What CNAs need to tell the nurse

Nurses General Nursing

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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.)

Specializes in Nursing assistant.

this is so helpful.....

but my brain hurts.....

no one at work gets my warped sense of humor....

I think that makes them normal

thank you

Specializes in ER, Medsurg, LTAC.
this one drives me nuts - and i dont know any other ways to say it to them but i find often they "oh sorry i forgot you want tio see it - noone else ever does" ugghhh - i have even made them dig in laundry or garbage to get the item in question out if i know they just took care of it and can find it - youd think theyd learn.

Wow, digging through the laundry/trash? Nasty!

And notice the "no one else ever does"- this is unfortunately true.

As a CNA, just keep bothering the nurses with specimens, etc so you know you have done your part!

On a separate issue:

I can understand the frustrated poster (kurosawa)- there are nurses out there who will try to get you to do their job. I have had numerous requests to change dressings, to stay with a patient until they can take this med, to give these papers to the patient to sign, to do a variety of other things that CNA's really shouldn't be doing and then if there is a problem I have found these awful nurses in empty rooms sleeping, in empty rooms watching TV, in the cafeteria- not on break, on other floors chatting....

Please report these nurses- they give the good ones a bad name!

Specializes in ORTHOPAEDICS-CERTIFIED SINCE 89.

A couple of pages back someone said something about not getting a total knee up......we did that all the time. Different doctors, different parameters.

Sorry, didn't mean to hijack either. Carry on Nurses.

Specializes in Nursing assistant.
A couple of pages back someone said something about not getting a total knee up......we did that all the time. Different doctors, different parameters.

Sorry, didn't mean to hijack either. Carry on Nurses.

Don't mean to be your partner in crime, but, with bilateral total knee replacements how do you deal with the weight bearing issue?

And to the rest of you, carry on....

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.
Don't mean to be your partner in crime, but, with bilateral total knee replacements how do you deal with the weight bearing issue?

And to the rest of you, carry on....

None of our orthopods will do that (bilateral TKAs), weight-bearing issues being one reason.

Specializes in ER/SICU/Med-Surg/Ortho/Trauma/Flight.
Yeah. So you collect the big bucks for assessment, care planning, and delegation--and you expect the CNA to do it for you.

Get a grip.

You know why you don't get abnormal data ASAP in the middle of the CNA taking vitals?

Because it takes 15 minutes to find you which she can't afford even when she's only vitaling half the floor, let alone the whole floor by herself, and you're not helping by not carrying your pager.

Because every other RN on the floor is hollering for (1) their vitals and (2) come here NOW and help me/do this/do that.

Because she's WAY overloaded before anyone starts hollering: if you took total care of your pts, you'd find yourself spending half your night on changing, cleaning, and bathing, yet with 5 RNs for 1 aide, you expect all that done "and where are my vitals and I's and O's?"

Because she knows what normal is, and not only that but what floor policy is, but so many times she's gone hunting for an RN with data that's out of limits and been told, oh I don't worry until it's X or Y or Z, or, did you really have to wake up the pt for a BP and anyway that's normal for him -or- leave him alone, he's dying.

But mostly she doesn't do your assessments, plan your care, do critical thinking, and do your delegations because she doesn't have RN training.

Like marie said that was rude, assumptive, and uncalled for I used to be an CNA and then an LPN then an RN and I didnt mind helping my LPN's and RN's gee weez I would hate for you to be my aide sounds like some ones got a little lazy in her geez some one outta talk to you that way.:angryfire

Just mention any color changes and smells in stuff such as urine or feces or vomiting.

None of our orthopods will do that (bilateral TKAs), weight-bearing issues being one reason.

dont know for sure - had a friend who did this - she swears it was the best way to do it. dont know its how i would do it but she did ok at 65 so guess it cant be all bad.

Specializes in Nursing assistant.

With one knee replacement, just keep the knee extended and bear most of the weight on the non operative leg, but what I was wondering was how that is done when both knees are done. They do that sometimes, but I have not seen how they handle first time up.

How about telling you when your patient is dead?This is the honest to God truth, I had a CNA once who wrote on the TPR sheet that she gave me that she was unable to do TPR on patient "due to death".How about reporting this little detail right away?:uhoh21:

Specializes in Nursing assistant.
How about telling you when your patient is dead?This is the honest to God truth, I had a CNA once who wrote on the TPR sheet that she gave me that she was unable to do TPR on patient "due to death".How about reporting this little detail right away?:uhoh21:

At least she had a good solid reason. Ive seen worse! ;)

Specializes in Utilization Management.
How about telling you when your patient is dead?This is the honest to God truth, I had a CNA once who wrote on the TPR sheet that she gave me that she was unable to do TPR on patient "due to death".How about reporting this little detail right away?:uhoh21:

Now I just got home from work and I have a mouthful of ice cream and then I read THAT.

And I can't stop laughing long enough to clean off my monitor.:rotfl:

Specializes in cardiology, LTC.

I worked as a nursing assistant the whole time I was in LPN school. I felt like the experience was invaluable to me after I graduated and began working. Since then I have completed the bridge class to get my RN. I work with a really great bunch of aides. I have often though of coming up with a list of things to give new aides on orientation. The original posters list was a good one. A lot of the problem I see is the aide vs nurse mentality. Our jobs are both the same- to care for patients- we just do different things to complete our jobs. I recently heard a new RN who just passed boards make the comment that she was glad she had passed so that she wouldn't have to clean up s**t anymore. Boy she is in for a rude awakening isn't she?!! That is a sure fire way to tick off the aides working with you!

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