even though I delegated the task of placing the patient on a bedpan. She said that the patient didn't want to use the bedpan. If she knew the patient has walking issues, why walk them back to bed alone? Why not wait for someone to help?

After we left the room, she went to the nurses' station and proceeded to tell people very loudly what I did [wrong] in her eyes. I didn't do anything wrong! She didn't follow what I delegated to her and was unprofessional in yelling in front of the patient and family! In my mind the patient was at the minimum of safe on the bedpan, I had to take the phone update as it was shift change and I had to give report on him to the nurse who would actually see and care for him when he got back on the unit.

I want to talk to the Unit Director about:

-her not following a clearly delegated task. (Remember, I was a nursing assistant within the last three years and never questioned how my nurses wanted someone toileted and just did what they asked. The nursing assistants on my unit do the same. If the patient was insisting, I told my nurse and mine do the same now.)

-her being so unprofessional in front of the patient and family. (I got into nursing as a second degree/career after my mom bravely fought against "The Beast" and lost. This patient also had CA and I know from experience how stressful everything is and the last needed is this.)

I'm really upset about this and even had a dream about it!! Should I talk to the Unit Director?? I do not believe that I delegated incorrectly at all. Would an explanation of why had been nice? Yes, but it's not necessary and not always feasible. As in this case, I was rushing to my new patient to transfer.

Sorry, it's so long and thank you in advance for replying.

[Here.I.Stand, BSN, RN]

Sometimes you'd love to just tell people to shut up and do their job, huh? No you didn't do anything wrong, and yes I think you should report her . I get pts don't love bedpans, but she should have communicated that to you so you could decide what to do. The pt could have fallen!! And her behavior was beyond unprofessional.