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BON and alleged verbal abuse via pt

Nurses   (4,351 Views 83 Comments)
by Beldar_the_Cenobite Beldar_the_Cenobite (Platinum*) Platinum*

Beldar_the_Cenobite works as a Certified Nursing Assistant.

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I'm in a bit of a predicament. I work on a ventilation unit. There's a very large female resident on ventilation. Somewhat young. Alert and oriented. Just started speaking today. Wednesday she claims I said something about a number regarding her weight as in "7 people in 1" or maybe it was like "5 people in 1". I don't really know. I don't remember saying anything about it. That day and that event that happened allegedly, me and an LPN were trying to reposition her. When she was first admitted, we had 4 CNAs at all times when it came to things like changing her, repositioning, bed bath, etc.  A few days later she all of a sudden went down to 2 CNAs. I understand I can't just pout and disagree with it, but to me it's a safety issue if there's 2 CNAs when doing something with her to get comfortable instead of 4. I think she's like beyond 400 lbs. I told the LPN like 4 times "I want more help" or "I want 3 people or 4 people" both in front of her, and outside her room. The LPN I worked with that run is energetic and motivated. He's a cool dude, but pressed for time. He kind of just blew it off and instead tried to encourage me  to pull her up with him, both of us on opposite ends. I was irritated, but I can't recall myself ever saying anything about her weight. I don't see why I even would considering it has no importance to my job. Tonight, an hour or two before the end of my shift and before her mother left, I was escorted outside as house sup, mother, and lead CNA all talked about it and off the property as there will be an investigation Monday. I don't know what will happen, but I did document 4 pages worth of my side. She was able to speak today and she says I did in fact say something that hinted at her being big, but I don't see why I would because that's just straight rude. I apologized to both her and her mom when they were in there together. The mom didn't want to write a report, but the daughter (patient) did. Now the ombudsman is going to come in and investigate. Am I 100% guaranteed to lose my job and license even though I don't remember saying anything like that? Or could both sides (state and facility) say ok we'll let it slide once, but that's it? I've always been nice to her whether her mom was there or not, always greeted her, always had no issue with helping others who interacted with her like a nurse or CNA. I never turn down a request for help if someone needs it, except financially. Me and the LPN that were in that room were involved and we're both going to be investigated. Also, could this affect me going into nursing school? I was told by my house supervisor who is a really good RN that this could ban me from working in the healthcare field period, but I don't know if that's a little exaggerating. Also, I was told in CNA school that I think in Nevada, if you mess up in one area of certification so bad you can never hold that title, that it won't affect other titles. I'm not trying to intentionally get fired or lose my certification, but it took two days for the pt to find somebody to report it, but I can't remember ever saying it. What I documented I did remember doing and would do in a scenario that needed it, but I never mentioned that I said something to point at her weight because why would I? I took my test for nursing school and I might get accepted, why would I want to go downhill? 

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You don't have a license as a CNA, you have a certification. To involve the ombudsman is a strong move on a verbal comment, but whatever. It should amount to nothing, but be respectful and serious anyway.

She is big, and it is your job to move her. If you need help moving her because of her size, then you are going to need to verbalize something about that and I don't think anyone could fault you for that.

What you said matters. If you said moving her was like moving 5 people, well that is not the nicest way to say it, but did you say it because you felt 5 CNAs should be present? 

At the meeting, explain that you were concerned for your safety and the patient's safety while moving her and wanted to make sure you had enough staff. Apologize for hurting her feelings. 

If you get fired for this, its not a good place to work. They should ensure you have adequate staff to move large patients and you need to be able to speak about it. 

If they counsel you on what not to say in front of the patient and admit that you were trying to get help and not trying to hurt anyone, then you can learn from this and move on.

Good luck. 

 

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Hoozdo has 15 years experience as a ADN and works as a RN.

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6 hours ago, Beldar_the_Cenobite said:

Or could both sides (state and facility) say ok we'll let it slide once, but that's it? 

Your facility can not let it slide. That is a federal standard - the facility must investigate any allegations of abuse. Additionally, you are not supposed to be in the facility until it is investigated.   

The result of the facility investigation is then forwarded, along with the complaint, to whatever entity in your state facilitates nursing home complaints and licensing. 

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9 hours ago, Beldar_the_Cenobite said:

I'm in a bit of a predicament. I work on a ventilation unit. There's a very large female resident on ventilation. Somewhat young. Alert and oriented. Just started speaking today. Wednesday she claims I said something about a number regarding her weight as in "7 people in 1" or maybe it was like "5 people in 1". I don't really know. I don't remember saying anything about it. That day and that event that happened allegedly, me and an LPN were trying to reposition her. When she was first admitted, we had 4 CNAs at all times when it came to things like changing her, repositioning, bed bath, etc.  A few days later she all of a sudden went down to 2 CNAs. I understand I can't just pout and disagree with it, but to me it's a safety issue if there's 2 CNAs when doing something with her to get comfortable instead of 4. I think she's like beyond 400 lbs. I told the LPN like 4 times "I want more help" or "I want 3 people or 4 people" both in front of her, and outside her room. The LPN I worked with that run is energetic and motivated. He's a cool dude, but pressed for time. He kind of just blew it off and instead tried to encourage me  to pull her up with him, both of us on opposite ends. I was irritated, but I can't recall myself ever saying anything about her weight. I don't see why I even would considering it has no importance to my job. Tonight, an hour or two before the end of my shift and before her mother left, I was escorted outside as house sup, mother, and lead CNA all talked about it and off the property as there will be an investigation Monday. I don't know what will happen, but I did document 4 pages worth of my side. She was able to speak today and she says I did in fact say something that hinted at her being big, but I don't see why I would because that's just straight rude. I apologized to both her and her mom when they were in there together. The mom didn't want to write a report, but the daughter (patient) did. Now the ombudsman is going to come in and investigate. Am I 100% guaranteed to lose my job and license even though I don't remember saying anything like that? Or could both sides (state and facility) say ok we'll let it slide once, but that's it? I've always been nice to her whether her mom was there or not, always greeted her, always had no issue with helping others who interacted with her like a nurse or CNA. I never turn down a request for help if someone needs it, except financially. Me and the LPN that were in that room were involved and we're both going to be investigated. Also, could this affect me going into nursing school? I was told by my house supervisor who is a really good RN that this could ban me from working in the healthcare field period, but I don't know if that's a little exaggerating. Also, I was told in CNA school that I think in Nevada, if you mess up in one area of certification so bad you can never hold that title, that it won't affect other titles. I'm not trying to intentionally get fired or lose my certification, but it took two days for the pt to find somebody to report it, but I can't remember ever saying it. What I documented I did remember doing and would do in a scenario that needed it, but I never mentioned that I said something to point at her weight because why would I? I took my test for nursing school and I might get accepted, why would I want to go downhill? 

do not know what you said, but your first mistake was apologizing.  You can be conciliatory without apologizing.  good luck

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Pixie.RN has 18 years experience as a MSN, RN, EMT-P and works as a ED/Trauma, Educator, IP/Nurse Epidemiologist.

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15 hours ago, Beldar_the_Cenobite said:

I told the LPN like 4 times "I want more help" or "I want 3 people or 4 people" both in front of her, and outside her room. 

This right here is excessive. Not surprised that the patient was offended. 

You already have a target on your back at your job with the recent issues with your van and being on private property after hours. You are probably done there. 

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Please make an appointment with a therapist. Although we are only seeing a small glimpse of you, you don’t seem to be thinking clearly or rationally. I wish you all the best and good health. 

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TriciaJ has 37 years experience as a RN and works as a Retired.

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I personally don't think you messed up that bad.  You're supposed to move a 400 lb person without adequate help, but you're not supposed to hint that she's big?  What a minefield.

I think you were right to apologize and when questioned, just reiterate your only concern was for patient safety.  Maybe your tact and diplomacy need work but that's hardly a hanging offense.

Someone who weighs 400 lbs and is completely helpless is desperate to feel in control of something.  Filing a complaint helped her feel in control.  Now it has to be investigated.  Bummer that you have to go through the stress and uncertainty.

I wouldn't apologize any further.  The investigation will happen and the chips will fall where they may.  Unless there's more to the story, this should not even come close to rising to the level of the BON pulling your certification.

Hang in there.

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shlbtlr has 2 years experience as a ADN, CNA and works as a Graduate Nurse.

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I work as a CNA and I have moved, bathed, shaved, surgical prepped, etc. many many patients with the help of one other person on several different occasions due to short staffing ratios and that myriad of problems. I’ve never once made remarks of how many people I wish I had or needed. 

Sure, the issue should be able to be discussed, but there are ways of doing such without offending the patient — the nurse’s station or your supervisor’s office, perhaps? 

 

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Snatchedwig has 3 years experience as a CNA, LPN and works as a LTACH Medsurg.

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On 5/11/2019 at 9:53 AM, FolksBtrippin said:

You don't have a license as a CNA, you have a certification. To involve the ombudsman is a strong move on a verbal comment, but whatever. It should amount to nothing, but be respectful and serious anyway.

She is big, and it is your job to move her. If you need help moving her because of her size, then you are going to need to verbalize something about that and I don't think anyone could fault you for that.

What you said matters. If you said moving her was like moving 5 people, well that is not the nicest way to say it, but did you say it because you felt 5 CNAs should be present? 

At the meeting, explain that you were concerned for your safety and the patient's safety while moving her and wanted to make sure you had enough staff. Apologize for hurting her feelings. 

If you get fired for this, its not a good place to work. They should ensure you have adequate staff to move large patients and you need to be able to speak about it. 

If they counsel you on what not to say in front of the patient and admit that you were trying to get help and not trying to hurt anyone, then you can learn from this and move on.

Good luck. 

 

In florida its a license

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Snatchedwig has 3 years experience as a CNA, LPN and works as a LTACH Medsurg.

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2 hours ago, TriciaJ said:

I personally don't think you messed up that bad.  You're supposed to move a 400 lb person without adequate help, but you're not supposed to hint that she's big?  What a minefield.

I think you were right to apologize and when questioned, just reiterate your only concern was for patient safety.  Maybe your tact and diplomacy need work but that's hardly a hanging offense.

Someone who weighs 400 lbs and is completely helpless is desperate to feel in control of something.  Filing a complaint helped her feel in control.  Now it has to be investigated.  Bummer that you have to go through the stress and uncertainty.

I wouldn't apologize any further.  The investigation will happen and the chips will fall where they may.  Unless there's more to the story, this should not even come close to rising to the level of the BON pulling your certification.

Hang in there.

Couldnt agree more. 

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You can’t judge until you worked it. Regardless you can not hurt yourself for your job it’s a job. They will not care of you if hurt your back or other areas. These d facilities need to address the safety of their staff. In our job description it never says lift 400 lbs. I love all my patients first and foremost but they got to know your not Ironman nurse. Don’t back down and go get your job description. You only apologized for her discomfort and that was the right thing to do that does not accept blame. You just have them see what you do it’s a lot.  I love my CNA and appreciate them. For the people that don’t relate you don’t know. Take care 

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15 hours ago, beekee said:

Please make an appointment with a therapist. Although we are only seeing a small glimpse of you, you don’t seem to be thinking clearly or rationally. I wish you all the best and good health. 

In what way do you see unclear, irrational thinikig?  Not disagreeing, just not understanding.

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