I just got home after one of the worst experiences in my nursing career.Okay,
so I'm a cna, but I'm trying to get into an lvn program. Most of my shift was fine.
It wasn't until 6 am that the **** hit the fan. I had a geri psych patient who is
a hitter and a fall risk. I was told not to change him without help. I had never
had him so I didn't know his history or condition. I passed water, did vitals and
made my rounds and changes. This guy, "Mr. Grey", was dry at 2:30 so I left him
alone. I wasn't going to wake up a combative psych pt to change a dry diaper or
to reposition him.
I know that ideally we should reposition and change patients every 2 hours,
but let's be honest, we usually don't have time for more than q4 hours. Flash
forward to 6 when I am helping Mr. Grey's roommate. The tx nurse comes in to
change Mr. Grey's gtube t drain. She calls me over and asks if his arm always
looks this way. The arm looked dislocated at the elbow. I told her that this was
my first time with the pt but I didn't think so. She called the LVN in to assess
the arm and the LVN said definately not. The tx nurse asked when I had last
changed him and I truthfully answered that I hadn't bcuz he was dry at 2:30.
She gave me a dirty look and fetched the RN ( who probably never even looked
at the pt)and reported the arm to him.
By this time, I had moved onto another room to toilet a pt. The RN came
into the room to question me about the injury. The conversation went like this;
RN What happened to his arm?
ME I don't know.
RN What do you mean you don't know? You were with him for 8 hours!You
have to know.
ME I don't know. I checked his brief at 2:30. He was dry and sleeping so
I didn't change him. I looked in on him every time I came by his room. He slept
the entire shift.
RN So you didn't check him again?
ME No, I didn't. I start changing at 4:30, so I knew I would check then.
RN Well there's going to be an investigation so you better come up with
a good excuse for why you didn't change or reposition him all shift. Are you
sure you didn't do something that could've caused this?
ME( very upset) Of course not. He was sleeping my whole shift.
RN Well we will see.
Reminder: This entire conversation took place in a room with 3 very alert
pts.
The MDS nurse told me that she would look at the pt's history for any
degenerative joint conditions and told me not to worry. I was then berated
by the RN in front of all my coworkers at the nurse's station. 
I was almost in tears. I thought I would lose my job, my certification, and
any hope at becoming a nurse. I felt like I was being fed to the wolves. I know
he was my patient, but he was the LVN's and RN's patient too. Where were they?
( Actually, the LVN did look in on the pt, but the RN never stepped foot in the room
until after 6.
I was on my way out when the RNAs asked me what was wrong. When I told
them, one RNA said,"His right elbow? He was admitted like that. Physical
Therapy knows all about it. Let me look at it. We went to the patient and she told
nurses that he was admitted with his arm like that. Upon closer inspection an
incision was found on his elbow. I thought I was gonna faint!
I am a good CNA. I pride myself on my patient care. I'm usually the one
that finds undocumented wounds or COCs. I missed this one. I feel like my
nurses were accusing me of neglect. I would never knowingly harm a patient.
I have worked for over 2 years with nary a complaint or write up. This really
shook me up and opened my eyes. My RN wasn't interested in what happened
to the pt, he was interested in keeping his licence. I knew he wasn't the best
RN I have ever worked with, but I didn't think he would be that mean. He
knows I'm a strong CNA. The LVNs love to have me work their station because
they know I get things done. And it's a acceptable procedure not to wake a
combative or aggressive pt unnecessarily. I did feel really bad bcuz I thought
"I should've started with him but I needed to get a pt who was trying to jump
out of bed( another geri psych)
Well thanks for reading this looong post. I needed to vent. Has anyone else
experienced anything like this? How did you deal with it. Were you ever able
to look at your coworkers the same way? Please give me your imput. BE NICE
PLEASE. 
MissJulie
214 Posts
This sounds like the RN and LPN were trying to pass the buck, so to speak, and it seems that no one did a full physical assessment of the resident.
Granted, I've never been in this type of situation because my work as a CNA has been only in a clinic-type setting, but it would seem that if an "investigation" does take place, it should be questioned why the LPN nor RN had done any type of assessment to look for any joint abnormailites, and for Pete's sake, at least to look at a medical history for past surgeries!
I say don't get discouraged, because it happens when there are people who look down on CNAs as the fall person. But, also, when/if they actually do an "investigation" don't just sit there and take it, be sure to stand up for yourself.
Good luck either way! :)