CNA Frustrated with Being the Blame

Nurses General Nursing

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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. I did chart ontime, but I forgot. I understand that was bad. I am always good with reporting what is questionable. 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? I know for the most part I am documenting every two hours. So how often are nurses checking and documenting. Don't come to me and put the blame on me when I feel it's a simple lookup right after vitals are taking just because of common mistakes like this. Me forgetting. So I just need some input. I know from now on I will be bringing all vitals to nurses before putting them in the computer whether they catch an attitude or not. I have to chase nurses down all the time because they hide or just give you a nasty attitude because you're bothering them when reporting abnormal VS. 

Specializes in Med Surg.

That sucks. I remember when I was working as a tech and the nurse blamed me for not reporting a vital. But it was after they were dead. I felt so bad and angry. The patient was actively dying for three days. Every other nurse had parked a WOW and chair in front of that patients room for the two days straight and getting his vitals themselves. On the third day, the clin lead had him and sat at the nursing station all day talking. I had 10 bed rest patients who were had incontinence so I was busy. I did not tell since I assumed that she knew he was dying. Fast forward as a nurse if I think a pt is unstable then I will get vitals myself. However I understand it getting busy. I would never blame the tech. I would blame myself. However I appreciate when techs tell me any abnormal vitals or changes with a patient since they have helped me save the patient. Sometimes a patient can change fast. Nor do I mind helping even if the tech tells me when they can't find the nurse. Once a tech called me for high heart rate and dizziness since the nurse was new and when I ran to the room, the pt had become unresponsive when I walked in. I understand what it's like to be a tech and nurse which has helped me in my work. We both are busy and should help each other. Just learn from this and keep going. 

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Specializes in oncology.
k1p1ssk said:

I think it is a great call on your part to start bringing all vitals to your nurses when you take them.

I gotta say if you hand me a paper of all the vital signs of our patients, I am gonna hand it back to you and say "circle the abnormals" After all you are not someone off the street doing vitals signs. you are a CNA. You went to a program that qualified you to weed out normals from abnormals. 

k1p1ssk said:

Maybe it's once you're done with your rounds, and if there is a concerning value and you want to tell them ASAP, there may be a way to communicate with them while they are "missing" - be it a pager, or their cell phone, an instant message system within the eMAR... and if you do not get a response, find the charge nurse and report to them.

Above is a much better plan and so much more professional. Do you want the RN to think,, Kirsten is my tech tonight ..sigh

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k1p1ssk said:

I think it is a great call on your part to start bringing all vitals to your nurses when you take them.

Disagree. In the case we are discussing it is a reactionary and defensive "I'll show you" sort of response that is not helpful for prioritization and is a waste of the OP's time writing it. Despite hearing responses, the OP seems happy with a sticky note idea, which does nothing to solve the original problem of needing to report a significantly abnormal vital sign to an RN right away.

The RN may have been out of line in how this was handled, but the bottom line is that significantly abnormal vital signs need to be reported to the patient's RN, another RN, a charge nurse or supervisor. Period. A sticky note does not suffice if vitals are significantly abnormal, and writing out sticky notes with normal vital signs that have already been documented is a waste of time and has no bearing on the issue being discussed.

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JKL33 said:

Disagree. In the case we are discussing it is a reactionary and defensive "I'll show you" sort of response that is not helpful for prioritization and is a waste of the OP's time writing it.

Agree. While malicious compliance sometimes is the right, albeit passive-aggressive, way to handle a situation, this ain't it. 

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Specializes in pediatrics, school nursing.

Well, it worked well on the inpatient floor I worked on - there was a working relationship between the RNs, LPNs, and PCTs (most of which were CNAs as well). It was standard practice on that unit for the PCTs to be a part of report and for them to work with the nurses, getting vitals at the same time as the assessment process - of course the timing wasn't always perfect, but the PCTs on that floor always checked in with their nurses after getting vitals, even if it was a quick "417a was normal, 417b has an elevated temp". 

Maybe it's a culture thing, but I feel like putting such separation between nurses and aides is going to brew discontent. Why are we promoting passive-aggressiveness???? That seems really unprofessional and catty to me.  

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k1p1ssk said:

Why are we promoting passive-aggressiveness???? That seems really unprofessional and catty to me.  

I don't think anybody is. If you took that from what I posted you misunderstood what I was saying. 

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JKL33 said:

Disagree. In the case we are discussing it is a reactionary and defensive "I'll show you" sort of response that is not helpful for prioritization and is a waste of the OP's time writing it. Despite hearing responses, the OP seems happy with a sticky note idea, which does nothing to solve the original problem of needing to report a significantly abnormal vital sign to an RN right away.

The RN may have been out of line in how this was handled, but the bottom line is that significantly abnormal vital signs need to be reported to the patient's RN, another RN, a charge nurse or supervisor. Period. A sticky note does not suffice if vitals are significantly abnormal, and writing out sticky notes with normal vital signs that have already been documented is a waste of time and has no bearing on the issue being discussed.

Actually I've already started. If they are not there when I come to bring abnormal vitals then a sticky note is there for them. I then go back after I have seen them and ask if it's OK to chart it. It's working out just fine! Thank you to all of you who commented. It really was a big help!

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londonflo said:

I gotta say if you hand me a paper of all the vital signs of our patients, I am gonna hand it back to you and say "circle the abnormals" After all you are not someone off the street doing vitals signs. you are a CNA. You went to a program that qualified you to weed out normals from abnormals. 

Above is a much better plan and so much more professional. Do you want the RN to think,, Kirsten is my tech tonight ..sigh

If you are MIA. You will have a sticky note. I still have a job to do that REQUIRES me to be hands on. I'm not delaying a patients needs because I can't find you or the charge nurse. So if that's the case moving forward.... Sticky note it is. That's to the ones for the idea.

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Specializes in Critical Care; Cardiac; Professional Development.
Kirsten Creator said:

Yea sticky notes will be my best friend from on ?

The problem with this is that those can get lost, they don't represent anything in terms of protecting you should you be dinged for failing to report and, most of all, the patient themselves are at risk without closed loop communication.

I really discourage you from reporting on normals, especially in this fashion, simply because it will then become like alarm fatigue. If the sticky notes contain normal information 9 times out of 10, the nurse will not prioritize them, and understandably so. 

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Dear Kirsten Creator, 

I am an RN and you are absolutely correct. Nurses do have to look at their vitals. Of course, since the CNA sees the vitals first, it is good to report them if something is off, but we're all human and we can get busy and forget. But ultimately it is the nurses' responsibility to look and keep track of the patient's status and act appropriately. I have seen some nurses over the years attempt to blame techs for not telling them about vitals that were off.  And I want to ask them, "Did you check? We're also very busy, but looking over your vitals takes all of 1 minute. You're not supposed to assume everything is okay just because you don't hear about it". But I digress. Of course if you see something off, you should report it, as I'm sure you do, but all nurses should cast an eye over their vitals. We are never absolved of that responsibility. 

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Nurse SMS said:

The problem with this is that those can get lost, they don't represent anything in terms of protecting you should you be dinged for failing to report and, most of all, the patient themselves are at risk without closed loop communication.

I really discourage you from reporting on normals, especially in this fashion, simply because it will then become like alarm fatigue. If the sticky notes contain normal information 9 times out of 10, the nurse will not prioritize them, and understandably so. 

It won't get lost. Especially if I'm waiting to chart after their approval ?

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athey1999 said:

Dear Kirsten Creator, 

I am an RN and you are absolutely correct. Nurses do have to look at their vitals. Of course, since the CNA sees the vitals first, it is good to report them if something is off, but we're all human and we can get busy and forget. But ultimately it is the nurses' responsibility to look and keep track of the patient's status and act appropriately. I have seen some nurses over the years attempt to blame techs for not telling them about vitals that were off.  And I want to ask them, "Did you check? We're also very busy, but looking over your vitals takes all of 1 minute. You're not supposed to assume everything is okay just because you don't hear about it". But I digress. Of course if you see something off, you should report it, as I'm sure you do, but all nurses should cast an eye over their vitals. We are never absolved of that responsibility. 

That's all I was saying.. I forgot after I couldn't find her. I felt horrible. This won't happen again and I will make sure of it.

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