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Really? Really

Geriatric   (1,953 Views | 8 Replies)

1,264 Profile Views; 16 Posts

This AM a CNA gave me a vitals sheet with a BP of xxx/xx for a resident. When I took the resident her AM medications, resident stated her BP had not been taken. Checked residents BP- xx/xx.

Spoke with CNA who stated she did take the BP this am BUT resident is A&OX3 and a very light sleeper.

Above is a "write up" I submitted to my unit manager. I don't see any reason for this resident to lie about this. I explained this resident is on a BP med with parameters to hold for systolic

As far as I know this was never addressed with the CNA, except for me telling her what the resident said and asking again if she did the vitals. I don't think the UM asked the resident either. I hope someone can tell me if it is the nurses responsibility to do vitals for meds? It's something I plan on doing anyway now but it is a "rule" that would make ME the one "in trouble" for delegating the task?

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5 Followers; 37,760 Posts; 104,860 Profile Views

No. When you are responsible for vitals before a particular med, you take the vitals. That does not absolve the CNA from taking vitals on their rounds, but you don't substitute their findings for your own when you are relying on a good set of vitals to hold/not withhold a med.

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16 Posts; 1,264 Profile Views

Thank you for your response. I wonder what situation a CNA would obtain vitals where you wouldn't rely on them being good? Really. This reminds me of something the instructor said in a recent BLS course. CPR is CPR it doesn't matter if you're a life guard, paramedic or MD it's the same no matter who does it. Kinda the same thing with vitals in my opinion, if done correctly. CNA's are trained to take vitals which should be the same regardless of who takes them. Sorry for the rant but seriously.

I commented recently (capecodmermaid, who's in charge) about how the nurses in my unit were told we need to take charge of the unit and start holding the CNA'S responsible for things. I was a little defeated when the UM didn't even address the fact that a CNA gave me a BP reading for a res that said her BP was never taken (A&O), and the reading I got was very different than the sheet. The idea that I would be "in trouble" bothered me too. I was NOT trying to get the CNA in trouble, more bring the situation to management's attention to be addressed. Instead the matter was used against me and dropped.

Edited by Dawnkeibals
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delawaremalenurse specializes in Occ. Hlth, Education, ICU, Med-Surg.

227 Posts; 8,019 Profile Views

You are ultimately responsible for having accurate VS's especially for a med with given parameters. It would be nice if you could delegate this task and trust the results but, unfortunately, that is not the norm.

A big issue here is the ignoring of "dry logging" by the UM. Now the problem becomes what documentation by the CNA or CNA's can you trust? Are VS's accurate, what about I/O, are linens really being changes, are items that need to timed and dated really accurate, etc.

Another concern is that your providers are most likely making decisions based on the documented data...decisions that may be in error due to false or inaccurate data.

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CoffeeRTC has 25 years experience as a BSN, RN.

3,734 Posts; 22,053 Profile Views

UGHHHHH. I can just scream about this issue. Can you tell I'm dealing with a similar issue? I find it amazing that the vital signs are done without the equipment moving from the desk. Amazing!

Vitals for meds.....I do, unless i see the CNA just walk out of the room before i'm going to pass the med.

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16 Posts; 1,264 Profile Views

Nice to know I'm not alone. Seems like asking a certified medical professional to get vitals would be acceptable but now I know better.

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dream'n has 27 years experience as a BSN, RN and specializes in UR/PA, Hematology/Oncology, Med Surg, Psych.

1,086 Posts; 15,259 Profile Views

Nice to know I'm not alone. Seems like asking a certified medical professional to get vitals would be acceptable but now I know better.

You haven't been around long enough...no matter what the CNA does, it'll be turned around and made the nurse's fault. That's been my experience; "well the nurse should of watched, seen, known, checked..."

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smartassmommy has 1 years experience.

324 Posts; 8,920 Profile Views

Nice to know I'm not alone. Seems like asking a certified medical professional to get vitals would be acceptable but now I know better.

Unfortunately, the attitude that CNAs are professionals is not one that is often seen. Even worse is that most of it is the result of behavior like not doing what they should.

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24 Posts; 547 Profile Views

Being "long in the tooth" I learned a long time ago to do my own VS before meds. That way, I know what they are and when they were done.

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