CNA Frustrated with Being the Blame

Davey Do · Jan 8

We are human beings subject to fallibility, we all make mistakes, but it sounds like you've come up with a plan to deal with it in the future.

Good for you, Kristen Creator.

Now, it would also be good to know the critical parameters of VS in order to know which to report immediately. For example, an 02 sat of 92% definitely needs to be reported, but immediate action is necessary for an O2 sat in the 80's or lower.

The best to you.

Kirsten Creator · Jan 8

Yes. It was in the 80's. Yes I will hand the nurses a list before documenting now on. I was just upset that she didn't go in behind me and double check what I had charted instead of being upset and putting the blame all on me. I was busy and she was MIA. The nurses are practically stuck in front of the computer screen. How did she not see what I chart til' almost two hours later. It just upset me so much. But I'm continuing to learn through trail and error.. Thank you for your response. I'll be sure next time because it's the patients life in the line.

Davey Do · Jan 8

I consider myself to be a monument to trial & error, and in that which I've errored becomes more deeply ingrained in my psyche, Kirsten.

The very best coworkers are those who constantly talk about the patients' status. For example, a great Tech I worked with had good intuition and would say things like, "Mrs. So&so's acting funny". On one occasion on a MN shift on psych, after he mentioned this, it was found the patient was experiencing the beginning symptoms of a life-threatening condition. She was evaluated in the ER and transferred to medical.

The best we can ever be in the caregiving process is a strong link in the chain.

londonflo · Jan 8

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I am a CNA inside of a small hospital. Couple of days ago I took vitals. I missed a crucial part with not reporting low 02 to the nurse because I couldn't find her and ultimately forgot.

When you develop your cares sheets, create a column for "Need to report"!

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The nurse came to me a couple of hours later upset that I didn't report. I explained I forgot. My question is why don't the nurses check the vitals on the computers?

Then why you have in a position? You're just trying to make your self feel better -

Davey Do · Jan 8

When we are confronted with any problem for which we are deemed responsible for its cause, it's not unusual to explore other root causes in an attempt to redeem ourselves.

Heck, in Kubler-Ross' Stages of Dying, even the first stage of acceptance is denial. Dr. Daniel Gilbert, in his great book Stumbling on Happiness says we always feel better when we have someone else to blame for our discomfort.

Eating Humble Pie is not an easy thing to do, but the sooner we admit our mistakes, learn from them, pull ourselves back up by the bootstraps, and get on with our lives, the better off we will be.

Career Columnist / Author · Jan 8

I hear your POV, and here's the other POV:

Busy RNs juggling a dozen issues that demand immediate attention will assume vitals signs are in the normal range because the policy says abnormal vitals are reported immediately to the RN.

Davey Do · Jan 8

A good action when critiquing another is to restate their premise in our own words, in doing this, any misconceptions can be righted. Restating their premise also has the added advantage of the one being critiqued feeling as though they've been acknowledged, in a sense, it gives them power.

We often come to this website in order to discuss a problem situation and casting aspersions does not, and will not, change another's perspective, it will only put them on the defensive.

londonflo · Jan 8

Kirsten Creator said:

Yes. It was in the 80's

This is a great learning experience for you...Was the patient alert, using everything at their disposal appropriately? I had to float to a unit where the patient couldn't put their coffee cup back on the table, lips were dark...it made me think how much oxygen is getting to their brain? Just treat this as a learning experience. Numbers only make up some of the measurement of good oxygenation. Keep learning!

Been there,done that, ASN, RN · Jan 8

50/50 call here. The nurse is responsible for assessing the patient's vital signs. However , nurses may not have time to review all of the vitals, in a timely fashion. They rely on the CNA to report a highly unusual vital sign. Now you know, that a pulse ox in the 80's would be a stat report to the nurse. Do you have guide lines to report for BP high/low . pulse rates, or respiratory rates? You are the first person to see the patient, when the nurse is in report. First to agree.. CNA's don't get paid enough.

Davey Do · Jan 8

Yes, the nurse is partially responsible. When working on the geriatric psych unit, another RN, LPN, CHA, or unlicensed Tech may be taking VS, and I routinely reviewed them. Across the board, sometimes VS out of parameters were not immediately reported to me.

VS were taken BID and PRN, as many of the patients were on antihypertensives, respiratory meds, etc. so status knowledge was a must.

Kirsten Creator · Jan 8

Yea from now on everyone gets a copy before I chart. Everyone gets busy. Things happen. Which is why she should have lowered her tone before approaching me. I saw someone mention that I was trying to make myself feel better. No, what I am doing is venting. I owned up to my mistake on that part. But she came up to me extremely upset that I didn't tell her. I said "Oops im sorry I came looking for you, but couldn't find you". I charted it when I saw it so it wouldn't go unnoticed and thought you would see it in the computer." Two hours later she sees it. In that time(when I did see her) she was sitting down in the hallway while I'm running like chicken with my head cut off. So to end this. Yes, my job is to report to you Mrs. Nurse. But check on your patient as well. Two hours went by with the information sitting right there for you. It's an easy pull up after I have charted. If I was a nurse I'd check my vitals because I can't trust that the techs will come straight to me and report. Thanks to the ones who made a post understanding both sides and not just looking at it from a nurse stand point because you are a nurse yourself.