charge nurse keeps making cna's put residents in danger

[Ninagrace44]

Ive been a cna for 7 years. Been working at my facility for 3 years now. We have a new nurse on third shift who came from a critical care unit. She makes us wake people up to do skin checks and out of a dead sleep for a sip of water. I dont mind doing these things at rounds however sje wants us to do it every hour. Last night she made us transfer a resident who was a mechanical lift out of bed with no lift and put her on tje commode. She made us also get someone up who was vomiting and so week she could not stand on her own at all. The resident almost fell on top of me. I confronted her about it and was told that she was the one in charge im just a aide so I have to do what she says. I have tried to her to understand that they need their sleep and when they wake up ill gladly do these things. Not only did I put the two of them in danger by transfering when they had no ability to stand I also could have hurt myself. How do you deal with a nurse who wont listen to reason and doesn't understand a nursing home is alot different than a hospital. We get in arguments all the time and I am afraid I will be the one to pay tje price even tho I am standing up for their rights. I am not lazy I will do anything I am asked within reason. In fact I get told by the day crew they like it when im on because I get more than the required amount of residents up in the morning. Has anyone else delt with this or have any advice? Someone is going to get hurt. And the only answer I will have it I was told I HAD to NO excuses im just a cna.

[Rose_Queen, BSN, MSN, RN]

Have you tried speaking with the nurse's supervisor and completed incident reports? I'm sure the risk management department would like to know about these incidents.

[No Stars In My Eyes]

Isn't there a policy regarding lift patients? Your butt is the one that would be in a sling if something were to happen to either you or the patient when transferring free-style!

"She told me to" isn't an excuse that would fly, IMO.

Ditto what Rose-Queen said; document, then take it to the next higher level.

[Glycerine82, LPN]

First of all, you're not "Just" a CNA. Your job is every bit as important as the nurses, without you she can't do her job.

Yes, they are your supervisors in some settings, but you never have to endanger yourself or your patients.

I would talk to the Unit manager, or follow whatever your chain of command is, and explain that you're not comfortable doing said tasks without a second person, at minimum.

Any time you feel that you are going to get hurt or your patient is, you have every right to say "I'm sorry, I don't feel comfortable with that". Then, bring up an alternative.

[imintrouble, BSN, RN]

I think the first problem is a clash of nursing cultures. A hospital nurse who has no history of working LTC, might not realize it's a home, not acute care. The same rules don't apply. The same rationales don't apply.

Go up the chain as the other posters have said. Your new charge nurse is dead wrong and she's not smart enough to figure that out on her own.

Never "just a CNA". Don't believe it.

[NRSKarenRN, BSN, RN]

Moved to allnurses Geriatric Nurses / LTC Nursing forum to get further expert advice.

[NurseQT]

All resident's should have a care plan that clearly states how a resident is transferred. And that careplan must be followed, unless a transfer status is downgraded on a temp. basis. Ie a person whose careplan states they are a assist of one with walker for transfers could be transferred with a lift if the patient's transfers decline and it needs to be re-evaluated. But a resident who transfers with a lift cannot be transferred with one assist and a walker. If that nurse tells you to do it, REFUSE!!! Because if you go against the careplan and that resident gets hurt, your butt's on the line.

Skin checks can and should wait until rounds or when the patient wakes.

As for the offering water, unless a pt is at acute risk for dehydration then that too should wait until rounds.

You need to speak with your shift supervisor or DON. This nurse needs to relearn the routines of LTC.

[Nola009]

I would take your concerns to the DON. Waking ltc residents up every hour just to give them a sip of water is just wrong. Does she not understand the need for REST?!

[dream'n, BSN, RN]

Seriously, going to have alot of confused, sleepy, irritable, delirious, combative patients very soon if she doesn't let them sleep more than an hour at a time.

[lablpn]

I am a night shift nurse (11 yrs experience) and I can tell you that management needs to sit down with this nurse. She needs to take off her critical care hat and put on her ltc cape. Let these people sleep. During rounds you can do skin checks, offer fluids, etc. Hopefully that a year has passed now the problem has gotten better or stopped completely. Either way, good luck!

[litbitblack, ASN, RN]

It does take a little bit of time to get used to the long term care environment coming from the hospital....I would talk to the DON about your concerns. You really shouldn't argue with her because she is your immediate supervisor and that will result in insubordiation but you can refuse to complete an unsafe task( which will most likely be insubordination as well but justified.).

[Zyprexa_Ho]

Some great advice here. A nurse can delegate a task to you, but that task has to be a safe one and it has to abide by the care plan. The nurse may write you up, but no manager with a grain of sanity would let that stick.