Opinion Please...problem at work

[chenoaspirit]

I had a 2 year old little girl as one of my patients yesterday. She was in with vomitting and diarrhea. She was dehydrated, hadnt voided all day, etc. The parents had been up with this child all night long. Apparently it was a form of virus because on shift yesterday the dad vomitted over and over into the floor, the parents are sick too. Now, housekeeping refused to clean it, said it was our job and after we cleaned it then they would come and sanitize it. Problem was, I hadnt even seen 3 of my patients, one had a CBI running wide open. I was trying to take care of the CBI between my assessments and med passes, my assistant was finishing vitals and wouldnt take the time to address the CBI at all. I asked her to help me clean the room, her response to me was "he can clean it himself, Im not cleaning it". Now, Im frustrated because Im so far behind as it is. I went to the charge nurse and before I said one word, her response was "let me guess, Kim wont help you". The charge nurse helped me clean up the vomit, which took around 15-20 minutes. I was livid. If I am willing to stir in vomit, what makes my assistant think she is better than I am and refuse to? The charge nurse was behind also, she had admissions/discharges that were needed, orders that hadnt been taken off, etc. My patient with a CBI had a PCA ordered for pain and I didnt have the time to get it set up, the doc was mad at me, etc. I have had the worst 2 weeks at work and Im miserable. This same assistant refuses to tell me when a patient has a high bp, one time a bp was 200's/100's and she didnt tell me. I went to her and told her that she needs to tell me when a bp is that high so I can address it, she keeps the vital board and unless she tells me I will not know. My butt was chewed out by a doc for that incident also. And the assistant REPORTED ME!...stating that I had chewed her out in front of patients, families, etc. I did not do that, I said it nicely but firmly and no one was around when I did so. I find this assistant in empty rooms doing homework, downstairs eating breakfast. She didnt even tell me yesterday when she was leaving the floor to go to breakfast so that I would know that she wasnt going to be around to help me with the CBI (she wasnt anyway though). How would you guys handle this if your CN and NM are unwilling to do anything? I need my assistant to do her job so that I can do mine.

[llg, PhD, RN]

Your hospital must have SOME mechanism for officially documenting (in writing) anything that is unsafe. Find out what it is -- by talking with someone outside your department if necessary -- perhaps an educator or someone in the Human Resources Department. You should probably have a 1:1 meeting with your Manager first to give her a chance to explain that procedure to you first. Tell her that you have serious concerns about this aide's behavior and it's effect on patient safety. Tell her that you would like to know the proper way to document that unsafe practice so that she can have the legal documentation she needs to follow-up on it. That gives her the hint that she either helps you document properly or be prepared to deal with the documentation you will probably provide to her superiors.

Find out what it is and then use it regularly for those incidents that endanger patients.

[Virgo_RN, BSN, RN]

I had a similar incident recently. I was in a room hanging TPN, lipids, and vanco on a patient that also had an insulin gtt, when the patient, who was of course C-Diff positive, was incontinent of stool in her bed. So I put on the call light to have the CNA come and help me clean her up. I waited for ten minutes, finding other things to do, getting all the washcloths and linens ready, etc., when I finally saw the CNA walk right past the flashing light! I went to the doorway and called out to her that I needed some help, and she said "In a minute, I have to finish picking up dinner trays." and just kept on walking. :angryfire

[barefootlady, ADN, RN]

No write up form?? Write what happened on a nurses note, signed, dated, and keep a copy for your records, and slip it into an envelope under the NM door. If nothing happens and this assistant continues to act in an unprofessional, task slacking, and potentially harmful manner, then go to the DON. Personally, I would have started this when the BP was not reported and I was jumped. Good luck, this is an all too familar complaint.

[back2bRN]

I would give them (NM) a copy, keep the original, date given or even email to your NM. These things have a habit of being filed, right into file 13. Remember to protect your pts, protect yourself.