It was one of those weekends! I had two falls of high risk residents on Saturday night. The Aide had forgotten to set one alarm and just let the other wander away. I lectured her on paying attention and resident safety and that was that. (I don't know what management will do as one required a trip to the ER for some stitches. At any rate, Sunday started well, she was on her game and we were having a great night. I was halfway through my charting when she ran into the nurses station and said the following:
"You are gonna be mad at me, I think she is dead"
It turned out to be a resident who has a tendency to lay down wherever and "play possum" but if I never hear that again it'll be too soon!
an aide documted that a residents pulse was 43 !!! Ofcourse she was wayyy off.
I wouldn't be so quick to say "of course she was way off"
I work on a Tele floor and I had a patient once that was waiting for a med/surg bed. She was there for asthma exacerbation, and considered non tele so we didn't have her on the monitor. When I looked at the vitals the aide had recorded her pulse as 40. I called her over and asked what her pulse really was and looked at her paper and said 40. I ran in there, took her pulse, and it was in the 40s. She had just bought herself an extended stay on our floor and a monitor. (This also goes back to my earlier post about aide reporting abnormal vitals right away, not waiting a hour, this of course was at least a hour later)
Specializes in Management, Emergency, Psych, Med Surg.
I just wish that some of my CNA's would say SOMETHING!! Plus, after all these years I can't get some of them to understand the concept of isolation. I saw two of them last week, in gowns and gloves going into a room where I knew the patient was not on isolation. I said "have you already been in an isolation room?". Well, of course the answer was yes and so there we go. And we wonder how every patient on the unit gets MRSA. Sometimes I feel like I just need to carry a shot gun to work and just say "well, you are just TSTL (too stupid to live) but of course, I just give them another lecture on why they can't be going from room to room in an isolation gown. It never ends. (It's a joke about the shot gun Ya'll).
I just wish that some of my CNA's would say SOMETHING!! Plus, after all these years I can't get some of them to understand the concept of isolation. I saw two of them last week, in gowns and gloves going into a room where I knew the patient was not on isolation. I said "have you already been in an isolation room?". Well, of course the answer was yes and so there we go. And we wonder how every patient on the unit gets MRSA. Sometimes I feel like I just need to carry a shot gun to work and just say "well, you are just TSTL (too stupid to live) but of course, I just give them another lecture on why they can't be going from room to room in an isolation gown. It never ends. (It's a joke about the shot gun Ya'll).
maybe so, but a few rock salt pellets is their orifices might get the point home.....
Specializes in Management, Emergency, Psych, Med Surg.
You might be right. I have threatened to take a cattle prod to work but so far I have not bought one but I may ask for one for Christmas and just put it on the front of my work space with a note that says "when you say or do something stupid, you get the prod". But it's like Ron White says "you can't fix stupid".
This was actually a new grad nurse in training at my facility...
I'm in a hospice resident's room giving meds and trying to get her comfortable. The trainee comes into the room and asks me "Can you come look at so-and-so." Very collected, no urgency. In the middle of repositioning my resident I reply "Sure, just hold on a minute." My resident began to say something to me and I stopped to talk to her for a moment. Meanwhile the trainee is starting to look a little antsy. "I need you to come look at so-and-so." Me: "Okay, just hold a a second while I finish up with my res." Trainee: "Can you come look at so-and-so first?" I leave my resident and follow the trainee into the hallway. Me: "What am I going to look at, exactly?" Trainee: "I think she's dead." Sure enough, only 15 minutes after she had had vital taken and been helped to bed, there she was- very much dead.
I think what got me most was the oh-so-roundabout way this poor new grad trainee had told me about it. Maybe afraid to say the word "dead"? I think this was his second day of training.
I guess what gets me is when they code the adl sheets that the resident is independant when they take 2 people to get there big hiney in a chair. etc.. and they code that they have not had a bm in 7 days and noone has bothered to do anything and they go to the hospital with an impaction that is embarrassing as heck to me!!!! and somedays they just leave the whole thing blank... but on the other hand had a nurse that could not remove a foley-- and had nurse aides laughing at her.... scary out there !!!!! (remind me not to get to sick to have to get in a nursing home around here lol)
I had a nurse aide that wrote textbook vitals for all of her residents. Thing is, she never at least switched up the vitals. Everyone's bp would be 120/60 LOL
You might be right. I have threatened to take a cattle prod to work but so far I have not bought one but I may ask for one for Christmas and just put it on the front of my work space with a note that says "when you say or do something stupid, you get the prod". But it's like Ron White says "you can't fix stupid".
I have a couple of cattle prods. Problem is the aide I usually work with would take one away and use it on ME if I were to poke her with it.
BTW, when she says "I need you NOW!", I know two things. It must be REAL important and I'm not going to be happy.
i had a nurse aide that wrote textbook vitals for all of her residents. thing is, she never at least switched up the vitals. everyone's bp would be 120/60 lol
i worked with an aide years ago on an ortho floor who wrote in random numbers on the vitals sheet and nothing any of us said sunk into her thick skull. eventually, an older man was admitted for repair of a torn rotator cuff. all should have been well, despite his hx of htn. post-op, hx
bp was something like 200/120, despite meds given. no room in icu, so he was returned to ortho. his nurse took vitals q15 min. as ordered but hours later and the aide was assigned to vitals check x2. she was to report his vitals as they were taken so the nurse and so she did. she reported bogus numbers and when she saw me in the hall, said, in passing, "btw, mr. ____'s bp was down. i think too down." i was off and running... when i checked it myself, it was about 190/100! the aide, who had followed me, went running down the hall toward the charge nurse, yelling, "see? i said it was much too low!" they finally got rid of her! many many complaints but nothing was ever done about her falsifying vitals until that day. boy, did she ever pick the wrong patient to fake vitals on!!
whenever that aide said something wasn't as it shoulcd have been, whoever was closest ran!
NurseLoveJoy88, ASN, RN
3,959 Posts
an aide documted that a residents pulse was 43 !!! Ofcourse she was wayyy off.
I hate " so and so fell" sometimes I think they set me up but no way to prove it.