To the nurses: Is telling you the pain level of the patient bothersome?

[chariot]

I'm training as a NA right now at a big hospital. I tell the nurses when the patients rings the call bell because he or she is in pain and is asking for meds. Why do nurses seem like they don't care or seem like I'm telling them something petty??

Also, what is the correct procedure for taking the blood sugar? I trained for 1 week during the day and the NA that was training me told me to wipe the finger with the alcohol swipe, air dry, poke, get blood on the strip, and put the alcohol pad on the finger again. That is what I did for 1 week during the day.

Then I'm training 1 week during the evening shift. The NA during the evening shift embarrasses me in front of the nurses saying I did the blood sugar wrong. He says, I need to wipe the finger with the alcohol pad, clean the first blood with a gauze, then put the 2nd amount of blood after squeezing the blood on the strip. I told him I was trained differently during the day therefore I did it that way. The nurses then doubted me after he embarrassed me like that. He says everyone is guilty of doing so. What was ironic was that when he went to do the blood sugar himself during the night, he didn't do the whole gauze thing. I felt so angry.

[KaeliF]

Nurses probably look like it's something trivial when you tell them about patients in pain because those are probably the same patients who have been incessantly complaining of pain all day, to be honest we just get tired of hearing it. That's not to say it's not important or necessary that you relay pain levels to the nurse. Trust me it's not that they think you are telling them something petty, they are just thinking "omg I have to go medicate them AGAIN???"

As for the blood sugars, the night shift NA told you wrong. I've never seen someone clean the first blood away before. And actually, you are not supposed to sit there and squeeze the finger after you've pricked it to get blood as that can give you an incorrect reading, and if you've already cleaned the first blood away then milking it out is the only way I can imagine you'd get enough for the strip. So go on doing it the way you were taught the first time, you had it right.

[anotherone, BSN, RN]

When you tell me someone is in pain how do you want me to react? I say, "ok, thanks". IF you tell me someone is having chest pain I might get annoyed as this will now delay my whole shift/day, but might react a bit differently than if you tell me so and so wants pain meds.... I don't know how I am supposed to react. Frankly, it annoys me to no end when adies or nurses think someone doesn't care because they don't start flipping out at every situation. If you tell me so and so is in pain and wants meds, I WILL acknowledge that I heard you and KEEP on charting or doing what I am doing, when I am done then I will go get meds( a few mins). If not than that is when charting errors or other things happen. It is not an emergency and I am not going to treat it as such and run to the pyxis machine........ It would all depend on the patient, what pain, have they been having pain etc. I don't excpect the aides to know this or to assess the situation but I don't want critiques either. A post op lap TAH BSO having pain is different than a corneal ulceration with severe pain, or a potential for compartment syndrome yelling out in pain, when previously that person had been fine. Just tell the nurse what the patient said, that is your job and the rest is the nurse's job.

I have heard the use the second drop of blood , don't milk, milk, all sorts of things to get an accucheck . I think at most hospitals they might have a class on this, seriously, you can ask the educator if there is one. Tell him/her you heard different theories and ask if the hospital prefers one be used.....

[JDZ344]

I would imagine that most hospitals have a protocol for taking blood sugars. You could ask one of the RNs or the manager- just say you have been told two different ways, could you please clarify which is correct?

Re: The nurses and pain medications. They probably already have a hundred things to do. Pain relief is likely low down the priority list for them, but not for the patient. If they don't do it in a timely manner, they will get it in the butt from the patient and management. So it probably is a PITA for the nurse.

[Ayvah, RN]

Pain number is a good thing to report when a patient wants pain medicine because some doctor's medication orders are based upon pain level. Regarding the blood glucose testing, I'm sorry you went through that. Keep your head high, look for information (like you are doing) to grow and move on.

I have always been taught at multiple facilities to wipe away the first drop of blood with gauze and use the second drop of blood in the meter. Check your facility's protocol (usually they'll have an intranet site with all their protocols somewhere).

Here's Johns Hopkin's protocol, for example, which says to wipe away the first drop of blood with gauze and test on the second drop. http://pathology.jhu.edu/department/staff/POCT/SelfStudy/Glucose.pdf

(Look at slides 16-17)

[PunkBenRN]

As for the blood sugars, the night shift NA told you wrong. I've never seen someone clean the first blood away before. And actually, you are not supposed to sit there and squeeze the finger after you've pricked it to get blood as that can give you an incorrect reading, and if you've already cleaned the first blood away then milking it out is the only way I can imagine you'd get enough for the strip. So go on doing it the way you were taught the first time, you had it right.

Um, you have this a little backwards. You should wipe the first blood off with gauze or alcohol wipe, as this blood is more superficial and could give you an inaccurate reading. "Milking" the finger will not affect the results, but will make collection easier. Also OP, after it is collected, do not use the alcohol pad on the pricked site - this will burn and actually encourage more bleeding; you would want to stop the bleeding with gauze.

And I tell all CNAs, dont let a nurse's attitude bring you down. If you think it is important for the nurse to know, than it is important for the nurse to know. If you have to keep hounding nurses about Pts in pain, what does that say about your nurses? Pain is never petty and needs to be addressed, keep up the good work.

[gummi bear]

O_o

This is the fourth or fifth post of this sort that you've created since you began training. Relax. Do your job properly and forget about people getting mad or not responding in a perky manner. As long as you are doing the correct thing, then it shouldn't matter. And some CNAs like to throw the other CNAs under the bus to make themselves look better. Let your hard work speak for itself and most of the nurses will see that the other CNA is delusional. We have one aide on our unit that likes to bad mouth the other aides. But no one believes her because everyone eventually found out that she's a complusive liar. You have to get thicker skin

[canned_bread]

I was taught the second way (drop of blood out and what not), however after much experience I have found it does NOT make any difference. My partner is a diabetic and I tested on him each time to see if it made a difference, also if alcohol wipes made a difference. It doesn't.

These days, the only time I would follow that procedure is if the patient is a) displaying signs of a hyper/hypo and the machine is telling me something contrary, b) the results are abnormal for that patient. I would also get a new machine in case the machine is wrong.

During my nursing school experience I frequently was taught different ways of doing things, and I explained that I liked to do the way we are taught at school, however I am open to various ways of doing things. It sounds like that nurse belittled you, and I would even go as far as to call it bullying. That's not on.