Now, all of us since we read forum boards know better than this (I HOPE!), but I have a little story from my time of working agency as a CNA back when agency was a going thing and a valid way to get work as a CNA.
One CNA I knew was a 5 year veteran of a local area hospital. After years of working the floor on a med surg unit in a hospital, she finally got a decent raise and moved to a prestigous ICU unit. Now, compared to the hustle and bustle of med surg, ICU is much more cilled out at this particular facility. All the nurses are much calmer because they have at most 2 patients. The workload is also much lighter on the CNA as all she had to do was assist the RN with baths, take vitals, and of course poo and pee removal.
One day, the CNA went on her rounds to take vitals. After she was through, she turned in her vitals sheet to all the RNs. As she turned it in, one of the nurses turned to her with a puzzled look. "You got vitals on Mr. J. Mr. J has been dead for 3 hours and they are waiting on the funeral home to pick up his body!".
Needless to say, tha CNA got fired. Probably because there where other issues I did not know about helped. But still, this is a pretty dangerous thing. I think the patient would want someone to know if his pulse rate was 150 resting. Last i heard of our CNA who made up vitals, she had to work for a nursing home well known in that area for being not too good of a place because she was blackballed in that town from working other hospitals.
Anyone else have any stories of gross incompetence like that?
In the last hospital I worked in I was trained on the job for tech work, with no previous experience. On my first day I asked what RR meant on the vs sheet and was told to "just write down 20". Yeah. I know for a fact some CNA's make up vitals, and weights as well.
Once on a hall I was on I noticed the shift before me did vitals on 3 pt's that were in the hospital and had been for two days and the thing is they only did vitals so never caught on to the fact they weren't even there. When I said something to charge nurse she said yeah they make up vs all the time :0
In the last hospital I worked in I was trained on the job for tech work, with no previous experience. One my first day I asked what RR meant on the vs sheet and was told to "just write down 20". Yeah. I know for a fact some CNA's make up vitals, and weights as well.
My point exactly. The nurse will have to deal will any unfortunate outcomes (in your case a potential respiratory arrest because the CNAs weren't even taking the vital sign) so why not just do the vital signs for yourself? They are you patients.
Also I'm confused, in the US you guys do "head to toe assessments" aren't vital signs involved in that assessment? ?
I didn't read all the responses here, but wanted to say that at my present facility, CNA's are not allowed to take blood sugars or do pulse oximetry checks. That always kinda irked me, but after reading this, I would rather just keep doing my own!
Specializes in PACU, LTC, Med-Surg, Telemetry, Psych.
In the last hospital I worked in I was trained on the job for tech work, with no previous experience. On my first day I asked what RR meant on the vs sheet and was told to "just write down 20". Yeah. I know for a fact some CNA's make up vitals, and weights as well.
Now, I will admit sometimes I do not actually wait the full minute counting respiration like the CNA textbook says on stable "with it" patients that do not have much wrong with them. Most of the time it is 20 or 22, if they are talking. BUT, I have been doing CNA so long, I pretty much can tell and have even gone back occasionally "the right way" to make sure I am correct in my observations. Even RNs do it like that if they are very experienced. However, if the patient is huffing and puffing or I can barely see a chest move, you bet my cheap walmart stopwatch is coming out.
But even then, she should nor have just told you to write 20, though. You still need to look at the chest going up and down. What if you went in the room and a patient was breathing at 8 or 10 because they were way overmedicated and you wrote 20. Or worse, sliding into some diabetic coma! I have saved people's lives by counting or at least saved them from huge inconveniences. Even as a CNA.
The making up of weights, I have seen. Usually it is because they either have a bed weight that does not work and the CNAs loath waking someone out of bed at 5 am when hospitals want these QD weights. Or worse, patient is a 300 lb whopper that is totally bedboud and you have to bring out 2 CNAs and hoyer lift and all! But, even on the bed weights where you press one button, you have to be careful. If one CNA does not remove all those thick blankets and heavy pillows and another does, a good reading is not going to happen. I also have a special place of hatred for EMTs that dump people off in the bed and leave without zeroing out the bed or nurses that are not in there when a new patient comes to make sure that bed is zeroed out!
Without reading 35 posts already, if you poke around on allnurses.com enough, you may find examples of such, ah, activity, attributed to RNs even, not just CNAs. Seems I've seen it referred to as pre-charting. Of course, this is all hearsay--or maybe even less than that--from any legal standpoint.
If you are re-checking the vitals/blood sugars yourselves, then why delegate it to a CNA unless you have reason to believe they are not doing it right the first time?
I work in a LTC facility as a CNA. We are not responsible for vitals. However, we are able to take vitals as it is within the scope of practice--usually it's only done if a nurse asks, but sometimes I will take a radial pulse on a resident who complains of some ailment (like a racing heart) after I notify a nurse. I do this mainly because it makes some residents feel better that someone is paying immediate attention to the problem, and sometimes it really helps for a nurse to have a number to compare to.
I know some people at my facility will do more with tube feedings than we, as CNAs, are allowed. I help one gentleman on a TF machine all the time. He is basically independent in his room, but when I help him, I am allowed to unplug the machine from the wall to assist him to the restroom or the sink or to ambulate, and to unclip the safety pin on his shirt when doing cares. Nothing else. I cannot disconnect the tubes, start a new feed, touch any buttons, etc. But I know people who will freely do whatever they please, and I've reported it several times to my nurse. It's extremely dangerous. Period.
I do think it is not just CNA's that engage in this false documentation.
Example: RN charts an entire admission assessment on patient that hasn't arrived on unit. A little later, oops, the patient doesn't end up on that unit due to bed change.
I can't imagine why anyone would put their name on a chart and take responsibility for a patient that isn't physically in front of them, but it happens.
One night on an ER shift it was kinda slow and the ER director was looking through charts of the patients in the ER and I happened to be sitting next to him. I heard him say "why does every damn ER patient have a RR of 20. Thats not even normal."
I had noticed when I was being oriented that if the pt looked warm, pink and dry the triage nurses would just put 99% O2 and 20 for resps. You can bet your bippy that after hearing the ER medical director say that, I CAREFULLY counted resps on every pt, discovering that 20 is actually a little high for most people.
I now work in an ICU and it is a running joke throughout our little hospital that 2 of the night nurses who have been there about 15 years each can tell a patients temperature through a closed door.
I so don't want to be the nurse that everyone is making fun of for doing a bad job.
I had a clinic visit once where the med assistant took my bp n I caught what she wrote down. It was 190/80. She quickly ran out th ed door. When the dr came in I asked bout the bp to find out the the med assistant never informed her and we found that I was 110/70. I cant believe the one girl was going to say nothing! It was an ob clinic btw
I learned to take my own vitals very early on in my career. My first job was LTC night shift, I was freshly off my 3 day orientation and I was told that CNAs take care of vitals. So at my partner was sleeping( she worked day shift at a mental hospital across the street). I took it upon my self to look at the vitals. I saw that one CNA had everyone's temp down for 98.5. I dont know how they where taking vitals we had NO Manual machines nor did I see any personal equipment. Also I notice a BP of 201/40 and resp of 56. None of this was brought to my attention. I awaken my partner she said honey just right something down everyone is fine, she said I make up my own too if I don't like what the CNAs wrote down . Needless to say I say that not only CNAs made up vitals but the LPNs also made up vitals and blood sugars. I had a family member to ask me to take his mom's blood sugar because we couldn't find that patient's nurse, and she had not charted her 11:30am blood sugars and it was 2 pm. I was just pricking the patient's finger and the nurse suddenly appeared and stated it was 67 at 30 minutes ago. I received a reading of about 487.
. Needless to say I say that not only CNAs made up vitals but the LPNs also made up vitals and blood sugars. I had a family member to ask me to take his mom's blood sugar because we couldn't find that patient's nurse, and she had not charted her 11:30am blood sugars and it was 2 pm. I was just pricking the patient's finger and the nurse suddenly appeared and stated it was 67 at 30 minutes ago. I received a reading of about 487.
On_the_on, BSN
80 Posts
In the last hospital I worked in I was trained on the job for tech work, with no previous experience. On my first day I asked what RR meant on the vs sheet and was told to "just write down 20". Yeah. I know for a fact some CNA's make up vitals, and weights as well.