Oct 9, 2005

Pediatrics part deux--evil aide

So Friday went well. I found another critical thinking issue rather quickly. A 6yr old with a ruptured appendix (Post op Lap Appy with perf) with peritonitis had not had a bowel movement for 4 or 5 days (mom couldn't remember). I proposed there may be the possibility of a paralytic ileum (intestines froze up) , blockage, or the most likely constipation due to the surgical trauma and side effects of the pain medicine.
Instructor was impressed.
It was a good day, very relaxed. I sat on the adjacent "abandoned" unit used now for offices for clinical managers where there was a computer available and I could look up and print stuff for resources. Twice I went to my floor and hung out with co-workers. It was weird being there as an ACC student for me and for them.
We as a clinical group had big problems, both days, with one of the Clinical assistants (CA). I'll call her Dina. Well Dina decided to get all power trippy and informed all the students that she required a report off to her before we left. (Not only is it impossible to find our nurse when time to leave but the CA too?) Keep in mind we are to the point in our education where we are supposed to be focusing on Nursing duties which includes delegating duties to the CAs. She should be working under us, not taking the day off. The first morning I asked her in the hallway. "You didn't, by any chance, take the vitals on room X did you?" (she was at the room next door) but I wanted to do it. She replied, "No I don't do student's rooms". Then I heard "You had better put that thermometer back on the charger or we'll kick your rear" out of her to another student, she said the same to me but left out the "or we'll" part. She also rudely "reminded" me to plug in the Vitals machine when I was done.
I work there. I know the routine. I don't need to be giving reports to CAs, especially when she hadn't even met my patient yet but is still supposed to be working with them. All the info she needs is in their charts.
When it was mentioned in our post-conference meeting all 7 of us students reported a bad experience with this CA. Our instructor informed us unofficially that it is being handled at a higher level and has been discussed before. There has been an ongoing problem with this Dina. It is especially infuriating to me as I am a CA and I have NEVER treated a student that way. I will admit when the first semesters students come on the floor I feel a little bit of relief as 1st semester students tend to focus on bed making and skills that fall in my job description. So I get a break when they are there. However, despite that, I still offer my help, check on the patients anyway, and find out what they are focusing on before making that assumption. [I remember one time helping a 1st sem. student clean up a pt after a BM...It was me that informed her that the odd things she was seeing were hemorrhoids].
Last semester I had 3 patients at the end, some with high acuities. I had a ton of meds and assesments. I didn't have time for vitals, baths, and beds, I was told by my instructor to delegate it to the CA who then and after, ignored me.
I am ashamed of the fellow CAs I've met so far in my rotations. We are not all like that! I was told once that sometimes the best nurses are the ones who used to be CAs. Perhaps, It may also be the other way around...The best CAs are the ones who are going to be nurses.

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