I'm a nursing student in my third semester of clinical and I work as a CNA on a pulmonary medical/surgical floor. I really like my job, but last night at work I think I made a mistake.
I had a patient whom I was assisting onto the commode, and her venturi mask (set at 15 liters) wouldn't reach. She asked me if I would give her the cannula instead. So I unplugged the venturi and replaced it with the cannula. She then asked me to turn down the oxygen flow, as it was burning her nose.
Mind you, I had no idea that venturi masks normally have a much higher flow rate. I asked her what she would like it set at, she told me, "ten." I then left her on the commode and gave her the call light so she could get a hold of me when she was through.
One of my other patients was calling out for help, so I went to see what he needed. In the meantime, apparently she used her call light to ask for the nurse and was complaining about the oxygen burning her nose because the flow rate was too high.
The nurse called the respiratory therapist, and she figured out what the problem was and fixed it. The patient was rather distraught. I was in that other room cleaning up my patient who had a rather large bowel movement in the bed. The nurse then came in to do a dressing change on this man and explained to me what happened.
My stomach instantly dropped. This nurse just happens to be one of my favorites to work with and assured me that it was just a mistake, and that these things happen, but I can't seem to stop thinking about it. Has anyone else ever made this mistake?
Don't be offended by my question but as far as I know the CNA in my state cannot touch the oxygen unless its adjusting the cannula. A CNA in Nebraska would surely be investigated for adjusting the Liter Output for gross negligence. Just be careful. I'm glad the patient was ok.
Don't be offended by my question but as far as I know the CNA in my state cannot touch the oxygen unless its adjusting the cannula. A CNA in Nebraska would surely be investigated for adjusting the Liter Output for gross negligence. Just be careful. I'm glad the patient was ok.
I start my program next week and my NM talked to me about keeping my scope of practice boundaries clear. When I'm working as a tech I cannot do things that I am allowed to do at clinicals.
Was this a new patient on the floor? I wonder because if you picked up the patient from the CNA on before you, they should have told you in report how to get this person to the bathroom. If not, then in the future ask the nurse before you move the patient so that you can move the patient safely.
And as a CNA I can't change the O2 settings for the patient, out of my scope.
Besides the excellent responses here, I want to clarify that oxygen is actually considered a *drug,* and it requires a prescription that includes route, volume and rate, including transcription onto a Medication Administration Record (in most facilities, anyway). That is the significant reason it was a real mistake to handle and change what you did.
I agree, however, that it is a learning experience for you, just as it was for any of us who have made our own errors in our careers. This patient could have removed the cannula due to discomfort, then fallen from hypoxia, etc. So, count your blessings, and move on with more knowledge than you had before. Glad it all worked out well in the end.
P.S. I know exactly what you mean by your stomach dropping when the penny dropped.
Don't be offended by my question but as far as I know the CNA in my state cannot touch the oxygen unless its adjusting the cannula. A CNA in Nebraska would surely be investigated for adjusting the Liter Output for gross negligence. Just be careful. I'm glad the patient was ok.
Same with me. I live in Georgia, and my textbook said never touch oxygen levels.
BUT I was thinking since her floor is specific maybe she has a broader scope. Base CNA's learn pretty much the same thing, but some CNA's are taught to do extra. Like there are CNA's who can pass out meds called "Med Tech" With my certificate and experience, i cannot TOUCH meds.
eek. I am glad a patient is ok. I would try my best to learn from that experience and never touch breathing equipment again without informing the nurse atleast. I hope you feel better.
You were practicing outside your scope and the repercussions could have been huge for you and for the patient. Thank goodness they were not. You made a mistake, and the best thing to do at this point is to learn from it.
I think the big lesson of nursing school for me was that I need to know when I don't know what to do. If I can figure out what I don't know, I'm home free. If I don't know something, I can find it out. But if I just go with my best guess, I can really hurt someone. It was really, really hard for me to learn this, but it was also crucial.
Nursing is not guesswork. It's science, with a touch of art. If you're not rock solid certain about something - ask someone who is. If it's outside your scope, pass the request on to someone who can take care of it. You don't want to jeopardize the license you're working so hard to earn.
I'm a nursing student in my third semester of clinical and I work as a CNA on a pulmonary medical/surgical floor. I really like my job, but last night at work I think I made a mistake.
I had a patient whom I was assisting onto the commode, and her venturi mask (set at 15 liters) wouldn't reach. She asked me if I would give her the cannula instead. So I unplugged the venturi and replaced it with the cannula. She then asked me to turn down the oxygen flow, as it was burning her nose.
Mind you, I had no idea that venturi masks normally have a much higher flow rate. I asked her what she would like it set at, she told me, "ten." I then left her on the commode and gave her the call light so she could get a hold of me when she was through.
One of my other patients was calling out for help, so I went to see what he needed. In the meantime, apparently she used her call light to ask for the nurse and was complaining about the oxygen burning her nose because the flow rate was too high.
The nurse called the respiratory therapist, and she figured out what the problem was and fixed it. The patient was rather distraught. I was in that other room cleaning up my patient who had a rather large bowel movement in the bed. The nurse then came in to do a dressing change on this man and explained to me what happened.
My stomach instantly dropped. This nurse just happens to be one of my favorites to work with and assured me that it was just a mistake, and that these things happen, but I can't seem to stop thinking about it. Has anyone else ever made this mistake?
Nobody goes into this to hurt people.
Accidents happen. You learned something.
Cheer up and drive on.
Your concern speaks very well of your commitment and care. Don't beat yourself up (leave that to the patients, Jk).
All that said always be very aware of your scope. On a pulmonology floor, issues surrounding O2 delivery should be front of mind with regard to this.
miabia, BSN, RN
43 Posts
Don't be offended by my question but as far as I know the CNA in my state cannot touch the oxygen unless its adjusting the cannula. A CNA in Nebraska would surely be investigated for adjusting the Liter Output for gross negligence. Just be careful. I'm glad the patient was ok.