Am I Crazy?

I have a question. So currently, I'm an LNA and am in nursing school for my LPN. I work overnights to pay my way through.

Now i do the best i absolutely can and my first and foremost concern is the safety of my residents.

Here's an example, a resident falls, the nurse does her assessment and decides there is no need for a trip to the hospital or xrays. Resident soon after begins bruising and swelling around her spine, forehead, and severely on her hip. Nurse still says resident just fine.

This resident is one i work with every night, and i can tell that SOMETHING is most defintely wrong, above just bruising. Nurse swears that she's fine.

Is it wrong of me to grab the other nurse working with us to take a peek? 1st nurse refuses to reassess pt. But then accusses me of going over her head to have someone else look at pt. where something is most definately wrong and needs to be looked at.

Is working in LTC a lose-lose situation for someone who truly knows and cares for her residents?

No. You are not crazy, in my opinion. You are doing exactly what you should, looking out for the health of the patients entrusted to your care.

While you're not crazy, know that you may be lonely sometimes because of your genuine concern for patients. And don't let that keep you from caring. Please.

There will be some who disagree with me here. I respect their opinions. I'm not even a nurse yet, and I understand and embrace the chain of command in the places many of us work. I rarely question the nurses I work with, even when I may differ with them about an approach to a problem with a patient. They do know more than I do and they are ultimately responsible for whatever happens to those in our care.

That said, there are occasionally times when I will not accept a nurse's approach in a situation - almost always these are times in which he or she has chosen to do nothing about specific symptoms or changes in status - and I will, respectfully and quietly but without hesitation, speak with the charge nurse about the situation. Sometimes the charge nurse agrees with the nurse I am working with, and I accept that. Sometimes she doesn't, and I let her do whatever follow up is necessary and try to stay out of the picture from there on out.

It doesn't happen often, but when it does, it isn't easy. I love the nurses I work with and I don't want to undermine them or alienate them. But I love our shared mission of taking care of people who need us even more.

Don't know if that helps, but there's my two pennies.

:)

If I were the first nurse in this situation and the aide came to me stating there was a lot of swelling and bruising, I'd definitely go check the pt out ASAP.

Also, I'm hoping the first nurse did an incident report, which should also involve calling the pts family or guardian . When something happens to a patient and I may decide the pt doesnt need to be checked out, I've always been reuiqred to inform the family of the incident and I always offer a trip to the ER if they'd like or the patient likes. If the pt has refused already, I do inform the family of that as well.

When I was a CNA a similar thing happened to me, I was tending to a pt and I noticed she was in mild resp distress, more so than when I was in there with her an hour earlier, I informed her nurse whose response was "she gets like that" I told her nurse, I dont think so, she was not like this an hour ago, we kind of went round and round and the nurse DID NOT go see the pt. So I simply walked down the hall grabbed another nurse and said "do me a favor, come check out this lady in 217" She did and by this time pt was extremely diaphoretic and a lovely shade of grey and now non verbal. The patient was in sever fluid overload and was transfered to ICU.

The house supervisor was livid with the pts assisgned nurse and let her know. I was very frustrated as I felt the assigned nurse dismissing me because I was "only a CNA".

So follow your gut, if you think the pt needs re assessed and the assigned nurse wont do it, grab another nurse. The guilt you would feel if something was wrong with the patient and you didnt do your best to get her the assistance she needed would be horrible.

Do not know why any nurse would dismiss out of hand the opinion of a cna who sees the pt roughly three times more often then she does.

I may not always agree with cna assessment, but I will always go check it out.

Even with the cnas who are kind of reactionary cause in ltc they usually know "normal " for their pts better then the nurses.

Keep up the good work !

Plus there is no such thing as just a cna !

Nurses would have a hard time doing their jobs without cnas.

You are an important part of the health care team.

I'm sorry that happened to you. It must be frustrating when you know and care about a resident and noone is listening to you. You sound like a great CNA by the way. I always listen to the CNA's and check out their concerns, no matter what they are. My CNA's are my eyes and ears and allow me to do a better job, If they don't count on me how can I count on them?