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.
Here is my gripe with PCTs as of late...and the kicker is that I am a PCT too :) Let's just say I am glad I have the experience, as it has taught me loads about teamwork.
Anyway - if you answer a call light, you are responsible for whatever you walk into. Far too many times as of late, my fellow PCTs will answer the light of one of my patients that has to go to the bathroom. These certain PCTs will tell the patient to wait, call ME to say that MY patient has to use the bathroom, and walk out of the room. WHAT THE HECK HAPPENED TO TEAMWORK??? Not once have I answered a light (regardless of if it's "my patient" or not), and not taken care of the patient myself at that moment!!
So I don't know exactly what it is, MissyF RN, but I can guess that is just plain lazy. Please know that there are PCAs (who will someday SOON be fellow RNs!) that do their job, and do it well :) I am sorry you have to deal with that mess, and I hope that management will get it together and hire someone willing to do their job - and you know there are people lined up outside waiting to get in!!
I had this happen just last week when I was on. I was taking care of a patient who needed help getting to the bathroom. As I am doing this I get another call from a PCT also on duty that another one of my patients needed to go to the bathroom at the same time. I assumed she was busy and couldnt get to it right then, so I said I would be there as soon as I can, and hung up. After about 3 mins I hear a relative of the second patient shouting at the PCT and 2 HUC's (who are also PCT's at this hospital, they HUC part-time) who were standing right outside the patients room. It seems the relative was ticked off that the three of them knew her mother needed help getting to the bathroom, and instead of one of them bothering to go in a help her since I couldnt get there right away, they stood right outside her room laughing and joking with each other. She demanded a apology, which they gave and the PCT then decided she better go in and actually help the lady. I was there within a few minutes as I was done with my first patient and told the PCT I would take over. If I were the relative, I would have been angry too.
Maybe she doesnt know how to take vitals? Maybe that is why she is falsifying info. They need to put her back on orientation and watch her closely.
I believe in teaching the PCTs working with me. For example if we have a diabetic patient with hypoglycemic episodes, I tell them the signs and symptoms to look for, even if they have been PCTs for yrs.
I think they really need to emphasize that vitals are a life or death situation in the hospital.
My only pet peeve with PCTs is guessing respirations on a pt on a PCA pump. I tell them that the pt might code if they dont watch count respirations accurately
I HATE it when people lose their jobs. Things rush through my mind like, "what about the kids?" "where's she going to find work?" "how's he going to put food on the table/pay the rent/bills/kids schooling?"
But at some point, you also have to think, "ENOUGH!" Some things warrant on the spot dismissal, and lying on patient documents is one of them.
This person is very lucky not to have lost her job. I hope she appreciates her good fortune and pulls up her socks; the OP and her colleagues will be well advised to watch this aide very carefully.
There was a documented case locally of a nurse (night duty) who recorded a particular patient's vitals throughout the night. In the morning it was found that he had been dead for hours....
Picks up shifts is such a lame a$$ excuse for keeping someone. Who gives a rat's patootie about picking up shifts? Monkeys can be trained to "pick up" shifts. Really? What should matter more is that the patient's are be being neglected.
I have heard the pick up shifts excuse for keeping a subpar worker way too many times, can you tell?
maybe she doesnt know how to take vitals? maybe that is why she is falsifying info. they need to put her back on orientation and watch her closely.
i believe in teaching the pcts working with me. for example if we have a diabetic patient with hypoglycemic episodes, i tell them the signs and symptoms to look for, even if they have been pcts for yrs.
i think they really need to emphasize that vitals are a life or death situation in the hospital.
my only pet peeve with pcts is guessing respirations on a pt on a pca pump. i tell them that the pt might code if they dont watch count respirations accurately
this statement, i have a problem with. if someone has been a pct for years and knows the s/s of hypoglycemia, it's insulting to "teach" them. would you like someone "teaching" you something you already know, and have known for years? just because they're a pct doesn't automatically mean they constantly need to be taught the same thing over and over again.
picks up shifts is such a lame a$$ excuse for keeping someone. who gives a rat's patootie about picking up shifts? monkeys can be trained to "pick up" shifts. really? what should matter more is that the patient's are be being neglected.
i have heard the pick up shifts excuse for keeping a subpar worker way too many times, can you tell?
agreed. what good is it that this pct picks up shifts, if she's not doing the work she should be while she's there for said shifts? it actually makes the entire situation worse, because any shift she works creates more work for her colleagues, more risk for the patients she's making up data on, and takes away the chance for a competent pct to pick up those extras.
we all learn every day , besides its not like I am giving a1hr lecture on hypoglycemia.
"we have a pt with so dx, so we are watching for symptoms like x, y & z". And I move on, I dont stand and query them about how long they have worked or how much they know about a dx.
Did you REALLY say maybe she doesn't know how to take vital signs? As if that should ever be in question of a PCT!!! I mean.. you put on the BP cuff and push a button.. and EVEN then.. if she can't figure that out.. she should have sense not to make it up.. .. or NOT be in a healthcare profession.
we all learn every day , besides its not like I am giving a1hr lecture on hypoglycemia.
"we have a pt with so dx, so we are watching for symptoms like x, y & z". And I move on, I dont stand and query them about how long they have worked or how much they know about a dx.
"1 hour lecture on hypoglycemia"? Did I say anywhere in my post that that's what I assumed you did? If someone KNOWS what the S/S are, though, there is no need to say what symptoms you are watching for....again, I feel that is insulting. Turn the situation around and tell me how YOU'D feel.
Of course we all learn everyday. I also didn't say that we DIDN'T. But if it's something that this person has ALREADY LEARNED, it isn't learning, is it?
I don't know whether to laugh, scream or be angry. Probably the entire gammit!
My PCT's take vitals? HA! They REFUSE. Flat out REFUSE. THey say that they are "too busy" with 12 patients so "do it yourself". They flat out tell the RN's that if we want to keep our licenses, we better do it because we are being told they are "too busy". They sure are too busy.....too busy watching TV, too busy on break after break after break....too busy yacking on personal calls and texting....want me to go on?
And in typical "martyr mary" RN fashion........we are all told to "care" about how they feel. I'm sorry, if you lose your job for goofing off and can't pay your rent, look in the mirror. DOn't like the work hired to do? Quit. Personally, I am long past the fed up point with techs that just don't want to do the job they are hired to do, and expect the RN to do it for them, or call them "not a team player". I am sorry, it is not MY job to do yours for you. It is that simple. You aren't going to do mine. And no, I do not need to tell you what I am doing and why I can't do your job for you. Can you tell this hit a raw nerve?
Write them up and get a paper trail started. Make sure everything is documented in writing. It is harder for management to sweep it under the rug when there is actual paper proof the prob has been reported. Falsifying documentation alone even once should have gotten her the boot. She's a danger to patients and she isn't providing safe and competent care. Doesn't matter that she shows up if she acts in an illegal fashion once there. Your NM is an idiot. Patients deserve better.
PedsHopeful
302 Posts
I had this happen just last week when I was on. I was taking care of a patient who needed help getting to the bathroom. As I am doing this I get another call from a PCT also on duty that another one of my patients needed to go to the bathroom at the same time. I assumed she was busy and couldnt get to it right then, so I said I would be there as soon as I can, and hung up. After about 3 mins I hear a relative of the second patient shouting at the PCT and 2 HUC's (who are also PCT's at this hospital, they HUC part-time) who were standing right outside the patients room. It seems the relative was ticked off that the three of them knew her mother needed help getting to the bathroom, and instead of one of them bothering to go in a help her since I couldnt get there right away, they stood right outside her room laughing and joking with each other. She demanded a apology, which they gave and the PCT then decided she better go in and actually help the lady. I was there within a few minutes as I was done with my first patient and told the PCT I would take over. If I were the relative, I would have been angry too.