Did I do the right thing?

GeminiTwinRN, BSN · Jul 14, 2008

Did she tell the other aide that the pt was dirty and needed to be cleaned up before she left? IMO, if she did, then she acted appropriately. Of course she could have done the BEST thing for the pt, which would have been to clean up the pt herself and then go to lunch, but the next best thing was to pass the info along and then go to break.

Like you said, everyone is entitled to their break. If we always do the next thing that needs to be done, none of us would ever go on break. I am my own worst enemy in that regard. I rarely sit down and take a lunch break because I hate the thought of my pt's needing me and knowing that my co-workers are so busy that my pt may in fact have to wait until I'm back before their needs are met. It's a darned if you do, darned if you don't situation I think.

To me, outright refusing to do something asked of her by a superior is totally different than explaining to a pt that she is off to break and therefore unable to do a task. She should explain to the pt that she is going to break but will have someone else come in and change her.

RN1989 · Jul 14, 2008

I say you did the right thing. That is as bad as the nurses who walk out of a pt's room to find an aide to put that pt on the bedpan. I wouldn't have tolerated that CNA as long as you did. You have a lot more patience that I do!

jadu1106 · Jul 14, 2008

i have something weighing heavily on me and wonder if i did the right thing. i filled out a formal complaint on a cna last night. there have been issues with this cna (insubordination and not doing tasks that were assigned to her.) last night i got fed up with her for several reasons, but what made me fill out the complaint was that a patient told me she asked this aide to change her because she was dirty and the aide told her she was on her way to lunch and left the hall. this is not the first time it has been reported to me that she has refused a task because she was on her way to lunch.
i helped one of the other aides put her to bed and she was indeed dirty.
i've always understood knowingly leaving a patient who has requested your help is a no-no. i know people are entitled to a lunch break but i feel certain what she did was very wrong. i am afraid she may be fired over this yet i don't feel i could just let this go. her behavior has caused a lot of disharmony on the hall and while she has been counseled on this several times before in the don's office it hasn't helped a lot.

:icon_hug:

i think you did the right thing and i hope that cna gets the full punishment. she is there for the patient and she should not say no just to go to lunch "on time"....she could have gone to eat after she helped the patient get dry and cleaned up...that is ridiculous. i commend you for writing a formal complaint on her. :) :up:

leslie :-D · Jul 14, 2008

if she was really on her way to lunch, i'm hoping she reported off to the nurse and passed the message along about pt needing to be changed.

i don't think it always goes over well if a cna delegates to another cna.

it really should come from the nurse.

but based on this incident alone?

no, i would not have written her up.

she has a right to take her lunch.

and if she didn't report off to the nurse, i would consider giving her a verbal warning.

it's all about continuity of care and effective communication.

leslie

BradleyRN · Jul 14, 2008

As you stated, this is not the first problem this CNA has caused, but one of many. Writing her up will hopefully encourage her to make a few changes to be more harmonious. At the first sign of insubordination, i would write her up again to show her that the discipline she received was not just a flash in the pan. If she cant work without causing trouble, then she shouldnt be there. :wink2:

lpnstudentin2010, LPN · Jul 14, 2008

If a CNA, nurse, or anyone, said that to me when I was in the hospital, I would be upset. I understand if you are busy and I need to wait a period of time but, sorry i need to go eat. I understand it is uncomfortable to be hungry, but it is also uncomfortable to sit in your own poop hoping someone will come clean you up.

TLCinCICU · Jul 14, 2008

I'm a fairly firm believer in "What you do comes back to you". If this CNA didn't report off to someone else who could follow through promptly on cleaning up the patient, she did the patient harm (although not on a grand scale). So harm comes back to her. In writing her up and bringing the incident to the attention of her superiors, you are just an agent of karma in that the results of her own unkindness coming back to her. You should be guilt-free in your own mind because you did not make up the occurrence nor did you act out of spite. Your own, very-appropriate conscience stirred you to action. The CNA needs to develop a conscience like yours.

leslie :-D · Jul 14, 2008

If this CNA didn't report off to someone else who could follow through promptly on cleaning up the patient, she did the patient harm (although not on a grand scale). So harm comes back to her. In writing her up and bringing the incident to the attention of her superiors, you are just an agent of karma in that the results of her own unkindness coming back to her. You should be guilt-free in your own mind because you did not make up the occurrence nor did you act out of spite. Your own, very-appropriate conscience stirred you to action. The CNA needs to develop a conscience like yours.

the point of emphasis here, is if she didn't report off to someone else, namely, the nurse.

and just because she has a shaky background, doesn't give anyone the right to write someone up based on past performances.

any write-ups should be focused on the here and now.

if she wasn't written up in the past, you just can't think, "well, she overall sucks so she deserves this".

and unless there is direct harm to the pt, you can't write someone up based on attributes not clearly defined in the p&p, such as "i'm going to lunch".

however, if she did go to lunch w/o notifying the nurse of pt needing to be changed, i agree, that is worthy of a write up...

since that would be a clear case of negligence.

what if she did tell another cna about this pt?

that cna could perceivably think, "i don't have to take orders from you".

that's why it's important to directly report to someone who does have the authority to delegate needed tasks.

as for karma, it is questionable to act as "agents" in this supernatural sequelae.

karma is supposed to act on its own accord, w/o any tangible involvement.

leslie

pagandeva2000, LPN · Jul 14, 2008

the point of emphasis here, is if she didn't report off to someone else, namely, the nurse.
and just because she has a shaky background, doesn't give anyone the right to write someone up based on past performances.
any write-ups should be focused on the here and now.
if she wasn't written up in the past, you just can't think, "well, she overall sucks so she deserves this".
and unless there is direct harm to the pt, you can't write someone up based on attributes not clearly defined in the p&p, such as "i'm going to lunch".
however, if she did go to lunch w/o notifying the nurse of pt needing to be changed, i agree, that is worthy of a write up...
since that would be a clear case of negligence.
what if she did tell another cna about this pt?
that cna could perceivably think, "i don't have to take orders from you".
that's why it's important to directly report to someone who does have the authority to delegate needed tasks.
as for karma, it is questionable to act as "agents" in this supernatural sequelae.
karma is supposed to act on its own accord, w/o any tangible involvement.
leslie

I agree with you. The CNAs that are unable to complete a task should report it to the nurse so that appropriate delegation is made. Many times, depending on the personality of the person that ranks equally to myself, I question it because it could be that this person is just trying to shuck their unwanted duties onto me and that doesn't fly well (this has happened to me often in the past).

I have seen many of the OPs posts, and trust her judgement that this is a neglectful and uncooperative CNA; it is just that we have to cover ourselves in order to protect from being accused of picking on someone.

Quidam · Jul 14, 2008

I think you absolutely did the right thing. Esepcially in light of the fact that she had repeatedly been counseled. People have to be held accountable for their actions or refusal to act. There were ways she could have handled this. Otherwise we will be in a world employed by people who will feel free not to do their jobs simply because they can suck up the paycheck and not do the work. That mentality is far too prevalent as it is.

My first semester clinical rotation began with an RN leaving a woman lying in her own excrement for well over an hour while the husband repeatedly asked me if I could get her changed. The nurse and I were in the room when the patient soiled herself. I told the nurse I would find a PCT and help get the lady cleaned up. I was told the PCTs were too busy at the time...then I offered to get another student and we would get the patient cleaned up. Again the nurse told me no...leave her. We will get it done in just a short while. So I told the husband I would be back very soon. Twice more I asked the nurse if I could get the lady cleaned up and was told no again and again. After about 90 minutes and the husband asking again and again and offering to help do it himself...I finally decided to just do it. It was my first day and I did not know where anything was and had never done this type thing myself...but I was MAD!! So I went to the front desk, told the nurese there that this patient had been lying in her own excrement for more than an hour and I needed to get her cleaned up. She called a PCT who brought all the supplies and we got the lady cleaned up. Ended up taking me, the PCT and the husband to get the job done due to circumstances. Later I saw the nurse in the hall and she asked me if I had been with Mrs. M. Yes...and she is all clean and fresh now. I avoided this nurse the rest of my shift and learned a valuable lesson that first day...what kind of nurse I do not want to be.

There was NO excuse for allowing this lady to stay that way. Later I told my instructor about it and told her I had not followed the nurses instructions to me. She said great...and next time something like this happens...call me...I'll help you. She earned a lot of my respect that day.

SuesquatchRN, BSN, RN · Jul 14, 2008

The aide didn't report off to anhyone. The patient did.

Write her up.