Got burned????

[heatherRNinAK]

Just interested in some of your wisdom/feedback. I'm going to make this short as I can, if you need more info, just ask. I am a new OB nurse, still in orientation (one month). I am on night shift right now, and last night was my third time taking an assignment on my own. I had two patients, only one was less than 24 hours out so she was the only one who needed an assessment q4. Three am, went to do my assessment. I felt like the patient didn't want me there at all, which was no different from earlier in the evening. I was polite, asked if she needed anything, did my assessment and nursing care (which I feel good about). Left the room, told the CNA that I felt like the patient didn't "click" with me and was uncomfortable with me, and that she (the CNA) is really good at making people feel at ease so while ordinarily at three am I would do vitals as well, could she get them? (which IS in her job description). She was really sweet to me, ya no problem, etc. and then when I went back in the nursery later, my Orientator asked me what happened with the CNA because she came in the nursery cursing me out etc. and calling me lazy etc. I explained my side but it still seemed that after that, my orientator had a different attitude towards me. All I was trying to do was make my pt. more comfortable and do what I needed to do to make sure she and baby were stable and safe. Thoughts?

[CEG]

Sounds like you were trying to do what's best for the patient. Maybe the CNA is sensitive to this because people in the past who were lazy have tried to shove work off onto her.

Maybe you could talk to her, tell her your logic for sending her in, apologize, offer to get her coffee or something. She may have just been having a bad night and took it out on you.

Maybe next time you could ask her to go in and go at the same time and chat with patient together? That might loosen the patient up a bit so she opens up to you. She may have just been sleepy:)

[rn/writer, RN]

Unless your patient actually raises an objection, I'd do the vitals. It isn't all that important that your patient "like" you or want you there. You have a job to do and that's what matters. Go into the room with the confidence that you belong there.

[Sis123]

How would you like to be awakened at 2 or 3 am for an assessment and your vitals? Nobody likes it, lots of people are grumpy, don't take it personally, just get your vitals and info anyway.

As for the passive aggressive CNA, I'm not sure what I'd do there, but it seems like she over-reacted to a simple request to get vitals on someone. Getting vitals is a easy quick job, and to get so angry seems odd.

I guess I'd question if she really said that, or question the motives of who told me that she said that if I were you. Don 't worry if you don't "click" with each patient, because there are lots of patients in your future that you won't "click" with.

[daisybaby, LPN]

Especially during NOC shift, I find it's much easier to make vitals part of my assessment. No one likes to be awakened at 3am by one nurse, let alone two staff members at separate times. Takes an extra minute at most. Ditto on the earlier post- you won't always get that warm fuzzy feeling from every patient you have- especially in the middle of the night.

In hospital-setting reality, you have to choose your battles as far as many CNA's go. I always take my own vitals,have been known to change beds, fill water pitchers, etc. when I know full well it's in the CNA's job description and not mine. I'm going in the room anyway. And when I actually do ask one of our CNA's to do something, they get right to it because they know I'm really that busy with nursing duties-I'm not just giving them busywork.

So, although it is in her job description to get the vitals, it's your responsibility to make sure they're done. Take the extra minute to do it yourself and it's a non-issue). Perhaps the attitude you caught from the CNA was, as earlier posted, r/t past nurses who were truly lazy. I'd just let it go.

Hope things get easier for you- good luck through the rest of your orientation!

[gr8rnpjt, RN]

One thing maybe you did not think of. Your Mom was not happy about being disturbed in the middle of the night, so you send someone else in a little later to disturb her again! The rationale for going in and doing assessment and vitals all at once is that you are only going to disturb someone one time! You were, in essence asking this CNA to go in to an already angry pt for being disturbed in the middle of the night, and this CNA knows she is not going to get a good reception. She had a right to be angry. In the future, do your assessment and get the vitals at the same time so the pt will not be disturbed twice.

[heatherRNinAK]

Thank you all for the thoughts, advice, and perspective, I really do appreciate it. :thankya:

PS. In the future, I'll remember to grab the VS cart and thermometer................before I go in the room!

[Elisheva]

Heather, you're so lucky to be reaping the benefits of the years of wisdom these nurse have.

I can't tell you how helpful a forum like this would have been to me 10 years ago. Take advantage!