Am I a horrible NA???

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Specializes in Trauma, MICU.

A little history - I was an NA on a regular med-surg floor April-June 2006. I stopped working to have my baby. I started back working two weekends ago. So today was my 4th day working since I stopped working a year ago.

I had 6 pts today. Not a horrible day, but a busy one. I had one elderly pt (80's) who repeatedly yelled at me all day. I asked him several times if he had to go to the restroom or if he needed his pad changed, he either said no or would yell at me. I worked the 7-3 shift. At 1:30 my nurse asked me if he had gone/been changed. duh I said no. We went in there and he definately needed to be changed. I know what I did was completely irresponsible and would never do it again! However does this make me a horrible NA? I'm in nursing school and now am totally doubting if I should continue. :o I think I was just so busy, and intimidated from him yelling at me, that I didn't push the issue with him. I know that I need to be more assertive with pts, even if they don't want to do what they should. What do you all think?

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Specializes in Developmental Disabilities, LTC.

OMG, you're so sweet! Please give yourself a break!

First of all, a horrible aide wouldn't have even taken the time to reflect on this. He/She probably would have turned to his/her nurse & said, "No - he's been yelling at me all day! What'dya expect me to do?"

You don't sound like a horrible aide, or like you're going to be a horrible nurse, so please don't drop out of school!

I'm not the most aggressive either (would prefer to let pts rest, rather than bother them with assessments, etc), so I would also appreciate some tips on getting over this.

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no, no, no! you sound so sweet and sincere. you've only been back 4 days; your assertiveness will build back up.

i have a gut feeling that you're going to make an excellent nurse.

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I agree with the post above, you're not a horrible NA! Was he a confused patient (I'm guessing that he is since he is in his 80's and wes yelling at you). When i have patients like these, i find it works best when i say to them"ok it's time to get cleaned up." or "it's time to get in the shower." instead of "would you like to take a shower?" not that i'm trying to take away their rights, but they need to be clean and dry or they will get all kinds of problems. hope this helps.

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Specializes in ICU.

You were gone for a year, it's going to take prob. a couple weeks just to get back into the full swing of things....you will be a great nurse....just because you didn't phsyically check to see if he needed to be changed has no reflection on your skills and abilities whatsoever...I say keep up the good work !

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Specializes in NICU.

You're doing great, sweetie :). Are you enjoying being back at work?

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I just wanted to put my two cents... I was once told by a very experiece nurse that you need to learn to talk to your patients. As a nurse you will get a lot of yelling and stuff and you need to learn to calm your patient down. She told me that sometimes all they need is someone to listen to them instead of telling them what to do. Also they need to be asked not told. I always keep that in mind. good luck;) ;) ;)

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Specializes in LTC, home health, critical care, pulmonary nursing.

The fact that you admit you made a mistake and accept responsibility for it speaks volumes about your integrity. We all screw up, and heck, you've been out of practice for a year. Consider it a lesson learned. You'll be a great nurse.

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Specializes in Trauma, MICU.

Thanks all for your wonderful, encouraging replies!!! The pt was confused and I later found out that he had late-stage alzheimers. I try to always talk to my pts, it amazes me that I can have an extremely rude pt but after I talk with them, they completely change and are very nice and even funny. I love it when that happens. Unfortunately this pt wasn't like that, it seemed that no matter what I did he didn't want to connect with me (which I can usually do with most of my pts). I have a problem being assertive with pts. I try to treat then the way I would want to be treat - left alone! lol I figure they are in the hospital to get well and they need their rest. I hate it that a lot of times pts aren't able to sleep at night, due to all the poking that is done to them. I think one big thing I've learned by this is that I will always make sure to check my pts and change him/her if needed.

In response to "Are you enjoying being back at work?" I do enjoy working with pts, but days like today are really tough on me. When I came home, my hubby was swinging my 11 mo baby and I started crying. I think it was a mixture of the bad day and that I missed her soooo much!

Another sad thing that happened to me today... I had a 50ish pt who came in for a minor surgery. He was doing fine, sore but fine. Then I heard the nurses talk about putting him in neutropenic isolation. When I inquired why, they said that his standard lab work showed that his blood count, platelets and WBC were all extremely low. The doc did a bone marrow test and they found out he has leukemia! :o I was so upset! I went in held his hand and talked with him while he cried. The worse thing is that he has an 80% chance of going into remission with chemo and blood transfusion - however his religious beliefs prohibit blood tranfusions! I felt soooo bad for him. I hate not being able to fix people!!!! :o

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Specializes in NVICU, NSICU.

I don't think that you're a horrible NA either, it was just a horrible situation. Just bear in mind that most elderly patients tend to yell because of presbycusis. They have a hard time hearing even themselves because of it. But, it's really demeaning to be yelled at for nothing especially when you're juggling a number of tasks in such limited time.

Don't give up! :balloons:

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Specializes in Rural - we do it all!!!.

Hi,

I think it sounds like you are on the right track.

Everyone doubts their actions sometimes, and I think that this can be a positive.

Are you a bad NA? IMHO, NO. Ask yourself these questions....

1. Would you have treated the pt differently r/t his being disagreable? That is, if this was the nicest pt, it's easy to interact with him....it's a sign of a good NA that you still chose to positively, repeatedly interact with a difficult or disagreable pt, and not just ignore him or the situation.

2. Were you actions based on patient care? You recognized that this pt needs to void....

3. Do you care about this patient? I see aides leave without another thought as to their pts, and this does not suit my personality. I see your asking about this situation as wanting to learn from it.

Things you might have done, they may or may not have made a difference.

1. Document your attempts and their outcomes r/t pt not voiding and refusal. Without knowing what is the problem, it's more difficult for you and this pt's nurse and dr to address. Just state them factually...your phrasing and the pt's response...

2. Let his nurse know....Perhaps this pt has underlying issues (as it seems later you learned of the end stage AZ dx). His nurse may have more info that makes helps to understand this behavior. It also gives you, his nurse, and the dr (eventually), a chance to develop a care plan that addresses this issue. Don't forget - you are a vital part of this pts care, and you are the eyes and ears for the nurse and dr, report, document, allow this pts staff to be aware of the problem.

3. Yes, I know you're just back, and it was busy...it sounds like you are doing a great job. And that you've recognized that it's in the little things that can make a big difference.

Keep up the good job!!!

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Specializes in Hospice, Med/Surg, ICU, ER.

First of all, a horrible aide wouldn't have even taken the time to reflect on this.

I agree. Don't let this get to you - we need more nurses like you. :)

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