Slipping CMA

This is an outpatient care setting with a walk in care clinic. But I work in immediate care. The patient was just in for a regular 6 month follow up. He was walking with the assistance of a cane and looked down for a second and that made him dizzy. I sat him down right away and took vitals. I reported all of them to the doctor but asked if I should get the oxygen because the O2 was 90. Doctor said yes. At the time my manager happened to be in the department and called other managers in because of her concerns for the patient but IMHO doctor is the one in charge of the situation because well he’s the doctor. The managers of the building and department started correcting the doctors. the managers are the ones who also decided to take away the nasal candelas because of covid. Not my decision I just have to deal with it.

I was told anything below 94-93 isn’t a good sign. So 90 was low. But fake nails, nail polish cold hands can affect the O2 reading.

We aren’t using nasal candula because of covid. Don’t ask me why it was a rule handed down by the higher ups. as for why the oxygen it was ordered by the doctor because of his o2 level and patient felt dizzy.

We had a pt with O2 of 90. Hand are warm and this is a hospital grade pulse ox. Dr says get oxygen and set it at 2 litters. The head managers and other head staff started barking orders too and say he’s on a rebreather not a nasel candela so it should be 10 litters and the bag should blow up. I don’t now about how many liters I just follow Doctors orders. But I thought the rebreather bag did not have to be full? anyone want to educate me.

Just wondering if I’m the only one and maybe I have a problem. I brush my teeth twice a day try to floss everyday and use mouthwash twice a day per my dentist. With the masks I notice at the end of the day my breath smells bad. Do I normally have bad breath at the end of the day or is this a mask thing?

Cheaper Dickier. More expensive kio.

Thank you for your insight I didn’t think about scene safety.

Obligatory I’m not a nurse. I work in a larger office building in a doctors office but we do have crash carts “just in case”. Yesterday we had a code blue drill. ( a patient drops to the floor and tells you they don’t have a pulse, you take it from there). One thing that shocked me from the meeting afterwords is they want us to do three things before starting chest compressions. Have someone call 911( yes OK I get it). Call a code blue and announce it twice over the intercom ( yep we need nurses and doctors and someon needs to bring the crash cart) third get into full PPE before touching the patient. This I don’t know about. Full PPE takes away precious time everyone has a mask and I would just do chest compressions no mouth to mouth. Plus patient should be with a mask or it’s easier to temporarily put one on the patient. those of you with more knowledge and experience than me what do you say.

Oh I can’t handle that my nerves.

OMG let’s not talk about someone watching me. It could be as simple as taking a pulse and I’ll mess it up.

I am a CMA with ADHD both inattentive and hyperactive. I am medicated which does help. my problem is I’ve been fire from 3 different places and I think it has to do with my ADHD and I’m looking for advice to help me out. The 1st place I was fired from I was told by the person teaching me not to take height on every patient and later I was caught not taking height and found out it was company policy to take height on everyone every time. 2nd time I was rooming a patient and for a second forgot what room I was going to so I stopped in the hallway then turned to the patient apologizing and went on to the room. Someone told my supervisor that I entered the wrong room which is not true but they let me go because of it 3rd time I was written up for saying umm when leaving a message for a patient. I talked to my doctor about this and he says it part of my anxiety that I have. In reality there was a girl who didn’t like me because of my ADHD and how I would have to really go over stuff because I am forgetful. I went to HR 2 times because one time she yelled at me that I’d never make it and was a horrible CMA. The other time She was telling me to just go home early when she had no authority to do so. She would also say “excuse YOU” in the hallways when passing each other but I just let that go because it’s stupid middle school crap. I have a new job I’m starting in a few weeks and really want this to work out. Any tips you can give that will help with my ADHD and getting along with others. I use a flow sheet when rooming patients so I learn to remember everything and I do take notes. I also take pictures of procedure trays so I know exactly what is needed. I could really use some advice because I think the real reason I’ve been let go from do many places is my ADHD.

In my spare time I make homemade soap and candles. I do notice my supplies are out of hand sanitizer.

I am a CMA (AAMA). That being said there is no real difference. But I highly suggest becoming either CMA or RMA. I see medical assistance without certifications all the time and just think if you need to be licensed to be a nurse we should have a governing body too. Even something as simple as a blood draw can have serious consequences if you don’t know what you’re doing.

Things like anatomy, physiology intro and 2 would transfer.

Let me start by saying I’m just a CMA so I have no real medical training like you nurses do when it comes to seizures. I grew up with an uncle that had epilepsy ( he lived with us ) my DH is type 1 diabetic, my daughter had febrile seizures as a baby and my son inherited my uncles epilepsy. Depending on the reason for the seizure will depend on your reaction. If this is an epileptic seizure like my son and uncle it can take a while to come back out of it. For my son after a grand mal type of seizure it takes him at least 30 minutes to be himself again. ( same with my uncle ). If after an hour he is not himself we call 911 because for them it means another seizure is on its way, and who knows when it will really stop. In my experience hospitals will give 1000 mg Keppra IV and an anti anxiety medication that I can’t think of the name of right now but it can also help with seizures.( it’s related to clonozapam ) I’m just saying a trip to the ER is not a waist of time, they can be very helpful. My one question is, if she is having them this frequently why aren’t they adding to her medication? I am only speaking from personal experience and not medical knowledge, but most neurologist that I have interacted with have a goal of trying to completely control the seizures. Sometimes one medication isn’t enough. I guess you could try asking for her to get an action plan from her neurologist. This would answer a lot of questions. With both my son and my uncle a seizure itself lasting 5 minutes is a call to 911, but we’ve never experienced that. ( knocking on wood ).

I don’t have a problem taking a pulse, the face stays on exactly 15 seconds.

Not a nurse as you can tell but one time I wrote as chief complaint “ pt c/o soar throat”. Luckily I proof read and found my mistake, but still watch out for those flying throats.

I’m a CMA but I was always terrified of needles. Then phlebotomy lessons came along, time to deal with it. I was to busy learning to think about my fear. Plus everyday you are getting stuck by your classmates that are all really scared they may hurt you. I knew I had to be calm so I could help give them the confidence they needed. It does get better.

Thanks, I just hate the fact I might have hurt someone even though I’m sure I did everything right.

I’ve been a CMA for 4 yrs and I’ve been drawing blood all that time. I’m not the type of person who can get blood out of a rock but I am experienced. I do work for a doctors office and draw about 20 patients a day usually there is one or two patients I don’t feel comfortable drawing blood so I don’t try and just call someone else I was drawing this one patient, he had a nice juicie vein, the median cubital vein I believe it’s called. It was a perfect draw, I didn’t go in too deep, I hit the middle of the vein and was right there at a good angle. Patient didn’t complain until I drew out the needle. He just calmly mentioned to me the sight was sore after I pulled out the needle. No sharp shooting pains just sore at that point. I called the head CMA to talk to the patient and she didn’t think it was a big deal just told him ice and OTC pain relief she has been working with this doctor for over 20 years so she is very knowledgeable and experienced Yesterday, one week after the blood draw, he came in to see the doctor about his arm. He now says he is getting shooting pains in his arm but there was no bruising or hematoma at the sight. Doctor asked me if I happen to dig around at the sight which I didn’t and told him so. The doctor told me to never “dig around” at the site because there are nerves right there. I didn’t know this but I don’t dig around, if I miss I miss and get someone else. I don’t try a second time because patients aren’t human pun cushions. It’s just the way I am, some people don’t have a choice but I do. I am just freeking out right now that I could have hurt a patient. Does it sound to you like I hit a nerve? I know only the doctor can diagnose this but this really has me worried that I might have hurt a patient. I just want others experience with this. I’m hard on myself when it comes to drawing blood and do take it very seriously. I try to make sure the patient is as comfortable as possible and they come 1st. Thanks for any help you can offer me, my nerves are shot over this.

Try breathing through your mouth. Sometimes it works, but sometimes the smell is so bad that you end up tasting the BO.

I Don’t live in that area but I suggest checking your local community colleges some of them have very good programs that are very inexpensive good luck

Doctors are the worst at stealing pens and stethoscopes.

I am wondering what I am doing wrong here. We just hired a new person in our office and I notice she has no respect for me. I must be doing something wrong because she doesn’t act this way with others. Sorry warning this might get long One thing to know is at this office it is a well known rule that when you room and vital a patient you are responsible for anything the doctor/provider needs for that patient. If the doctor wants an EKG you do it, get it signed by the provider and during free time or at the end of the day make sure it is scanned into the EMR. On Thursday this week one of our front office girls left work very ill. MA A we’ll call her was told by the office manager to go up front and help up there. New Girl and me managed fine that day. Friday front girl is still sick so A comes up to me and says “I went up front yesterday it’s someone else’s turn today”. I just went up front and did front desk work that day.No arguments from me someone needed to do it who knew what they were doing up front. Check in patients, answer phones etc. The problem came when we had a family come in for an immigration physical. Everything is paid for at the time of service up front and the cost can vary by what needs to be done. I do the front office work, get paperwork together, charge them for the doctor visit and then they are ready to be roomed. I did not room the patients because I am up front at the time I had no clue who was rooming the patients. Now in this case who ever rooms the patient must keep track of everything, and before they draw blood for a titter they need write it up on an invoice and the patient has to pay 1st before the blood is drawn this didn’t happen Remember I’m up front and all of a sudden the immigration family is standing in front of me ready to pay there bill and I have no invoice. I excuse myself go to find the invoice. I’m looking through there paperwork thinking it got lost in there. New Girl asked me what I was looking for and I said the invoice so I can charge them. I can see New Girl is putting in the lab order for the titters for this family which means she drew the blood and roomed the patient. But she just says I think A wrote it up. I do a quick look for A and she is nowhere to be found. I go back to New Girl and ask her if she is sure A did the invoice because it’s important. She says I don’t know. I told her I needed an invoice the patients are waiting to pay there bill. She then tells me to just do the invoice, I tell her in a nice voice that I can’t since I don’t know everything that happened and what to bill for. I tell her because it’s her patients it’s her responsibility. She snaps at me that I’ll just have to wait while she is still placing lab orders which is something that can wait. I got pissy by the rude way I was being treated and raised my voice at her and snapped back that if I wait that means the patients up front have to wait. I then just left her because I was getting upset and I don’t like to raise my voice at people. I go back up front to tell the family it’ll be just a few minutes and notice another employee had called the office manager and explained everything that happened between New Girl and me. Office manager walks past me to New Girl and just tells her to stop what she is doing get the invoice done now and if she has any questions to just ask office manager. Finally someone gets some sense into New Girl and she brings me the invoice. I’d like to know what I am doing wrong. I handled it very poorly from the beginning and New Girl just ignored me and walked all over me. How can I better give the impression that I know what I’m talking about because I have worked here longer without being nasty to her. I really get no respect from her, but she will listen to others which makes me think my approach or something is all wrong. I have worked there just as long as A has. And she seems much more respectful to A. Am I being to nasty? Or to nice or am I just wording things the wrong way Thaks is for your help