Need advice,Problem CNA - page 3

I am a nursing student in school, and I am currently working on my preq reqs. My question is this, my mother in law is in ESR (End Stage Renal Failure) and my spouse is trying to assist his mom in... Read More

  1. by   stillwant2banurse
    Quote from Virgo_RN
    Wrong. Your MIL has the right, as long as she is of sound mind, to decide what health care information you are privy to. Just because she is your MIL does not entitle you to know her private health information.

    It's not that simple. I can give general information, such as "she's comfortable" or "she ate all her breakfast today", but I cannot divulge protected health information just because a family member wants to know. It's illegal. Protected health information consists of diagnoses, lab and imaging results, medications, etc. That information is for the patient to decide who gets to know. If the patient is incapacitated, then the MPOA gets the info. In the hospital, we require an actual legal document. So, if you were to ask me how your MIL is doing, and you are not the MPOA, you'd get a very general answer, and if you didn't like it, too bad. You can think whatever you'd like of me.

    If your name is indeed on a legal document as her health care proxy and she has been presumed to be incapable of making her own health care decisions, then I don't understand what the problem is and why you haven't had an RN come visit and make a written care plan, and why you haven't taken her to her doctor's office to have her medications adjusted. If you are indeed the responsible party, then the CNA is only part of the problem here.
    Yes we have the legal document and we are the proxy on her case, we havnt had the opportunity to take her to have the med adjusted nor have we had the opportunity to have a RN come in and make a written care plan because like I have stated the CNA is stating she is the nurse, and these are her responsibilities, she has taken on the role of her nurse (RN) and that is wrong. I would never suggest that she gives us privy information, in that I would not be getting that from her I would get it from her MD, but if a family member wants to know how there family member is doing ie, is she eating well, is she going to the bathroom ok, did she have any concerns while she was with you today, that I should bring up with her MD, then as a CNA these things she must answered, the problem that we are having is that she is a CNA , not a nurse, my MIL meds we are already aware of because we have record of this information from the doctors that did the orders, but we are seeing first hand that these meds need to be adjusted that she needs a RN to come in and create a written care plan however, she is interjecting herself over us and assuming this role, and then these things do not get done without my FIL becoming more fearful by the second.

    I will say this she is my MIL, my spouse comes to me, for advice, and knowing that he has this proxy document he comes to me for my opinion and of course I am going to tell him what I know- which is she needs a RN to give an assesment with a written care plan, and she needs to see about having her meds adjusted. As a family member all this is stressful enough I really do not need the added stress of having to explain to someone I dont want their job, I just want what is best for my MIL.
    But like I said if the CNA would just be the CNA and stay in that scope of practice and the health proxies are allowed to play there role it would make everything easier.

    I am a CNA while going to school, and I may know how to perform a certain task but I always let my pt know that is not within my scope of practice, and I will be more than happy to get your RN nurse.
  2. by   Virgo_RN
    It sounds like your spouse is actually the name given as the health care proxy. As such, your spouse needs to call the agency and discuss these concerns.
  3. by   stillwant2banurse
    so, if you were to ask me how your mil is doing, and you are not the mpoa, you'd get a very general answer, and if you didn't like it, too bad. you can think whatever you'd like of me.

    in my facility it is general know who has a poa during admission in that this information is taken then. in a home setting the poa is general know because that relationship has already been established as well. i hope again i am misunderstanding you, but for me to come back with that attitude to a family member wouldnt make things any better. if i cant give them information then i would simply explain that i have a obligation under hippa to not disclose certain information to you, i know that you are a family member and you are concern, however, i can tell you how she was a dinner today, did she eat her breakfast, ect..... and i hope that helps, if you have a health proxy you can express these concerns to him or her and they will come back to me, and i am able to give them that information.
    we are also aware of speaking this way with family members because from a family member preception they are concern and i want things to be as smooth as possible. so i dont know about you but yes i want to make my family members happy as legally possible, without crossing the line
  4. by   stillwant2banurse
    Quote from Virgo_RN
    It sounds like your spouse is actually the name given as the health care proxy. As such, your spouse needs to call the agency and discuss these concerns.
    yes, that was a suggestion that was given and I think this would workout the best, thanks for your comments
  5. by   Daytonite
    You did say your MIL is in hospice, correct? There is an RN who is in charge of her case. There must be by law. Her name is supposed to be listed on a folder of documents at the house or the chart if your MIL is in a facility. Contact that RN and complain about the CNA. If that gets you nowhere, call the hospice agency and talk to the person in charge and complain. If that gets you nowhere, call Medicare directly.

    We had a horrible hospice experience with my mother. With the way the economy is they are forcing people into home health or hospice and I won't do it because of the poor services we received in the past.
  6. by   stillwant2banurse
    I wanted to thank everyone for the advice, but I am going to take Virgo RN advice on this and butt out!.

    my MIL is not on hospice and she still dosnt have a RN- the hospital will most likely have her placed into a nursing home and no she dosnt want to be there nor is my FIL or spouse willing to place her there. Now here is the problem, today I made arrangements putting off my school work and staying up for the last 3 days between work and helping here trying to setup and speak with my spouse about getting her a RN and having her meds adjusted. The CNA comes in and instead of staying at the home with her, she leaves and goes home early, she stated she did not see the need for these services, I have had enough with being put in the middle of all of this trying to get her help, just to have things cancel so I cant do anymore.

    I thought maybe if she knew I was just giving advice to get her the services she needed and not try to take her job she would feel more comfortable about things but this is not the issue. I dont know maybe if she is in a nursing home or placed on hospice at least eventually she will get the assistance she needs. hopeful it would not be too late. The doctor, state to me when I called him back, that he would not make any changes in her plan based on the word of a CNA so he is stating she needs a nurse, and since she has gone behind us and made such a fuss about things he dosnt feel my FIL can handle her and he is recommending hospice, or #1 choice would be a nursing home, either way he states he refuses to treat her while she is in this perdictment because it is extermely dangerous. But then again at least the CNA get to keep her job, never mind my MIL - Sad I thought we were in this field for the better of the patient instead of the soul better of our pocket books.