Why don't nurses listen to cna's

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I have been working at this place for awhile and I knew my pts, I was on the same hall every night. I had this one pt he was deaf and I knew some sign language and he told me that he has not been urinating for awhile I told the nurse,she does not do sign at all and she just goes in there and gives meds and I told her that he is trying to tell her that his bladder is hurting she says "ok" and goes about her night, the next day I come in and ask him if he has urinated yet he says no and he has not in three days, by this time his left side is very edematous. I told the nurse that I think his kindney's are failing she rolled her eyes and said ok and then I told her that I think she should have him sent out to the hospital he has not urinated in three days and she said "you are just an aide, when did you go to nursing school or med school". I told her I have been in the med field for several years and also I know my pts I see him every night and I see changes and he is telling me it hurts. Well anyway I was off the next day I was off and when I came back they said he died of kidney failure. I went strate to the charge nurse and told her what happened and the nurse would not listen to me. What could I have done? I begged her to send him out and the more I begged the more she would not listen to me. This was six yrs ago and I still feel horible about it. I am now getting ready to go to nursing school and I vow to myself that I will always listen to the cna's that I work with in the future.

I was not trying to diagnose the pt, last I checked neither can nurses. But I did end up being right when I told the nurse "he might be going into fenal failure" I was trying to help the pt. To answer some of your questions:

Was he a renal failure pt? NO

Was he on dialysis? No

Did he wait 3 days to tell anyone? No, He told me on the 3rd day, he tried to tell them when he was first starting to have pain but they blew him off.

Very few people knew sign language there, and I was one of he few that knew how. So many of them would just give meds and go. And the aide that was on the opposite shift did not know sign language eaither. He did tell me that when he first told them he wrote it down on paper.

They should have known something by the change in him. He used to be self care and was able to get up and down when he pleased, to not being able to get up at all and running fever. IT WAS NEVER DOCUMENTED!!!

No I was not telling her how to do her job, I was telling her to do her job!

we as people that take care of people in the health care field we have to remember that its not just a job we are all patient advocates and it is all of our resposibility to do what ever possible to save the life of pts that can be saved.

Ok, if I told the nursethat he had not urinated and she had done anything at all (do straight cath, check on him, call Dr. etc.) I wouldn't be so ******. all she did was tell me "your just an aid what do you know" what I did know is the was a man in pain, no one listening to him, half of his body has edema with fluid leaking from him, his testicals were extremly swollen. No I am not a Dr. but as an aide I do know that something is not right. She just walked away and let him die.

Again, it's not your within your scope of practice to imply the patient might be going through renal failure. Thats NOT WITHIN YOUR SCOPE OF PRACTICE. Your job was to report to your nurse that the patient had complaints of pain, hadn't urinated and that's it. You're correct, you're a patients advocate, and reporting it to your charge nurses boss was the right thing to do. That's your job and you did the right thing! But to order the nurse to send him to the hospital because he hasn't urinated isn't your job. Plus they don't send patients to the hospital for not urinating in 3 days, they will usually have standing orders or they will obtain one from the doctor. It doesn't matter what this particular nurse did that was wrong, it sill does not give you the authority to act out of your scope of practice and make implications and give orders.

Do you even understand why the nurse said to you "you're just an aide and what do you know"? You offended her by telling her how to do her job. You gave implications and gave orders. That will tick any nurse off, and in that instance you were in the wrong. That's why I'm telling you how to keep your hands clean in this industry, you don't want the reputation of the "Know it all CNA/Student Nurse" Believe me, I see it all the time, we have know it all CNA's in our hospital, we have know it all new grads, and we have know it all student nurses. I'm sorry if I offended you, that's not what I'm trying to do. All I'm trying to do is to show you the other side of the spectrum. Just my :twocents:

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Specializes in MED SURG.
Again, it's not your within your scope of practice to imply the patient might be going through renal failure. Thats NOT WITHIN YOUR SCOPE OF PRACTICE. Your job was to report to your nurse that the patient had complaints of pain, hadn't urinated and that's it. You're correct, you're a patients advocate, and reporting it to your charge nurses boss was the right thing to do. That's your job and you did the right thing! But to order the nurse to send him to the hospital because he hasn't urinated isn't your job. Plus they don't send patients to the hospital for not urinating in 3 days, they will usually have standing orders or they will obtain one from the doctor. It doesn't matter what this particular nurse did that was wrong, it sill does not give you the authority to act out of your scope of practice and make implications and give orders.

Do you even understand why the nurse said to you "you're just an aide and what do you know"? You offended her by telling her how to do her job. You gave implications and gave orders. That will tick any nurse off, and in that instance you were in the wrong. That's why I'm telling you how to keep your hands clean in this industry, you don't want the reputation of the "Know it all CNA/Student Nurse" Believe me, I see it all the time, we have know it all CNA's in our hospital, we have know it all new grads, and we have know it all student nurses. I'm sorry if I offended you, that's not what I'm trying to do. All I'm trying to do is to show you the other side of the spectrum. Just my :twocents:

No I am not offened at all, its your opinion. I was not trying to work out of my scope of practice. Maybe I came across wrong, I was just trying to look out for the man. I am by far not trying to be a know it all CNA/Student nurse. When I do enter the program I don't even plan on saying that I have any medical background at all, I will just take notes and do the best that I can. Sorry I offended you. But she never did do anything for the man even if there were standing orders she didn't do them and nothing was even documented.

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Your intentions were very good, and I don't think you intentionally were trying to work out of your scope of practice. I believe you did rub that nurse the wrong way and that's why she snapped at you the way she did. From what you're telling us, her actions, she wasn't doing a very good job with the patient and documentation. If she didn't document then guess what, it didn't happen. But it sounds like to me that that whole unit is liable who was responsible from his care, CNA's and nurses. By reporting to that nurse and also her nurse, washes your hands clean. You did your job and sounds like you're the only one who did. I don't think that you should keep your CNA status a secret, and you earned those stripes. As long as you don't offer any unsolicited advise to the other students you will be fine. You will also find that sometimes they come to you when they have a question. As I said I think you'll make a great nurse! You have compassion for your patients and you will be saving a lot of lives in the process. Good luck in your journey down the road of nursing. Having your CNA will open a lot of doors down that road and will make things a lot easier, and you will have seen both sides of the world.

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Specializes in Cardiac Telemetry, ED.
But she never did do anything for the man even if there were standing orders she didn't do them and nothing was even documented.

How do you know this?

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Specializes in Peds/outpatient FP,derm,allergy/private duty.
I was not trying to diagnose the pt, last I checked neither can nurses. But I did end up being right when I told the nurse "he might be going into fenal failure" I was trying to help the pt.

That's trying to diagnose the patient. Saying, "he might have this, or he might have that" is part of the differential diagnosis that a doctor will make. The process of diagnosing isn't a straight line process.

You might have approached the nurse and said, I'm seeing this or that symptom, will you come look at this patient with me? Ask her what might be causing his whole left side to swell up, like a collaborative thing. You might learn something from her, or you might get her attention to his problems with a good close look like that.

Sorry you're still feeling bad after all this time. And if the nurse just had a straight on dysfunctional personality, the patient has alarming symptoms like that, I would make a bee-line right straight to her manager's office!!!! :wink2:

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Specializes in High Acuity / Emergency / Trauma.

as an aid in a local hospital i have crossed this very same attitude. being a patient advocate and going to management to let them know that the nurse in question did nothing for the patient never worked for me. hopefully you have better luck with it. of course in this particular er the management and floor nurses were pretty tight. no matter what you told anybody; no matter how high on the food chain, it boiled down to this... "your not a nurse and they are, you know nothing about anything so how could you possibly feel qualified to convey a patients' needs. furthermore, our nurses have phenomenal cosmic knowledge and are as such, infallible. let us handle the management and quality control; in the meantime don't you have some linens to restock or bedpans to empty?"

like i said (and it seems to be pretty widespread), good luck with people like that, especially when the management is as thick and conceited as the floor staff. so fast forward a few years, i am now half way through a bsn program. thank god i don't work there anymore. when i finally graduate i have vowed not to treat people as unintelligent, menial slaves.

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Specializes in MED SURG.
How do you know this?

After the man died, I went to the charge nurse and I told her what had happened. She looked into it and in the documentation and when we had a meeting over the situation it was brought up that it was not documented.

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Specializes in MED SURG.
as an aid in a local hospital i have crossed this very same attitude. being a patient advocate and going to management to let them know that the nurse in question did nothing for the patient never worked for me. hopefully you have better luck with it. of course in this particular er the management and floor nurses were pretty tight. no matter what you told anybody; no matter how high on the food chain, it boiled down to this... "your not a nurse and they are, you know nothing about anything so how could you possibly feel qualified to convey a patients' needs. furthermore, our nurses have phenomenal cosmic knowledge and are as such, infallible. let us handle the management and quality control; in the meantime don't you have some linens to restock or bedpans to empty?"

like i said (and it seems to be pretty widespread), good luck with people like that, especially when the management is as thick and conceited as the floor staff. so fast forward a few years, i am now half way through a bsn program. thank god i don't work there anymore. when i finally graduate i have vowed not to treat people as unintelligent, menial slaves.

my sentiments exactlly, just because people decide to be a cna does not mean that they are not educated.

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Specializes in Med-Surg.

When a CNA tells me "would you look at this patient, something is not quite right"....I immediately stop what I'm doing to check it out. 99% of the time they are spot on......CNA's have that same instinct and inner voice that tells them something is not right that nurses have...sometimes better.

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My sentiments exactlly, just because people decide to be a cna does not mean that they are not educated.

I believe you're missing the whole point here. Nobody is saying that you're not educated. You can be educated as a CNA, but the fact remains that you CAN'T work beyond your scope of practice. Just because you can give tylenol to your child for a fever doesn't mean that you're able to give a patient vicodin for pain. It's not within your scope of practice. There is more to it when you give a pain medication. You can't go and give Lanoxin to a patient. Just because it's ordered doesn't mean it needs to be given, there are parameters that nurses must follow and you wont know that as an aide unless a nurse tells you what it is.

BTW, nurses do diagnose, it's called a "nursing diagnosis" and RN's do it all the time. It's a different type of diagnosis that a MD would make. The fact remains that you must act within your scope and you went beyond your scope and you can't assume anything regarding nurses and patients. You can only see from the eyes of a CNA, you can't see from the eyes of a nurse because you're not a nurse. I can tell you that as a CNA I didn't understand a lot of stuff until I went to nursing school. You wear a different cap while in nursing school, you're working as a nursing student under your clinical instructors license.

You said "But she never did do anything for the man even if there were standing orders she didn't do them and nothing was even documented." Did you read the chart? Even though it was brought up in the meeting that it wasn't documented, you're not saying what wasn't documentd. What exactly wasn't documented? That he was having pain, that he had edema? Do you know what his reason for being in the hospital was for? What medications was he on? Was he on some new medication? Was he experiencing some side effects if he was on new medication? Was his edema reported before you reported it to your nurse? Was he on Lasix? Also, did you read the nurses notes and understand what was going on those 3 days that he hadn't urinated? What activities was he doing during those 3 days that might have triggered to him not urinating and having edema? Most likely a CNA wont know the answers to that because it's not the CNA's job, that's what the nurse is for. The CNA reports the s/sx to the nurse and it's the nurses job to GO CHECK IT OUT!

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Specializes in MED SURG.
I believe you're missing the whole point here. Nobody is saying that you're not educated. You can be educated as a CNA, but the fact remains that you CAN'T work beyond your scope of practice. Just because you can give tylenol to your child for a fever doesn't mean that you're able to give a patient vicodin for pain. It's not within your scope of practice. There is more to it when you give a pain medication. You can't go and give Lanoxin to a patient. Just because it's ordered doesn't mean it needs to be given, there are parameters that nurses must follow and you wont know that as an aide unless a nurse tells you what it is.

I know what is in my scope of practice. And I never said I gave any medications to anyone, I don't know where you got that I did.

You said "But she never did do anything for the man even if there were standing orders she didn't do them and nothing was even documented." Did you read the chart? Even though it was brought up in the meeting that it wasn't documented, you're not saying what wasn't documentd. What exactly wasn't documented? That he was having pain, that he had edema? Do you know what his reason for being in the hospital was for? What medications was he on? Was he on some new medication? Was he experiencing some side effects if he was on new medication? Was his edema reported before you reported it to your nurse? Was he on Lasix? Also, did you read the nurses notes and understand what was going on those 3 days that he hadn't urinated? What activities was he doing during those 3 days that might have triggered to him not urinating and having edema? Most likely a CNA wont know the answers to that because it's not the CNA's job, that's what the nurse is for. The CNA reports the s/sx to the nurse and it's the nurses job to GO CHECK IT OUT!

Yes I read the chart, but I did not read it until after he died and that is when I went to the charge nurse. And yes the facility keeps charts after they die the just put them in a diff. place just in case you want to know.

When I said nothing was documented about the whole matter I mean NOTHING.

It was not documented that he was in pain.

It was not documented that he was swollen.

It was not documented that there was a change in behavior.

It was not documented that he had a fever.

It was not documented that I had brought anything information to the nurse.

No he was not on any medication.

He was an elderly man in his seventies and was deaf but otherwise in good health.

If the nurse would have done anything, she would have not gotten written up for pt naglect. And there would not have been a meeting about the whole thing.

As I said before I could have gone about it in a differant way... I did not mean to diagnose anything, I was just concerned about him. As I am with all pts.

I don't care that she got upset with me, but her not helping him or even checking to see what I was talking about was just wrong.

If you have any other question I will be glad to answer them, thank you for your opinion.

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I didn't say that you personally gave any medications. I was using medication distribution as an example because there is more to it than just popping pills into a cup. Meaning, that the pills are ordered, and they're there. But does one who isn't a nurse understand the reason why it was ordered? Certain medications can't be taken with others etc. Medication comes with lots of complications that involves more than just seeing it there. That's what I'm trying to point out. As in your patient that you were caring for. There's more than just what you see, it goes beyond that. I'm sure if you read the chart thoroughly you will find lots of stuff about him that you didn't know but the nurses and other members of the health care team did. I know you read the chart after his death and correct, it's still available after death, because it usually will go to medical records so they can close out the chart and file it.

The only thing that I read that you did was wrong was trying to diagnose a patient, and order the nurse to send the patient to the hospital. That is all I saw that you did that was beyond your scope of practice. As mentioned before, I knew that your intentions were well and that you were looking out for the patient. I know you didn't mean to go beyond your scope, but you did. You also did your job by notifying the nurse of the pain, and edema. What the nurse didn't do was wrong. She should have assessed the patient, documented, & notified the physician.

The patient wasn't on any medication? I find that hard to believe since he was given a pill during/after the nurse was notified of his pain & edema. I wonder what medication he was given. Maybe it was his pain medication.

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