would like your opinion...

[spunky1281]

Okay. Here's the thing, I work in LTC on overnights as a CNA. I got written up for this and wondering from everyone else if I should learn my lesson or fight it

Res. X started yelling. When asking what he wanted, he stated he felt sick and requested I give him a basin. I gave him one, made sure he was fine, and then left his room. I went to answer another call light across the hall and put that person into the bathroom. I came back to check Res. X and he had a sm. amt of emesis in the basin. HOB was elevated, call light was within reach, and basin was in front of him. While I had been in with X, a tabs alarm had been going off as was a pressure alarm. This resident (whom I'll call F) has a hx of falls, is unstable with ambulation, and can be confused. Knowing that I was only 20-30 ft from Res. F's room and that all the other staff was on the other end of the hall and had no way of making it to her in time, I decided to check on the alarm. I escorted Res. F back to bed and returned to Res. X, who had thrown up more in the time I was gone. I alerted the nurses right away and cleaned up Res. X right away.

I found out I was written up several days later from another nurse that hadn't even been working that night. When I questioned another nurse, she confirmed the rumor going around. I confronted the nurse that had written me up and she said that she had to do it (Chg nurse told her to) and that the Res could have aspirated. I was told that I should not have left that res and that I should have radioed for help on the walkies to respond to the alarms. Despite refusing to sign the write up and telling her I felt I did what was best at the time (a resident that falls easily was more of a priority than a resident that had emesis with a HOB elevated--and it wasn't like I left him and never returned). I knew the rest of the staff could not have gotten to her and thats why I left him.

Was I in the wrong? What would you have done? Should this be fought?

[firstyearstudent]

This is why I hate health care. No matter what you would have done someone would say you shouldn't have done something else. And management is always focussing on "safety first" until you start calling for backup/help all the time, then they tell you that you need to "use your judgement" and handle the situation yourself.

I don't think you did anything wrong.

[netglow, ASN, RN]

IMO it is no reason to write you up. You cannot be in all places at once, and you know how people are, if you had called for help, somebody would've chided you for not handling 3 patients on your own.

You already did what was in your control in the way of preventing Res. X from aspirating... in the end, if he's gonna, he's gonna. Sure it would be great if you could just remain with him during all of his nausea/vomiting, but that isn't the way it works, and that wouldn't prevent him from doing it anyway.

[justiceforjoy]

Unless he was violently throwing up as you left, I don't see how you could have done anything differently. Was Res. X at a risk of aspiration already from an existig condition?

[lisarn123]

I don't think you did anything wrong and you should not have been written up. I've worked as a registered nurse for 12 years, currently as a clinical manager home health, and I would never have agreed to write you up even if the charge nurse said so. She could do it herself instead if she felt it needed to be done. You should be commended for doing your job as well as possible with the limited resources available in health care right now. Funny there is any wonder why there is a shortage of health care workers now. Lisa RN

[mochabean]

As I always say, 1 person can only do 1 thing at a time! You did the best could in the situation.

[leslie :-D]

it seems you were trying to balance 2 priorities simultaneously.

unless pt x had a hx of it, it's unlikely s/he would have aspirated.

given that pt f DID have a hx of falling, i think you prioritized correctly and handled it quite well.

you should write up your perspective of events, and have it added to your file.

good luck, spunky.

leslie

[Nurse Elizabeth]

I agree with the others.I was a CNA before becoming a nurse and am well aware of our workload.I think I would of done the same thing as you.I mean you did notify the nurse that the pt was vomiting,its not like you left and didnt inform anyone.When you are shorthanded which is a reality in healthcare you have to prioritize.I think you choose wisely IMO.I would go to whoever is your superior and have your side heard for sure.Good luck to you!

[CoffeeRTC, BSN, RN]

Wow...having worked 11-7 as a CNA and nurse, I know what a hectic shift it can be. As the PP stated, unless that resident was a high risk for aspiration, you did what you should have.

If you had the radio access, I would have called for the nurse and asked for them to come down while you checked on the fall pt.

This doesn't deserve a write up at all! With that type of stuff happening, how is your place able to keep staff???

[morte, LPN, LVN]

i have worked a looong time as a nurse, and there is no wayan alert nauseated patient can be "baby sat" at the expense of a known faller.......you could teach prioritization to the higher ups.......and staying with an alert vomiting patient is NOT going to prevent aspiration.....geesh, someone in your institution needs a review......good luck

[pagandeva2000, LPN]

Disgusting! As mentioned earlier, B-S like this is what makes people say the heck with nursing or health care. It seems that you knew as a CNA much more than the licensed personnel! Even an octopus could not concentrate on doing too much at one time! I would write a rebuttal and even request a meeting to get this idiots to explain to my face what rational they have. The nerve...

[morte, LPN, LVN]

Disgusting! As mentioned earlier, B-S like this is what makes people say the heck with nursing or health care. It seems that you knew as a CNA much more than the licensed personnel! Even an octopus could not concentrate on doing too much at one time! I would write a rebuttal and even request a meeting to get this idiots to explain to my face what rational they have. The nerve...

gee pagan, tell us what you really think...lol ....i cant see either one of us allowing a higher up telling us we had to "write up" a person in an incident that we werent even there for! and without asking the person for their side even.....and i agree, go up the chain and find out why this was done.....