Defending the Patient

I hate drama. HATE HATE HATE drama. I don't like to cause drama.
Unless there is a patient on the line.

We had a psych patient last night in a 1:1. The things heard coming from that room were screaming, crying, worrying and feeling frantic. I had approcated the aide and the patient a few times, and both times it was a situation that was under control. The patient was exactly as the board stated, a 1:1. It was an emotional patient.

Shift change came and the charge nurse told the night aides to do whatever they felt. BAD IDEA. Our night aides aren't smart, or sweet, or kind. They are know-it-alls and mean to our patients. I have had many incidents with our patients and this was no excuse.

They wrote all of their names on the 1:1 board, explaining that they would all do the 1:1 for 2 hours a piece. "What about the rest of the unit?" I asked. If the aide covering one area went in a 1:1 who would watch their patients? Would their assignment change.

"We are not doing the 1:1 for 8 whole hours." The oldest aide said. I was shocked and frankly appaled. I respected this aide, she was a nice lady. She kept quiet, her patients loved her and she did a good job. So why was she in this mood?

"It's a 1:1. A PSYCH patient." I repeated to her.

"Who has been screaming, crying, yelling and freaking out. I am NOT going in there." She said.

"Sounds like a 1:1 to me."

"You don't understand 1:1's." She said with a snitty tone and then looked away and kept writing.

"Bet me." I said, starting to feel a pissy mood come over me. "I did 1:1's for an agency for a year, and I do 1:1's all the time here. I get psych patients and if you want a decent evening with this patient you need to work with the patient."

"Its more convenient to do it this way." She replied.

"We ain't here to convenience ourselves we are here to convenience our patients." I replied stepping closer to her. If I was an inch shorter we would be eye to eye. "Yeah its gonna suck, but you aint here for yourselves. Ya'll are aides because you like to help people. This 1:1 is a PERSON." The other aides were trying to ignore the fact that I was verbally demolishing their plans. Meanwhile I was trying to hide my midwest accent that shows up when I am mad.

"You gonna do it?" She hollered back. A seemingly good comeback, if we were 12.

"Naw, I did my 8 hours of service. And I did it well. I busted my ass and took good care of my people. This patient." I said pointing to the 1:1 on the board. "Is a psych patient. She needs stability or she will be screaming and hollering and freaking out at all y'all all night long. This patient needs two aides every 4 hours or one aide in 8. She's been good with the 1:1's all night long. Only crying when something scary shows up." I sighed. "I respect ya as an aide, and thats why I'm gonna tell you this is bullshit."

She rolled her eyes and another aide wrote her name in there for the 8 hours. The rest of the assignment was written and I started to give report. The aide I gave report to looked to me worriedly.

"What?" I asked.

"Why did you yell at her?" She asked. I paused for a moment to gather my thoughts.

"We do this job for other people. If we wanted to make money we would have become automotive techs or lab techs. But we like people and we like making them feel better, so we become CNA's. We become patient advocates. There is a reason I learn as much about my patients as possible- so I can be on their team."

"So you pick your patients over your colleagues?"

"Yep. Everytime." I replied opening a patients chart. "Does that make me a bad person?"

I took her silence as a no.

Before I could clock out I was cornered by the charge nurse. He began to yell at me for causing problems with the other aides. I took it, for a minute, until I realized he hadn't been told what I got upset with them over. I calmly defended myself and asked him what he would have me do. He also said nothing.

I left work to see the 1:1 room assignment had been changed, and the charge nurse was hollering at the aides about it. When I passed the 1:1, the patient was screaming and thrashing around.

Hope it all worked out ok.

I defend my patients over my colleagues. I am a patient advocate. That does NOT make me a bad person.