how would you react to this

I would wonder if the patient has a GI bleed, or another medical condition that I must be made aware of.

"ummmm...no, unless I was in the room, saw the brief and had the time to change it. It's part of YOUR job to make sure residents are clean and dry...mine too, but whoever notices should change it." (that being said, if you feel you are "above" changing briefs....you're not. If you went to hunt down the aide for 15 mins about it....you're in the wrong. If, however, you were in the middle of med pass/doc rounding/getting meds, etc for patients, then the aide should be changing that patient. Me thinks we need some details on the situation.....

While we do need some details (is the aide generally good and a hard worker, does she try to make others do her work all the time, was she just overwhelmed at that moment), I say it is NOT the job of the nurse to do much hands on cleaning up of patients. We're too busy doing the work that only we can do - med pass, charting, processing orders, trying to call the doctors, pharmacy, etc., admission evals and paperwork, discharge teaching and paperwork, and all that.

Once you let an aide get you to do what is basically her work, you're in trouble.

I help when I can but I do not hesitate to keep right on doing my own work when I need to. And I do take my breaks. I have volunteered way too many hours of my own time to employers already and they do not appreciate it, they just expect it.

exactly, why would the request be made that 'a nurse' only change a diaper. Sure we all can change them but that statement makes absolutely no sense. Then again, could be the patients perspective. They don't necessarily realize the roles each member of the health care team play. And sometimes they view everyone as 'a nurse.' For instance i've seen patients ask regular office staff to heLp them to the bathroom...lol -and the look on their face-too funny. Wouldn't take offense, but would look into the situation more. Is the patient oriented?

It depends on the situation at hand. If it needed to do done, and the tech was obviously too swamped to have time with other tasks, then I would do it, without questions. Just because I am an RN doesn't mean I don't know how to clean a patient. IMHO, every bit of patient care is in the end, my responsibility.

Even if the tech isn't busy, if she has done the task a hundred times that day, and frankly is just tired of it, it will not hurt the nurse to do it.

Since I spent longer as a tech then a nurse, I can think of plently more situations where it would be perfectly within reason for the tech to request the nurse to change the patient (in a nice way of course).

I guess it depends on what the aide was doing at the moment. Was she dealing with another resident at the time who needed help?

I have asked a charge nurse to help me with a 2 person transfer a couple of times when I couldn't get any help. I only did that as a last resort, since they were busy passing meds at the time.

We all as nurses learned "CNA" "work" in school, while it is not our primary concern and we do have other higher priorties (as mentionin OP). IMHO I am not above changing a pt. if it is needed. I would question if I had to do it on a daily basis if there were aides on the shift, but if its needed and I noticed it I would do it rather than hunting down an aide, which could take longer than the task itself. If I were the pt. I would not want to sit there and have to wait XX mins for an aide to be found.

let me clarify this. this cena hates this patient. more than once i heard her saying "i'm not going to answer her call light." or i'm not going into her room. when she saw that her call light was on, she immediately told anotehr cena that "a nurse have to change her brief" no she was not busy with other patient or doing other things. so my reaction? i told her its not my job and she need to answer her call light and take care of this patient. i told supervisor what happened and i told her she needs to be written up. do you think i over reacted?

me thinks it's time for a little talk between you and the cna.

you need to find out, why this cna is avoiding the pt.

is the pt being abusive?

is the pt's expectations/demands, just waaaay off??

communication is everything in nursing.

once you understand the cna's concerns, only then can you give appropriate direction.

leslie

i told her its not my job and she need to answer her call light and take care of this patient.

any part of the care provided for that patient is your job. end of story. aides are there to help, but in the end the patients care is your responsibility. i would start by finding out why the cna 'hates' that patient. she may have legit reasons. and like i said earlier, even if it is simply the fact that she has changed the brief 20 times that day, and is sick and tired of it. working as a team means the rn taking a few stabs at it to keep the team from burning out.

Well frankly that would make me wonder..."why?". I would ask more questions as I walked WITH the CNA to the room. Is it something I need to see, does the CNA have a probelm with the patient or vs versa that is hindering this task, or is this a probelm with too much to do themselves and can't do it quickly enough?

So basically I would ask why 'the RN' has to do it vs the CNA? Not that I wouldn't clean my pt...just wanting to know why they want an RN to do it (that rings in my ears of a probelm I need to check out!).

let me clarify this. this cena hates this patient. more than once i heard her saying "i'm not going to answer her call light." or i'm not going into her room. when she saw that her call light was on, she immediately told anotehr cena that "a nurse have to change her brief" no she was not busy with other patient or doing other things. so my reaction? i told her its not my job and she need to answer her call light and take care of this patient. i told supervisor what happened and i told her she needs to be written up. do you think i over reacted?

i don't think you did overreact, the cna needs a write up for that attitude.