Terrible Incident

[josebeltran88]

So I'm in a CNA program, and we're in clinicals right now. Last Tuesday, my CNA student partner and I were assigned peri-care on a 94yo. lady, who is anemic, and is covered in dressed skin sores. As we were cleaning her, she requested that my partner take off the sore dressings so that thorought cleaning could be done around the sore. My partner misunerstood the resident's request and took off all of the dressing (about 3 or 4 in total.) When the resident found out about this, she threw a tantrum, and began to cry in pain.

When the LVN was made aware of this, she told my partner and I (in a very distasteful tone of voice) that we couldn't undress any sores because we were "only" students, and not actual CNA's. She said it was "against the law."

Aferwards, I asked the LVN if we were to fill out an incident report, and she just disregarded my question. Now, here's what I was left wondering; What law, if any, did we break? And, why weren't we required to fill out an incident report?

[Virgo_RN, BSN, RN]

Don't remove dressings unless instructed to by the nurse. I don't know that you broke any laws per se, but what you did do is make more work for the LVN. Now she has to go redress all of those wounds. That's probably what she was really irritated about.

[topher-67]

You never remove dressings! Not even a band-aid for that matter. CNA's change briefs not dressings, gauze, etc. of any kind. If I even see a loose dressing I let the nurse know about it. Even if the resident or Pt. requests you to do so it is not within the scope of pratice for a CNA.

We all must learn from our mistakes.

[josebeltran88]

So then why weren't we required to write an incident report??

[caliotter3]

An incident report would have required even more work on the part of the nurse and she probably did not want any more hassle or to have anyone look at her actions in response to the report.

[lorelei1973]

So you were on your own without a regular CNA from the facility helping and overseeing? That makes no sense from both a practical and a liability stance. The facility is negligent for putting two students in a situation with a patient like this without supervision. Just get through the clinicals, sounds like you're stuck in a real dump for this part of your training.

[iamoore]

A incident report is to be used for serious accidents/falls etc.. not this type of incident. You really shouldbe having anexperianced CNA ther to guide and asst. you. But now you know.

[work&play]

I had the same situation last week when i finished my clinicals. I had to retake my CNA course because I let my certification lapse.

I have over seven years of job experience. Needless to say, I kept forgeting I was ONLY a CNA student and wasn't allowed to anything with apatient besides. changing linens, feeding and bathing with an employed CNA.

Well, I proceeded to transfer a patient from a wheelchair to a chair. They made an enormous deal about that. My last two days there, I desided to sit and watch people work. I didn't do ANYTHING anymore.

I was so upset about how they make a big deal when something like that happens. We understand we made a mistake. I know it won't happen again.

[jnrsmommy]

Now, had a skin tear occurred when the dressing was removed, an inicident report would have definitely been required.

CNAs are not to remove dressings as that is considered wound care and is out of the scope of practice for them. That being said, the only time I have had my CNAs remove dressings is when the dressing is covered by a brief and is saturated w/ either feces or urine, then they come and tell me what they have done. I would rather an open wound be covered w/ a clean brief for a few minutes until I can get there to change it, rather than remain soiled in that fashion.

[josebeltran88]

Well that makes sense now. Work&play; we aren't allowed to transfer patients either. A lot of the times I feel like a by-stander in my clinicals where I "watch and learn." Honestly, I'd rather watch and learn from the videos on the CD ROM that came with my CNA textbook. At clinicals I would seriously like to "do-and-learn." Hands on is the best way to learn procedures, in my opinion. It's a rare occurence when I'm paired up with a CNA that actually lets me do some hands on learning which I appreciate a lot.) I'm learning a lot though, during these clinicals.

[work&play]

It's sad when you're student. You pretty much can't do anything except watch. I was used to doing everything a CNA does at my job and going back to being a student was BORING!

I would just take my homework from my physiology evening class and work on that. It was worse for me because, I was also a medical assistant.

I was used to giving shots, drawing blood and changing dressings that I bhad to ask the profesor to just let me sit in my car during clinicals.

Don't worry time will fly and you'll be out of there and not be limited anymore. Hang in there!!

[dallet6]

They let you sit in your car doing clinicals and still passed you? Our state requires a minimum number of clinical hours and they do have to actually be spent there.