It really irritates me when we get to the floor, get patient assignments, and go in to see patients that have not been cleaned for at least a day. I'm not talking about diapers that need to be changed, I'm talking the entire patient is stinky and there are techs/cna's standing around. This really grinds my gears.
Do people working as nurses have this problem? If so, what do you do? Can you write up the techs for this?
I had a patient the other day who was stinky as all get out, Foley bag was full, and he was slumped down in his bed. The nurse is busting his butt trying to get all the medications out, and there are techs standing around talking. I say something to my clinical instructor and she says, "sometimes you'll have that, it's a game where they want to see if you'll do it for them." Can't people like this be punished?
Well, I can't speak to where you went to school 18 years ago, but today's instructors are not teaching students how to make beds and give sponge baths anymore. As I said, I follow the instructions I'm given BY MY PROFESSORS, not by some hospital staff members who think someone else should do their work for them. Nor do the nurses on the unit have time to do CNA work. Maybe this is a regional thing, I don't know. I've heard hospitals in more rural areas don't even have CNA's. But I do know that I go to school to learn, and missing out on inservices, missing meds, and missing actual student duties because I have to do someone else's work is not acceptable.
And who do you expect to do this for you after become a nurse? Many areas of practice are total care.
Also, if CNA's are being told that the students coming in are going to do their work for them, I should find this out. That would cause a big stink with my instructor. I don't know who would do that, it certainly wouldn't be the nurses.
Honestly, I wonder about this school, too. Clearly it's not "today's instructors" that feel this way, it's the teachers in her school. Maybe, if we're getting this story straight.
But the shock, disgust we feel about this situation probably shouldn't be dumped on the student who doesn't know any differently.....it should be on a program that makes the students feel elite, 'above' certain kinds of tasks. THAT's the problem, really, not that the student unknowingly believes it. In that sense, it isn't really her fault.
So while she may be mad at us, in a few years she's going to be very mad at THEM!
I guess I just don't understand your mentality, here.
I'm 11 weeks into my program, so far I've been checked off all basic CNA skills (though I am a certified CNA, we all had to get checked off in the beginning), physical assessment, injections, medications, urinary catheter, and NG tubes. I had clinical on Monday where I had the opportunity to give meds and injections to my nurse's entire hallway, it would have been awesome... However, my patients desperately needed baths. They hadn't had an aid on the floor for 2 days... I went in, spent nearly an hour with each patient, cleaning them up, getting them in fresh clothes, helping one female fix her hair. It's why I'm here - to help.
Just think to yourself why you wanted to become a nurse. It's not because you were dying to perform physical assessments, I'm sure, it's because we all want to help. And believe me, for a patient who can't get themselves cleaned up, they truly appreciate your help.
I just finished RN school in 2012 and believe me, doing baths were a huge part of our schooling and clinical. It was a great time to do a skin assessment. I now work in a 96 bed ED with about five CNA's for the whole department. while we don't do bed baths in the ED, we certainly do our share of cleaning up incontinent patients, linen changes, etc. Thanking God for that practice in clinical to help me get those tasks done for the best practice for my patients.
As a nurse with more than 18 years under my belt and a nursing instructor, if I ever found one of my student's patient assignments filthy and said student stated, "I'm a RN student- not a CNA student." Said student would be out of the nursing program lickety split. In my opinion, Veggie's post is symptomatic of the tremendous entitlement issue rearing it's ugly head in schools and facilities these days.
I recall a student who was incensed that the patient she just picked up had completely wet the bed: incontinent to the max, and the entire bedding was a mess. She made a point of interrupting report to announce that this patient was a MESS, and wanted to know "who was responsible for that patient" in the five minutes prior to her arrival.
It was ME.
I politely informed this student that incontinent patients aren't typically courteous enough to 'hold it' until late enough in the shift to acccommodate the oncoming staff's routine. That that particular patient had been changed and fluffed exactly ONE HOUR prior to the end of the shift. And that he was now HER responsibility, thank you. The last 12 hours were mine, the next four were hers.
You were much, much nicer than I would have been. Demolishing the pedestal that special snowflake put herself on would have been my priority task of the day.
Interesting that no one has mentioned, unless I missed it, the possibility that the patient refused to be bathed. That happens, sometimes even when they super-crazy NEED a bath. I've seen varying levels of cajoling, convincing, and debating employed, and I've also unfortunately witnessed people being ordered to bathe or placed into shower chairs regardless of refusal. I also, once when very new, participated in a bed bath insisted upon by a nurse and completed while the patient screamed "no" the whole time. (I felt like a complete d'bag and swore never again.)
So I wonder what OP thinks should be done with a patient who refuses. Discussion, okay, but force?
I hope I never have a student like this. It's tough enough being a nurse or a tech with out having to deal with a student like this.
This patient may of refused baths, and may be on lasix (why the foley was so full). And I have repulled up the same patient all day. Only the have the slump back down the minute I leave the room.
To the people who said that I should just do the CNA's job because I'm a student and I'm being "uppity"...just, no. I am given what assignments I do by my clinical instructor, and washing patients is not among those duties. I'm an RN student, not a CNA student, maybe I didn't mention that. My assignments that I receive from my instructor are assessment, meds, and so on, and if there is extra time I'm expected to be looking things up, not giving bed baths.
I guess I didn't expect so many "oh, just do it yourself" replies. Kind of shows people's attitudes toward students.
As a practicing nurse AND a clinical instructor, let me reply to this. No one who has responded to you has shown any sort of bad attitude. It is a realistic attitude. Student nurses ARE expected to learn how to clean/bathe/change sheets, etc. Nurses do it every day in 'real life' when the CNAs or techs are not able to get around to it.
As a student - YES - you are supposed to look up meds, plan patient care, do assessments, intervene, reassess. However, you need to take care of the patient HOLISTICALLY, and if your patient stinks or has a wet bed, you need to address that one way or another. As a nursing student, you can ask the CNA/tech to HELP you get the patient cleaned up. You can do it yourself or with another student nurse. You NEED to know how to do these things, because as a nurse, you will have to do them at some point! I do these types of things EVERY time I come to work. We have only 1 tech for the floor - and she is running her you know what off. Why would I ask her to do what I can do myself? Of course, I have asked for her help many times, but not when she is meeting herself coming.
I think your answer realllllly rubbed me the wrong way, because the people who answered do not have an "attitude". They are telling you like it is.
I say something to my clinical instructor and she says, "sometimes you'll have that, it's a game where they want to see if you'll do it for them." Can't people like this be punished?
idialyze, BSN, RN
168 Posts
And who do you expect to do this for you after become a nurse? Many areas of practice are total care.