We had a bunch of call in for nights tonight (a bugs been jumping around). I agreed to stay until 11pm until another nurse was able to come in. Right after shift change a patient's daughter called me to tell me her mom had a BM. She is on tube feedings, so she has frequent dairrhea. Her bottom is getting a little raw, and I'm scared she's going to develop an ulcer from the diarrhea, and basic status. I have never worked with the cna they have on nights, but everyone razes about how great she is. She had just started vital signs. I called her and said "I know you just started vs, and I'm sorry, but I need..."and that's as far as I got. She replied "look, if you are calling me about 222, I know and forget it. I am going to finish my vital signs. When I have the time, I will let you know so you can help me.". :angryfire
So, here's way it p.o'ed me
1. I spent years as a tech. I wasn't asking her to do anything I would not have been willing to do. Techs have menioned to me that I don't ask for help enough.
2. I am responsible for that patient, as well as 5 more. If their needs are not met, it is my liscence, not yours. So I need your help to care for them, not the other way around. (I just wish I had a tape of how she emphasized that statement, and the attitude she used)
3. I prefer my patients not lay in crap while you do vital signs on 25 patients.
Long story short, I cleaned her myself. I was difficult, since she fights, but she was cleaned. My question, am I getting upset over nothing just because I am a little tired...or would this situation have upset you guys?
Specializes in Community Health, Med-Surg, Home Health.
Who knows if this CNA had a bad moment already, or if she is really as good as they were saying? I know this one male CNA that received an employee of the year report, but working on his floor, you see him sitting on his rump, the RN doing admissions and discharges, and the LPN is instructed to 'hurry up and give medications' to 25 rehab patients so that she can 'then do patient care'. I was shocked to hear this, because I thought that this CNA was the greatest thing since sliced bread, according to the award given to him. But, he does nothing. I understand that he intimidates many of the RNs, but, hey, what is his job? I would not want to have the LPN rush through her med pass and possibly make a mistake, while a CNA is dictating what he will or will not do.
I think that I would let this one go, but the next time it happens, speak to the CNA. But, for sure, I would watch the interactions between the CNAs and the other nurses and supervisors before I speak...I have seen CNAs do things that are dead wrong, but receive more support from the nursing supervisors than the nurses do. You need to know this, I believe before you speak...it will let you know how you have to approach the subject. I remember once, on the med-surg unit at my hospital, the CNAs reported to the supervisor that the nurses were not answering call lights (don't know if this is true, I was not there), and one of them is a 'favorite child' of a higher-upper. The nursing supervisor told the two CNAs to watch a one to one and and made the nurses do patient care. The CNAs laughed at the nurses all night long.
Also, (I am desperately trying to give the CNA a bit of credit), what if she is being threatened and harassed that certain things are not done the way that they wish (even if it is unreasonable or impossible)? Maybe she snapped because of that? Who knows? Of course, delegation is not within their scope, we know that. But I also know that many times, people who should not do just the opposite.
And sometimes it is good to look at the situation from the other guys point of view. I do agree that patient should have been cleaned up. If the aide had 25 patients to do vital signs on, that will take a long time. She has probably had nurses getting on her before for not having them done in a timely manner. The more interruptions, the more untimely. Does the aide usually take good care of the patients or is slacking her usual? We are all busy but if you cleaned that patient once and the aides did it the other multiple times that day the patient was incontinent then maybe you just have to look at it as your contribution to good patient care.
Excuse me??? I don't care how many times a pt is cleaned by this person or that, if the pt is incontinent 6 times in one hour, that pt still needs to be cleaned up before the skin breaks down!!
Specializes in ICU, CCU,Wound Care,LTC, Hospice, MDS.
Excuse me??? I don't care how many times a pt is cleaned by this person or that, if the pt is incontinent 6 times in one hour, that pt still needs to be cleaned up before the skin breaks down!!
According to the original post, it was already breaking down due to diarrhea!
Just the thought ... if the patient is CONTSTANTLY oozing stool... up to 6 changes in one hr.. and his skin integrity is being extremely compromised.. why don't you use a rectal tube.?
Seems like you can change that pt. 6 times eventually no matter how often you change him/her, due to oozing stool skin will eventually break down due to constant wiping, and ph balnace of this stool due to tube feed...
When the nurses ask me for help and I'm doing vitals, I drop my vitals to help. Obviously, they need help or they wouldn't ask. It takes all of 5 minutes (if that) if two are cleaning, changing the bed, gown, etc. So, I might have to stay 5 minutes over my shift, but at least my patient would be clean and dry. This aide gives all of us a bad name and reputation.
I was an aide for 6 years and have been a nurse for a couple of months. I know how annoying it is to constantly change the same person over and over and over again and as soon as you get done and start gaining some momentum- a nurse comes and tells you the pt. needs changes AGAIN! It is irritating. BUT- it's the techs job to do it. You can help, but it's her responsibility. I think of it like this, esp. when I'm busy- I can help the aides with their job, but they can't help me with mine. So, if I don't have time and I know the patient is OK I just delegate the requested task. When I was doing my nurse extern position before I became a nuse (mainly treatments and paperwork working with a nurse) I changes so many people and answered so many call lights and did so much that I'd be late and running behind doing my job. Finally, I just learned to tell the pt. "I'll let your aide know" and continue with the pts. that the aides told "I'll let your nurse know". It's set up that way for a reason. Anyway- I'd be upset also. You're the nurse and the supervisor and I don't think "no" is ever even an option when being asked to do something reasonable and within your scope by a supervisor.
RNs delegate for a reason...I'm personally behind some nites because 3 total cares are having BMs, or things were left over from day shift, or the nurses need a hand with one of the 3-4 sx that just arrived, or who arrived 3 hrs ago and dont' have any water, haven't been fed clear liquids, etc....VS are important, but they're not the end all to end all....they'll get done in time, and if nobody's dying, they'll be ok for a few minutes....after all, there are some nights that I don't get into see stable pts until 7 or 8PM after I've been on since 5PM....tech wise that is.
pagandeva2000, LPN
7,984 Posts
Who knows if this CNA had a bad moment already, or if she is really as good as they were saying? I know this one male CNA that received an employee of the year report, but working on his floor, you see him sitting on his rump, the RN doing admissions and discharges, and the LPN is instructed to 'hurry up and give medications' to 25 rehab patients so that she can 'then do patient care'. I was shocked to hear this, because I thought that this CNA was the greatest thing since sliced bread, according to the award given to him. But, he does nothing. I understand that he intimidates many of the RNs, but, hey, what is his job? I would not want to have the LPN rush through her med pass and possibly make a mistake, while a CNA is dictating what he will or will not do.
I think that I would let this one go, but the next time it happens, speak to the CNA. But, for sure, I would watch the interactions between the CNAs and the other nurses and supervisors before I speak...I have seen CNAs do things that are dead wrong, but receive more support from the nursing supervisors than the nurses do. You need to know this, I believe before you speak...it will let you know how you have to approach the subject. I remember once, on the med-surg unit at my hospital, the CNAs reported to the supervisor that the nurses were not answering call lights (don't know if this is true, I was not there), and one of them is a 'favorite child' of a higher-upper. The nursing supervisor told the two CNAs to watch a one to one and and made the nurses do patient care. The CNAs laughed at the nurses all night long.
Also, (I am desperately trying to give the CNA a bit of credit), what if she is being threatened and harassed that certain things are not done the way that they wish (even if it is unreasonable or impossible)? Maybe she snapped because of that? Who knows? Of course, delegation is not within their scope, we know that. But I also know that many times, people who should not do just the opposite.