BON and alleged verbal abuse via pt

[Beldar_the_Cenobite]

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?

[JKL33]

13 minutes ago, Beldar_the_Cenobite said:

Like nursing is a risky death trap for easy unemployment where all your opportunities you had are gone because you were frustrated at the lack of help you were getting and may have said something that the patient took the wrong way or what you were trying to professionally tell your supervisor who was doing your job while you were busy you were helping to remind him in the future when he wants help for that patient.

But you are in control of this. If it's too much, find a different place where there aren't so many challenges. I know that's pie-in-the-sky and not very realistic because many working environments are harsh, but it's still the bottom line: Either do whatever it takes to function as a put-together future professional, or else find a place where your chances of doing so are improved because the environment is better overall.

Don't feel pressures that aren't yours to feel. Refuse to. In the example of this OP - - interact pleasantly with the patient, coordinate your efforts away from the patient/out of earshot as much as possible.

If you are having trouble getting the help you need and need to discuss that with a supervisor or nurse, etc., that is not the patient's fault and the patient should not have to overhear it. Staffing isn't your fault, either, but it is often within your/our ability to maintain the patient's dignity despite these other hurdles.

You will have to realize that you rarely need to tell or remind your superiors about the difficulties of the work you do. You aren't educating them - - either they literally don't care or else they have no power to change what you are complaining about. So don't waste your rep/cred on those useless diatribes. Just don't. I think you need a hefty dose of "rise above." Accept reality and don't get any ideas about putting people in their place for the difficulties of reality. Do the job within the confines given, or else don't do it. BTW, this is not a chastisement, it is an encouragement. See the light. ??

[NurseBlaq]

2 minutes ago, Beldar_the_Cenobite said:

I tried to apologize, but it made her more upset. Not sure why. I apologized to her in front of her mother. I've worked with residents who were big. Not once did I ever comment on their weight.

And does the Ombudsman understand that or is that absolutely no excuse? That is one of the reasons why I wrote my post.

You haven't physically harmed the patient or prohibited her care so I honestly don't see this being a major faux pas.

[NurseBlaq]

2 minutes ago, Beldar_the_Cenobite said:

What sidebar jabs? What you consider sidebar jabs were not what I said and I know what I didn't say. If I called her a whale or something, that's outright corrupt from a moral perspective in this field.

I saw that as a sidebar jab but you said you didn't mean it as such so I'm leaving it alone. Let's move on from that. I was just responding to another poster.

[JKL33]

7 minutes ago, NurseBlaq said:

I didn't begrudge what he said in the OP, I found fault with the sidebar jabs and the immediate insult as a result of pointing it out.

I'm sorry for the lack of clarity. I meant "you", the patient. I didn't mean that "you" to be associated directly with you as the quoted poster.

[NurseBlaq]

Just now, JKL33 said:

I'm sorry for the lack of clarity. I meant "you", the patient. I didn't mean that "you" to be associated directly with you as the quoted poster.

Oh, duh! ?

[Beldar_the_Cenobite, CNA]

23 minutes ago, JKL33 said:

1. But you are in control of this. If it's too much, find a different place where there aren't so many challenges. I know that's pie-in-the-sky and not very realistic because many working environments are harsh, but it's still the bottom line: Either do whatever it takes to function as a put-together future professional, or else find a place where your chances of doing so are improved because the environment is better overall.

2. Don't feel pressures that aren't yours to feel. Refuse to. In the example of this OP - - interact pleasantly with the patient, coordinate your efforts away from the patient/out of earshot as much as possible.

3. You will have to realize that you rarely need to tell or remind your superiors about the difficulties of the work you do. You aren't educating them - - either they literally don't care or else they have no power to change what you are complaining about.

4. BTW, this is not a chastisement, it is an encouragement. See the light. ??

1. I would like to work somewhere else. Especially where direct deposit is offered and the company spends money to improve care. My company HATES spending money, despite the fact that spending money makes money. Maintenance will try and find a way to work around spending money of any kind whether it makes the job easier or faster or not because they will hear from the owner. I don't know what it's like working at a hospital as a CNA, but I've heard it's very different and hospitals want experience. I think it's stupid, but at the end of the day it should be all about the training. One day my facility had a new admit and they had this weird inflatable donut shaped thing under their bottom. I think it had the words "pressure ulcer sore reducing device". I thought to myself "why the f don't we have this?".

2. I don't know if these are pressures I'm not supposed to feel. I feel like in nursing we can be sued for anything. Training is a very important factor in the outcome of care at a facility. I think it's important that schools should be, by law, 6 months which includes how to work and how to pass the state board, such as satisfying what the board wants. People want to graduate CNA school quickly, but end up working in a vent unit at a SNF where they see the trachea tube pop off the canula tube or gooey mucus jumps out when the tube pops off, then the CNA leaves either during shift or after they clock out and never come back and then there's the shortage. I've verbally explained to people how to do something and they stayed, yet I'm scolded for trying to bring new ideas to management like a dedicated trainer CNA who works the floor with others but specific residents who are more difficult such as size, behavior, or number of wounds, etc, because I don't have the experience other CNAs who have been there.

3. The LPN I was with in there is a supervisor. He was once a CNA. Two red flags that show he should have known better such as "Ok, we'll wait until we get people to come in" or "Go get more people. This might not be safe for the both of us" or "Is there a certain number of people this resident needs to be pulled up?". Mind you, the nurses and RTs at my work leave opened packages and caps on the residents or under their blankets at my work. They leave their trash on the patient they just took care of. Yes, people need to be reminded. People need to be reminded everyday until it clicks. I complain "How do you get paid more than I do and you leave your trash around like I'm supposed to pick up after you? I'm your assistant, but not your ****** maid or your ****** ****** mother" Oh yeah. I forgot to say, nurses and RTs at my work like to say I can't do that. I don't have the energy or that's not my job. RTs love saying "I don't do that" or "that's not my job". It should be everybodys job to answer call lights and help CNAs pull people up. If you can't do that, you don't belong in this field.

4. Thank you. I appreciate your comment as well as a few others.

[TriciaJ, RN]

17 minutes ago, Beldar_the_Cenobite said:

3. The LPN I was with in there is a supervisor. He was once a CNA. Two red flags that show he should have known better such as "Ok, we'll wait until we get people to come in" or "Go get more people. This might not be safe for the both of us" or "Is there a certain number of people this resident needs to be pulled up?". Mind you, the nurses and RTs at my work leave opened packages and caps on the residents or under their blankets at my work. They leave their trash on the patient they just took care of. Yes, people need to be reminded. People need to be reminded everyday until it clicks. I complain "How do you get paid more than I do and you leave your trash around like I'm supposed to pick up after you? I'm your assistant, but not your ****** maid or your ****** ****** mother" Oh yeah. I forgot to say, nurses and RTs at my work like to say I can't do that. I don't have the energy or that's not my job. RTs love saying "I don't do that" or "that's not my job". It should be everybodys job to answer call lights and help CNAs pull people up. If you can't do that, you don't belong in this field.

Beldar, I'm getting a picture of a conscientious and caring person who shares too many thoughts out loud. Most of us have had to learn that lesson the hard way.

The trick is to remove the trash from the patient and think to yourself "I'm not their ******* maid!" while you keep a smile on your face for the patient's benefit. It takes a bit of doing but an excellent skill to start working on before you get into nursing school.

It's a sad fact of nursing that you're going to work with lazy people that management won't address or get rid of. It's going to make you gnash your teeth but try to just be there for your patients and think of your paycheque. If a workplace is too toxic, or they make it impossible to do a decent job and then throw you under the bus, then you have to look around for a new job.

By the way, those donut cushions can cause problems of their own. That's why they're not used in a lot of places.

[Horseshoe, BSN, RN]

2 hours ago, Beldar_the_Cenobite said:

3. The LPN I was with in there is a supervisor. He was once a CNA. Two red flags that show he should have known better such as "Ok, we'll wait until we get people to come in" or "Go get more people. This might not be safe for the both of us" or "Is there a certain number of people this resident needs to be pulled up?". Mind you, the nurses and RTs at my work leave opened packages and caps on the residents or under their blankets at my work. They leave their trash on the patient they just took care of. Yes, people need to be reminded. People need to be reminded everyday until it clicks. I complain "How do you get paid more than I do and you leave your trash around like I'm supposed to pick up after you? I'm your assistant, but not your ****** maid or your ****** ****** mother" Oh yeah. I forgot to say, nurses and RTs at my work like to say I can't do that. I don't have the energy or that's not my job. RTs love saying "I don't do that" or "that's not my job". It should be everybodys job to answer call lights and help CNAs pull people up. If you can't do that, you don't belong in this field.

4. Thank you. I appreciate your comment as well as a few others.

If this is how you speak to your colleagues, you will never make it as a nurse; for that matter, you won't be successful in any profession unless you can manage to go straight to CEO, have no clients to please, and don't have a board of directors to answer to. It doesn't matter if their nursing practice needs improvement-there is no up side for communicating in that manner and you will NEVER get anywhere behaving like that. If you can't do a better job of conflict resolution, perhaps YOU don't belong in this field.

As already noted, you will run into slackers in any field you go into. Speaking like that to your peers and to those to whom you have to report is not only unprofessional-it's incredibly foolish, EVEN IF YOU ARE CORRECT in the gist of the issue.

Perhaps you could use some anger management classes. It would be a good idea to read a book like How to Win Friends and Influence People, by Dale Carnegie. I can assure you that the way to get people to do what you want them to, the way to get people to help you, the way to manage a conflict of interests, and the way to gain respect does not involve cursing at people and questioning why they make more money than you.

[Alex_RN, BSN]

I am so sorry you are going through this. The reality is, if the patient is 400 lbs, then she is 400 pounds, and what does polite have to do with physics? Are you supposed to cripple yourself and pretend that she is not morbidly obese? A simple, "I am sorry that I expressed my frustration with the lack of necessary and safe staffing," should be enough in my book.

Best of luck to you.

[Horseshoe, BSN, RN]

By the way, based on your own words-the way you speak to your colleagues, the language you use to describe the facility owner, etc., it seems fairly likely that you did indeed speak of this patient in terms that she found offensive.

You are in sore need of a filter.

[Not_A_Hat_Person, RN]

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.

My state licenses CNAs (They're called LNAs).

[VivaLasViejas, ASN, RN]

I think the OP needs to mature and learn some diplomacy. You don't stand at the bedside and complain that you need more help to reposition the 400+ lb. patient; frankly, if I were the patient I'd have been embarrassed and even humiliated. She knows she's morbidly obese, believe me. No one needs reminders!