Need advice,Problem CNA

[stillwant2banurse]

I am a nursing student in school, and I am currently working on my preq reqs. My question is this, my mother in law is in ESR (End Stage Renal Failure) and my spouse is trying to assist his mom in anyway possible. The CNA that is taking care of her is becoming unapproachable to the point that everytime we ask her a question she assumes that I am after her job and instead of just speaking with me about her condition she runs back to our father in law and tells him that we undermine her and we think she dosnt know what she is doing.

Let me first state I do not want her job, I am too busy with school and my own job at a local hospital, but it has now gotten to the point that my mom (in law) was placed on too much meds her bp was dropping and she was rushed to the hospital on several occassion almost having a heart attack. When I went to look at her meds I continued to try and point out to her that her medication was incorrect, but instead of trying to look at the problem she was more concern with her job then her patient.

Now she has had these medications in her system for so long, the doctor is convince her health is warranty Hospice and my spouse dad is confused and do not want her on all these meds (being that the meds are 4-5 different psych. meds) and she is not combative in anyway.

I cant get past why this CNA is so protective about her job, to the point that she dosnt want to share information with her family members which is us?

When going to school, or obtaining your RN, did any of you guys experience this before?

If so how did you handle it?

I have not said anything to my spouse because I dont want to complicate things more, but it makes me wonder sometimes what is she hiding if anything.

I should also mention, that I believe my mother really can benefit from a RN doing quaterly vist and assesments to prevent this, but when she meets anyone she introduces herself as "her nurse" and she is not a nurse! and this impression is hindering her from receiving or asking for the appropiate care.

[CNA Tony]

honestly as a CNA my self id get rid her after reading this im sorry she cannot provide the appropriate care then get rid of her we do not needs CNAs giving the good ones like me a bad name.

[Penguin67]

Not sure what state you are in, so I don't know the laws. But I am left wondering if talking about meds should be in the scope of practice of a CNA? Med administration and related discussions should be done by RNs, I believe. I'd try to get an RN to make periodic visits and discuss the RN things with the RN and the CNA things with the CNA.

Also, "nurse" is usually not a protected title by state practice acts. Unfortunately, the usual title that is protected is limited to "registered nurse". Check your state's nurse practice act and you'll see what I mean. It ticks me off to hear of folks calling themselves a "nurse" when indeed they are not, but not much we can do legally unelss they use the "registered" part with "nurse". I try to calm myself down by thinking how lucky I am to be in a profession that others want to be in so badly that they'll stretch the truth to be a part of.

Good luck with your schooling!

[mariahas4kids]

PLEASE, please, please contact her employer. Of course your mother-in-law should have an RN look in on her. Trust you feelings, if something feels hinky, it usually is.

[pagandeva2000, LPN]

I was just reading a book written for UAPs (unlicensed assistive personnel) to be able to administer medications and I was completely blown away. This occured because a friend of mine is becoming certified as a medication aide at a group home and she showed me her booklet and notes. I used to be a certified AMAP myself years ago in a psych hospital (before I become a nurse and saw the risk). The first thing I noticed was how similar these things were to nursing. I did see that they had a nice summary of the medications, so, I ordered a used book from Amazon hoping for a similar purchase, just to sort of remember about the medications I don't give, and I was blown away at what this book was saying. It was geared towards Home Health Aides, CNAs, med techs, etc... and while they stated they were 'not teaching assessments', this was EXACTLY what they were doing, and there was not one step that any LPN or RN was not taught in nursing school.

I noticed over the years that home health aides in my state are not state certified, but are certified by their agency; which is only a store brought certificate that totes the name of the agency, saying that the person passed their competency, and it seems that each agency has their own rules about what their HHAs can do.

I have another friend who was a HHA for many years. One agency said that if the family organized the medications, they can place the medications into the patient's hand for them to swallow themselves, others don't allow it and then, there are some that allow it. Then, there were some situations where the family was not really around, so, they would pay the aide extra money to give the meds. I mean, there is not a nurse present when these meds are administered, and even if she did come, unless it is mentioned, how would the licensed nurse know unless someone told her outright?

I think that first, you should call the agency and find out what they are allowing their aides to do and secondly, you do have a right to be able to question this person. If this agency IS allowing UAPs to give meds, then, they needed to be trained. Personally, I don't believe that they should at all, under any circumstances, but if the agency is allowing her to do so, then, this may be an agency I would not want caring for my loved one. Screw her feelings, she needs to get over it. Maybe they are unaware she is giving meds at all.

[DolceVita, ADN, BSN, RN]

I am a student nurse and a CNA. I don't think you should be asking a CNA about a medical condition. They are not qualified to discuss this with you. Nor is the CNA the person to point out that medications are not correct.

I a not saying CNAs are stupid but they have their own scope of practice. Even if I feel I can field a question about a disease or medication from a patient, I do not. If I did I would expect my butt to be on the BBQ.

What this CNA should be doing is explaining that she is not in a position to have these discussions with you or anyone. As for introducing herself as a nurse? I would report her to her agency...not OK.

Just some thoughts. Sorry about your mother in law.

Peace

[onetiredmomma]

I agree that if this is an agency CNA you should ask her agency to replace her. If she is private hire, find a replacement and get rid of her. Your family doesn't need the added stress of an uncooperative employee. Ask your MIL MD about her meds and tell him/her your concerns. Good luck, hugs and prayers to you and your family.

[Virgo_RN, BSN, RN]

You're barking up the wrong tree. The CNA has nothing to do with prescribing the meds, nor assessing your MIL's response to them. MDs prescribe, RNs assess, and LPNs "collect data". If you have concerns about your MIL's plan of care, you need to talk to the RN on the case.

[cursedandblessed]

it sounds like your mil is being cared for at home. if the cna is a certified medication aide (which we do have in my state) then in regards to the medications for bp, the bp must be taken as well as the pulse and you need to discuss with the primary physician about a hold for the meds if the bp/pulse is below a certain number.

if she's not, then her duties are simply vitals and adl's period. if she is not qualified to give the meds, then someone in your family needs to be administering these meds.

lastly, it seems like the situation is hostile. this is not a good situation for your mil.

in nursing school, i've found some cna's are wonderful and see us as assets on the floor, we lighten their loads considerably, and there are some who resent nursing students. i've always gotten along well with almost all of the staff from the housekeepers to the cna's and the nurses, but sometimes there are those who you just cannot make get along with you as a member of the healthcare team whether it be in the hospital or as part of the team with your family in the care with your loved one. if this is in your loved ones home, then another care giver with more respect to their responsibilities and their patients might be in order. as a cna, she should be under the supervision of a licensed nurse even if not on site, you should speak to her supervising nurse.

[cherrybreeze, ADN, RN]

I am lost on what input a CNA should have about the meds in the first place....if what you mean by "the meds are incorrect" is that you think she should be on different meds/dosages or none at all, the CNA has nothing to do with it, you need to talk to your MIL's physician. If she is GIVING the wrong meds, as in, not what is prescribed or as they are prescribed, that's obviously a WHOLE other issue.

Leaving that aside and looking at the rest of the situation, it's just plain not a good one. I would suggest just replacing her, I don't see a reason NOT to. She doesn't sound like she's providing an environment that's compatible for progress in your MIL. BUT, if most of your MIL's issues have to do with the meds she's on, a new CNA wouldn't make a difference. I think you need to find the root of the problem.

Best of luck with fixing this; if it were me, I'd start the search for her replacement.

[Mike A. Fungin RN]

stillwant2banurse, it would help to know what state you're located in. The laws vary by location, but here in California "nurse" is by itself a protected title. Only registered and licensed vocational nurses may use the title "nurse" and the Board of Registered Nursing takes violations very seriously.

[HospiceAide]

If the MD suggested Hospice it may be the best in the sense that they monitor the medications and when they need to be given. That way she can not "fool around" with them. But more important, she needs to go. You pay her paycheck, and it sounds like she "Makes" your MIL that way to be dependent in some aspects it sounds like a kind of Munchausem by Proxy for your MIL. She will give a bad name and no matter what even if the are Med. cert, or nurse del. you can report her to the state and her super. Good Luck