CNA help!

[nursesp83]

I have a question regarding CNA's and home health. We have a CNA that is constantly calling the primary nurse working multiple times a day reporting things that are not an issue. For example: unwrapping wounds and sending pictures almost daily when she has been asked to leave dressing in place until next nurse visit unless saturated. When explained to her that this is not only wasting supplies and technically wound care I get the response "you don't have to be a nurse to wrap a leg (insert eye roll)." A pt was feeling tired, all VS WNL and pt did not want to be seen by their MD. Pretty much anything down to a paper cut is being reported to primary nurse.

I try to answer at all times when CNA's call me because it could be something important, but when she calls a hundred times a day I feel it is taking time from the pt I am caring for over something that doesn't even need to be reported.

How do I tactfully tell her what requires a phone call to a nurse??? Do I make a list of things that she should call about? If so, what do I not forget to add to that list? I don't want to come across as rude or ungrateful because I know how hard CNA's work and I do appreciate what they do...but the hundred phone calls a day have to stop!

THANK YOU!

[AJJKRN]

So how much experience does the CNA have? As someone who busted their tail as a CNA for many years during nursing school, after the initial learning curve was endured, I became the nurses right hand and functioned quite independently with always keeping my spidey senses on to involve the nurse whenever anything was awry. But not for piddly things.

My point...unless the CNA is really new, I think you may be dealing with a really weird power struggle of some sort. I just can't think of any reason why the CNA would blatantly unwrap dressings unnecessary after being explicitly told not to within reason and yet do so AND text back that response after they did. Seems like somebody just being a PITA to me with the info I've read.

[InScrubs_Wyoming307]

So how much experience does the CNA have? As someone who busted their tail as a CNA for many years during nursing school, after the initial learning curve was endured, I became the nurses right hand and functioned quite independently with always keeping my spidey senses on to involve the nurse whenever anything was awry. But not for piddly things.

My point...unless the CNA is really new, I think you may be dealing with a really weird power struggle of some sort. I just can't think of any reason why the CNA would blatantly unwrap dressings unnecessary after being explicitly told not to within reason and yet do so AND text back that response after they did. Seems like somebody just being a PITA to me with the info I've read.

I couldn't have said it better! Maybe make a plan with the CNA to call you at a certain time of the day to report all of her concerns unless she has a legit emergency.

[JKL33]

This should be reported to her direct report. Come on; she just can't go into people's homes and do whatever she wants.

[Nurse SMS, MSN, RN]

It isn't your job to train a CNA on how to be a CNA. Theoretically they got that training prior to being hired. If that isn't the case, then he/she should be working with a CNA preceptor and not independently. In other words, this is something that needs to be escalated. It is a patient safety issue. Why? Because she is crying wolf. It is just like alarm fatigue. Sooner or later she won't be taken seriously because of the nature of her usual "reports". Then when something serious really does happen, the patient will suffer from the pattern of behavior that made the primary nurse unwilling/unable to listen.

Escalate this. Do not make a list of what should/should not be reported. That isn't your responsibility. Her manager needs to find out what is going on here and address it. If it is a lack of knowledge, the company should provide education or hire someone else. If it is willful, then the CNA should be coached.

[crazin01]

Do other nurses have the same issue with her? If so, perhaps your company could offer a mandatory education day?

[Glycerine82, LPN]

She needs to be written up and terminated if it continues.

[nursesp83]

She has quite a few years of experience and has worked home health. I think you are right about the power struggle. It is hard because we only have two nurses and two CNA's in our area so I don't want her to feel like I am singling her out but something has to change.

[nursesp83]

Yes she does as well. I will be contacting our DON and discussing these issues.