aides that put your job on the line - page 4

I had an aide blurt out in front of another patient and his family that I had just given a drug that a patient was allergic to. Horrified, I felt stupid and looked in the chart to verify this. It was... Read More

  1. by   LydiaRN

    Let me share this incident with all since we are on this topic:

    Yesterday I had a patient receive a very large infusion of heparin. My NA decided that she was going to take the drip off the infusion pump since my pt had to go to echo.
    All she had to do was call me instead of taking this upon herself. I was in the midst of another crisis with a pt who a glucose of less than 50. My patient goes off to echo with this heparin drip free flowing. I saw the patient was returning so i headed towards the patient. When I saw the drip off the pump piggybacked in to the mainline empty, my heart sank to my knees. I asked if the pump was removed while at echo and patient and transporter said no. I approached my NA who said, Oh I took her off.
    Like nothing she said it. I wanted to give her a good shaking there. I clamped off the line even though the bag was dry. I called the MD, had stat pt/ptt levels drawn, vs. The levels came back ptt >200. The drip remained on hold for the remainder of the day and levels drawn q4hrs. Constant monitoring of the patient. The patient did fine. By the time I left her levels had come down and resumed as per the attending physician.

    Not to bad-mouth NA's, but some just find it a task to walk that extra step or two instead take it upon themselves to do what they think is right and it only puts pts lives at stake and one' job. The incident was dealt with.

    I was an NA before I became a nurse. I worked side by side with the very same nurses that I work with today. I knew better than to go ahead and taken it upon myself to do something that I knew could endanger a pts life and a nurses job.

    There are still good, hard-working NA's out there, and we must not let one individuals poor judgment tarnish the good ones.

    Originally posted by erezebet:
    I had an aide blurt out in front of another patient and his family that I had just given a drug that a patient was allergic to. Horrified, I felt stupid and looked in the chart to verify this. It was untrue.
    Later I asked this aide "who told you he was allergic to that med?" "Oh, no one" she replied, "he was confused last time he took it."
    This patient was always confused. And she wanted to know why I was so pissed off at her. She should know better having graduated from nursing school (she is an aid because she can't pass boards)
  2. by   neonnurse
    Originally posted by Mijourney:
    Hi posters. I agree with all your assessments regarding Butt Wipers post. It sure lit a fire under this topic. As a former aide, I can appreciate the frustrations expressed by Butt Wiper. However, as an aide, I never felt a need to overstep my boundaries regarding my role limitations or felt that I was more equipped for comprehensive coordination of patient care then the nurse. I respected the nurse and because of my attitude and caring, the nurse respected me. When I became a licensed nurse, I proceeded smoothly, because I didn't have to worry about saving face with any staff that I may have offended as an aide. As a nurse, I've had excellent collaborative relationships with some wonderful aides in my career. I applaud them. But Butt Wiper, your post indicates you have a huge chip on your shoulder for whatever reason. I'm with the poster who suggested additional education and training to become a licensed nurse.
    I agree that Butt Wiper should go back to school for more education, but screw nursing, go into law! BW would make a great sreaming lawyer!!!
  3. by   longforseaair
    We have some very good assistants on our floor and we have many who don't want to do much of anything once they finish taking vitals. It's frustrating night after night, to never see them and wonder where they are. I am not able to care for seven reasonably acute patients and fetch boxes of tissue, snacks, change tv channels, get ice for pitchers, etc. We have enough trouble keeping assistants without me getting after them. And when I have a really good night, when I feel like I have bonded with my assistant and we worked like a team, instead of me not seeing them for long periods of time all evening, they avoid taking my group on subsequent nights and complain that I made them do things. We have several high school aged assistants and I swear I think they want nothing to do but vital signs. Well, fine and good, but each time I enter a patient's room, esp. when passing meds, I'm in there umpteen minutes walking them to the bathroom, changing their bed, cleaning their floor, fixing their pillows, fixing their tv, getting purses out of closets, clothes out of closets, finding their eyeglasses, filling their pitchers, etc. I don't want it to sound like I don't appreciate this side of nursing care, but it gets old when you have acute patients, I get ragged. It's impossible to pass meds, esp. a lot of IVP's and IV's that go bad on you, in the time allotted if you have to spend so much time in each patient's room. I find myself watching for the assistants as I fetch meds and they are nowhere to be seen. I had to warn them to let me know when they go for breaks. Then after they have gone home, they can only work so many hours a night- child labor laws, I discover that they didn't record some vitals, or didn't empty some foleys, etc., or the trash cans are all full. If they have to clean up two patients a shift they get all stressed out. It's difficult because I like them as people, but they are so extremely inefficient. They can walk into a room and do one minor thing and not notice that the patient has thrown off their O2 tubing, has a full urinal on the bedside table, thrown their tissues on the floor, their pitcher is empty, and they are way down in their bed. Then, when I have ten pills for them to take and get tap water from the room because their water pitcher is bone dry, the patient invariably says, oh no, honey, I can't drink that water and would you get me some ice?
    Then, after all the fetching, I make it back to the nurse's station and think I'll get some charting done and there is a patient's husband glaring at me because the doctor told his wife half an hour ago that he was sending her home and I hadn't seen the orders yet. They need an ordered med list from pharmacy, our unit secretary has to call and schedule two tests and two follow-up appointments, and there is discharge teaching to be done. Well, the patient and husband are fuming because they expectrd to leave as soon as the doctor leaves their room. Meanwhile, they see me getting a patient a pitcher of ice. They will be mad until they leave, no matter what I say, and they will forget all the good care they received while they were there and had CP night after night and all kinds of drips. All they will remember is the night they had to wait to go home, while other patients were demanding ice water or having CP.
    The public needs a lot of education. And what is the thanks that the nurse gets because of bravery in the line of duty? Now, I'm laughing because of my melodramatics. I love being a nurse. That is what the public needs to hear, I guess. Because it's true that I do, but there are definately some changes that need to be made.
  4. by   Spellbound
    I was a CNA in Oregon for 5 years and psychology and worked in LTC, home health, and adult foster care before moving to Indiana a year and a half ago and I just started school for nursing. In Oregon, CNA's are not allowed to even give a patient an aspirin or cough syrup, not even if a nurse hands it to them and says give this to so and so, unless you are in a home setting such as home care or foster care. Butt Wiper really pissed me off, and I just wanted nurses to know that I worked with a lot of aides like this as an aide and hated it as much as the nurses did. Yes there are good aides, I think I was one and my patients and their families agreed with me. But there are bad aides and bad nurses out there too. No aides should not make as much as a nurse, they don't have to have the education that nurses do and the responsibilities are much greater. However, like nurses, aides are paid far too little esp. in LTC facilities. In Oregon I could have made more money working at McDonald's than I made as an aide, but I chose the profession because I like to care for people.
    Anyway, I just had to say that butt wiper is just that, and that is all he/she will ever be even if by some evil plot he/she does acqire a degree.
    It takes alot more than a degree to be a nurse, it takes a heart, and a love of people, and that is not evident in buttwiper's comments.
  5. by   mustangsheba
    Well, I am from Oregon, too, and all I could think of while reading this was SCOPE OF PRACTICE. I'm fairly sure it must be the same in most states, correct me if I'm wrong. We do not do tasks that are not outlined in our nurse's practice act. It doesn't matter how much you know or think you know, it's moot because unless you are licensed or certified, you just don't do it. I won't be redundant and repeat all of the other appropriate comments already made so well.
  6. by   susanmary
    As many of the nurses have already mentioned, both nurses and nurses aides need to practice WITHIN OUR SCOPE OF PRACTICE. Nurses should not delegate tasks that are inappropriate and that the nurses aide has not been trained to do. Likewise, if an aide messed with my heparin drip (as mentioned in a different post) -- I'd speak with him/her, fill out an incident report, and speak with my manager. I work with some nurses aides with all different kinds of work ethic, but I am supportive of them all and clear with expectations -- the patient comes first & teamwork matters. When Buttwiper wrote "aides seem to know more than nurses" his/her ignorance clearly showed. Ditto with his/her comment about "most....nurses don't seem to give a crap about patients." Where did this anger and hostility come from? No way would I want Buttwiper taking care of my patients or any of my loved ones. Lordy, Lordy! True, nurses aides and nurses are overworked, underpaid -- but I believe that most truly care about their patients. Teamwork is essential -- it's challenging for aides to do the insurmountable -- so much to do for so many patients. Ditto for nurses. Nurses tend to see the "big picture" -- look at patients and their care holistically; we constantly use our critical thinking skills. I make it a point to help orient/validate some new nurses aides and nurses to my unit. I'm clear that teamwork is essential. However, I believe that nursing is a profession (will probably get diverse posts on this line) -- we're held to a higher standard, must keep current on our education, etc.
    Kudos to the great nurses and nurses aides out there!!!!
  7. by   ktwlpn
    Originally posted by erezebet:
    I had an aide blurt out in front of another patient and his family that I had just given a drug that a patient was allergic to. Horrified, I felt stupid and looked in the chart to verify this. It was untrue.
    Later I asked this aide "who told you he was allergic to that med?" "Oh, no one" she replied, "he was confused last time he took it."
    This patient was always confused. And she wanted to know why I was so pissed off at her. She should know better having graduated from nursing school (she is an aid because she can't pass boards)
    And what has happened to the work ethic? Respect for authority? Administrations that enforce disciplinary actions?I have been at my present facility for about 6 months..Have never had my nursing judgement and skills called in to question in my entire career.Not in acute or long term care and not by a co-worker,physician, pt or family member.The techs I am working with now question me at every turn.***** and complain every time I ask them to do something.I have stood in a residents room while a particular tech told our on staff nurse practicioner"this lady has been acting funny for days"while the resident was in a crisis.I am charge nurse in a dementia unit-most of my residents are no codes and many are "no hospital transfer" per family request.My job is to carry out the wishes of the residents and the families..The techs can't seem to accept the inevitable-we have recently lost several longtime residents.So they seem to want to blame someone...
    I just this minute realized that this could be part of the problem-I am not as attached to these residents-I have had a lot of losses of my own in life.I look at an 80 yr old on the way out and rejoice that the family had so much time together.All of our attitudes are influenced by our lifes journey. But man-Am I on a rough trip right now.I just dread going to work every morning-and hope it gets better...
  8. by   el
    John boy, you are way too funny!!!! Making light of the fact that Buttwiper's attitude is one that is extremely prevalent and is the exact attitude that is ruining healthcare today gave be a well needed belly laugh.
    I was forming my ideas reading through the posts and thinking that we as RN's need to cultivate a team work attitude, respect our aide's for their work, and accept their level of education and training and work with that.
    However, I am overwhelmed with a screw that attitude. Aide's can't do our work. I am sorry, but you can't. You can't even know what we do. If you were a receptionist at a Nuclear Power plant for 25 years, would you believe that you could maintain the reactor????? You Buttwiper are an insult to our profession, and that is not ok. Next time you leave at the end of your shift, check your RN's, do they leave on time? What about breaks? Do they get to go to lunch for the full time, do they even take their breaks.
    The biggest part of our job, that you don't have, for obvious reasons, is the responsibility. If you notice a patient going bad, do you get the RN, or do you handle it? You probably get the RN, and you are probably so thankful that you can. Do you realize that the buck stops there?
    Maybe you should notice what the RN's are doing, just quietly open your mind and watch. You may be surprised at what you see.
  9. by   deLadyPanther
    to the self-titled butt wiper ... obviously you have no clue ... perhaps (not that I think you can), you should not only have the chip knocked off your shoulder you should also take off your shaded glasses. Since you have obvious issues, try going back to school. If you successfully pass Nursing 101 (which I seriously doubt), maybe you will began to have some understanding of the knowledge behind passing medications and performing skills not learned in your 6-8 week training course.
    Fortunately I have been blessed not only to work with but also to supervise nursing aides that are great and upon whom I depend for their skill and understanding; nursing aides that are comfortable with their skill and knowledge base and who know their limitations.
    Unfortunately I have also had the experience of working with and supervising some like you. Although I suggested that you go back to school, I think it would be better that you move away from healthcare. In your present stance, you can only be a danger to some trusting, unsuspecting patient.
  10. by   lorrie

    [This message has been edited by lorrie (edited January 11, 2001).]
  11. by   hollykate
    If you read back through the posts, I think you will find that Butt-Wiper actually identified themselves as "Butt-Wiper" so those that post in reply have no other name to address the poster by. No One is running down nurses Aides. Most of what we are saying in this post is that we wish that our Aides would work within their scope of practice. I work in an all RN (only RN) unit, so I don't really have contact with anyone but RN's- but I used to be an aide, and have a lot of respect for them. However, since that person chose to be addressed as Butt-Wiper, what are we to call them? I think that says a lot about the respect that person has for themselves, rather than how other posters feel about it.
  12. by   prmenrs
    Thank you, Holly Kate, that was VERY tactfully put.
  13. by   Nancy1
    I have been away from the boards for a while, so I scrolled through this as the topic intriqued me. First I would like to say about the opening post: Does your facility have a privacy act????? Does your staff get inserviced on it????? And when someone breaches the confidentiality of a resident it is up to anyone who hears that breach to remind the person. That the discussion needs to move to a private area. Nurses need to not feel sabatoged, TEACH.

    Then about the comment about reading a piece of paper and being able to give pills. I thought that after being an CNA for 6 years, so I enrolled in a BSN program at the age of 40, because "I only needed a piece of paper" to do the job of a nurse. Well that tells you how naive I was. I have now been an RN for 6 years. I am invited back to my college to speak because my final paper was my journey to seek a "piece of paper" which was my license, turned out to be a "piece of paper" my diploma from a BSN program.
    I chose to become an RN because I did not want to lift and do the heavy work all day long. If someone does not like the work, change fields or pursue a degree, but never stray from the fact that the client is first and formost and his/her privacy is everyone's business.NA