What to say to veteran CNA

[newtress, LPN]

Hello to all, I am a nursing student recently hired at a local acute care ICU as a PRN CNA. My first noc shift and was teamed with someone who has been at this hospital for years. We were 2 assisting a patient with multiple complications and finishing his bed bath. She asked me to finish up with shaving the gentleman as she was gathering dirty linens from the floor. Gave me the disposable razor and cream. I saw the wash basin behind me that I knew had contaminated soap water in it and thought she was getting a clean one with clean water for me to finish and rinse the razor off with. That's what I would have done: removed the dirty one and brought a clean one for the aide I was working with as a team. I didn't put the razor into the dirty water and asked if there was a clean basin available to rinse in, and that's when I got jumped. She got stink eye on me and said "this ain't nursing school, you better get that out of your head right now and hurry up." I would not EVER put a patient at risk by shaving a face and running contaminated water across skin that can be broken or nicked with his own feces and blood. Another CNA came in and joined up with her telling me you better get a move on. At this point, now if I mentioned the clean water and basin they would have thought I was downing them and me being "by the book." What could I have said that would be a fair statement and have a better working relationship? Thank you for your replies.

[pagandeva2000, LPN]

I would have just gotten the clean water myself and called it a day. This is nothing...even as a nurse, you will see things done differently than what was taught in school. I am not defending them, just saying that this is a reality. Next time, get the tools that you need when you want them and do the job yourself. Sorry this happened to you; you know what is right.

[jb2u, ASN, RN]

There are some people that no matter what will always not like you...that being said, you could always ask...

1) "So is that what you would say to The Joint Commision when they come around?"

2) "So if this was YOUR father laying here, you would be ok if I shaved his face with dirty water?"

3) "I realize that this is not nursing school, but I will do things the right way for the pt's benefit even if it takes me more time."

4) I would have got my own basin of clean water and stated that "I am not comfortable shaving the pt's face with dirty water. If that means that you look down on me or think that I am a know it all, well then I am sorry that you have not taken the time to get to know me, but still, I will not shave this man with dirty water. I would not ask you to do something that you consider to be wrong and I only ask that you do not ask me to do something that I KNOW to be wrong."

Remember, you have to go home and lay your head down on your pillow at night. Do the right thing always!!! If I have a choice between taking care of my pt or doing what a lazy coworker says just to be liked, well, then I guess I won't be liked, but I WILL sleep well that night (and so will my pt)!!

I wish you all the best and good luck in school.

Sincerely,

Jay

[JaredCNA, CNA]

Hey, I agree with the rest. I have worked on a 30-bed ortho/neuro med/surg unit for the past year. I'm not a "veteran CNA" by any means, but that's what I'm looked at as being r/t I have been there the longest out of the noc CNAs.

I see where said "veteran CNA" is coming from, but at the same time I do not think it is right. I've learned in this position that there isn't a place for attitudes, and I don't take them...from fellow aides or from nurses. I do my job how I think is the best way to do it. Don't get me wrong...there are a LOT of shortcuts you will see that aren't by the book but there is a fine line between which ones you can use and which ones put the patient at risk.

IE- I never get an estimated SBP when taken a manual blood pressure unless I hear the first beat after deflating the cuff by about 2 mmHg. And while dirty linens don't go on the floor, and clean sheets shouldn't be "flipped" in the air to change linens, I usually do that too.

[TiggerBelly]

Amen jb2u

[firstaiddave908]

I agree with the rest by getting a clean basin of water and shave the mans face. You are thinking the right thing by changing the water and getting a clean basin just go with what you learned in your training as a CNA.

[callmekipling]

get the clean water.

the eight kindest words to say to any CNA/nurse/anyone are "you go on ahead, I'll finish up here." At least it's the diplomatic solution, and then you can go ahead unencumbered.

For the future, consider shaving him first - if it is absolutely physically impossible to change the water, at least shaving cream is loaded with moisturizers, and there's nothing in it that can't go in a cut, obviously (though it may sting a bit, as we all know by now)

[newtress, LPN]

You are so right callmekipling. My objection to this scenario was not only a contamination/patient health risk, but the fact that I was told to start the shaving procedure as we were both simultaniously tending to this patient and to do it quickly. When the other assistant abruptly left the bedside after I started this as I was told to do so, went on to other tasks in the room I didn't understand at the moment why the one with the free hands didn't just instinctively bring a back up water as I was already in the middle of what I was doing. I should have left HER by the bedside after I was handed the shave gear and came back with the new water, and that probably would have rubbed her the wrong way as in me not taking her orders and snap to it. So I tapped the extra cream into my other hand and got pounced on for that also. It felt more like I was being tested; or the fun some employees have with the new girl on the first night. It all kind of smelled like a set up. I worked the following night with a completely different employee and guess what. We backed each other up, I got what she needed to help speed things along and visa versa. The same scenario handled completely different. I rest my case.