So this is a vent. A few nights ago we had a newish PCT work with our night rotation. She normally works with our other night rotation. She's still in her probationary period.
I had one patient who was s/p CVA who was a turn q2, aphasic, contracted, the works. Blood pressures never dipped below 180. The doctor was aware and was not treating it. Anyway my 2000 vitals on him were 199/75. pretty normal for him. I wasn't concerned. The family members in the room actually told me before I saw the sheet from the PCT.
At 2200 I noticed he was not turned so I turned him. No problem he was an easy turn.
For 0000 vitals I had noticed the PCT was making her rounds and was passed his room while I had did my q2 rounding. When I went into his room he was again not turned and I had asked the family member, who by the way was sitting by his bed holing his had, if his blood pressure had went down. She had told me that they had not come to check his vitals since 1930. I thought to myself maybe she was saving him for last so she could check him to make sure he was not dirty. I turn him before I leave.
One of my other patients had just gotten out of the bathroom when I made rounds on him and had asked for the PCT to go in his room to take his vitals because he was in the bathroom when she went to his room. I called her on her phone and she said ok. I went back to the desk. She gave me my vitals about 20 minutes later. She had not gone back into my patients room who was up in the bathroom, I know this because he was across from the nurses station and I could see his room, but of course I had vitals on him. At this point I'm mad. I ask her to re-do his vitals, which she did. I then noticed that my CVA patient had a blood pressure of 131/50. I go into his room and ask the family member if his blood pressure was taken, and she tells me "no". I take his blood pressure myself and its 180/50. Now I'm fuming. I confront the PCT who tells me "I took them". I roll my eyes at her and then let the charge nurse know about it.
For 0200 rounds I follow her a few rooms apart. Pt. not turned. I turn him. Still mad.
At night it is at the nurses discretion whether or not 0400 vitals should be taken. I request for my CVA patient's vitals to be taken. The PCTs normally start vitals at 0430 so they can collect I&Os and do vitals at the same time. When I get my I&O's and vitals my CVA patient, who was pretty much comatose, had an intake of 270 and a blood pressure of 130/50. I take a deep breath before I blow up. I go into the patients room take his vitals and I get 195/50. I can also feel heat radiating off his body. His temp was 101.2 axillary, the PCT had 97.5 written down. I ask the family member who about the vitals and she tells me all the PCT did was empty his foley bag and leave.
When I look at my other I&O sheet all of my patients have intakes of 270. and most of them were wrong after I go and ask the patients myself. I don't even talk to the PCT again. I tell the charge nurse again and she makes copies of all the sheets.
When my nurse manager arrives in the morning I show her all the sheets and tell her what had happened during the night. She takes my papers and pulls the PCT in the office. Of course the PCT does not get fired. The NM tells me they are working with her because she is a "good" PCT who shows up and picks up shifts when we need her to. OMG is she serious. They are keeping someone because she shows up. What she did was falsify medical records which was ground for termination. I can not trust her with any of my patients. Especially when she says she took the patients blood pressure when the family member said she didn't.
Specializes in Oncology; medical specialty website.
Maybe she had a bad day or something. I like to think that we all want to work together to accomplish something. I know your goal is to treat your patient and get the vitals signs on time so you can monitor him. I know your goal is not to fire the PCT or humiliate her. Anyway, there are always two sides of the coin, no need to get upset or mad because she didn't do what you asked her to do. Next time, maybe talk to her (not tell her, "I asked you to do XYZ, why didn't you do it?") There are slackers everywhere, and there are people who like to get things done quickly and on time. Just calm down and think from the other person's point of view. Communication, communication, communication. Pointing fingers will not do the patient any good. Remember the patient is your priority, it's why you are working there.
You've got to be kidding. There is no other POV when someone is not doing their assigned duties and is falsifying documentation, and there is plenty of reason to get upset. The nurse is responsible for the patients' care based on those VS, I&O, etc.
Specializes in Oncology; medical specialty website.
Team work. Instead of sitting on your bottom while your PCT is busting hers - why don't you help out?
I didn't get the impression the OP was "sitting on her bottom." Where did you get that? Sounds like she was doing her job and the PCTs job. That's more than teamwork.
As a CNA in the hospital, I can't believe they did not fire her. Usually, there are certain things that are grounds for immediate termination, and falsifiying records is one of them. What excuse will the hospital have when someone dies in her care and they had prior knowledge of her incompetance. And as for the RN not busting her butt, usually the PCT/CNAs jobs are fairly simple.. I try to do as MUCH as possible, because I am here to HELP the nurse.. try to make their lives easier. (and no, I have no intention of being an RN.. ya'll have too much to deal with.. and NO support from management).
If I were a family member, I would want to know the type of care being given. Hospitals are much more likely to act on a patient's family members' concerns than they are on the report of an employee of poor care. If the care is not even adequate-no turning, fraudulent vital signs-the hospital should be taking immediate action. No RN should have to be held responsible for this PCT's actions.
I am angry for you. That PCT was wrong; damn wrong, and who cares if she was having a bad day? Last shift I had a horrible day. just imagine the worst shift ever and multiple it, that was us. But for the many vitals I did, I did not make one up. There is NO EXCUSE to make up vital signs. It's just sheer laziness.
Hopefully, now she has been caught, she will be more aware of being watched, and will do her damn job.
This PCT sounds like ones I worked with years ago. The senior aides would tell me to stop working so hard....I was making them look bad. They did look bad...on the rare occasions I was able to take a break, I saw them sitting on the back patio smoking and eating candy bars! I don't care if you scrub toilets for a living; do it well, do it with pride.
Infuriating that admin. won't back the nurse up on this. The RN is not being paid additional to babysit this sloth. (If sourapril is not in admin she's aiming for it.)
Maybe she had a bad day or something. I like to think that we all want to work together to accomplish something. I know your goal is to treat your patient and get the vitals signs on time so you can monitor him. I know your goal is not to fire the PCT or humiliate her. Anyway, there are always two sides of the coin, no need to get upset or mad because she didn't do what you asked her to do. Next time, maybe talk to her (not tell her, "I asked you to do XYZ, why didn't you do it?") There are slackers everywhere, and there are people who like to get things done quickly and on time. Just calm down and think from the other person's point of view. Communication, communication, communication. Pointing fingers will not do the patient any good. Remember the patient is your priority, it's why you are working there.
It is beyond my comprehension how anyone could seriously think this.
Specializes in PICU now, Peds and med-surg in the past.
I normally like giving people the benefit of the doubt but having a bad day is no excuse for this type of performance. What if the nurse believed those vitals she was given and the BP was really 230/120 and the patient stroked again, dying, and nothing was done to help him? A nurse is responsible for what the unlicensed personel on her unit do and her license is at stake! Sure, we all have bad days but when I have a bad day I might not be as talkative with coworkers - I don't not do my job and falsify critical medical information. If your day is that bad call off and let someone who will do the job right do it. And if you are the type of person who just doesn't want to be there ever just leave and do everyone a favor.
Maybe she had a bad day or something. I like to think that we all want to work together to accomplish something. I know your goal is to treat your patient and get the vitals signs on time so you can monitor him. I know your goal is not to fire the PCT or humiliate her. Anyway, there are always two sides of the coin, no need to get upset or mad because she didn't do what you asked her to do. Next time, maybe talk to her (not tell her, "I asked you to do XYZ, why didn't you do it?") There are slackers everywhere, and there are people who like to get things done quickly and on time. Just calm down and think from the other person's point of view. Communication, communication, communication. Pointing fingers will not do the patient any good. Remember the patient is your priority, it's why you are working there.
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OCNRN63, RN
5,979 Posts
You've got to be kidding. There is no other POV when someone is not doing their assigned duties and is falsifying documentation, and there is plenty of reason to get upset. The nurse is responsible for the patients' care based on those VS, I&O, etc.