Indiscrete CNAs

Nurses General Nursing

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Specializes in LTC, Med/Surg, Peds, ICU, Tele.

I worked over on Med/Surg yesterday. There is one CNA there who, although a hard, willing worker, takes it upon herself to blab way too much to the patients. I would be walking by the door to the patient's room and hear her giving out way too much information that wasn't really her business to be giving out. Then, when there was a crisis that came up where PT had left a fresh hip pt in his chair after ambulating(first time up), and was going to come back in 2 hours (according to pt), severe pain, pt extremely orthstatic, diaphoretic, thready pulses, light headed. When I checked the BP systolic was 70, so I turned his LR back on for a 250 fluid bolus and got two other people to lift him back in bed, then called the doc (BP went up to 100/50). Pt responded to a another 1000cc fluid bolus that the doctor ordered and was fine, he was still behind on his fluids from the surgery apparently.

I planned to talk to PT and let him know that next time a pt is lightheaded, esp his first time up, second day after sx, to not push so hard and to get him back in the room for a BP check when he has these symptoms. Well, of course this CNA had to say all this in front of the patient (to the physical therapist) before I had a chance, telling him that he was in big trouble, ha ha ha. He was very embarrassed. I managed to help him save face, and the patient and his wife were really nice (He was a very young PT guy, good learning experience for him). But, it forced me to have this conversation in the room, in front of the patient, a big no no in my mind.

I didn't want to make a stink, but I sometimes don't like working with CNAs because some are indiscrete like this. I've noticed this throughout my nursing career. Has anyone else had this problem?

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Specializes in Community Health, Med-Surg, Home Health.

Oh, yeah. And, actually, some nurses as well. My friend works at a hospital (oncology unit) that no longer employs LPNs. Those that were employed as LPNs that chose to remain were bumped down to PCAs. One of these (I call them LPN/PCAs) employees has a tendency to say to patients "I don't understand why the doctor prescribed this to you... or...that (whatever it is) is not the way it is supposed to be done...", basically undermining the nurses as well as the doctors. My friend reported her to a manager saying that she seems to first not recognize that she is operating out of her function there at this facility because she is not employed as a nurse and also, that because she happens to be one, she should know that it is not therapeutic to instill fear into the patient, nor is it appropriate to speak about things you have no knowledge of. I hear that this has not stopped her, yet.

Personally, I think that this particular young lady needs to update herself on current nursing practices and if she feels that she should operate as a nurse (and she is), that she should work elsewhere under that title.

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Specializes in LTC, Med/Surg, Peds, ICU, Tele.

I agree pagandeva. I hate it when any healthcare worker undermines another in front of the patient. Big pet peeve of mine!!!!

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some people love to impart info as ego booster

conuseling does little to correct this i

i would request her transfer

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The CNA needs some coaching from you then document it. Also the charge nurse or nursing supervisor needs to know about this and give them your documention of this event.

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It looks like the CNA needs an education about HIPAA, and possibly on what's in her scope of practice if she was saying things to the patient that a nurse or doctor would normally say.

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Specializes in ED, Critical Care, Peds & Nursery.

i agree with the posts on this thread. not only are patients' right to privacy with their health information being compromised, but can put patients in a position to be harmed or make poor medical decisions. i too have worked with cnas and techs in the ed more recently that have done this and it is very inappropriate. if something happened to the patient - a bad outcome due to their meddling, i am sure that a court of law what frown upon it as well. what always bothers me about situations like this, is that these people are working under the auspices of our license and we are ultimately responsibile for the patients and the unlicensed personnel that are working with us.

i would have to lean towards writing episodes like this up...occurrence report in a factual manner. document, document, document! especially if it something that keeps happening.

~kelrn24

life is better at the beach!

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Specializes in Nursing assistant.

there is a conundrum of sorts in all this.

i know nurses are constantly amazed with nursing assistants. they are amazed that we think we know so much, and then again, are surprised we know so little.

sounds like double speak, but this is how it works.

obviously the cna has no place sharing this info with pt or the patient. she knows too little, she may misspeak, and this is out of her scope etc.

but then there is the expectation that the cna should be pretty darn smart, knowing the nuances of what not to, and what to say.

maybe the pt asked how the patient was doing, was it safe to move him? i have had pt ask me that, knowing i have spoken with the nurse and have possibly moved him earlier. i have gone as far as to say "i'll ask the nurse for you" but often, they will say

"what have you seen?" it is not inappropriate for cnas to share observations. we just can't draw conclusions.

the med stuff and what not; educate. it is your job to let the cna know where to draw the line. much is said out of ignorance, and even sympathy for the patient.

nursing assistant are not rocket scientist, lets face it. you need to supervise and educate. i have so so appreciated the nurses who have done that for me. even the ones that have been a bit tough on me.

you could create a bond with this cna and have a real great assistant.

oh, and of course, she should have never said the patient was in big trouble!

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We have a PT in our ICU who takes it upon himself to tell the pt's family members that they should get their family member out of our ICU before they get an infection.

For a while, we had a slew of patients trying to transfer their family members to other hospitals. But being that we were the only Level I trauma center no one would accept them.....

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Specializes in Ortho, Neuro, Detox, Tele.
I worked over on Med/Surg yesterday. There is one CNA there who, although a hard, willing worker, takes it upon herself to blab way too much to the patients. I would be walking by the door to the patient's room and hear her giving out way too much information that wasn't really her business to be giving out.

(what exactly is she saying? I feel uncomfortable commenting on this without a complete knowledge level. If she's discussing meds, dr orders, etc...then ok...However, I work with hips and frequently comment on "yes, you have to keep the o2 in for 24 hrs after surgery. The IV fluids will probably be stopped tomorrow. You need to rest tonight, they will get you out of bed tomorrow. When was the last time you had pain meds?" etc. That is certainly not out of my scope...)

Then, when there was a crisis that came up where PT had left a fresh hip pt in his chair after ambulating(first time up), and was going to come back in 2 hours (according to pt), severe pain, pt extremely orthstatic, diaphoretic, thready pulses, light headed. When I checked the BP systolic was 70, so I turned his LR back on for a 250 fluid bolus and got two other people to lift him back in bed, then called the doc (BP went up to 100/50). Pt responded to a another 1000cc fluid bolus that the doctor ordered and was fine, he was still behind on his fluids from the surgery apparently.

I planned to talk to PT and let him know that next time a pt is lightheaded, esp his first time up, second day after sx, to not push so hard and to get him back in the room for a BP check when he has these symptoms. Well, of course this CNA had to say all this in front of the patient (to the physical therapist) before I had a chance, telling him that he was in big trouble, ha ha ha.

(ok, while I agree that the humor was ill-placed...the timing was just off. Did the patient act embarrassed? How? Maybe that was good for the PT, cause you know he'll remember the next time that happens.....I wouldn't have said that to PT, but maybe you could have told the client to just tell PT that if he's having difficulty getting around that he needs to turn around earlier.....)

He was very embarrassed. I managed to help him save face, and the patient and his wife were really nice (He was a very young PT guy, good learning experience for him). But, it forced me to have this conversation in the room, in front of the patient, a big no no in my mind.

What else does this CNA do that gets under your skin? Cause really, you sound like you are picking on the CNA for something (relatively) minor.

Please respond so we can give you more specific feedback...Thanks!

From a current CNA/RN student and future nursing educator....

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Specializes in LTC, Med/Surg, Peds, ICU, Tele.

Just a clarification: PT = physical therapist, pt = patient.

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Specializes in Nursing assistant.

Wondering....

would you all rather Not have nursing assistant input?

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