CNA Frustrated with Being the Blame

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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. 

londonflo said:

You are dismissing someone who lived a life..probably contributed to the community which you may have benefitted from , provided taxes to fund community college nursing programs and state programs, other services that you take for granted. You were dismissing a loved one's dying (the patient was someone's mother/father/sister brother. 

It is NOT OKAY to diss someone's life as you illustrated: "LIKE" Communicated their vitals to the RN, oops they were dead when I got around to reporting them

*rolls eyes* so I guess you want to continue.

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Specializes in CEN, Firefighter/Paramedic.
Kirsten Creator said:

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.

You are steadfast in your opinion that the nurse was as much to blame if not more than you because she didn't see what you were charting.  

The flipside of this position is that you want your nurse to be in a position where they don't trust you not to tell them when something is off and always need to check your work.  You should want to be in a position where your nurse has confidence in you to alert them to critical events so that they can focus on the big picture, because that's exactly what they're trying to do.

I am used to epic, so maybe your RMS software is different, but in epic there's not an alarm that goes off that says "hey, a vital sign was very out of whack, go check it", and nurses also don't spend our time staring at vital signs and flow sheets, we're checking lab values, MARs, and notes.  Do you know what that alarm is?  The aid/tech who obtained that vital sign dropping everything to come find me.  I'm fortunate to work with techs/aids that I trust who give me that information immediately.

Lastly, there are some events that are an "all stop, we need to address immediately", and a pulse ox of 80% is one of them.  If you truly made an effort and couldn't find that nurse, find a different one, that must be addressed.

You probably don't appreciate my opinion because you don't feel I viewed your side of things, but I don't really care.  I'm not going to sugar coat this, you were wrong in this situation and I hope you learned from it and that no patient harm came from them being hypoxic.

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FiremedicMike said:

You are steadfast in your opinion that the nurse was as much to blame if not more than you because she didn't see what you were charting.  

The flipside of this position is that you want your nurse to be in a position where they don't trust you not to tell them when something is off and always need to check your work.  You should want to be in a position where your nurse has confidence in you to alert them to critical events so that they can focus on the big picture, because that's exactly what they're trying to do.

I am used to epic, so maybe your RMS software is different, but in epic there's not an alarm that goes off that says "hey, a vital sign was very out of whack, go check it", and nurses also don't spend our time staring at vital signs and flow sheets, we're checking lab values, MARs, and notes.  Do you know what that alarm is?  The aid/tech who obtained that vital sign dropping everything to come find me.  I'm fortunate to work with techs/aids that I trust who give me that information immediately.

Lastly, there are some events that are an "all stop, we need to address immediately", and a pulse ox of 80% is one of them.  If you truly made an effort and couldn't find that nurse, find a different one, that must be addressed.

You probably don't appreciate my opinion because you don't feel I viewed your side of things, but I don't really care.  I'm not going to sugar coat this, you were wrong in this situation and I hope you learned from it and that no patient harm came from them being hypoxic.

Already said I was wrong and already came up with my solution. So... yea there's that. 

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Specializes in Psychiatry, Community, Nurse Manager, hospice.
Kirsten Creator said:
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Specializes in Psychiatry, Community, Nurse Manager, hospice.

Sorry for the blank post earlier folks. I messed up on the quote feature.

Kirsten, why was the nurse upset? What was she worried about?

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FolksBtrippin said:

Sorry for the blank post earlier folks. I messed up on the quote feature.

Kirsten, why was the nurse upset? What was she worried about?

Hi! The patient had an low o2. My intention was to tell the nurse who wasn't around at the time. Well.. My foolish self forgot. She ended up seeing the vitals two hours later. My guess is though I forgot to bring it to her attention and something horrible would have happen.. like.. you know.. the D. word. The blame would have definitely been on her because it would have looked like she didn't resolve the issue. She could've lost her license or worse.. My mom was a nurse for years and explained this to me BUT she also told me she always checked her vitals. She also told me sticky notes is good as a reminder for myself and for the nurse in some instances so.. yeah. I spoke with the nurse and apologized and she did agree that she also needs to check her vitals as well. Learning experience for the both of us. We're okay now.

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Specializes in oncology.
Kirsten Creator said:

My guess is though I forgot to bring it to her attention and something horrible would have happen.. like.. you know.. the D. word.

What is the D word?

Kirsten Creator said:

My mom was a nurse for years and explained this to me BUT she also told me she always checked her vitals. She also told me sticky notes is good as a reminder for myself and for the nurse in some instances

Is Mom up to 2024 standards for the responsibilities of CNAs? Why they are certified, what their curriculum brings to the the hospital (acute care versus LTC) and your requirements??? But I getcha Moms will always support us, stand behind us, nurture us.....but if you are old enough to know the perimeters of the job, know the requirements, know your role with collecting data and the timely report of it. . 

Kirsten Creator said:

sticky notes is good as a reminder for myself and for the nurse in some instances so.

Gotta tell me those instances? 

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Specializes in Psychiatry, Community, Nurse Manager, hospice.
Kirsten Creator said:

Hi! The patient had a low o2. My intention was to tell the nurse who wasn't around at the time. Well.. My foolish self forgot. She ended up seeing the vitals two hours later. My guess is though I forgot to bring it to her attention and something horrible would have happen.. like.. you know.. the D. word. The blame would have definitely been on her because it would have looked like she didn't resolve the issue. She could've lost her license or worse.. My mom was a nurse for years and explained this to me BUT she also told me she always checked her vitals. She also told me sticky notes is good as a reminder for myself and for the nurse in some instances so.. yeah. I spoke with the nurse and apologized and she did agree that she also needs to check her vitals as well. Learning experience for the both of us. We're okay now.

Let's look at the situation without blaming anyone, including you, and including the nurse. Let's just say that what happened was no one's fault. But even though it's no one's fault, maybe there is a way to do it better next time. Is that something you would be interested in? 
 

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londonflo said:

What is the D word?

Is Mom up to 2024 standards for the responsibilities of CNAs? Why they are certified, what their curriculum brings to the the hospital (acute care versus LTC) and your requirements??? But I getcha Moms will always support us, stand behind us, nurture us.....but if you are old enough to know the perimeters of the job, know the requirements, know your role with collecting data and the timely report of it. . 

Gotta tell me those instances? 

Death, but yea now im assuming that you have read everything above otherwise you wouldn't have made it this far down. So your mind is already made up. You asked that question for what.. To ease in your critiques? That's it for you.

FolksBtrippin said:

Let's look at the situation without blaming anyone, including you, and including the nurse. Let's just say that what happened was no one's fault. But even though it's no one's fault, maybe there is a way to do it better next time. Is that something you would be interested in? 
 

I received an idea from someone in the comments. I am now implementing it into my work routine :). 

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Specializes in oncology.
Kirsten Creator said:

Death,

Reporting the vital signs Before the death of the patient or after

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Specializes in Psychiatry, Community, Nurse Manager, hospice.
Kirsten Creator said:

Death, but yea now im assuming that you have read everything above otherwise you wouldn't have made it this far down. So your mind is already made up. You asked that question for what.. To ease in your critiques? That's it for you.

I received an idea from someone in the comments. I am now implementing it into my work routine :). 

Are you talking about giving the nurse a copy of your written vitals before you put them in the computer?

I don't think that's a bad idea.

Also, it sounds like the patient was okay in the end, so no real cause for alarm. But that's exactly the situation for learning.

I feel like, in your mind, there must be some situations in which you would drop what you were doing, run and get a nurse. There must have been a reason you didn't do that this time. And I'm not saying you should have, I'm saying just knowing what those situations are is a good thing. If a person looked like they weren't breathing, you would probably run and get a nurse, right?

 

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londonflo said:

Reporting the vital signs Before the death of the patient or after

BEFORE. Are you guys not reading or???

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