Yelled at by NA for shaving pt.

evans_c1 · Jun 14, 2005

Atleast the NA didn't do it in front of the pt..couldn't that pose a different problem? Sometimes people try to inform you of something in a joking manner, too. I realize that you have to "roll with the punches" at times...but as someone else stated dont let people walk all over you. Don't most of us have the older experienced person at our facility that likes to run the show?

nurse_wannabe · Jun 14, 2005

As someone else said, we learned early on that any patient taking an anticoagulant should be shaved with an electric razor only. I personally hate electric razors, but better safe than sorry.

Also, the fact that the NA asked you to step out of the room to speak with you implies that she does have some degree of professionalism. I think that if she were trying to exert any kind of power over you or put you in your place that she would have done that in front of the patient. You said she gives good care to her patients - she was probably just worried about what COULD have happened and how it could have reflected badly on her if you cut him, so she overreacted a bit. Maybe you are taking it a bit too personally, as well?

Anyway, now you know, and I'm sure you'll never make that mistake again. Good luck with your new job! :)

sbic56, BSN, RN · Jun 14, 2005

Yesterday at work I was shaving a patient's face when the NA that I was working with asked me to step out of the room. She says to me " I specifically told the family that he could not be shaved with anything but an electric razor because he is on Lovenox." Now I know that I am new to this unit and I am still in orientation but I felt confident 1. That I would not cut the patient's face, 2. That if I did cut the patient's face that he would not bleed to death. Does your facility have a policy against shaving a patient while on anticoagulant. Any input would be appreciated. I tried to look for a policy for my institution but I couldn't find one. I can see telling the family to use an electric razor for home use but I don't feel as if I was endangering the patient by giving basic care. This is just frustrating. This NA is very good with patients but she is also very opinionated and tries to tell everybody what to do. I don't want to do anything that would make our working relationship bad because I am the newbie and I plan on staying on this unit for a very long time. Anyway I don't know why I've been thinking about this incident for the past two days. I guess its because I feel like this encounter could happen again in the future. And if it does... what should my response be? Note: I am not a very assertive person and people with strong personalities tend to intimidate me. Thanks again for any insight.

The NA handled this situtation appropriately and professionally. She was correct in advising the client and his family to use an electric shaver while on the Levenox. She was probably trying to avoid of the mixed message being conveyed with you using the razor. Consistancy in patient teaching is imporatant and even though you were probably not going to harm the patient by using the razor, the point was is it is contraindicated. The client might have tried it at home since the nurse did it and put himself at risk.

lady_jezebel · Jun 14, 2005

She was correct, but her approach was wrong.

Nellie Nurse · Jun 14, 2005

I guess the lesson learned is that it is better to play it safe and use an electric razor, even if no policy exists with the institution (I haven't been able to find one). However, how can you shave a patient with an electric razor when there are none on the unit? Anyway, thanks for your advice. This nursing assistant is very good with her patients, and has been there for 15 years. I know that I can learn a lot from here. I was a nursing assistant before so I know what it is like to be in her shoes. I will show her respect but I expect it in return. For clarification, she did not yell- as in scream at me, but she did speak loudly in front of other staff members in the hallway.

Its sometimes so hard to be the newbie :)

pricklypear · Jun 14, 2005

I guess the lesson learned is that it is better to play it safe and use an electric razor, even if no policy exists with the institution (I haven't been able to find one). However, how can you shave a patient with an electric razor when there are none on the unit? Anyway, thanks for your advice. This nursing assistant is very good with her patients, and has been there for 15 years. I know that I can learn a lot from here. I was a nursing assistant before so I know what it is like to be in her shoes. I will show her respect but I expect it in return. For clarification, she did not yell- as in scream at me, but she did speak loudly in front of other staff members in the hallway.
Its sometimes so hard to be the newbie :)

Hey Nellie - we've all been in your shoes! It is hard. Cultivating relationships with staff who do a good job is really important, and will make your job easier in the future. Respect is a 2 way street, like you said.

You say there is no electric razor on the unit?? We have 1, which we keep on a charger in clean holding. It gets a lot of use. Maybe there is one, and it's hiding from you, or maybe you should speak to your manager about aquiring one! A lot of our patients have their family bring their own in to use. Good luck with your career!

Mystery5 · Jun 14, 2005

Hey Nellie,

You sound like you'll do fine. These old CNAs often know a lot, and I always pay attention to what they have to say. But just make sure that you don't get bowled over by 'em. Some of them are like battleworn, combat experienced sergeants, and they see you as a 2d lieutenant, just out of the academy. Time will take care of your inexperience. :)

~Jan

lna2rn · Jun 14, 2005

In NH at every facility or hospital I worked at we have a policy to never shave patients on any blood thinners with a razor, electric only.

medsurgnurse, RN · Jun 14, 2005

The NA handled this situtation appropriately and professionally. She was correct in advising the client and his family to use an electric shaver while on the Levenox. She was probably trying to avoid of the mixed message being conveyed with you using the razor. Consistancy in patient teaching is imporatant and even though you were probably not going to harm the patient by using the razor, the point was is it is contraindicated. The client might have tried it at home since the nurse did it and put himself at risk.

SBIC56, the NA has no place doing patient teaching; it is outside the scope of NA practice to conduct patient education. Are you a nurse? If so then you know that the cognitve domain is withing the realm of RN practice. It is acceptable for the NA to reinforce. For example the RN educates the patient regarding the purpose of clear liquid diet to prep for tests, the patient asks for food, the NA may reply ' the doctor ordered and the RN instrcuted that you may have clear liquids only, you are being prepped for tests.' IT IS OUTSIDE OF THE NA PRACTICE TO CONDUCT PATIENT EDUCATION. The NA was trying to assert her authority over the OP.

medsurgnurse, RN · Jun 14, 2005

I guess the lesson learned is that it is better to play it safe and use an electric razor, even if no policy exists with the institution (I haven't been able to find one). However, how can you shave a patient with an electric razor when there are none on the unit? Anyway, thanks for your advice. This nursing assistant is very good with her patients, and has been there for 15 years. I know that I can learn a lot from here. I was a nursing assistant before so I know what it is like to be in her shoes. I will show her respect but I expect it in return. For clarification, she did not yell- as in scream at me, but she did speak loudly in front of other staff members in the hallway.
Its sometimes so hard to be the newbie :)

Nellie Nurse, you are the nurse. The NA trakes direction from. The NA actions are an attempt to undermine your authority. Also, Patient education is outside the scope of NA practice.

lna2rn · Jun 14, 2005

Nellie Nurse, you are the nurse. The NA trakes direction from. The NA actions are an attempt to undermine your authority. Also, Patient education is outside the scope of NA practice.[/quote
So me as an aide if I see a RN doing something unsafe I should not say anything to her? I am not sure what point you are trying to get across. I was taught to inform a nurse if I thought if they were being unsafe and they would let me know what the apprpriate procedure is or should be.

pricklypear · Jun 15, 2005

This was probably something the NA was very familiar with (being a NA for 15 years on that unit) so I think pt education was appropriate in this situation. I don't agree that pt education is outside of a CNAs scope of practice. It depends on the education, that's all. I certainly wouldn't expect a NA to educate a pt on medications - but telling a pt that "since you are on blood thinners, you should be careful not to cut yourself" is fine with me. This is pretty common knowledge. If she really wanted to undermine the OP's authority, she would have done it in front of the pt. But , obviously, this happened in the hall where other staff could hear - which could be construed as undermining - whether intentional or not.