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.

[Esme12, ASN, BSN, RN]

"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.

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

I said and I quote ....."More experienced nurses" and it's not an assumption when under experience it says how long the4y have been a nurse. I myself have 33 bedside years.....and you're right you should know what they say about ass-u-me ing...........they say the same about opinions.

If the presence of a blood borne pathogen is so insignificant to the care of the patient....Why do you need to know? I know so you know what to look for and labs to monitor......but If you want you CNA to act apart of the team and go the extra yard for you......then treat them as if they mean something other that to do the unpleasant aspects of care. The exclusive possession of important information necessary for the care of the patient has nothing what so ever to do with being a patient advocate......it does however have everything with being in the position of power and utilizing that information to control the behavior of others is an act of enforcing superiority. Is that being a bully? I think so.

I get so tired of hearing from nurses how the nurses aides are lazy and won't do as they are told if you aren't inclined to treat them as if they belong and a valuable member of the team. (if you ask them and respect them you might find their cooperation and initiative a bit more available) How are you advocating for your patient by telling or not telling someone involved in the patients care that is performing intimate functions for that patient. Do you not give report of the patient they care for?

If you want to be respected by others you need to be respectful. Do the nurses aides that work with you know you withhold information from them? I believe that every team member is important in the tasks they are responsibile for and we are all inter-dependant on one another and equally important.

You have the obligatiiion to yourself to practice the way you feel is prudent and proper.........but I just don't get it.....

[Gently.me]

Enough with the superiority complex because it is garbage. There is no nursing conspiracy where we have a secret nightly meeting to see what information to hold back from from the aides for "funzies". It is a moral and ethical decision for the rights of the patient.

The nurse determines what information gets relayed, and the nurse should do it with the pts best interest in mind. Sometimes this means filling them in 100% sometimes it means withholding information. If at any time, the nurse does not have the best interest of the patient at heart, the nurse is not doing their job as a patient advocate.

I think one of the biggest problems we are having in this debate, is that we all work in different settings, that have different styles of nursing. I work in an ambulatory surgery center where we have a pain clinic and do back surgeries. My other job is at an Urgent Care. In both jobs, a patient is there for a specific purpose/goal, and they are only treated for that specific diagnosis. Treat em and street em so to speak.

We see roughly 40-60 patients a week for pain management. That is roughly 200 patients a week, and 2400 patients a year in pain alone. They are there for their steroid shot and that is that. We dont even ask them if they have a bloodborne pathogen because we do not need to know to do our jobs correctly. We do have them sign a consent that states that if someone does get exposed, we can then draw the appropriate labs.

For surgeries, we do ask them beforehand if there is anything we should know about their blood history. Sometimes patients tell us, sometimes they dont. We do have them sign the same consent.

At Urgent Care, unless they are physically coming in for that specific disease related process, we wont know ever.

I have found that most of my patients who have these diseases, hate these diseases and do not wish them upon others. It is why they tell us about them so we can be aware. A lot of these patients have been ostracized because of their disease, even by healthcare team members who do not know better.

Now, to a lot of the CNA's here. You guys truly seem intelligent and caring for your patients. I hope you continue your education to nursing so you guys can do more than what you are doing. When it comes to nursing however, a CNA is usually working under the license of an RN. This means an RN is liable for everything regarding the patient. It is up to that RN to delegate appropriately. Although there are many CNA's that I know who are smarter than a lot of nurses I know (in my humble opinion), but "street" knowledge does not hold up in court. You guys need your nursing degrees, because our field can use your intelligence and your passion.

As much as I love this debate, I do think we need to agree to disagree. I do respect your guys' opinions, and it does give me food for thought when I get myself into a nursing field different than the one I am in :)

[kool-aide, RN]

Enough with the superiority complex because it is garbage. There is no nursing conspiracy where we have a secret nightly meeting to see what information to hold back from from the aides for "funzies". It is a moral and ethical decision for the rights of the patient.

The nurse determines what information gets relayed, and the nurse should do it with the pts best interest in mind. Sometimes this means filling them in 100% sometimes it means withholding information. If at any time, the nurse does not have the best interest of the patient at heart, the nurse is not doing their job as a patient advocate.

I think one of the biggest problems we are having in this debate, is that we all work in different settings, that have different styles of nursing. I work in an ambulatory surgery center where we have a pain clinic and do back surgeries. My other job is at an Urgent Care. In both jobs, a patient is there for a specific purpose/goal, and they are only treated for that specific diagnosis. Treat em and street em so to speak.

We see roughly 40-60 patients a week for pain management. That is roughly 200 patients a week, and 2400 patients a year in pain alone. They are there for their steroid shot and that is that. We dont even ask them if they have a bloodborne pathogen because we do not need to know to do our jobs correctly. We do have them sign a consent that states that if someone does get exposed, we can then draw the appropriate labs.

For surgeries, we do ask them beforehand if there is anything we should know about their blood history. Sometimes patients tell us, sometimes they dont. We do have them sign the same consent.

At Urgent Care, unless they are physically coming in for that specific disease related process, we wont know ever.

I have found that most of my patients who have these diseases, hate these diseases and do not wish them upon others. It is why they tell us about them so we can be aware. A lot of these patients have been ostracized because of their disease, even by healthcare team members who do not know better.

Now, to a lot of the CNA's here. You guys truly seem intelligent and caring for your patients. I hope you continue your education to nursing so you guys can do more than what you are doing. When it comes to nursing however, a CNA is usually working under the license of an RN. This means an RN is liable for everything regarding the patient. It is up to that RN to delegate appropriately. Although there are many CNA's that I know who are smarter than a lot of nurses I know (in my humble opinion), but "street" knowledge does not hold up in court. You guys need your nursing degrees, because our field can use your intelligence and your passion.

As much as I love this debate, I do think we need to agree to disagree. I do respect your guys' opinions, and it does give me food for thought when I get myself into a nursing field different than the one I am in :)

Gently--

I completely agree that our places of employment are probably influencing our opinions of this subject.