Overheard at the nurse's station

[Teacher Sue]

My office is at the opposite end of the unit, away from the nurse's station. My daily routine is to spend the mornings on the unit, rounding with doctors, helping with care, and talking to patients. I spend the afternoons in my office doing paperwork and administrative tasks. The hospital is remodeling the floor above ours, and I needed to move out of my office for a few weeks because of the noise and dirt directly above me. My office is now temporarily in a small storage area right behind the nurse's desk. Some of the staff must have forgotten I was there, because this is the conversation that took place. (Some details have been changed to protect the innocent. And HIPAA)

CNA: Can you look at the IV in 412? It keeps beeping.

RN: That's not my patient.

Me, coming out of the office: Did you just tell her that's not my patient when she asked for help?

RN: NO

CNA: Yes she did.

ME: Go take care of the IV then come into my office

So we had the talk about teamwork, respect, integrity, and putting patients first. Of course she said she was sorry, she had been distracted, this is not her normal behavior. I warned her that this was unacceptable, and I did not want to hear this type of thing again. Then about an hour later, another conversation between the same two staff.

RN: I was just in 411. She needs a bedpan. Go put her on.

CNA: OK

Me, coming out of my office: Did you just tell her to go put a patient on a bedpan when you were in the room?

RN: NO

CNA: Yes

ME: Go put her on the bedpan yourself, then come into my office.

I usually dislike writing staff up, but this girl really deserved it.

[AnonRNC]

Wow! Same nurse? That's bold. I think you're right to write her up because this seems to be a well ingrained pattern of behavior. Had I been admonished the first time (well, I would be mortified, but...) I would have been on my very best behavior - at least until you went home. Come to think of it, not only is this her pattern, but she is disrespecting you. She also lied to your face. Twice.

[wish_me_luck, BSN, RN]

agreed, AnonRNC. But, I will say, if you went to the unit I was on as a tech, then you would spend all day in the hall/NS area. Unfortunately, this is common practice (the better than thou attitude and once you are a nurse, you don't wipe tail side or put them on the bed pan). But, glad you stuck up for your staff. :)

[mindlor]

They teach us in RN school to delegate.

It is management refusing to staff up at adequte levels that drives this type of behavior.

Sure write up the RN but take a LONG HARD LOOK within yourself and the staffing policies of your facility......

Just my two cents.

[wish_me_luck, BSN, RN]

mindlor, no one is saying delegating is bad; but, come on, the nurse was just in the same room that she wanted the CNA to put on the bed pan. That's just a bad attitude and poor teamwork.

[mindlor]

what if that RN had to fly and assess a new admit and the CNA had the time.....

CNA gets the bed pan RN does the assessment

not hard.....

[Teacher Sue]

I am not naive enough to believe that this is the first time this particular nurse has behaved in this way. And I also know that these kinds of behaviors will continue when I am not around. But staff is aware that I will hold them accountable for their actions. No one on our unit is above doing any task. I will place patients on bedpans and empty garbage if it needs to be done. I have cleaned stool and vomit off of the floor. Our policy is that if you are in the room and the patient needs something, just take care of it. And the RN was not busy with anything emergent.

Wow! Same nurse? That's bold. I think you're right to write her up because this seems to be a well ingrained pattern of behavior. Had I been admonished the first time (well, I would be mortified, but...) I would have been on my very best behavior - at least until you went home. Come to think of it, not only is this her pattern, but she is disrespecting you. She also lied to your face. Twice.

[Teacher Sue]

So it's my fault this particular nurse is lazy? She did not have a new admit or anything emergent happening. She just didn't want to do it.

They teach us in RN school to delegate.

It is management refusing to staff up at adequte levels that drives this type of behavior.

Sure write up the RN but take a LONG HARD LOOK within yourself and the staffing policies of your facility......

Just my two cents.

[Sun0408, ASN, RN]

I understand delegation very well, but come on.. If the nurse was just in there; why make the pt wait for the CNA? Thats not delegation, thats laziness or a feeling of being to "good" to do it. Delegation is very important in nursing, it frees you up to do things only a RN can do but NOT when you are in the room..

We have great team work and everyone answers beeping IV's, call lights and bedpan requests. It is a treat for us to have a tech/CNA.

[mindlor]

Sue, do you pay your RNs overtime to stay after and finish the charting they did not get done because they were doing CNA work?

[mindlor]

For the record I did my fiirst day of my preceptorship today. Most of it was spent putting patients on and off bed pans and the associated cleaning. In between I also picked up a previously undiagnosed case of AFIB in another patient which was confirmed via ECG......

When I am not busy I have no trouble doing tech work. But I will be damned if I am gonna do it while they are out smoking or hiding back in the supply room......ya know?

[Meriwhen, ASN, BSN, MSN, RN]

I feel bad for that CNA. That RN is probably pretty peeved at being written up, and may end up blaming the CNA for her (the RN's) problems...since it's safer for the RN to blame the CNA than the OP or even herself for getting into trouble.

I hope she doesn't take her frustrations out on that CNA.