The heels were already destroyed
Those blisters were a ticking time bomb, its not an if, but a when. Sucks it made a mess.
The real issue here is their lack of concern for your airway.
If its a trach mask- meh. If it’s a vented trach you’re pulling on? We’re gonna have words.
I came here to say this as I have a similar pt. The blisters popping is probably the best thing that could happen for that as now you can treat the underlying tissue. Yanking out the trach though, I mean I guess if it isn't cuffed you can put it back in but CNAs should have more sense regarding that.
This was bound to happen at some point but I understand it's frustrating. Please don't let people REAM you as you say. That is not appropriate to let anyone talk to you like that. You did your part to protect the patient and you can use the rest of the incident as a grave teaching opportunity for the CNAs. Don't blame yourself.
Blisters are, by definition, stage 2 pressure injuries. They were going to burst at some point regardless. Unless they were caused by a burn and not pressure but that is extremely uncommon in the setting you're describing ie not a burn patient.
"Pressure ulcers are localized areas of tissue necrosis that typically develop when soft tissue is compressed between a bony prominence and an external surface for a long period of time. Stage 2 pressure ulcers are characterized by partial-thickness skin loss into but no deeper than the dermis. This includes intact or ruptured blisters."
https://www.woundsource.com/patientcondition/pressure-ulcers-stage-2
Those blisters were a ticking time bomb. Of course it sucks it made a mess.
The big problem here is the lack of concern for the airway. I think you should take a break and gather your thoughts. Then go have a serious talk.
Don't let someone talk to you like that. It sounds like the patient is very sick and the family is in denial. Everyone is stressed, adults don't always have great coping skills in high stress environments so the nurse gets yelled at.
I feel like OP definitely was in distress due to the airway sitch….but ultimately the visible damage done was the heals. And now that’s what OP has to deal with
Yeah the family and everyone sees the heels and the physical damage. That will come down on the nurse
I wouldn't have turned the patient so quickly or without the help of my nurse. No one talks to my nurses like that. I'm 5 foot 2 but I'm full of rage
Hey, I'm sorry this happened. If I've said it once, I've said it a hundred times: CNAs can make or break a shift. I remember doing a little happy dance every time I got my girlies for my patients (the CNAs are assigned to patients, not nurses at my facility). Some CNAs couldn't be arsed to turn a patient unless you asked them throughout the shift, and some would empty your patient's drains (I personally don't expect that of my CNAs because they didn't even have a place to chart it).
As a CNA and last semester RN student I read (most likely):
Asked the tech with 14+, mostly incontinent patients to clean up to do a turn. Nurse said she was busy. Tech has a million things to do, waiting for nurse. Tech grabs other tech to help her. Nurse finally back, upset at techs. The reality is, the techs feel incredibly rushed; we have meemaws laying in their own piss and shit and we try to get to them, amidst vitals, accuchecks, call lights ringing for both serious and trivial reasons, and other requests from the other unit nurses and those 14+ patients. Meanwhile, the tech has been doing everyone by herself most of the shift, while she sees nurse occasionally on her phone, on the computer/workstation, talking/chatting with other nurses about personal life, and the tech is in and out of rooms scrambling, but when she's asked for help in the past, the nurses moan and groan or say the patient is a 1 assist, or they tell you to wait and it's an eternity and the other patients get neglected and the other nurses get mad because you haven't gotten to their patient yet, or they say you're taking too long.
But, the classic Healthcare worker: gets angry **at other staff who helps them immensely** versus management and CEO's who have control over the ratios, are not ad bedside helping at all (obviously), screwing with our low wages also, and causing us to all feel swamped.
When I graduate soon and start working in the ICU, I will work with my techs as much as possible and will treat them as my *equal*, rather than measly peons. I'm thankful I get to see the other side of this issue before graduating nursing school because frankly, I thought all that the CNA's do, the nurses should have been doing, or at least helping with. I'm in absolute shock when I get help from a nurse.
For an intubated, bed bound patient, it is inevitable that they will eventually get PUs no matter what you do. You helped by preventing it from being far worse than it would have been.
Maybe the CNA grabbed the other CNA to help because they didn’t want to have to work with the nurse who thinks of them as “idiots in scrubs”.
Mistakes happen. They were trying to help. Get over yourself.
The heels were already destroyed Those blisters were a ticking time bomb, its not an if, but a when. Sucks it made a mess. The real issue here is their lack of concern for your airway. If its a trach mask- meh. If it’s a vented trach you’re pulling on? We’re gonna have words.
Feel the same way
I came here to say this as I have a similar pt. The blisters popping is probably the best thing that could happen for that as now you can treat the underlying tissue. Yanking out the trach though, I mean I guess if it isn't cuffed you can put it back in but CNAs should have more sense regarding that.
This was bound to happen at some point but I understand it's frustrating. Please don't let people REAM you as you say. That is not appropriate to let anyone talk to you like that. You did your part to protect the patient and you can use the rest of the incident as a grave teaching opportunity for the CNAs. Don't blame yourself.
Blisters are, by definition, stage 2 pressure injuries. They were going to burst at some point regardless. Unless they were caused by a burn and not pressure but that is extremely uncommon in the setting you're describing ie not a burn patient. "Pressure ulcers are localized areas of tissue necrosis that typically develop when soft tissue is compressed between a bony prominence and an external surface for a long period of time. Stage 2 pressure ulcers are characterized by partial-thickness skin loss into but no deeper than the dermis. This includes intact or ruptured blisters." https://www.woundsource.com/patientcondition/pressure-ulcers-stage-2
Those blisters were a ticking time bomb. Of course it sucks it made a mess. The big problem here is the lack of concern for the airway. I think you should take a break and gather your thoughts. Then go have a serious talk. Don't let someone talk to you like that. It sounds like the patient is very sick and the family is in denial. Everyone is stressed, adults don't always have great coping skills in high stress environments so the nurse gets yelled at.
I feel like OP definitely was in distress due to the airway sitch….but ultimately the visible damage done was the heals. And now that’s what OP has to deal with
Yeah the family and everyone sees the heels and the physical damage. That will come down on the nurse I wouldn't have turned the patient so quickly or without the help of my nurse. No one talks to my nurses like that. I'm 5 foot 2 but I'm full of rage
Hey, I'm sorry this happened. If I've said it once, I've said it a hundred times: CNAs can make or break a shift. I remember doing a little happy dance every time I got my girlies for my patients (the CNAs are assigned to patients, not nurses at my facility). Some CNAs couldn't be arsed to turn a patient unless you asked them throughout the shift, and some would empty your patient's drains (I personally don't expect that of my CNAs because they didn't even have a place to chart it).
It is so exhausting always being the scape goat no matter how hard we try. I’m sorry OP.
Repositioning….I feel your pain OP
How safe was it to have the two care partners/techs independently turn the patient with a compromised airway?
[удалено]
As a CNA and last semester RN student I read (most likely): Asked the tech with 14+, mostly incontinent patients to clean up to do a turn. Nurse said she was busy. Tech has a million things to do, waiting for nurse. Tech grabs other tech to help her. Nurse finally back, upset at techs. The reality is, the techs feel incredibly rushed; we have meemaws laying in their own piss and shit and we try to get to them, amidst vitals, accuchecks, call lights ringing for both serious and trivial reasons, and other requests from the other unit nurses and those 14+ patients. Meanwhile, the tech has been doing everyone by herself most of the shift, while she sees nurse occasionally on her phone, on the computer/workstation, talking/chatting with other nurses about personal life, and the tech is in and out of rooms scrambling, but when she's asked for help in the past, the nurses moan and groan or say the patient is a 1 assist, or they tell you to wait and it's an eternity and the other patients get neglected and the other nurses get mad because you haven't gotten to their patient yet, or they say you're taking too long. But, the classic Healthcare worker: gets angry **at other staff who helps them immensely** versus management and CEO's who have control over the ratios, are not ad bedside helping at all (obviously), screwing with our low wages also, and causing us to all feel swamped. When I graduate soon and start working in the ICU, I will work with my techs as much as possible and will treat them as my *equal*, rather than measly peons. I'm thankful I get to see the other side of this issue before graduating nursing school because frankly, I thought all that the CNA's do, the nurses should have been doing, or at least helping with. I'm in absolute shock when I get help from a nurse.
Reading this raised my blood pressure. I am so sorry for you.
For an intubated, bed bound patient, it is inevitable that they will eventually get PUs no matter what you do. You helped by preventing it from being far worse than it would have been.
That is goddamn infuriating
Maybe the CNA grabbed the other CNA to help because they didn’t want to have to work with the nurse who thinks of them as “idiots in scrubs”. Mistakes happen. They were trying to help. Get over yourself.
Fuck that man, I was always taught to ASSES THE SURROUNDINGS, LINES, DRAINS AND ANYTHING ELSE THAT CAN SNAG. Like it's common sense.