how would you react to this

squeakykitty · Feb 29, 2008

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.

lvnandmomx3 · Feb 29, 2008

If the case was her blantent refusal to care for a specific pt.or do something that is part of her job then she definetly needs to be written up. We all can't just refuse to do certian thing that are not "fun". I am all for team nursing and would give a bed bath change a pt or whatever if needed as I posted earlier. Its a little different when someone is just being lazy or doesnt want to deal with a specific pt.

locolorenzo22, BSN, RN · Feb 29, 2008

true....but if it's a patient who refuses to get up, or one that treats the aide like poop while doing it...that aide may just have been sick of it. There's been plenty of days that I've answered a light for a fellow aide because they're at their wits end...so it depends.....you need to do some assessment of what the problem is....

racing-mom4, BSN, RN · Feb 29, 2008

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?

it sounds like a crash course in manners need to happen. now how would you have reacted if the cna said "ms.rn i simply cant go in that room one more time, i have tried to be nice to patient a, but it is not working, i think we need a break from each other, if i go get patient bs vital signs could you go put a new brief on patient a?"----

and vice versa...if you tell her "it is not my job" do you think she is going to jump up and help you when you need it?

versus you saying. "mary- i know patient a is a pain, i am right in the middle of med pass now, could you ask cna susie to help you?"

cloister · Mar 1, 2008

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.

Amen.

I don't think changing the pt. or giving the bath or any of the personal care is the sole province of the CNA. When I graduated from nursing school in the 80s, we didn't have CNAs on the floor where I took my first job. Basically, if it went into the patient or came out of the patient, you owned it - everything from Code Browns to IV meds was your responsibilty.

I think CNAs are a great addition to hospital staffs, because primary care on 6 or 7 patients could be seizure inducing some nights. I have been noticing, however, that some of our newer nurses are shying away from perfoming basic nursing and personal care tasks for patients, citing that as being the CNA's job.

Wrong.

Whatever her reason for refusing, it's still the resposibility of the RN to take care of the patient. Yeah, write her up, talk to her, notify your supervisor, yada, yada - but first, take care of the patient. It's what Real Nurses do.

UM Review RN, ASN, RN · Mar 1, 2008

Amen.
I don't think changing the pt. or giving the bath or any of the personal care is the sole province of the CNA. When I graduated from nursing school in the 80s, we didn't have CNAs on the floor where I took my first job. Basically, if it went into the patient or came out of the patient, you owned it - everything from Code Browns to IV meds was your responsibilty.
I think CNAs are a great addition to hospital staffs, because primary care on 6 or 7 patients could be seizure inducing some nights. I have been noticing, however, that some of our newer nurses are shying away from perfoming basic nursing and personal care tasks for patients, citing that as being the CNA's job.
Wrong.
Whatever her reason for refusing, it's still the resposibility of the RN to take care of the patient. Yeah, write her up, talk to her, notify your supervisor, yada, yada - but first, take care of the patient. It's what Real Nurses do.

While I understand the point that you are making, I respectfully submit that the nurse simply does not have time to do two jobs.

If the CNA needs help with a patient, that's one thing. But if the nurse is doing the CNA's assigned tasks all through the shift, when is the nurse supposed to get nursing tasks done?

cloister · Mar 1, 2008

It doesn't sound like she was being asked to do all of the CNA's job - just one task.

I still maintain that it falls to the RN to make sure that patients are taken care of, regardless of what the CNA does.

Again, I came out of school in the 80s when "primary care nursing" was all the rage. Basically, the RN did everything.

Was this a good system? Ummm, not if you had 6-8 patients.

Do I think CNAs are a good addition to the staff? Absolutely. Anything that gets the patients taken care of safer and faster is a good thing, in my book.

I respectfully submit that patient care is not two jobs. It's one job, shared by an RN and a CNA. I agree that it's not likely possible for the RN to do all of it without help. I still feel strongly, however, that if you have RN behind your name and a patient needs help, it's your job.

flightnurse2b, LPN · Mar 1, 2008

I respectfully submit that patient care is not two jobs. It's one job, shared by an RN and a CNA. I agree that it's not likely possible for the RN to do all of it without help. I still feel strongly, however, that if you have RN behind your name and a patient needs help, it's your job.

i completely and totally agree with you. we just recently had this debate in school because during clinicals, a CNA was getting the heck beat out of him by a combative patient and popped his head out in the hallway where we were and said "please can someone help me change this patient, i can't deal with her anymore" and one student in my class said "i am not in nursing school to change diapers".. so i put some gloves on and changed the patient diaper, i wasnt about to let the CNA get hurt or let the patient stay dirty. i dont care what credential i have after my name.

i asked my instructor about it. if the CNA asks you to change a diaper, is it a big deal, because the rest of the class is under the impression that its not our job. she called a class meeting and said "listen, it is ultimately your job to make sure the CNA does what needs to be done. they work under your license, and if that patient is sitting in poop and gets skin break down, the state is coming after you, not the CNA. if you are ever asked to change a diaper, you will change it"

having worked as a tech in the ER, i didnt have to deal with too much poo, but enough to where i am comfortably changing a diaper and i will continue to do so when i become a nurse. i would ultimately find out why, though, that the CNA did not want to change the patient. maybe the pt needs something for pain and was agitated and hitting. maybe the patient is having a GI bleed and they are squemish. maybe the patient said something hurtful to the CNA. regardless, time sitting in a dirty diaper is increased risk for infection and skin breakdown. i would rather take 5 minutes to change them.

when you become a nurse, the only thing that "isnt my job" is practicing medicine. the good, the bad, the ugly and the poo will all belong to me the day i pass the NCLEX.

racing-mom4, BSN, RN · Mar 1, 2008

when you become a nurse, the only thing that "isnt my job" is practicing medicine.

That is a great quote coming from some one with a great attitude!!!!

I love it. Thank-You :up: