am I wrong?

[Ms.RN]

Here is a scenerio. Nurses aide was in the shower room and she is undressing the patient to give a shower. At the same time, her other patient who cannot do anything by herself says she have to go to the bathroom. So I went to a shower room and asked her if she can toilet this lady first before she gives her a shower and she refused and her reasoning is she is busy with another patient. My reasoning of asking her to toilet her first is because there is a toilet in the shower room and if this patient is not taken to the bathroom, then she is going to be incontinent. Since a patient who needs a shower is already in the shower room she can wait a minute or so until she toilet another patient. So am I wrong? I need an objective opinion beceause my manager is not being objective at all.

[Flying ICU RN]

Let's put the scenario another way, the aide does precisely as you ask without argument, then,... The first patient in the shower stall slips, falls, and develops a subdural hematoma requiring surgical evacuation.

Would you have been quick to absolve the aide of any responsibility as it had been your call?

[LauRN]

i too agree with everyone, you should have toileted the pt yourself.

[squirtle]

Ovbiously we don't have all the details but a few thoughts...

If the aide was needed to assist to first pt with a shower, wouldn't that mean that it was unsafe for her to shower alone? And if so, why would it be ok for her to leave that pt alone to toilet the other?

Also, can you explain what you were doing at the time? Did you also prioritize your activity as being more important than assisting either pt yourself? I honestly can't think of anything that would be worth risking the safety of the first pt who is all ready in the shower.

I am just hoping you realize you have just as much responsibility in these tasks as the aide does.

[Miller86]

You definitely approached the situation wrongfully. You should have just went and assisted the pt with his/her toileting needs. Your co-worker was clearly busy and does not have a million hands. It's not nice to think an RN is above toileting a patient (regardless of it being your assignment or not). It appeared you had a little extra time, so in that case please help out your co-workers, and in turn they will help you out.

[luvthegsp]

I have encountered this very situation MANY times with LPNs in a LTC. Yes, my primary work as a CNA is to assist the nurse and the residents with ADLs, BUT it the ultimate responsibility lies with the NURSE!

[kyleRN]

I would say you're definitely wrong. a CNA is there to help, not to do all of the patient care for you... she's your aide, meaning if she can't help you because she's busy then you have to do something yourself. Didn't you get any experience sitting someone on a toilet during clinical in nursing school?

[NotFlo]

I feel like we might be missing something in this story.

How does the pt. that needed to go to the bathroom transfer? Do they require a mechanical lift or an assist of 2?

Honestly, the CNA was in the right. If the pt. she had half-dressed in the shower were to fall that CNA would be in so much trouble. I would never approach a CNA who was in the shower room with a pt. about providing care to another pt.

If you couldn't toilet the pt. by yourself for some reason I would have found someone else (another CNA or nurse) and gotten the pt. on the toilet myself.

[NurseLoveJoy88, ASN, RN]

I agree with everyone else. You should have just toileted the resident yourself. It is also a safety issue to leave a resident in the shower unattended even if the shower isn't running. WE are the nurses and it is OUR job still to provide adl care as needed when CNAs are not around.

My cnas always Thank me for toileting a resident and I tell them not to because I'm just doing my job and they are there to ASSIST us. When we are short CNAS guess who is doing ADL care, feeding, doing showers , bed baths and etc ? ME the NURSE :)

[cathyrn01]

Any chance the OP is ever going to come back to this discussion? I would like to hear more of your side.

[nursinger]

Here is a scenerio. Nurses aide was in the shower room and she is undressing the patient to give a shower. At the same time, her other patient who cannot do anything by herself says she have to go to the bathroom. So I went to a shower room and asked her if she can toilet this lady first before she gives her a shower and she refused and her reasoning is she is busy with another patient. My reasoning of asking her to toilet her first is because there is a toilet in the shower room and if this patient is not taken to the bathroom, then she is going to be incontinent. Since a patient who needs a shower is already in the shower room she can wait a minute or so until she toilet another patient. So am I wrong? I need an objective opinion beceause my manager is not being objective at all.

Your manager was right in probably telling you that you should have taken the resident to the BR. Please remember this for the next time... they are all our residents no matter who is assigned to take care of them. If the NA who is assigned to take care of a resident is busy taking care of another, especially in the shower room, it is your duty to take that resident to the BR yourself.

[Kelly2010]

Am I missing something? Are your arms or legs broken? Did you have some dire situation that needed your absolute, immediate attention? Because that is the only reason why I could walk away from a patient who told me they needed to use the restroom.

I just started nursing school and one of the first things we learn is how to care for the basic needs of patients. Have you forgot how to ambulate a patient to the restroom? Are you too good to help them clean their perineal area?

Humble yourself. The CNA was totally in the right. There is no reason why you couldn't have helped out that patient, especially when you had the time and energy to track her down and order her to do it.

Were you even thinking of the other resident who was sitting in the shower half naked. Does his/her time, comfort, needs, safety, wants not matter?

I don't mean to be rude, but I am so glad that I never had to work with nurses like you when I was working as a CNA.

[Ruby Vee, BSN]

your manager isn't being objective? or she just didn't agree with your priorities?

you should have toileted the patient yourself.