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?

[Not_A_Hat_Person, RN]

No way should 2 people try to position a 400+ lb. patient, unless they are using a mechanical aide, like a lift.

In Nursing Home Hell, I had to try to position a resident who weighed over 500 lbs, with 2 LNAs and a lift. Things did not go well.

I worked in another facility where the official standard for lifting or turning without some kind of mechanical device was one person for every 75 lbs. A patient weighing 400 lbs. would require at least 6 people.

Hopefully, nothing will come from the patient's complaint. You may want to look for a new job, if only to save your back.

[TriciaJ, RN]

11 minutes ago, Not_A_Hat_Person said:

No way should 2 people try to position a 400+ lb. patient, unless they are using a mechanical aide, like a lift.

This is the part the ombudsman should be most interested in.

[JKL33]

4 minutes ago, Not_A_Hat_Person said:

I worked in another facility where the official standard for lifting or turning without some kind of mechanical device was one person for every 75 lbs. A patient weighing 400 lbs. would require at least 6 people. 

Agreed, and this is likely true for most positions and is often going to be found right in the job description - number of lb/kg expected to be able to lift.

Although the consensus is that the OP should've used care in discussing the situation and making a plan for the care, the fact is that finding enough help to provide completely predictable care in these situations is frequently some sort of a rigamarole. And why should that be the case?

You have a tech/aide/CNA who is right smack dab in the middle of a patient who needs help (sometimes sort of urgent either d/t the condition or the patient's dignity - such as helping them use a bedpan or commode so they aren't incontinent) and the fact that the facility has neglected to have on hand the number of people required to do the job (or do it in a timely manner).

I think honestly this is indeed frustrating to most people who find themselves right in the middle of it.

[xanderx]

17 hours ago, Beldar_the_Cenobite said:

What about the post is detailed? Location, names of facility, name of patient, etc, is not mentioned, therefore, nothing is being violated.

The description of the events is not general and could easily be uncoverexuncovered

[Horseshoe, BSN, RN]

I doubt you will find anyone here at AN who will argue that it is a reasonable expectation that only two people should attempt to lift a 400 lb. patient. That's really not the primary issue. The OP is being investigated for inappropriate comments made in front of this patient, not because he refused to attempt a dangerous lift. He could save himself a lot of trouble and hassle down the line if he would learn how to communicate with more tact. By his own admission, he is seriously lacking in that department.

[Leader25, ASN, BSN, RN]

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

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.

I agree.Do not apologize any more,it is done.Keep your mouth shut ,do not discuss with anyone,not even your perceived friend because many are known to throw you under the bus for extra points.If you had injured your self they would blame you anyway.

Be glad it could be worse,good luck.

[Zippy83]

I could see how even asking for extra staff to reposition her when standing over her might have drawn the reaction that you got. Even if you had said “We need 5-6 people”, she might have heard “she’s like 5-6 people”.

I would just recommend always leave the room when talking about a patient, never in earshot unless you are addressing them directly, to avoid exactly these issues. It’s a good habit to start now.

Getting extra staff to assist in the repositioning would have been a request that you would make to a supervisor anyway, so saying it to the other staff members while repositioning her doesn’t serve any purpose other than to complain.

It is possible that they are coming down so hard on you in order to deflect from the fact that they really should be providing adequate staff and are not doing so, therefore putting you and the patient at risk for injury. Have you brought this up at all to a trusted supervisor?

[Nurse SMS, MSN, RN]

Beldar, from nearly everything you have posted here recently you are suffering. Anxiety, anger issues, near paranoia, escalating problems at work, a sense of entitlement over things you cannot control. It is not normal to feel this way and you don't need to. I, again, strongly encourage you to seek out assistance with these issues. You will not meet any of your goals if you continue down this path. Some of the things you state here are alarming.

[CapeCodMermaid, RN]

Did you post that you are jealous because a facility is using donuts for pressure relief? This is way off topic but no one should be using those donuts anymore...they cause more problems than they treat

[Zippy83]

4 hours ago, CapeCodMermaid said:

Did you post that you are jealous because a facility is using donuts for pressure relief? This is way off topic but no one should be using those donuts anymore...they cause more problems than they treat

This made me laugh out loud because I read it imagining donuts from the bakery. I was thinking to myself, I’m jealous too if a facility is using donuts for pressure relief! Thinking in terms of the pressure of nurses to get a job done, and giving them donuts to feel better. Then after a few seconds I put it together. No donuts after all. Wah wah. But those donuts also cause more problems than they treat, haha.

[NurseBlaq]

6 hours ago, not.done.yet said:

Beldar, from nearly everything you have posted here recently you are suffering. Anxiety, anger issues, near paranoia, escalating problems at work, a sense of entitlement over things you cannot control. It is not normal to feel this way and you don't need to. I, again, strongly encourage you to seek out assistance with these issues. You will not meet any of your goals if you continue down this path. Some of the things you state here are alarming.

Symptoms of depression. ?

[Nurse SMS, MSN, RN]

We definitely are not qualified over the Internet to diagnose and per terms of service we can't give medical advice. I am simply stating an opinion that has no medical bearing and should not be construed as a diagnosis or medical advice beyond that to seek out assistance in sorting out what appears to be a very complicated time in Beldar's life.