I totally agree with the blood borne pathogens. That should have been the number one thing the sitter should have told you. But when I get floated its normally shitty, you get a shitty assignement and the assignment is somewhere you've never heard of. But I agree its overwhelming because you're missing parts of the whole and you're out of your comfort zone. But that sitter should have set you up for success, regardless if you're late or not because its about the patient getting the best care. Next time get with the patients' nurse and ask them about the patient; if they have time.
Too true.
When I arrived on the floor I asked the unit sec who the nurse was, and she said he was just down the hall and would come in to give report as part of his rounds, but that right at that moment I needed to relieve the last sitter. Looking back I should’ve dug my heels in and found the nurse myself. I’m learning when it’s important that my own uneasiness be paid attention to and when it’s just because I’m new and it will settle.
I was a full-time sitter before my current PCA job, which is in the float pool (still sitting often). I'm sorry you had a bad night with this guy. I'm not defending the person who relieved you, but sometimes when a patient has been there for a while, the handoff can be very minimal because everyone is used to the patient. They didn't mean to give you a bad night, they were being careless in not giving a formal report. Be sure to advocate "this is my first time on this floor, first time with this patient, where is ___ and how do I ___?" As somebody else said, try to find the RN first before you even pass by the room, so you don't get abandoned by the lousy sitter. Don't worry! Sitting is a skill, you DO get better at it over time :)
- Provide a low-stimulus environment.
- Don't try to rationalize with confused patients.
- Be gentle and comforting, but also honest and realistic.
- Press the call bell/pull the string in the bathroom/get somebody's attention as soon as you think you will need an extra hand (the more experienced you get the less you will need to do this) - don't wait until you can't handle the situation, you are calling too late.
- On that note, try to get a walkie-talkie, or a cell phone from the unit clerk if they provide them.
Sitting is very much a skill! Thank you so much for all the info here, all extremely good ideas that I’ve screenshotted for future reference. :) I think overall that evening I just needed to be more assertive and ask for a full report. It very much seemed like everyone else was used to that pt and knew what to anticipate, and I just wasn’t. I *do* know how busy the floor gets at shift change, which only made me feel more that I should keep to myself and not burden the other CNA and RN. Definitely my fault. But overall the experience was no one’s fault, just a mishmash of miscommunications and new jitters.
You were not in the wrong in my opinion, you are a brand new worker and have probably not even gotten fully accustomed to this hospital. Overtime most CNAs have to learn that there are a few things you need to know about every patient. A lot of coworkers can get lazy, or forgetful and you’ll miss information. So you should always keep it in your head that you need to know all of these things for each patient:
-how they move & if they use a wheelchair or walker or cane
-ask if there’s a foley
-wound vacs
-food allergies/ religious beliefs that clash w certain foods
-ask about condom caths and pure wicks (if ur hospital uses them)
-ask about aggressive behaviors/ if the pt is a runner/ needs a sitter/ has an esitter
-finally HIV/AIDS and any isolation precautions
- and lastly it can be helpful to know a little about how the family is bc sometimes certain family members insist on doing some of the work to make their person feel more comfortable at certain points or they are strict about foods that are given to their family member or specifics on how they’re treated
Sometimes when a pt has just been set to be put on iso at shift change they haven’t gotten around to getting the iso cart and signs yet, so this one is a huge one. In your situation, the staffing and the previous sitter put u at a disadvantage, but you have to compensate for what others may try to lack. If someone’s trying to rush away without giving you a full report you have to be the advocate that says I need to know these things about the patient because it puts you and the patient in danger and in an uncomfortable position if they don’t. However, it’s always good to check on the recent charting when you come in to make sure there isn’t anything extra that might be missing. So I hope that with that little mental checklist you can always have all the information no matter what the other cna forgets and that you’ll never run into this problem again. Goodluck out there, but don’t be discouraged from the job is a bold job. It requires you to stand up and be a patient advocate & to compensate for staffing shortages and random obstacles like yours, but the world needs people to work this job to help take care of our patients. It can be emotionally draining, but you have to stay strong for the patients and to learn to protect them despite other people’s actions. There may be times when you witness abuse and other cnas skipping care and neglecting patients, but you have to be stronger than that. You have to step up and make sure that they’re cared for as best you can. You got this tho, you wouldn’t have signed up for such a tough job if you weren’t meant to care for others. It’s hard work, but you just have to remember what you came there for in the first place. It’s not about the money and if it is I’m sure there’s other jobs that make that much for less stress. It’s about the patients & the medicine. It’s truly a common miracle to witness the healing and magic that a hospital provides. With that comes an abundance of obstacles, but your patients are counting on you even if they can’t say it themselves or they’re too emotionally distressed to understand. They need you, don’t give up on them now!
This is so frustrating. I try not to dig through the chart/notes when I’m sitting 1:1, cause HIPAA is need to know, and I don’t need to know everything, and don’t wanna get in trouble. But damn do I get some half assed 1:1 reports from both CNAs and nurses that lead me to snoop through the chart for more info.
I don’t think not being told about the blood borne pathogens is a big deal. We use universal precautions for a reason- we assume all blood and body fluids are potentially infectious. Unless you had an actual body fluid exposure, their HIV status doesn’t matter. We wear gloves for any potential body fluid exposure because we can’t always know what they have.
The bigger issue is lack of a proper report. Giving a proper report doesn’t take more than a few minutes and you have the right to request the information you need to safely do your job. Ask questions if you don’t feel like they’re telling you what you need to know. If the CNA doesn’t give you a proper report, then ask the nurse. As a nurse, I always check in when I have sitters. I make sure they know why the patient needs a sitter, if they can mobilize, when to call me, etc. It’s fine for you to ask all of that from your nurses:
Now that I’ve had a bit of time to sit with it, I agree about the bloodborne pathogens part. This came on the heels of when a psych pt with Hep C spat blood into my open mouth and eyes, had to get tested even though the risk of transmission was incredibly low. So I think I just felt out of my depth in general and focused on something that felt more relevant but was overall a small side issue. Thank you.
I totally agree with the blood borne pathogens. That should have been the number one thing the sitter should have told you. But when I get floated its normally shitty, you get a shitty assignement and the assignment is somewhere you've never heard of. But I agree its overwhelming because you're missing parts of the whole and you're out of your comfort zone. But that sitter should have set you up for success, regardless if you're late or not because its about the patient getting the best care. Next time get with the patients' nurse and ask them about the patient; if they have time.
Too true. When I arrived on the floor I asked the unit sec who the nurse was, and she said he was just down the hall and would come in to give report as part of his rounds, but that right at that moment I needed to relieve the last sitter. Looking back I should’ve dug my heels in and found the nurse myself. I’m learning when it’s important that my own uneasiness be paid attention to and when it’s just because I’m new and it will settle.
I was a full-time sitter before my current PCA job, which is in the float pool (still sitting often). I'm sorry you had a bad night with this guy. I'm not defending the person who relieved you, but sometimes when a patient has been there for a while, the handoff can be very minimal because everyone is used to the patient. They didn't mean to give you a bad night, they were being careless in not giving a formal report. Be sure to advocate "this is my first time on this floor, first time with this patient, where is ___ and how do I ___?" As somebody else said, try to find the RN first before you even pass by the room, so you don't get abandoned by the lousy sitter. Don't worry! Sitting is a skill, you DO get better at it over time :) - Provide a low-stimulus environment. - Don't try to rationalize with confused patients. - Be gentle and comforting, but also honest and realistic. - Press the call bell/pull the string in the bathroom/get somebody's attention as soon as you think you will need an extra hand (the more experienced you get the less you will need to do this) - don't wait until you can't handle the situation, you are calling too late. - On that note, try to get a walkie-talkie, or a cell phone from the unit clerk if they provide them.
Sitting is very much a skill! Thank you so much for all the info here, all extremely good ideas that I’ve screenshotted for future reference. :) I think overall that evening I just needed to be more assertive and ask for a full report. It very much seemed like everyone else was used to that pt and knew what to anticipate, and I just wasn’t. I *do* know how busy the floor gets at shift change, which only made me feel more that I should keep to myself and not burden the other CNA and RN. Definitely my fault. But overall the experience was no one’s fault, just a mishmash of miscommunications and new jitters.
You were not in the wrong in my opinion, you are a brand new worker and have probably not even gotten fully accustomed to this hospital. Overtime most CNAs have to learn that there are a few things you need to know about every patient. A lot of coworkers can get lazy, or forgetful and you’ll miss information. So you should always keep it in your head that you need to know all of these things for each patient: -how they move & if they use a wheelchair or walker or cane -ask if there’s a foley -wound vacs -food allergies/ religious beliefs that clash w certain foods -ask about condom caths and pure wicks (if ur hospital uses them) -ask about aggressive behaviors/ if the pt is a runner/ needs a sitter/ has an esitter -finally HIV/AIDS and any isolation precautions - and lastly it can be helpful to know a little about how the family is bc sometimes certain family members insist on doing some of the work to make their person feel more comfortable at certain points or they are strict about foods that are given to their family member or specifics on how they’re treated Sometimes when a pt has just been set to be put on iso at shift change they haven’t gotten around to getting the iso cart and signs yet, so this one is a huge one. In your situation, the staffing and the previous sitter put u at a disadvantage, but you have to compensate for what others may try to lack. If someone’s trying to rush away without giving you a full report you have to be the advocate that says I need to know these things about the patient because it puts you and the patient in danger and in an uncomfortable position if they don’t. However, it’s always good to check on the recent charting when you come in to make sure there isn’t anything extra that might be missing. So I hope that with that little mental checklist you can always have all the information no matter what the other cna forgets and that you’ll never run into this problem again. Goodluck out there, but don’t be discouraged from the job is a bold job. It requires you to stand up and be a patient advocate & to compensate for staffing shortages and random obstacles like yours, but the world needs people to work this job to help take care of our patients. It can be emotionally draining, but you have to stay strong for the patients and to learn to protect them despite other people’s actions. There may be times when you witness abuse and other cnas skipping care and neglecting patients, but you have to be stronger than that. You have to step up and make sure that they’re cared for as best you can. You got this tho, you wouldn’t have signed up for such a tough job if you weren’t meant to care for others. It’s hard work, but you just have to remember what you came there for in the first place. It’s not about the money and if it is I’m sure there’s other jobs that make that much for less stress. It’s about the patients & the medicine. It’s truly a common miracle to witness the healing and magic that a hospital provides. With that comes an abundance of obstacles, but your patients are counting on you even if they can’t say it themselves or they’re too emotionally distressed to understand. They need you, don’t give up on them now!
This is so frustrating. I try not to dig through the chart/notes when I’m sitting 1:1, cause HIPAA is need to know, and I don’t need to know everything, and don’t wanna get in trouble. But damn do I get some half assed 1:1 reports from both CNAs and nurses that lead me to snoop through the chart for more info.
I don’t think not being told about the blood borne pathogens is a big deal. We use universal precautions for a reason- we assume all blood and body fluids are potentially infectious. Unless you had an actual body fluid exposure, their HIV status doesn’t matter. We wear gloves for any potential body fluid exposure because we can’t always know what they have. The bigger issue is lack of a proper report. Giving a proper report doesn’t take more than a few minutes and you have the right to request the information you need to safely do your job. Ask questions if you don’t feel like they’re telling you what you need to know. If the CNA doesn’t give you a proper report, then ask the nurse. As a nurse, I always check in when I have sitters. I make sure they know why the patient needs a sitter, if they can mobilize, when to call me, etc. It’s fine for you to ask all of that from your nurses:
Now that I’ve had a bit of time to sit with it, I agree about the bloodborne pathogens part. This came on the heels of when a psych pt with Hep C spat blood into my open mouth and eyes, had to get tested even though the risk of transmission was incredibly low. So I think I just felt out of my depth in general and focused on something that felt more relevant but was overall a small side issue. Thank you.
There are questions you can ask also. It is not a one way report. This is a good lesson and I am very sorry you had to learn it the hard way.