Nursing Assistants Responsibilities-I Need Help!!

Katnip, RN · Feb 10, 2006

If I'm in the room, I'll put the patient on the bedpan, then ask the assistant to keep an ear out for when the patient is done while I take care of the other patients.

pink2blue1 · Feb 11, 2006

I've been a nursing assistant for 3 1/2 years and I am also a nursing student. Personally I agree with the other poster. If you were there it couldn't have hurt to put her on the pan and then have the CNA listen and take her off. Getting a patient on the bed pan isn't the time consuming part, it's the clean up.

I had floated up to another floor one day and I had a nurse come HUNT me down to put her patient on the bed pan because "He has dierrhea and needs it NOW" I was the onlllly aid for 25 patients and was in the middle of vitals. By the time I got to the patient he was about to go in the bed and just as I slid the pan under he started to go. I can't imagine having someone make me put on the light to wait for the CNA if I had to go now. I can understand why the family complained.

Sorry

Town & Country · Feb 11, 2006

I understand where you are coming from, but once you're in the room, you probably should have put her on the bedpan.

It's very CHALLENGING (to say the least) having to deal with situations like this.

DusktilDawn · Feb 11, 2006

What the OP did, considering the situation, was DELEGATE to an appropriate person. Whether a nurse appropriately DELEGATES can become an issue in a court of law. She had two critical patients that required her attention at the same time. Unfortunately we cannot justify our actions to patients by violating HIPPA, meaning I cannot explain exactly the situation of another patient to justify why I'm delegating a task or why they have to wait. BTW, I have encounted a number of patients where it was not a "breeze" to put them on a bedpan.

Under normal circumstance, I would agree that hunting the CNA down for this would be inappropriate. However, with 2 critical patients that required attention at the same time, I do feel these actions WERE NOT INAPPROPRIATE. The OP delegated appropriately.

trepinCT · Feb 15, 2006

As a soon to be RN and a 16 year CNA, I say, if your patients were that critical, you should be with them , however, you WERE in the room, you could have put the patient on the bedpan and had her put call light on for the CNA to take her off.Where I worked before, I encountered many nurses who would do this. I realized the scope of a nurses job and the responsibilities they have for their patients, but they also have to realize that there is usually 1 aide on a unit ..so, as in my case, we had up to 20 patients, each nurse had 2-3 patients..but that meant that I had 20!!! Some of the best nurses I have ever worked with used to be CNA's. Nursing care should be a team approach with the ONLY goal being delivering the best patient care you can. I worked the 3-11 shift for many years with the greatest team of nurses and housekeepers..We all helped each other out whenever we could..we never hear "its not my job" from anyone..if a patient put her call light on for water..anyone available:wink2: would get it..many time the unit secretary would do it.(we worked on a L&D unit , so knowing who was NPO, ice chips, water was easy to figure out by looking at the patient assignment board)..I have worked with nurses washing a discharge bed to get ready for a new patient if housekeeping was busy(even the "non life saving jobs" are important)..dietary aides positions were eliminated, so passing meal trays became my job, always a nurse, unit secreatry to help out..same with dishcharges, pharmacy runs, etc..all things the day shift nurses often gasped about !!! There was actually a nurse who told a nursing student not to help pass meal trays or do discharges b/c it wasnt her job!! nice training!!! The nursing shortage in many areas have called for an increase in support staff..work as a team and the patient gets great care and aides and housekeepers stick around!!

Marie_LPN, RN, LPN, RN · Feb 15, 2006

I was so busy I ask that she put the light on for help from a nursing assistant, apparently the patient complained and I was remrimanded and told I should have taken care of it that it took just as much time to put her on the bed pan as it would take for an assistant to come in.

I understand the busy part, however, as a former aide that worked as the only aide on a floor of 35 pts., i would have been extremely peeved that a pt. was told to push the light for me to put them on the pan. Who knows how long it would have taken me to get there to answer the light.

As a nurse (no matter how busy), i would have put the pt. on the pan, and had them ring when they were finished. On my way to the next room, i'd tell the aide "Ms. So and So is on the pan, i need to go into Mr so and so's room, can you please watch and help Ms. so and so?

Marie_LPN, RN, LPN, RN · Feb 15, 2006

The OP delegated appropriately.

I don't agree. The OP told the pt. to ring the light for the aide to put her on the pan. Nothing was actually delegated.

ChattyRN · Feb 16, 2006

I am the RN that asked for the opinion of the majority out there. I was also a NA at one time and I guess I do not know how to express in this forum the day I was having. I have always been and continue to be the nurse that helps out everywhere, but this particular day was different. I have no problem putting someone on a bed pan but like I said I cannot express in writing here the day I has having. I thank the nurse who stood behind me and I still feel I did nothing wrong. The NA that went to management was someone that I got a job at my hospital (not that she owes me anything) but I think it would have been move respectful and helpful to the moral of the floor to have come to me about the issue. Working together not being out to get each other. I would also like to add that I understand the tedious work of an NA but we cannot operate without all members of the hospital from volunteers all the way to nursing and everyone in between, dietary people, housekeeping, transport people everyone-but as an RN having walked the shoes of an NA and being on a critical care unit, their job does not compare to what we have to do and I have a license on the line. I wonder how it would sound in a court of law if asked where I was and I replied I was putting a patient on the bedpan. Thank You for your replies to my dilemma.

mollysn · Feb 16, 2006

I really feel for you the day you had. I think in the time it took you to tell the patient to put the light on you could have had the bedpan under the patient and moved on with your responsibilities. I'm sorry you had a bad day.

Cute_CNA, CNA · Feb 16, 2006

I had an event happen at work and would like some feedback or advice from all of you. I have been a nurse now for just over 5 yrs and during that time have worked critical care right from the start. I had two out of three of my patients the other day needing a lot of attention including a spastic family member. I went to one room to check a blood pressure when I needed to be in another room at the same time I am sure you get the picture. While I was in there she asked for the bedpan (which she had been on several times and not having a BM) I was so busy I ask that she put the light on for help from a nursing assistant, apparently the patient complained and I was remrimanded and told I should have taken care of it that it took just as much time to put her on the bed pan as it would take for an assistant to come in. I was so frustrated I said I have two critically ill patients what do you want me to do? Was not a good conversation with an assistant manager. Later I asked the assistant about it and she replied well if you were in the room you should have taken care of it. My reply was I always help you when you need it and she agreed, I said I really wish you guys could walk a day in our shoes to truly understand what we are up against. She is an excellent assistant but I did her job at one time and it does not compare to the reponsibility a nurse has. What do you think?

Don't forget what she said above... it seems that there were a few attempts made already to help this woman, but she just wasn't using the bedpan when given the opportunity for one reason or another. The OP was probably expecting the same result when the person asked the last time. So I don't think it was inappropriate to delegate. It sounds like it was "one of those days."

Don't flame me for this, but I have to wonder if the woman asking for the bedpan several times wasn't just looking for attention. Now, maybe she did need to use the bathroom. But based on the fact that she complained that she wasn't given attention "one more time," makes me wonder if she complained out of revenge for not getting attention. I also wonder if she really needed to use the bedpan every time. Again, don't flame me for doubting the patient's intentions, but it does happen. There are attention-seeking patients out there.

NYCRN16 · Feb 16, 2006

I will probably get flamed here, but I am agreeing with the original poster. Ill start off by saying that you will never hear the words "that is not my job" out of my mouth, the PCT's that I work with all say that I am one of the few nurses that really helps them out and does not abuse them. I rarely ask them to do anything other than EKG's, most other patient care issues i ALWAYS offer my assistance unless I am truly too busy with a sick patient.

It seems like the OP is the kind of nurse that helps out and does not sit on her butt and let the CNA do all the work. This night she had 2 patients who were sick, and needed her attention at all times. Lets call this woman patient X and the other patient, Y. She is in X's room doing something, now this woman needs a bedpan. Maybe she is 300 lbs and needs the assistance of 3 to get her on it. Maybe the bedpans are all the way down the hall and not near the room. It does not take "1 minute" to put all patients on the bedpan like some have said. It can be a 10 minute project in some cases. Now lets think about patient Y. She works on a cardiac floor. Maybe this patient was having runs of v-tach, or was on pressors and had a b/p that need to be recycled q5min. Maybe he needs like 10 meds to be given now. How do you know that while she was in the room with X, that the monitor wasnt beeping in Y's room, which needs immediate investigation? Those 5 minutes that it takes to get the bedpan and get her on it could mean its too late for patient Y.

If there are only 2 staff members in this situation who are able to help, the RN and the CNA, guess what..The CNA cannot go monitor patient Y, give him his meds and assess his condition while the nurse is giving the bedpan. So the OP made the choice to delegate to the CNA. That is the only logical thing to do in this situation. Now if the nurse was sitting on her behind while the CNA was running around then I would feel differently. Some other posters have said that in previous facilities the RN's would give bedpans and the OP doesnt. That is totally irrelevant. We are not questioning her willingness to help out, but the decision for the nurse to not do it at that time was based on nursing judgement, which the CNA obviously did not understand.

I have been in the above situation with 2 unstable patients, and sure the PCT's have complained, but most of them are knowlegeable enough to understand why I was not able to do it at that time and are more than willing to help. Nobody went to complain on me, but even if they did it wouldnt get very far because anyone with common sense can understand that situation if they were there and totally aware of everything going on at that time, which we were not able to totally do from the post, but anyone who cares for cardiac patients can imagine a situation above, and know that its not uncommon for that to happen.