Did the title catch your attention? Good, I was hoping it would.
I've seen people talk about this attitude on allnurses quite a bit, and I find the reactions fascinating. I'm amazed at the passion, care and professionalism of the nurses on this board and really about every nurse I've ever met.
BUT, everyone-from the most seasoned nurse to the student- knows that nursing is changing and will probably continue to change dramatically over the years to come. There are CNAs and MAs who seem to have an increasing role in the healthcare system and nurses themselves have more responsibility (all the charting etc.) and demanding jobs as new diseases, new medicines and standards of care make their way into our lives.
My question is, do you think their should be a change in what nurses do? Will there come a time when basic hygiene and certain other tasks often done by nurses in the past will be the responsibility of CNAs and others in similar roles? Would this be a good thing for nurses? Is there really anything wrong with nurses who feel that four years of education + all of their other demands and responsibilities should mean that they shouldn't have to do these tasks?
If you think that signing out and registering a different name will mean that this alter ego you are posting under now is the only one that will be banned from posting and you can sign back under your old name and carry on as you desire, think again. The system registers your computer.
I love it! A bit of intrigue: alter egos, covert identities...so Agatha Christy.....Who is she really?
Our facility actually carries the fecal containment device Lizz is talking about. I also think you've come to wrong conclusion.
I've seen one too many red, raw, and bleeding behinds from frequent diarrhea, I can only imagine the pain these people experience each and every time they are cleaned, and I always hear their cries. A fecal containment device prevents this kind of skin breakdown, it also is attached to a dependant drainage bag, which also saves the staff time by eliminating the frequent clean ups involved in this type of situation. Lizz brought up a good point, it is very time consuming to be constantly clean a patient 5-6 times a shift, it's also a situation that affects the care of all patients on a unit. It's not about the patient being an inconvenience, unfortunately frequent diarrhea is not something they plan on having. It's not about the nurse being too lazy when it comes to a situation involving frequent clean ups, it's about already operating under limited time conditions, and still getting everything done. First and foremost it is always about preventing skin breakdown and the potential for infection that accompanies that breakdown.
I'm all for fecal containment devices, most importantly because of the skin breakdown and the pain/discomfort associated with frequent diarrhea that it can prevent.
Thank you. I've had patients literally soaked with diarrhea that was so bad that it spilled onto the floor. You could not keep up with it, even if you were doing constant cleanups ... and do everything else that needs to be done for other patients. I'm not talking about 5-6 cleanups in a shift, I'm talking about 10-20 cleanups for just one patient. It's incredibly frustrating.
If that makes me lazy because I'm looking for realistic solutions that allow me to take care of other patients and get all the work that needs to be done ... done ... then, so be it.
If you work in the trenches, your gonna end up shoveling dirt. I have no emotional/ego problem doing the whipe and dipe stuff.
I do have logistics problem with it sometimes.
My ED is a patient mill: the influx is astounding most days, so faced with prioritizing work functions it usually gets passed off to the tech or aide to do.
I have to get the nurse only things done, and delegate the rest most days; or I'd never accomplish anything other then croaking from frustration or exhaustion.
On a quiet day I'm Jonny on the spot with the wash cloth; after all they asked for me by name "nurse...".
Thank you. I've had patients literally soaked with diarrhea that was so bad that it spilled onto the floor. You could not keep up with it, even if you were doing constant cleanups ... and do everything else that needs to be done for other patients. I'm not talking about 5-6 cleanups in a shift, I'm talking about 10-20 cleanups for just one patient. It's incredibly frustrating.
If that makes me lazy because I'm looking for realistic solutions that allow me to take care of other patients and get all the work that needs to be done ... done ... then, so be it.
:angryfire
Oh, these lazy RNs, always looking for something that might actually work. We do use fecal bags from time to time. Hard to keep them in place, though. Maybe it's the brand we use. Still, better than nothing. I've also seen a fecal tube, sort of a catheter inserted into the rectum. Works pretty well, but the docs don't seem to like 'em. Well, I guess they are sort of invasive.
Maceration and breakdown are huge problems on a neuro unit. A lot of pts. can't call for a bedpan, or even know they need cleaned up. Our aides and nurses work hard, but it's a struggle.
Frankly, I find the whole premise of this thread to be very much the exception. I can't think of a nurse on my unit who doesn't do whatever it takes--even the "lazy" ones who routinely call the aide if a pt wants coffee or water or an extra blanket.
In the time it takes to "wipe behinds," other assessments can be done with great ease. For example checking for skin breakdown, dressing and applying ointment to any sacral skin breakdowns, this is also a perfect time to auscultate lungs from behind a patient. Personally I always like to throw in a soothing back massage and position this patient comfortably on their side to relieve pressure on backside for the time being.
No problems just opportunities for better patient care. And when your CNA sees your care for your patient, in my experience they always are more willing to join in and do better patient care for your patients because they know you care.
In the time it takes to "wipe behinds," other assessments can be done with great ease. For example checking for skin breakdown, dressing and applying ointment to any sacral skin breakdowns, this is also a perfect time to auscultate lungs from behind a patient. Personally I always like to throw in a soothing back massage and position this patient comfortably on their side to relieve pressure on backside for the time being.
No problems just opportunities for better patient care. And when your CNA sees your care for your patient, in my experience they always are more willing to join in and do better patient care for your patients because they know you care.
I've been a CNA for 5 years. I'm currently in nursing school. The way I see it is -when your heart is in what you do, and you actually love what you do, things of that nature should not bother you. That's why I became a CNA first to get expierience from the bottom. Besides you are doing it for the patient.
On the other hand...ever had to break sterile proceedure to answer a phone call and have it turn out to be that a patient needs a bedpan, and your aide is on break, and the other aide can't cover it because she's on break, too? Ever had to go refill a water pitcher to give an 0700 med at the end of your shift, while two-shift's worth of aides give "report" on who's dating whom?
Weekends I make almost triple what a starting aide makes. Weekdays I still make double what a fairly experienced one gets. I figure that entails a degree of responsibility, and I try to do right by my aides. Most of the aides I work with a very smart, hard-working, and dedicated, and I'm damned proud when one or another of them says she's glad to work with me. I help, I listen, and I respect them. On the other hand, if we're just looking to criticize, I'm sure we've all seen aides who'd be glad to let us do our work and theirs, too.
One of the nurses I've learned a lot from is not well-loved by the aides, but she's right--you have to delegate. I'm younger, I move quicker, and my back is stronger than hers, but she's a better nurse than I am, and I'm old enough to recognize that the time will come for me, too, when I'll have to rely a lot more on my brain than my brawn.
nursemike - I love you!!
Frankly, I don't think the good CNA's get the respect they deserve. I feel like the good ones should be paid more!
The last place I worked, an ambulatory surgery dept., had an aide during the day - it wasn't her function to answer all the lights - she was there to restock and help transport patients out, etc. But this girl did more than was expected - she made sure that everything was stocked and stocked well, and would look around for things to do to make life smoother for the nurses.
She asked questions, and was interested in all the things we did.
chadash
1,429 Posts
I love it! A bit of intrigue: alter egos, covert identities...so Agatha Christy.....Who is she really?