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. 

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

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

Out of fairness to you, I finally had a chance to read through all of your responses.

I would think that even with a base level of education, you would understand the significance of a pulse ox of 80%, but clearly that is not the case. 

You don't get it.  You won't get it.  You refuse to acknowledge the actual problem here, and your solution does not fix it.

Someday, you may end up going through nursing school and then you will understand the big picture.  At that point, I hope that you are embarrassed about the things that occurred as you described and the responses you have given to experienced nurses who are trying to help you.

 

Sticky notes?  I just can't even fathom what a ridiculous "solution" this is.

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Specializes in CEN, Firefighter/Paramedic.
FolksBtrippin said:

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.

 

There is a name for this - normalization of deviance.  Look up the Mike Mullane talk about it on YouTube, fantastic and haunting revelation on how the space shuttle challenger crash occurred.

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Specializes in Peds.

I trust and rely on CNAs heavily and I have worked with some amazing CNAs.  As the RN, you know that your trust worthy CNA will do the right thing and notify you when something is off.  A CNA is an RNs first line person.  That RN may have not seen the vitals until it was time to see her patient for meds or otherwise and that is when it was noted.  It would have worried me too.  She may have approached you harshly but remember that having an RN that trusts you with her patients is a huge deal and we respect our CNAs greatly.  

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You did your job. You took vital signs and recorded them. The nurse is mad that it was not  flagged sooner. That is not your responsibility. If only we had computer technology that let nurses know of vitals out of range... I heard it exists. Move on. If the facility actually gave a crap, this wouldn't even be a question. It's not your job to assess what to tell the nurse.

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Btw, these people saying "you should know better,” they are either full of it or completely ignorant. Again, you did your job. I have had COPD patients that stay in the 70s. It's up to me as the RN to review the vitals taken, don't let anyone tell you different 

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grnfld86 said:

You did your job. You took vital signs and recorded them. The nurse is mad that it was not  flagged sooner. That is not your responsibility. If only we had computer technology that let nurses know of vitals out of range... I heard it exists. Move on. If the facility actually gave a crap, this wouldn't even be a question. It's not your job to assess what to tell the nurse.

Thank you and I appreciate you for your honesty. Like I've mentioned before I always bring abnormal vitals back to the nurses, but that particular one I forgot. Dang it I got busy, but felt horrible about it because of course thats the reason I took on the job because I care about people. She should have known it was an honest mistake on my part. I have moved on from it. Once again thank you ?

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Kirsten Creator said:

Thank you and I appreciate you for your honesty. Like I've mentioned before I always bring abnormal vitals back to the nurses, but that particular one I forgot. Dang it I got busy, but felt horrible about it because of course thats the reason I took on the job because I care about people. She should have known it was an honest mistake on my part. I have moved on from it. Once again thank you ?

You are human. You got busy doing an incredibly busy job and forgot something. All the back and forth aside, this one comment here from you should have been the end of this. You made a mistake. We all make them (if we are willing to be honest). Own it, apologize for it and tomorrow is a new day to learn from it and do better going forward.

You knew the abnormal vital sign was very significant and needed to be reported to an RN ASAP. Please don't start with stick notes. They are a waste of time and easily lost. Chart all vitals immediately. You don't the nurses approval, vitals are facts, they are what they are. It was wrong that the RN was rude to you, but in the heat of the moment lots of people loose control of their mouth. I've had more than one CRNA, Doctor, Tech or fellow RN come to me at the end of a shift and apologize to me for how they spoke to me in the heat of the moment. 

Just remember they are human too. We are all trying our best to care for our patients in overwhelming circumstances. We don't need the added stress of all this us and them nonsense between RN's and CNA's. We are all on the same team.

Best of luck for a great next shift!  

 

 

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kp2016 said:

You are human. You got busy doing an incredibly busy job and forgot something. All the back and forth aside, this one comment here from you should have been the end of this. You made a mistake. We all make them (if we are willing to be honest). Own it, apologize for it and tomorrow is a new day to learn from it and do better going forward.

You knew the abnormal vital sign was very significant and needed to be reported to an RN ASAP. Please don't start with stick notes. They are a waste of time and easily lost. Chart all vitals immediately. You don't the nurses approval, vitals are facts, they are what they are. It was wrong that the RN was rude to you, but in the heat of the moment lots of people loose control of their mouth. I've had more than one CRNA, Doctor, Tech or fellow RN come to me at the end of a shift and apologize to me for how they spoke to me in the heat of the moment. 

Just remember they are human too. We are all trying our best to care for our patients in overwhelming circumstances. We don't need the added stress of all this us and them nonsense between RN's and CNA's. We are all on the same team.

Best of luck for a great next shift!  

 

 

Amen to that!

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I hate to be mean about this but I think you need to hear this. 

If a patient's oxygen saturation is in the 80s, you need to GET HELP IMMEDIATELY. If you cannot find the primary nurse in person or over the phone, you need to tell the charge nurse IMMEDIATELY. The patient might need a rapid response. This isn't a "Oh the osat is 92 I'll tell the nurse soon" type of deal. 

Regardless of whether or not someone should be checking your charting, you need to escalate potential emergencies to SOMEONE. If you can't find the primary nurse or the charge, find another nurse on the unit and tell them about the vital sign, that you can't find the nurse or charge, and you need immediate help. 

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Barriss Offee said:

I hate to be mean about this but I think you need to hear this. 

If a patient's oxygen saturation is in the 80s, you need to GET HELP IMMEDIATELY. If you cannot find the primary nurse in person or over the phone, you need to tell the charge nurse IMMEDIATELY. The patient might need a rapid response. This isn't a "Oh the osat is 92 I'll tell the nurse soon" type of deal. 

Regardless of whether or not someone should be checking your charting, you need to escalate potential emergencies to SOMEONE. If you can't find the primary nurse or the charge, find another nurse on the unit and tell them about the vital sign, that you can't find the nurse or charge, and you need immediate help. 

I read the first sentence, but didn't read the rest. We are done here.. Have a great day

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Specializes in CEN, Firefighter/Paramedic.
kp2016 said:

We don't need the added stress of all this us and them nonsense between RN's and CNA's. We are all on the same team.

 

Just to clarify, my comments have nothing to do with RN vs CNA, it's about a lack of recognition of a critical finding.  This would be no different than the OP finding a patient on the floor from an unwitnessed fall but neglecting to tell anyone because they couldn't immediately find the primary RN and they had other things to do.

Someone mentioned that COPD patients live in the 70s as if this were a justification for not being concerned here, but this was obvious not the case with the patient based on the response from the RN's response once they found out.

Yes I'm being harsh, but this was a critical event that could have lead to a significant patient outcome.  Those of you placating this "it's not really your fault" attitude are contributing to the potential for future similar events occurring.

TL:Dr - bathing the patient in room 4 is NOT more important than addressing the profound hypoxia in room 3.

 

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FiremedicMike said:

Just to clarify, my comments have nothing to do with RN vs CNA, it's about a lack of recognition of a critical finding.  This would be no different than the OP finding a patient on the floor from an unwitnessed fall but neglecting to tell anyone because they couldn't immediately find the primary RN and they had other things to do.

Someone mentioned that COPD patients live in the 70s as if this were a justification for not being concerned here, but this was obvious not the case with the patient based on the response from the RN's response once they found out.

Yes I'm being harsh, but this was a critical event that could have lead to a significant patient outcome.  Those of you placating this "it's not really your fault" attitude are contributing to the potential for future similar events occurring.

TL:Dr - bathing the patient in room 4 is NOT more important than addressing the profound hypoxia in room 3.

 

I hope you are done after this. 

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