Major venting about some CNA's

[michelle95]

First, let me say that I am not venting against all CNA's or even most...I've been one myself. I know how hard they work. I applaude the good ones.

My problem is the majority of the ones at where I work. They talk back, they leave people in messes...it's really making me mad. Just this morning, I told a CNA that was going to get my blood sugars at 5:30, to wait until at least 6:00 because I didn't feel comfortable giving insulin at 7:00 on a 5:30 accucheck. I had originally told her 6:30, but, after she explained to me that she couldn't at that time, I told her I would compromise and make it 6:00. (Sometimes our patients don't get their breakfast trays until almost 8:00 and 11-7 is responsible for the insulin at 7:00) She flat out refused. She told me that the boss said it was ok. I told her, she's not here right now, is she? You're working on MY license, not her's.

She told me no and went and got them at quarter of 6 in defiance.

I told the 'boss' when she came in, but, this is the same boss that let another CNA get away with telling me to 'shut the hell up', as well as, telling a patient to shut up. (Which is why the CNA told me to shut up...I was getting on to her for doing that)

I am so SICK of not being backed up when I tell a CNA to do something. I know I am just a little 'ole LPN at this time, but, I still expect the CNA's to do what I tell them.

I try to be fair. Like I said, I was a CNA, I know how hard the work can be....but, I didn't talk to my nurses any old way I feel, much less, tell them no when they told me to do something.

If the big bosses won't do anything, what am I to do? Go over their heads?

This is my last night tonight. I've done decided that the next place I work, I am not going to be so nice. I've got an interview tomorrow and I am going to explain to the administrator that I DEMAND back up. If I tell someone to do it, and, they snap off, I EXPECT there to be repercussions.

I hate to be so down and dirty, but, I had an spiritual experience a couple of weeks ago that made me see that every patient I come in contact with, is someone's loved one. I don't expect to see them laying in pee or dried food for hours. That is soooo undignified. If I don't take up for them, who will?

Any advice? Should I go to the ombudsman if the bosses won't do anything about these CNA's with an attitude?

I hope any CNA's that read this don't take offense. If you do your job honorable, I am not talking about you.

[SmilingBluEyes]

Originally posted by Sleepyeyes

i worked in a nursing home in which a resident on pain meds lit up in her room and set her bed on fire. happily no one was hurt because the smoke alarms went off and we were able to evac before the roommate's O2 blew.... which is why most NH's are smoke-free now.... ins co's just don't wanna chance it.

And these are the "good ole days" we want to return to? Mario, I admire your compassion, but we need to let common sense rule here. Smoking is not a nursing priority; said it before (too many times) and I will keep on saying it.

[mattsmom81]

Deb, what I meant by the 'customer satisfaction' question was : does your administration support you in OB if Moms complain 'the nurse wouldn't watch my baby while I smoke'.

Or do they blame you because in their minds if a patient complains the nurse did 'something' wrong ( and I feel this is frequently the assumption of administration..at least in my area.)

[mario_ragucci]

No blue eyes, not return to good old days. Just acknowledge that they did exist. And this topic raises pinpoint concerns for me. Let me explain. How should I chart watching a baby for someone? I would have to ask my nurse manager what to do, because I would want to help the family, but at the same time would not want to be misappropriating the hospitals use of my normal function. Would it be my favor, or the hospitals favor? What should the answer be?

[SmilingBluEyes]

Originally posted by mattsmom81

Deb, what I meant by the 'customer satisfaction' question was : does your administration support you in OB if Moms complain 'the nurse wouldn't watch my baby while I smoke'.

Or do they blame you because in their minds if a patient complains the nurse did 'something' wrong ( and I feel this is frequently the assumption of administration..at least in my area.)

No complaints about us not watching the baby while they smoke that I know of...why? Maybe cause the ONLY time we refuse is if there is a bonafide emergency or critical situation occuring at the time they ask. We politely decline and explain briefly why. They seem to understand and comply readily. We really DO try to accomodate people in any way we can. Like you said in OB, that is the name of the game: PR!

[SmilingBluEyes]

Originally posted by mario_ragucci

How should I chart watching a baby for someone? I would have to ask my nurse manager what to do, because I would want to help the family, but at the same time would not want to be misappropriating the hospitals use of my normal function. Would it be my favor, or the hospitals favor? What should the answer be?

It's quite simple: I chart "infant in care of RN while mother takes a break. Infant is Pink/Eupneic has normal tone , no distress noted." If vital signs are indicated or it's time, I take them then. I try to do weights, PKU and prints at this point, if they are not done--- in order to best make use of the time. Sometimes, however, its all we can do to keep an eye on the baby if there is a lot else going on on the floor. It's case-by-case thing that requires creativity and critical thinking, like all else in nursing, I guess.

[BBnurse34]

Last night I had a G11 P9, past drug history, all other kids taken by CPS couplet admit.

LDR let me know that the woman was "a nightmare" they had already given ativan twice for combative nature.

On admit I asked her what her issue was. She said "I am cranky because I need a cigarette"

I finished the admit, put her in a wheelchair (800EBL) dropped the babe off in the nursery and took her outside to smoke.

She was a model patient for the rest of the night.

Just because I don't smoke doesn't mean that I don't recognize that it is a NEED for some patients....and it was easier than pushing ativan on her all night.

[BBnurse34]

BTW that was my state's New Years Baby.

[SmilingBluEyes]

Originally posted by BBnurse34

Last night I had a G11 P9, past drug history, all other kids taken by CPS couplet admit.

LDR let me know that the woman was "a nightmare" they had already given ativan twice for combative nature.

On admit I asked her what her issue was. She said "I am cranky because I need a cigarette"

I finished the admit, put her in a wheelchair (800EBL) dropped the babe off in the nursery and took her outside to smoke.

She was a model patient for the rest of the night.

Just because I don't smoke doesn't mean that I don't recognize that it is a NEED for some patients....and it was easier than pushing ativan on her all night.

I hear you...however did you see where I said, not all of us have a nursery to drop babies off to? If you do, it does indeed free you up a bit more to take em out to smoke. It may be a "need" for them...but all our patients have "needs", also. It's about priorities and what kind of staffing you have.

[micro, RN]

please forgive me all.....as I don't post like i used to.....

but in checking out old friends and their posts......

this one 'called to me'...........

I too, feel compassion and empathy, Mario....for the patient that is in the hospital for another diagnosis.....and has their rights removed just like that to smoke a cigarette at their time and leisure.........

then I also read what browns and mattsmom said.....and I also remember when smoking was allowed and 'at times encouraged even post op' certain surgeries by the physician/surgeon to their patients that were long time smokers........

when smoking was allowed in the hospitals, and in the hospital rooms.....etc.

one case scenario that will always play on my mind.......

after surgery, think it was a open choley.....the doc saw the patient after and told the patient to 'ignore' any do gooder nurses and other docs.....and to continue to smoke as the patient felt the need......

then the doc went on in 'simple, layman's' terms and said.....you are not here to quit smoking, we can discuss that another day.....you are here to heal from abdominal surgery

you have smoked for many years.....your lungs are 'used to that'.........so smoke.....and also DB and C as they suggest.........

NOW IS NOT THE TIME TO STOP SMOKING'

I guess I 'feel' compassion for my patients.....and that is a 'fault' of mine.........

but I almost think at times.....a return to some of the old ways would........oh, well better just stay off that soapbox........that turns into a large slimy can of worms......

but, what I do think that with now, the We Don't Smoke Here and now, you can't either and if you are a smoker, even though that is not what you are here for...........let me tell you how you are lower than other human beings" is brought across to our patients.........

I think it has went too far.....imho.......

I feel that smoking should be addressed as the initial part of the admitting history and doctor's orders.......

1) is person a smoker

2) would smoking during stay adversely affect them in their acute period of illness(duh.....not.......of course we know smoking is bad for you.....duh.....so does any smoker)

3) doctors order yes or no.......patient is physically able to go to specified smoking ___ # of times during day to smoke with/without 'supervision'

4) patient signs waiver releasing doctor, etc.....from any harm occurred during a 'smoking' episode.........

5) and patient signs in and out when leaving room, floor, etc...........to go smoke, etc.........

now, I can agree the environment of hospitals, etc. are indeed healthier......now with the no smoking rules......and those o2 burns are nothing to mess with.........

if the person is not physically able to take themselves to smoke and without o2..........then during their stay.........they should be told that for that time they cannot be allowed to smoke in that it would adversely effect them during their immediate stay and their health.........as well as put others at risk and harm.........

I have found that the nicotrol inhalers seem to help people more than the patches.....though I have tried neither myself........

because cigarette smoking is "for this ex- current- ex- " smoker.....nicotine is an addictive substance, but cigarette smoking is also a 'nervous' or something to do "with the hands" habit...........

I also remind/patient education my patients under my care.....that if they must smoke and are able to physically.........

don't leave/hide without me knowing where they are going.....

they are adults with their own rights..........

just to tell me.......I have them sign the 'correct forms' and then we both know what is going on.....and they are not forced to

resort to "smoke in the bathroom" like they were a bad teenager..........

I have also educated patients, that if they are using the patches and that they ever feel that they must have that cigarette, to remember to remove the patch................

for the 'perfect nurses' out there.......that disagree with me.........

I understand.........and that is okay.........

I am not a perfect nurse, but I strive to be and I also strive to provide holistic care in my care of my patients and their families.........

now when a pt. requires a staff member to go with them to smoke, etc. monopolize time of staff.....take time away from other patients to 'grab that cigarette'.........

that is where the needs of the many, outweigh the needs of the one

and I strongly feel that way also.....

no wisdom here.....

just a soapbox subject of mine.....

soapsuds away,

micro

I try to stay away from soapsuds.......of late.........

but