What info should nurses let a PCT/CNA be aware of?

[sh_eany]

I am a nursing student and work as a MBT Mother Baby Technician in a hospital dealing with post partum mothers and babies. Amoung other things my duties are helping with breast feeding, peri care for c- section mothers, blood sugars, removing foleys and IV and taking care of the babies. My question is whenever we have patients with certain disease that can be transmitted by body fluid are the nurse suppose to let us know. I do know we are all suppose to follow HIPPA and Universal Protocols but at least they get that info in their reports from their peers. I don't get it why can't they just let us know to be a little more cautious. There was a incident recently where one of my collegaues had to do blood sugar on a patient every 2 hrs during a 12 hrs shift and the nurse NEVER mention to here this patient had HIV. I am concerned and just need to know what you guys think, should I ask for this info if it is not being pass on. HELP.

[abbaking]

Yeah yeah yeah, sure. Nurses withholding information like this isn't cool at all! You can argue until you're blue in the face that we don't NEED TO KNOW because it doesn't affect us, but I think that's a load of crap! What do you care? Tell the ******* CNA if the pt has a blood borne pathogen! This is no different than me asking a nurse what my pts are in isolation for! If a nurse EVER told me to "just follow posted precautions, you don't need to know what they're in isolation for," I'd be LIVID! Do you get your jollies off of withholding info from assistive personnel because you're the nurse?!

You hit the nail right on the head. EVERYTHING a patient is being treated for is shared and discussed with all staff providing care for the patient. Its called a nursing TEAM for a reason. When I was working as a CNA, often times a certain RN withheld vital information from me about the patients condition due to HIPAA and some other horsecrap. CNAs are a vital piece of care and they need to be informed of all things relevant to the RN staff aswell. Universal precautions - Come on people lets get real - Who among us uses gloves for EVERY patient interaction ALL THE TIME? N-O-B-O-D-Y!

Universal precautions - would like to see that go in the future. That was hype and hysteria that came about in the 1980s over the AIDS crisis....it does nothing more than to reinforce the hysteria and panic done but the early 80s.....life has changed since then. Infection control is well understood aswell is handwashing and hand sanitation.

Back to the present - ALWAYS demand to know whats is going on with a patient, what they have isolation for and any major medical information. God forbid, the patient somehow transmitted HIV to a CNA and that information was withheld by the RN, that CNA would have a MAJOR settlement and never have to work again and the RN would be flipping burgers.

Remember its all a two way street. As a healthcare TEAM, all people providing direct patient care have a right to know about certain medical conditions.

[Esme12, ASN, BSN, RN]

I replied right as I was getting ready for class and was late (darned all nurses makes me late every time!), so I was a little rushed! lol :)

But you should be ANGRY they are not treating the CNA as a team member. I find it interesting that us "more experienced nurses" are the ones appalled with this lack of report and sharing of information with the CNA's:smokin:

[Do-over, ASN, RN]

This is another one of those posts with answers and I think WHAT THE HECK!!!!:smackingf

Funny, I am thinking the same thing.

As for relationships with CNAs - I have good working relationships with all on my shift. I guess I'll have to make it more clear that I am "getting my jollies" by acting all superior and hiding all kinds of private info from them. /sarcasm off

[Do-over, ASN, RN]

You may not treat them differently, but you're extra cautious. If you say otherwise, you're kidding yourself.

I am not "extra-cautious", I don't even know how I could be...and I am not kidding myself. Considering I don't believe double-gloving serves any purpose other than wasting gloves. What other steps are considered "extra-cautious"?

[Gently.me]

But you should be ANGRY they are not treating the CNA as a team member. I find it interesting that us "more experienced nurses" are the ones appalled with this lack of report and sharing of information with the CNA's:smokin:

"More experienced nursing"... Yikes! That sounds like an assumption and you know what they say about those.......

I think those of us that are standing by not telling anyone who need to know are looking out for the patients best interest. I can only speak of my own nursing style, but I always see the need to be a patient advocate first.

Although I understand certain circumstances would deem necessary for everyone involved to be aware of a pts bloodborne pathogen status, not all circumstances require this. In my personal and humble opinion, drawing blood/starting IV's are not a need to know situation, because if we do our jobs correctly there should be no problem. Sure we could be EXTRA careful when there is a positive bloodborne case, but we should be EXTRA careful anyways.

My experience comes from having two needlesticks. Both were silly errors on my part, and either one of them could have been extremely life changing. Anyone who deals with patient care should take it very seriously because it only takes ONE little drip of blood to change your life forever. I see nurses start IV's all the time without a glove or the tip of a finger (and I am guilty of that as well). This is just so stinking silly of us to do. I feel like this entire conversation could be avoided if we all took universal precautions more seriously. It is just safer and more intelligent that way.

By reading these posts, I have learned a lot, but I still think I stand by my initial response. CNAs are a vital part to the team, but their education does not include pathophysiology of diseases. I am not trying to sound mean or demeaning because I hold the highest respect for every person on the care team, but CNAs are nursing assistant not licensed nurses. Every facility is different on the role of the CNAs. I respect the opinions of everyone here, but I have a right to my own opinion.

Please please please take precautions seriously guys, because we know Murphy and his law. The one time we forget, is going to be the only time that matters. Assume everyone has HIV/Hep B+C and take extra care with everyone. Slow down and protect yourself first. You do not need to know everything about a patient to protect yourself.

[canigraduate]

Still walking.....

I give up. One of the ways that a bully operates is by withholding information. Please make sure that your motivation is truly patient advocacy and not keeping things from the CNA because you can.

And by the way, all the assertions that a CNA doesn't need to know come across as mean and belittling. Yes, I will repeat it so you understand how I feel as a CNA - MEAN and BELITTLING.

Where I work, it is understood that CNAs spend more time with the patients and we can report observations to the nurses that they need to know. If, for example, a patient is on blood-thinners and we see them bleeding, let the nurse know ASAP. If a patient with HIV is having a new onset of the sniffles or a sore throat, the nurse needs to know so she can check labs or get an order for more. If a person with Hep C is having new swelling of the belly that I noticed at bath time, the nurse needs to know. However, I need to know the hx beforehand so I know what is relevant to report. Some nurses get downright snarky if you call them too often about things they don't think are relevant.

Aaaargh - CNAs aren't working in a vacuum, most of us are really trying to help the nurses and the patients. Try giving us some credit.

[Do-over, ASN, RN]

Still walking.....

I give up. One of the ways that a bully operates is by withholding information. Please make sure that your motivation is truly patient advocacy and not keeping things from the CNA because you can.

And by the way, all the assertions that a CNA doesn't need to know come across as mean and belittling. Yes, I will repeat it so you understand how I feel as a CNA - MEAN and BELITTLING.

Where I work, it is understood that CNAs spend more time with the patients and we can report observations to the nurses that they need to know. If, for example, a patient is on blood-thinners and we see them bleeding, let the nurse know ASAP. If a patient with HIV is having a new onset of the sniffles or a sore throat, the nurse needs to know so she can check labs or get an order for more. If a person with Hep C is having new swelling of the belly that I noticed at bath time, the nurse needs to know. However, I need to know the hx beforehand so I know what is relevant to report. Some nurses get downright snarky if you call them too often about things they don't think are relevant.

Aaaargh - CNAs aren't working in a vacuum, most of us are really trying to help the nurses and the patients. Try giving us some credit.

It is not about giving credit. Aides have a role and I have mine. Those roles are very different.

I can state positively that during my shift, no one spends more time in my rooms than I do, unless there is a 1:1 sitter in that room. One of the reasons I can say this is that I have a max of 5 patients, while the aides on nights often have half the unit (18 patients). I am responsible for assessing. The CNA is responsible for reporting all abnormals, in my opinion. If you get snark for reporting your concerns to the nurse - shame on him or her. I need to know if the patient is bleeding, has new complaints, etc. no matter what medications/disease/etc. It is not the role or scope of the CNA to decide what is relevant to report to the nurse - I consider that assessing and it is not the CNA role.

[canigraduate]

It is not about giving credit. Aides have a role and I have mine. Those roles are very different.

I can state positively that during my shift, no one spends more time in my rooms than I do, unless there is a 1:1 sitter in that room. One of the reasons I can say this is that I have a max of 5 patients, while the aides on nights often have half the unit (18 patients). I am responsible for assessing. The CNA is responsible for reporting all abnormals, in my opinion. If you get snark for reporting your concerns to the nurse - shame on him or her. I need to know if the patient is bleeding, has new complaints, etc. no matter what medications/disease/etc. It is not the role or scope of the CNA to decide what is relevant to report to the nurse - I consider that assessing and it is not the CNA role.

Never mind. I can see that you aren't considering anyone else's opinions or feelings and I am done worrying about this.

Thank you to all the nurses out there who try to teach their CNAs and keep them informed.

[Do-over, ASN, RN]

Never mind. I can see that you aren't considering anyone else's opinions or feelings and I am done worrying about this.

That is a door that swings both ways. From my POV, I have attempted to explain and support my opinions because this is a discussion board. I am not name calling or accusing anyone of bullying just because I don't agree. You gave some reasons why you believed the info was pertinent, and I countered it specifically - so I would say that I did in fact consider your opinion - I simply don't agree with it.

I like opinions, my own most of all. My second favorite type of opinions are those that agree with my opinions. I have read others here and I don't agree with all of them. Shocking, I know, but the opposing arguments presented in this thread have failed to change my opinion, just as your opinion has not changed.

To quote my granny, "opinions are like bellybuttons, nearly everyone has one"... Except, she didn't really say bellybuttons, but clean language is my perpetual new year's resolution.

[kool-aide, RN]

But you should be ANGRY they are not treating the CNA as a team member. I find it interesting that us "more experienced nurses" are the ones appalled with this lack of report and sharing of information with the CNA's:smokin:

Believe you me, I am.

[N.U.R.S.E.]

According to the law do you have a right to know and if you did know would the care the person receive change. You knowing does that guarantee that the pt will receive better care. At any given moment a stable pt can turn into an unstable pt and everyone involved directly in their care should know

[Esme12, ASN, BSN, RN]

Still walking.....

I give up. One of the ways that a bully operates is by withholding information. Please make sure that your motivation is truly patient advocacy and not keeping things from the CNA because you can.

And by the way, all the assertions that a CNA doesn't need to know come across as mean and belittling. Yes, I will repeat it so you understand how I feel as a CNA - MEAN and BELITTLING.

Where I work, it is understood that CNAs spend more time with the patients and we can report observations to the nurses that they need to know. If, for example, a patient is on blood-thinners and we see them bleeding, let the nurse know ASAP. If a patient with HIV is having a new onset of the sniffles or a sore throat, the nurse needs to know so she can check labs or get an order for more. If a person with Hep C is having new swelling of the belly that I noticed at bath time, the nurse needs to know. However, I need to know the hx beforehand so I know what is relevant to report. Some nurses get downright snarky if you call them too often about things they don't think are relevant.

Aaaargh - CNAs aren't working in a vacuum, most of us are really trying to help the nurses and the patients. Try giving us some credit.

I now have a moat around my house.....:throcomp::grn: