northernguy

Ive only worked in a couple nursing homes that had really strict hiring standards, paid their employees well, and fired and investigated people at the slightest suggestion of abuse, as in we went through a least an employee a month because of suspected rough treatment, inappropriate tone with the residents, somebody fell etc, most of them new employees who were overwhelmed by the job. Ive personally reported CNAs for abuse when I thought it was occuring, so its not like I just dont care, and Ive never had any complaints against me that im aware of. However ill use one example to illustrate why its not always so cut and dry, although I could give many examples. We had a patient with crippling rheumatoid arthritis whose wife angrily accused an aide of rough treatment. The aide was suspended, investigated, and fired after a CNA on orientation(who had no previous experience) validated the wifes claim. Then she accused another aide of the same thing, with the same results. Before long she and her daughter were accusing people of abuse left and right. Any time her husband yelled or cursed(which was often given the poor guys condition), she was sure it was because the aide did something wrong. It got to the point aides were afraid to go into the guys room or even touch him. Eventually the new aide who had validated her claims of abuse was in turn accused by the wife of abusing her husband. The state was there investigating and observing us on at least one occasion. One day I asked her if I could demonstrate how we are trained to transfer her husband, with a physical therapist watching. We made sure the guy had pain medication before moving him(which we always did anyway), he verbalized some pain, but not as bad as he sometimes does, and the wife got angry. I asked the PT outside of the room what I did wrong. He told me you did it absolutely perfect. I then asked the wife if she could demonstrate to me how she transfers him, which she sometimes did. She did it, struggled with him, refusing my assistance, and barely got him into bed, with him howling in pain. In the end 2 aides were fired as a result of this guy. Did any of them actually abuse him or do anything wrong? I doubt it. Im sure most CNAs whove done this job for a long time have similiar stories. So no, because one person says abuse doesnt mean theres abuse, and its not always black and white. Does that mean you shouldnt report it? No. Only that I give less weight to the opinion of someone who hasnt done the job over someone who has. But obviously if your instructor is the DON at that facility there is a conflict of interest and her opinion is biased, but you didnt mention that earlier.

I dont mean to totally trash Doctors(like they would care what I think anyway), or ER Docs in particular, I just get annoyed at the tone of some of the responses. How dare a CNA suggest something to a Doctor! Give me a break, as a CNA I have people telling me how to do my job all shift long. RNs and other staff, patients....and especially patient's familys. In some cases their advice is neither desired nor remotely helpful, I still dont act rude. Im not saying an ER Doctor wouldnt have reason to be arrogant or rude, for all you know the ER was swamped and this Doctor just finished intubating a crashing 5 year old kid right before she got this call, but I notice a couple responses were by EMTs, and I noticed a tendency by many EMTs and Paramedics to hero worship ER docs. Most of them, including the really nice ones, tend to have a pretty healthy ego, so they dont need people fueling it even more. RNs dont seem to do this as bad as many EMTs do.

The RN should have made the call, but who cares if the Doc was rude and snotty. You make a fraction of the money she makes doing a thankless job that gradually wrecks your back. Yeah the ER doc has a stressful job, but she has a nice mercedes Benz and the occasional skiiing trip to Aspen to take her mind off it. Besides, you dont work at that hospital, so if a doc you dont work with or for gets snotty, id get snotty right back. Most Docs are rich kids whove never done a day of hard physical work in their life, so they can take their attitude and shove it.

95% of the RNs I work with are great, never have had any problems with nearly all of them, either working in long term care or on med/surg. OR Nurses are another story altogether, some of them I've encountered at work are just plain evil. Not sure what it is about them, if its ego or what(not sure why, their scope of practice seems pretty limited), but I have encountered outright hostility from them, and many other Med/surg RNs and PCTs have said the same thing. Theyve also hurt a couple peoples backs transferring surgical patients in a hurry. I told one of them to slow down or someones going to get hurt transferring people(they always take the easiest position when transferring), she looked at me like she wanted to claw my eyeballs out lol. Sure enough a PCT went down with a serious back injury thanks to her.

I dont understand why the students would be so resistent to riding the hoyer to begin with. Yeah you might look kind of foolish, but if everyone does it, who cares. If their knees are so bad, how are they gonna work as a CNA? Im pretty sure a lot of patients/residents who regularly use a hoyer have bad knees, along with bad everything else. Still, if the student had been an aide before and had probably lifted people a thousand times with a hoyer, I doubt her not riding in it is going to somehow compromise patient safety in the future. I guess its an integrity thing on her part, as for you not reporting it, dont sweat it. There is a world of difference between failing to tattle on a student over some petty crap like this, and failing to report elderly abuse or neglect.

I'll never forget one patient who was admitted numerous times, with longer stays each time. He was a bed jumper who was continually pulling off his telemetry leads and o2, hitting his call light and swearing up a storm and verbally abusing whatever staff was unlucky enough to be taking care of him. Occasionally he would try to choke someone or take a swing. He punched one unsuspecting RT in the back of the head. He was in his late 60s, and when he wanted to be, such as when his daughter was in the room, he could act almost completely normal. His wife was what him so difficult to deal with. Everytime he would be going off she would say its all OUR fault, or even threaten a lawsuit. I remember one time my shift had just started when he hit his call light. As I walked into the room he threw his open urinal at me and said"bout f*&^in time one of you &$^#ers showed up!"(this was like 20 seconds after he hit his light). After dodging the urinal and most of its contents, I looked at his wife standing next to him, expecting her to chastise him or apologize for his behavior, or try to calm him down. Instead she said, "I guess he doesnt like you, better get someone else to take care of him". This is pretty much how it went with every aide and nurse, every time he was there. I would end up spending half the night continually going into his room, then trying to get out to help my other patients. Occasionally we would have a sitter for him, but most of the time not. I remember the last couple times he was admitted I would be looking at my patient list and see his name and think NOOOOOOO!!! It made for some really long nights.

To the snotty ER nurses who either completely ignore the aide when bringing up a patient, or try to order you around on the floor and dismiss anything you say. Get off your high horse Nurse Jackie and hand me that ******* transfer board. No I dont want to throw my back out not using one, I have to lift patients all shift long unlike you. And no im not impressed you work in an ED, Ive been an EMT for years, how many unresponsive 350lb patients have you lifted down from their roach infested 3rd floor apartment and driven to the hospital in a blinding snowstorm on ice covered roads?

I think Nursing schools are requiring people have their CNA for two reasons. Number one because they have an overabundance of applicants, so they can afford to be selective and if people are already trained as a CNA, they can spend more time on RN skills instead of wasting classroom time. Second reason is I think a lot of people have unrealistic expectations of nursing, and are getting into the field for the wrong reasons. People just look at the pay and job security or see hospital shows on TV. The reality is far different from what people expect. If someone has worked as an aide, they know what to expect, and have already done most of the backbreaking unpleasant nursing tasks. Having students be CNAs first ensures you have students willing and able to do the job in addition to being academically qualified. At least this is how it was explained to me. Ive seen Nursing students from two different schools where I work. One school required they be CNAs and the other didnt. The students from the school that required it seemed a lot more prepared and relaxed during clinicals than the one that didnt. Now both schools require new students have their CNA. As for why they dont accept MA instead of CNA, I can only assume thats because MAs are trained more for Doctors offices and clinics while CNAs more for long term and acute care.

I would say it is definitely in your scope. Again, EMTs do it all the time, and ER techs are pretty much just EMTs minus the pre hospital stuff like driving an ambulance or extricating a patient from a vehicle. I wouldnt sweat it though. I work as a PCT on a med/surg unit and there are times when a Nurse has asked me to do something I was never trained to do and I will ask them to please show me. For instance the first time I had a post surgical patient who had orders for a CPM, I asked if the RN or another aide could set it up while I watched so I didnt screw this persons knee up for life. The Nurse was angry and lectured me on how I should already know how to do this, but she got over it, and I learned how to do it right. In the military we used to say see one, do one, teach one. How can you do it if youve never even seen it.

I'm curious if you have any training or experience as an EMT. As an RN you have a lot more training than me, but stabilizing a penetrating object like this seems like a pretty simple thing to do and something pretty much every EMT has been trained for and practiced. I understand in the real world things are always more complex and maybe Im missing something, but this seems like it would have been pretty simple and straight forward, which is probably why the other techs were saying hey let me do it. Still, its always a good thing to not let your ego get in the way of what is in the patients best interest and admit that you arent comfortable doing something, so I wouldnt criticize you for doing that.

Sounds to me what a PCT is varies depending on your state/area/hospital. Where I work you have RNs and CNAs doing patient care. No LPNs and no "PCTs". The CNAs pretty much do all the work described as a patient care tech except for EKGs and drawing blood, which the RTs and lab techs do. No one uses the term PCT, they just call it CNA. Im not sure if my hospital is typical or unique, since its the only one Ive worked at. To be honest I dont know how PCTs can do all the CNA stuff, plus do EKGs and all these extra things. We are so busy where I work you can barely get everything done. Who does the patient care and answers call lights while the PCTs are doing EKGs and lab draws? They must have a lower number of patients to take care of.

Take the CNA class. If you are feeling awkward about just practicing on female students, imagine how awkward your gonna feel taking care of female patients. Better to get over it now before you start doing Nursing clinicals. As for the students being immature or trashy or whatever. Oh well, its more good practice, because your patients are going to come from all walks of life.

I know a lot of military medics go into EMS, but I believe most have to start from scratch in terms of education and obtaining licenses. I think the same would be true for other health care jobs, including CNA or patient care tech, but maybe not, since they are unlicensed positions unlike EMS. You obviously have a lot more medical training than your typical CNA, so maybe you could just start working at a hospital as a PCT right out of the Navy. You have one major advantage being former military. Thats the GI bill. If I were you I would go to school to be an RN or maybe lab tech or something. The new GI bill is a pretty sweet deal and has an actual living allowance in addition for paying for nearly all, if not completely all your tuition costs if I understand correctly. My GI bill was a total joke, it maybe covered the costs of books and a small fraction of tuition and nothing else, which is why I had to start working as soon as I got out rather than go to school(I didnt do anything medical related in the military).

CNA class is pretty easy, very little studying involved from my experience, but I also had some medical training in EMS prior to CNA school, so it might be different if you are completely new. Towards the end of the class you might have to do some practicing and studying for your practical exam, but for the most part you shouldnt have to spend much time on the class outside of your classroom time. CNA school will also give you the chance to decide if you really want to be a Nurse before you get too far into school. There were several students in my class who were doing a career change after years of working outside of health care, doing things like carpentry or working as a mechanic, like me. Some of them decided during class, and especially clinicals that this type of work just wasnt for them.

I'm assuming HUC means unit clerk. If so these are two totally different jobs. Which one you prefer would depend on your personality. Obviously an ER Tech job will have you dealing with a lot of drunk, obnoxious, or mentally ill patients. You will also have pediatric patients, which can be difficult to deal with, especially if your doing things like drawing blood or starting an IV on em. If you are tired of dealing with patients on a telemetry unit its certainly not going to get any easier in the ER. You would most likely have to get your EMT license, although Im not sure why, since EMT school is mostly geared towards pre hospital stuff that you would never do in an ER. (Ive met ER Nurses that have no clue what a KED or hare traction splint is and have never even ridden in an ambulance). EMT basics arent even allowed to start IVs and get no EKG training beyond putting leads on a patient and learning basic cardiac anatomy and pathophysiology, so Im not sure how valuable the training is in an ER setting, you would still have to get all that training in house. If nothing else maybe they just want to be sure you can handle stress, since EMT school can certainly be stressful.