What CNAs need to tell the nurse

[UM Review RN]

in a postop, i want to hear about:

pain level (could indicate compartment syndrome or that dose needs adjusting)

c/o nausea/vomiting (could indicate an ileus)

bp over 140/80 or under 90/50 (lots of reasons, but needs treatment)

temp over 100.4 (some temp is expected in a postop patient, but after a certain point, the doc will want stat blood cultures)

but in the stroke patient, a temp over 99 needs to be reported (stroke patients need treatment for any temp over 99f)

a previously alert, oriented patient becoming confused. (could be an infection, a stroke, low o2, or a low blood sugar, but needs immediate investigation)

please save or show me any bleeding, any diarrhea, any discharge, any vomitus, and any urine that is not clear yellow or stool that is not soft, formed and brown.

if you notice any change in temperature or color of the skin of an extremity, please tell me. (a cold, white extremity could mean a clot and is an emergency)

if you find any pills in the bed, save them and tell me.

(some patients carry their own stash and can od themselves by accident)

please let me know if anyone has any trouble breathing or if their o2 sats are 92% or less or if their respirations are over 23. (the patient may need o2)

please let me know if the patient's heart rate is not regular or if it's over 100 bpm. (patients with an irregular heart rate might have a more accurate blood pressure when taken manually.)

[texas_lvn]

i can not say enough of how important they are. i truely believe if you want to do any form of nursing, medical, that you should be required to be a cna for at least a month.

i currently work for a hospital that does primary care, and it sucks. to be able to know that a cna has your back and is doing important stuff like vitals, and so on really helps. i miss our backbones. (ya know what i mean!!!) they are important team members.and very much needed.

[NurseyBaby'05, BSN, RN]

Anything abnormal. ***And, pretty please, don't wait until you're done with vitals, blood sugars, etc. for all the patients on the floor first and then tell me.*** In the time that it took you to finish all of them, I could have been getting treatment for the ones having a problem.

[emsboss]

CNA's....GOD LOVE'EM...'Cause I do!!!!!!!!!!!!!! ...They have our backs, just like was said previously. For me they need to tell me the abnormals, normals, and ANYTHING that concerns them with the pt. You know, the vague things, like, he/she just don't look right, something is not right, etc. A good CNA is my eyes and ears...I LOVE'EM!!!!!!!!:kiss :1luvu: :w00t: :thankya: :thankya: :thankya: :thankya:

[chadash]

thanks! this is sooo sooooo helpful! keep them coming! It is great to reheorifice some of this in the quiet of my home, cause when you are running, you have to interrupt a very busy nurse who has plenty else to do!

[MidnightTang]

I work on an ortho floor and all our total knees and hips are nwb on the affected leg, but they all get up the day after surgery. We don't run them around the hospital, but they do sit in a chair.

[UM Review RN, ASN, RN]

Weird smells. Like really foul urine, or that distinct C-Diff odor. The smell of a GI bleed.

Weird colors. Blue lips, green stool, orange urine.

Any patient who c/o chest pain needs to have the nurse alerted and a stat full set of vitals, and prepare to do a stat EKG.

Blood pressures under 90 systolic needs treatment asap, in case I didn't mention that before.

Sudden severe headache, blurred or double vision, numbness or weakness (especially on one side).

[UM Review RN, ASN, RN]

Rashes.

Decubs. Blisters. Bruises. (Had one patient who had sudden bruising on her arm--turned out that her Coumadin level was too high and the automated BP cuff was too tight and caused the bruise!)

Perineal irritation.

Reddened skin folds.

Oh, and for the older gents--the inability to pee more than 50 cc's at one time, yet having to pee more than once every couple of hours. He's probably retaining due to an enlarged prostate.

[AuntieRN]

The pt who you know is incontinent a lot and all of a sudden is now dry for a period of time.

The open area on the bottom of a pt that noone told you about.

The pt who will not eat or drink anything.

I too love my CNAs...(not just because I used to be one either....)

[bethin]

Blood pressures under 90 systolic needs treatment asap, in case I didn't mention that before.

Sudden severe headache, blurred or double vision, numbness or weakness (especially on one side).

Is there anything CNA's can do for nurses in these situations (besides vitals - that's what I'd do first while I send someone else to get the nurse). Sometimes in these situations I feel useless and that I should be doing something.

I love my job, but hate being a CNA. Sometimes you just feel useless because you can't help the nurse pass meds, call dr's, do assessments, etc.

[NurseyBaby'05, BSN, RN]

Beth-

What you aides do in these situations for the nurses is the most important. You act as their eyes and ears when they can't. The aides that are able to pick up on these things and inform us right away are worth their weight in gold. The other thing you can do, if it is feasible, is to stay with the pt if he/she needs calming while the nurse is running around like a chicken. Again, to reiterate, acting as eyes/ears of the nurses is the best thing you can do.

[UM Review RN, ASN, RN]

Is there anything CNA's can do for nurses in these situations (besides vitals - that's what I'd do first while I send someone else to get the nurse). Sometimes in these situations I feel useless and that I should be doing something.

I love my job, but hate being a CNA. Sometimes you just feel useless because you can't help the nurse pass meds, call dr's, do assessments, etc.

You can be ready to get the supplies and things that the patient will need for treatment--such as the crash cart, O2 tubing, a Foley kit, suction apparatus, the EKG machine. Know where to find all the emergency stuff on your unit.

I never wished that I had 15 hands and six pairs of feet more than when a patient is crashing.

In fact, it happened the other night. I had techs runnining everywhere to gather supplies while I assessed and monitored the patient.

They did such a great job, everything was set up so fast, that we were able to to transfer the patient so rapidly, I forgot to call Rapid Response team! Patient survived and is doing much better. But it would've taken another half-hour to round up all the supplies and equipment I needed by myself, and then who's monitoring the poor patient?

Thank God for PCTs!

[all4schwa]

Is there anything CNA's can do for nurses in these situations (besides vitals - that's what I'd do first while I send someone else to get the nurse). Sometimes in these situations I feel useless and that I should be doing something.

I love my job, but hate being a CNA. Sometimes you just feel useless because you can't help the nurse pass meds, call dr's, do assessments, etc.

coming from a new nurse, you can offer to do what you can...sometimes i feel like the techs are too busy to be bothered and only ask them to do stuff when i absolutely can't. i'm really relieved when they offer to help....