Problem with Care Assistant.

newtress, LPN · Jul 3, 2009

This is a big time issue with me. While in nursing school I was working weekends as a nurses aid and had two deplorable incidents occur at two different facilities. One being another nursing aid was cleaning a gentleman and as you stated, left the feces infested wash clothes on his bed table. And then comensed to take the other wash cloths that had been floating around in the feces contaminated wash basin and rub those on his face, eyes, lips etc. Finally ending her poison care by throwing the soiled wash cloths across the room hoping they land into the soiled laundry bag, missed and they hit the wall with feces stuck on the wall and walked out of the room asking me to assist her with another patient. I had observed all of this as I was walking by the room. I purposely asked her if she needed any help as a reason for me to linger at the door to see all this. I wanted to scream "what the **** are you doing!?" I was at the same level as her at the time as a CNA and wanted to tell the charge nurse immediately of this. She had been working there a very long time and I knew if I tattled I would be taken off assignment. So after she was done I went back in the room and disinfected the table, the side rails, THE WALL. Thinking back, since I was only a temporary employee from an agency, the most they could have done to me was told my employer to not send me back to that hospital if I had reported that aid. I should have. And because I think that any employee that puts a patient at a high risk for life threatening infection is a severe threat to patients. They could be setting this patient up for death, and the healthcare team may not have known what was introduced into the patient to cause the death and the family members might think it was just a severe infection from their disease or illness that caused the demise. If these dangerous wreckless employees leave evidence in the room of the soiled items on tables, wet pads on tables, giving skin care with feces on her hands etc I would tell the best person you know of on shift to come with you and take a look. Look at the evidence, or walk in on the employee as she is ungloved and putting those deadly hands back on the patient's face. At that venture they can not tell you it is hearsay and that they never see her doing anything wrong. Also find out who your infection control managers are, or if you have something similar to what we have in the states, a risk management person. Some other entity other than your matron management because she simply isn't considering the health and wellbeing of those patients. Go get 'em!

Vito Andolini · Jul 3, 2009

Hi all, just looking for a little advice really.
I'm a new grad working night shift in a nursing home in the UK. I have done 2 night shifts so far and to be honest I'm less than impressed with the level of care I have seen. I have a real issue with the nursing assistant that seems to always be on my unit. She is much older than I am and has made it clear that she thinks she controls the unit. I have been told by her how she is 'always in matrons office in the morning, reporting people.' She has told me how she has 'got rid' of several staff members because of their poor levels of care and she constantly insults other staff members to me which makes me concerned what she is saying about me.
I do my best to do everything correctly and my patient's wellbeing is paramount so I'm confident she can have no valid reason for reporting me but I really feel that I am being dominated by her on a shift.
My main concerns are her lack of adherence to infection control. She refuses to wear gloves to perform personal care, claiming her skin condition (she has psoriasis) means she can't..I have seen her literally put her hand in faeces and then touch the patients face. I tried to put across that she MUST wear gloves but she refused to listen. She had a coughing fit into a patients towel and then used it to dry them...I have yet to see her wash her hands. She doesn't wear a uniform overnight, just a skimpy vest and hands full of rings which she takes off before the day staff come in...
She does turn the patients regularly and is always changing pads but her practice just isn't good enough in my opinion. I found a wet pad on someones table!
I feel I need to report her but worry that nobody else has yet..I'm also worried about reporting her to a matron who obviously uses her as a 'spy' on other staff, apparently promising her a senior assistant position for her hard work..
A difficult situation and I'm unsure of what to do...
We had a staff meeting last night and the matron was not happy to hear any issues people had even though she had asked for them. I told her that I thought there was a need for clinical waste bins in each room as dragging a bag around the corridors for each change isn't good enough and involves leaving your patient to dispose of the waste mid change. This wasn't well received...
How do you report poor levels of care about a staff member who seems to be in the pocket of the management? I feel other nurses have turned a blind eye because of the relationship with the matron but I can't do it..the patients wellbeing is at risk.
Help!

My first reaction was to say you should get a different job. I also wondered if you saw all of this on just 2 shifts. No matter, though, really.

I think you are probably right that the manager uses the aide to spy. I think it's really bad that she puts other peoples' stool on her hands and it then gets onto the patients, I think you have given lots of examples of really bad behavior, dirty and dangerous behavior.

Normally, I would say to write it all down, just as you have here, with dates, times, who the patients were (to pinpoint it in time), and turn it in to Management. The trouble is, you're a new graduate and a new employee. You will likely be fired if you try to do anything that Management doesn't want done - like expose this awful person. I guess you could try talking to her directly and from your heart, say you're concerned about her not wearing gloves, concerned about her coughing into the patient's towel and then using it on the patient, etc. However, she likely would not be happy to hear it and would proceed to crush you and she will succeed - at least, it sounds like your Manager would take her side and be against you. I guess you could report her to someone over the Manager's head, after the Manager does not receive your report well.

Take my next statement with a grain of salt. Try not to mind the patients' wellbeing so much. They have apparently been surviving her atrocious behavior for a while now. Or have you not told us the whole story?

I really don't know how to advise you. I do wish you well.

PhoenixTech, LPN · Jul 3, 2009

Hi Bammy

As a Patient Care Tech working in a hospital I'm truly ashamed of my fellow aid and assure you that we're not all this dispicable. :cry:

Having said that, as RN's, you are the patients' advocates. They depend on you and if you don't speak up for them, who will? I also understand your concerns about job security, I'm so sorry that you are in this position.

Here in the States, we have a confidential hotline directly tied to JACHO that we can utilize and we also have a non retaliation rule that protects us if we report unsafe practices. With healthcare insurances no longer paying for HAI's, it'll be prudent for management to follow up on this. See if you have anything like this in the UK.

As far as that manager is concerned, maybe you can try going up the chain of command. Also pray, God will bless you with the answer. I truly wish you well and success in this unsettling situation. :icon_hug:

Bammy · Jul 3, 2009

Thank you for your advice. You have really just confirmed what I knew I had to do already..I can't let it continue or if I'm fired for speaking out, at least my conscience will be clear and I know I've acted as best I can.

Vito Andolini, I'm a little unsure why you seem to be implying that I'm lying. What would I gain from that? Witnessing shoddy hygiene standards on two 11 hr shifts is not unusual when she is doing it with each change of pad.

How can I be sure they HAVE survived her shoddy practices? It's a continuing care unit with palliative patients on there, many with compromised immune systems.

Thanks again guys, wish me luck!

HelenVie · Jul 3, 2009

Assertiveness and balls come with experience. You can make a difference. Whistleblow, their is new legislation in Ireland protecting the whistleblower, I am not sure about the UK. Fitness to practice, report the Matron, she is ultimately accountable, if you report in writing this issue, and even if you move on, and the issue persists and is identified at a later point in time, by design or not, the Matron has accountability. Good Luck and keep strong. We can and do make differences, never lower your standards. Helen

Vito Andolini · Jul 4, 2009

Thank you for your advice. You have really just confirmed what I knew I had to do already..I can't let it continue or if I'm fired for speaking out, at least my conscience will be clear and I know I've acted as best I can.
Vito Andolini, I'm a little unsure why you seem to be implying that I'm lying. What would I gain from that? Witnessing shoddy hygiene standards on two 11 hr shifts is not unusual when she is doing it with each change of pad.
How can I be sure they HAVE survived her shoddy practices? It's a continuing care unit with palliative patients on there, many with compromised immune systems.
Thanks again guys, wish me luck!

It never once occurred to me that you might be lying. I guess you think that I think you might be lying because I said it seemed like a lot to have seen in just 2 shifts. Is that it?

Assuming it was your reason, I will say this: At no time did I either think you were lying or state that you were lying. Again, so you truly hear me - At no time did I think or state that you were lying.

What I also did not state was that I wondered if you had seen this in just 2 shifts or perhaps you had worked there as a student or had some orientation prior to your 2 shifts that involved observing some of these things.

It doesn't matter. I still think you are in a situation where you will not be able to either change her or change the boss. However, someone else says to report to a place that I had not thought of and I think their suggestion was good. So maybe you should do that. Good luck. For what it's worth, I was very sleepy when I wrote my first response earlier. I wasn't at my best, and I was not thinking as clearly as I normally do. Of course you must care about the patients' wellbeing, first and foremost. And you are doubtless correct when you say that perhaps she has contributed to the demise or suffering of patients over her years of working there, due to her horrid habits.

I hope you will be courageous and speak up to the authorities so they can get rid of Typhoid Mary quickly, along with that Matron.

PhoenixTech, LPN · Jul 4, 2009

Try not to mind the patients' wellbeing so much. They have apparently been surviving her atrocious behavior for a while now. Or have you not told us the whole story?
Hi Vito
I think it was this statement that did it. It's what I thought also when I heard it. Takes a big guy to attempt clarification.

PhoenixTech, LPN · Jul 4, 2009

Assertiveness and balls come with experience. You can make a difference. Whistleblow, their is new legislation in Ireland protecting the whistleblower, I am not sure about the UK. Fitness to practice, report the Matron, she is ultimately accountable, if you report in writing this issue, and even if you move on, and the issue persists and is identified at a later point in time, by design or not, the Matron has accountability. Good Luck and keep strong. We can and do make differences, never lower your standards. Helen

:yeahthat:The Whistleblower Law!

Trishalishus, PhD, CNS · Jul 19, 2009

I agree with all the supportive things that have been said to you. I'm sorry for your distress. Your story reminded me of a woman I work with who is as incompetent and dangerous as your horror. "Mine" once gave an enema to a pt into her lady parts. I didn't see it at the time because I was standing on the front side of the pt giving her a cuddle and holding her on her side (she had MND). The pt told me after the horror left what had happened - I went right to the top because the RN on duty was a "peacemaker" (read: coward). When that didn't work, I told the daughter (with whom I had a good rapport) - she went and told the DON that her mother had told her... (another good strategy to bear in mind, folks, when you know you're in the right and authority won't listen = family - I ALWAYS for many reasons build good rapport with family). Of course, the DON immediately got the PCP over to the facility.

When I first started working there, the same horror slapped/punched a demented patient who spat at her. At the time (it being my first day) I did nothing but vent to my friends when I got home. After I developed a reputation as diligent, competent, reliable and a patient advocate I told EVERYONE IN AUTHORITY as well as my respected colleagues what this woman is capable of. The really sad thing is they won't fire her because they are so short-staffed. BTW, the pathetic staff who call me "Dr Trish" behind my back? I could care LESS - because the pts feel protected, cherished and cared for when I am around - and the ones who badmouth me are the ones whose professionalism I don't respect - you might bear that in mind for your future dealings as well.

Best wishes and good luck