Then a co-worker says, "Don't give her a drink! It'll maker her have to go to the bathroom!"
I do not like to argue. I feel like slapping that girl who is giving me orders when she is not a charge nurse and she doesn't have a licsense.
On one occasion, the girl ordering me around and demanding that I abuse and neglect an elderly patient was so popular on the floor that no one would listen to me, ie, "I'm sorry J... but we can't use you...."
I didn't think this joke made by the charge nurse was funny!! I finally did report this girl's attitude to the administrator who just listened and made no comment.
The second time someone said, "Don't give her a drink," after a patient asked for one I had been doing patient care for about ten years and I walked up to the charge nurse and asked, "What's the situation with this
patient....." when I knew quite well there wasn't one. Then I reported the CNA ordering me to be abusive. The charge nurse was on top of her in no time.
Unless they have a fluid restriction this is patient neglect and emotional abuse. It is also abusive to staff members who have feelings for these patients and who are stressed out when they are not permitted to give them good care.
I agree - the possibility of being overheard is one of the reasons that this comment isn't ideal behaviour. But I think it's still a lesser evil than actually withholding the water (which this girl might also be doing, but we don't know that).
Threatening abuse is considered assault, and is just as illegal as actual battery. Don't know that there is a distinct term for threatening neglect, but if the statement was made in an area that it could be heard by the resident involved or any other resident or family member, I would definitely be worried.
Yes, nurses do say things sometimes to let off steam in a high stress job, but we need to be aware of who we say those things to and where we say them.
Anyone want to start a running list of all possible complications of dehydration in the elderly? It's gonna be a loooong list. Already mentioned: heat stroke, migraines, DVT, UTI.... I'll add acute renal failure and hypovolemic shock. who's got more (there are tons...)?
Call me evil...but I would be tempted to push fluids on that woman the whole shift! it is cruel and abusive to hold fluids from somebody who wants to drink. I know that people are busy and don't have time to toilet people sometimes, but would they want fluids held from them?
Anyone want to start a running list of all possible complications of dehydration in the elderly? It's gonna be a loooong list. Already mentioned: heat stroke, migraines, DVT, UTI.... I'll add acute renal failure and hypovolemic shock. who's got more (there are tons...)?
I'll add constipation secondary to poor fluid, lethargy...
I'll add constipation secondary to poor fluid, lethargy...
Then the next thing is she'll want the nurse to hold the MOM or Dulcolax so that the patient won't have a bm; the cycle just continues. And yes I've had a resident tell me that a certain CNA doesn't want her to have MOM at night. I mean really, how would she like to be "stopped up"??????
Then the next thing is she'll want the nurse to hold the MOM or Dulcolax so that the patient won't have a bm; the cycle just continues. And yes I've had a resident tell me that a certain CNA doesn't want her to have MOM at night. I mean really, how would she like to be "stopped up"??????
Seriously? A CNA said that to a resident? Wow. I am a CNA, and I would NEVER discuss medications with a resident or patient. Anything they ask about meds, I get the RN to go to speak to them. I would never just say to a person 'I don't want you to take the MOM' or whatever. That is way inappropriate! Maybe that CNA should be told that overflow faeces tend to go on and on leaking, whilst a good BM is just change and move on
The girl who said this to me was a CNA of five years on the Long Term Care Unit and she was popular with the charge nurses and had an overinflated ego and knew how to be charming when she wanted to be.
In this case, we all had seven patients and all the long-time staff members were feeling at ease with their work load. I think this CNA was just trying to have her way with me and with the lady asking for a drink.
correct me if i'm wrong, but it sounds like this took place in a ltc facility, and it was a cna who was doing this, yes?
if so, i have worked with cna's such as this, at my very brief stint in ltc.
and while it is totally abuse and neglect, a cna had a meltdown after i had observed and written her up r/t a similar incident.
while she conceded how wrong she had been, it was the pressure of having 10 residents on her assignment, with 70% of them being total care.
knowing that many of these residents are on polypharmacy with many having anticholinergic components, these folks are always complaining of thirst.
for a resident to continually have to be assisted w/toileting, cuts into the cna's time w/other residents, who are time-consuming.
i'm telling you, i don't know how these aides do it, and still be expected to deliver superior care.
anyways, i told that i heard everything she said, and would take it into consideration.
that day, i conferred w/the DON.
by the end of the week, additional help had come on, and the assignments were reduced to a more manageable 5-7 (on days).
now i realize that most facilities only care about the bottom line, and whatever the reasons are, it still is abuse/neglect.
and, i have also dealt w/cna's who just didn't give a crap.
they were just insensitive, cold-hearted people.
a nurse needs to differentiate betw those who are totally frazzled, versus those who are lazy and indifferent.
i happened to know this cna, and was incredibly disappointed to have observed what i did.
2- way communication can often produce further insight into any given situation, and sometimes, there is even a solution.:)
my point being, is not everything is as it seems.
and hopefully you can go to the adon or don with your concerns, and something will be done.
Specializes in Psych/CD/Medical/Emp Hlth/Staff ED.
So we all agree that we shouldn't withhold water from a patient to avoid them having to pee, but are we also saying that it is acceptable to refuse water to a patient on a fluid restriction who is capable of making their own medical decisions?
So we all agree that we shouldn't withhold water from a patient to avoid them having to pee, but are we also saying that it is acceptable to refuse water to a patient on a fluid restriction who is capable of making their own medical decisions?
Of course any competent patient is at free will to refuse medical care or treatment if they desire. I would hope someone on fluid restriction d/t renal failure would know enough about their condition and the consequences of fluid overload to not drink more than they are alloted. I worked very briefly in hemodialysis and have seen first hand the effects of fluid overload (extreme SOB and nausea/vomiting); also try pulling fluid off of someone who has gained 10-15 lbs of fluid in just two days without causing cramps and hypotension.
That being said, the renal/hemodialysis residents where I work generally are able to manage their fluids wisely and we don't leave a pitcher of water or any beverages at their bedsides.
HealthShepherd
183 Posts
I agree - the possibility of being overheard is one of the reasons that this comment isn't ideal behaviour. But I think it's still a lesser evil than actually withholding the water (which this girl might also be doing, but we don't know that).