What would you make of this?

[bluemorningglory]

I work as an aide/CNA/LNA on a critical care unit. I took care of a patient last night. I work part time. Apparently, the patient had been on the floor 10 days but due to being floated to other floors, being sick one night and only being on a few nights I only took care of her once before that.

I went to change her soiled sheets last night and realizing that I would need a nurse for help, grabbed her nurse. The nurse is very abrupt and barks out orders (what I would call an "old school" nurse) to me and makes petty comments(For example, she was the RN who told me not to call patients "honey"; I checked and there is no policy on using terms of endearment like that; she was basically sharing her own opinion). So we changed her and the entire time she is saying,"Watch her neck". Ok.

I leave to do other things and then this nurse comes up to me. Here is the conversation:

"You know that she has a broken neck, don't you?"-her

There was nothing obvious to indicate this woman had a broken neck. She was not wearing a collar, was not on a Stryker frame, did not have screws, had full mobility, yadda, yadda,yadda.

"I had no idea"

"Well you must have known..she has been here for 10 days"(see above) and she stormed off.

I felt horrible about this. I went over to the kardex (With the CNAs and the Kardex, I don't think anyone would say "Don't read it" but I do not want to come across as invasive; that rule changed for me last night)and read throughh the info-all I saw were a lot of odd symbols and nothing about a broken neck. On nights we do not do "report" like they do on days . Anyway, the patient was ok (thank God) . I really did not know the woman had a broken neck and no one sure as heck was volunteering this info. Starting tomorrow, I am going to insist that I get a report from someone about the patients.

Anyway, I am sick of this nurse and her attitude. I am an aide not a ^&&(($)_+ slave and a little gratitude for the care that I do provide would be appreciated. I am not going to let this deter me from becoming an RN but I am beginning to see what lateral violence is all about. How should I handle this?

[Katie5]

(For example, she was the RN who told me not to call patients "honey"; I checked and there is no policy on using terms of endearment like that; she was basically sharing her own opinion).

No other way to say this easy, but she is right about that. Policy or no policy, the patient has a name, please use it.

[bluemorningglory]

No other way to say this easy, but she is right about that. Policy or no policy, the patient has a name, please use it.

I do use patients' names and might throw in a "sweetie" or "honey" here and there. If my supervisor wants to say something to me about it, I will listen then;)

[bluemorningglory]

I do use patients' names and might throw in a "sweetie" or "honey" here and there. If my supervisor wants to say something to me about it, I will listen then;)

Oh and the supervisor might want to mention it to nearly 90% of the staff that uses those terms of endearment

[brownbook]

She did tell you to watch the patient's neck while you were changing her. To tell you after wards that the patient had a broken neck, with an abrupt rude tone of voice, and storm off is rude and unprofessional. I'm glad you vented here but I would say let it go. Forgive her, stay away from her, learn from her how NOT to treat people. Different cultures and customs use the term honey more than others. I don't think that is an issue.

[SummerGarden, BSN, MSN, RN]

The nurse was upset that she too missed the fact that the patient had a broken neck and helped you with the patient without taking precautions. In the future follow up the way you said you will (get report in the future, read the kardex, etc.) so that this does not happen again. As for the nurse, let it go until another incident occurs. If she talks down to you or makes you feel uncomfortable, then address the issue at that time away from prying ears and eyes. If this does not work, then address the issue with management. BTW, when you become a nurse, this type of treatment does not end.

[silverbat]

In LTC, with state surveyors, if you use a name other than the one preferred by the resident, you are at fault and will be tagged (NOT a good thing). We have to care plan that the resident prefers to be called "honey" "grandma", etc. If this is not careplanned, it is a violation. When I worked in hospital, I was taught that it is disrespectful to call someone "honey". It is "talking down to them".

If you occasionally drop in a "honey", I don't think anyone will fault you, but if you do it all the time, you are in error.

Personally, having been a patient before, if my caregiver calls me honey exclusively, then I wonder if they care enough about me to even know my name. JMHO

As far, as the pt having a broken neck, and you being unaware, easy fix: BE AWARE. Get report, talk to the nurse who has your patient. Personally, I would NOT take care of patient unless I have had report. Even if I help another staff memeber with their pt, I ask if there is anything I need to know, do they need special care, etc? The nurse could have handled it better, of course, and you have seen the wrong way to do it, so you have learned something good!

[evolvingrn, BSN, RN]

I do use patients' names and might throw in a "sweetie" or "honey" here and there. If my supervisor wants to say something to me about it, I will listen then;)

You really aren't suppose to do that, they teach that in certified nursing training and i even think they test on that very subject.

[EmmyBee]

I agree with your new plan. You should always know what's going on with your patients, no matter what role you are performing in. Read what you are allowed access to, ask their nurse for a quick report, as well as the off-going CNA. It is not safe practice to start care of anyone, until you know what their restrictions/limitations are, at the very least.

As far as the nurse's attitude...I always say that communication is the key. Try talking about it with her. If she refuses or nothing gets resolved, keep your distance. But at the same time, remain professional. You don't have to like each other, but you do still have to work together.

[laynaER]

Okay can we please not go into the whole 'don't call patients honey' discussion because 1) we've already had a long drawn out thread about it (see that thread also started by bluemorningglory) and 2) that's not what the OP came here to address.

To the OP I wouldn't take care of a patient until I got report on them so I hope you do that in the future like you said you would. If the nurse's attitude continues to make you miserable, you should talk to her about it even though it may be uncomfortable sometimes we don't know what a person is going through that makes them such unpleasant people to be around. I hope you and this nurse get along in the future because you two already have history (w/ the calling people 'honey' issue)

good luck

[evolvingrn, BSN, RN]

Okay can we please not go into the whole 'don't call patients honey' discussion because 1) we've already had a long drawn out thread about it (see that thread also started by bluemorningglory) and 2) that's not what the OP came here to address.

To the OP I wouldn't take care of a patient until I got report on them so I hope you do that in the future like you said you would. If the nurse's attitude continues to make you miserable, you should talk to her about it even though it may be uncomfortable sometimes we don't know what a person is going through that makes them such unpleasant people to be around. I hope you and this nurse get along in the future because you two already have history (w/ the calling people 'honey' issue)

good luck

I think it is part of the issues. this lady is being 'delegated' to and she does have a responsibilty to take direction from the registered nurse... to which she clearly by her own words is not going to listen to. Yes it is the nurse's rsponsiblity to know about the patient and direct the CNA... so there were two issues here. but i certainly think that there is a root problem to the issue in the first place.

[Meriwhen, ASN, BSN, MSN, RN]

Starting tomorrow, I am going to insist that I get a report from someone about the patients.

I am very surprised--and concerned--that you aren't already getting report. How can you give the best care possible to a patient if you don't know what's going on with them? In almost every hospital I've been in, the CNA/aides get report before they get the patient--it's either from the offgoing CNA or they sit in on the nurses' report.

I would definitely insist on getting a report from someone before taking care of the patient...and I'd also make it a practice to give report to the next shift's CNAs/aides, so they also won't get caught in bad situations. This will help protect you in the long run. Also make it a practice to read the Kardex and ask for translations--AFAIK, a Kardex is not a nurses-only thing, but there for everyone providing care for the patient.

I'd let this incident go with the nurse and work on improving communication. Yes, someone should have told you what was up with the patient and the nurse should have handled things better with you...at the same time, if no one's telling you anything, you should have made it a point to find out the info for yourself. So definitely start insisting on reports.

As far as not calling a patient "honey"...the nurse is damn well right. Even if you live in the south, even if 90% of the other staff uses those terms, IMO it is not appropriate. When I was on my preceptorship, I had a nurse who kept calling me "honey" and I felt it was demeaning, like she wasn't taking me seriously. It certainly didn't make me feel warm and cherished like you may mistakenly think it does when you call someone that. I didn't complain because I was a student at the time, and I'll bet that most of your patients aren't going to complain either because they'll think they're being a bother. If the patient specifically states he/she does not mind being called "honey," then that's fine--otherwise you don't be unprofessional because everyone else is doing it. Rant over, off soapbox.