Negligent nurse?

[byjessi]

So, I'm currently working as a CNA and during my shift one of my residents needed to be suctioned. Sorry, I'm not sure what her exact condition is, but she has a tube going down her throat and it needs to be suctioned of else she can't breathe. Although, she does have a habit of wanting to get suctioned often, and the charge nurse knows this. So I told the nurse the first time, and she said okay, she was currently passing out medicine. The resident turns on her call light again and tells me to get the nurse. I tell the nurse again, and she says okay, she'll deal with it. The third time the resident's light is on again and she's making a clicking sound with her tongue (her vocal cord is injured, so this is how she's trying to get attention). She also says she's having a hard time breathing. At this point, I can hear how congested she sounds. So I go and tell the nurse, I tell her she REALLY needs to get suctioned, she can't breathe. She's no longer passing out medication, but charting. Of course, the nurse still didn't do anything. So I told the resident what the nurse said, "she'll be here in a minute."

I finally decided to get another nurse from a different hall to do it. When the charge nurse from my hall saw the other nurse going into the room, she went in there also.

Not only that, but after she finally get suctioned, she tells me to ask the nurse for some pain medication for her back. The nurse just happened to be outside of the door so I told her right away, the resident even heard me tell her. At the end of my shift, the resident told me she never got her pain medication and she's going to report the nurse.

I don't want to step out of my lane ,or whatever, but honestly, I don't think the charge nurse was doing such a good job... I can understand the first time I told her she'd push it aside for a while since she does have a habit of asking to be suctioned often. But when I told her she couldn't breathe... that should've made her stop what she was doing? Do things like this happen often? This is my first time working in the field so I'm not sure how things usually operate...

[dtchavey]

I am a Director of Nursing in Long Term Care and know exactly what you are talking about. So to answer your questions:

1. Yes, unfortunately this does happen a lot. I am saddened and embarrassed that this is the case. I suspect there are many factors at play; nurse burnout, heavy workloads, and maybe a lack of urgency from complacency.

2. You did the right thing. You told the nurse, repeatedly. Additionally, when the nurse failed to respond you went and got someone who would respond. The first thing a state surveyor would look at is just that, how did you make sure that the resident did get suctioned. Follow through is important.

3. I would write a concern letter to your DON. The nurse may simply need some re-education.

Finally, with that said, remember that it ultimately falls back on the nurse to triage the situation. Some nurses don't always communicate very well, and that resident may or may not have orders for everything they asked for.

Keep up the good work.