After CNA Training – Dealing With Sticky Situations: The Patient in Denial

cna trainingAfter CNA Training – Home Health Aide

As a former Certified Nursing Assistant, I’m very aware that your CNA training, regardless of how much you pay and how thorough they claim to be, can only teach you so much. While CNA training may prepare you to recognize life threatening situations, teach CPR, infant CPR, the way to safely move a patient, and even how to prevent bed sores, there are many emotional situations you may run into that your CNA training instructor simply didn’t cover. Here is one real life situation I’ve run into over the course of my career. Although I had a wonderful instructor, my CNA training didn’t help me to face the following.

After CNA Training – The Patient in Denial

Sometimes, as a home health aide, you may run into the patient whose health begins to rapidly decline, but you can’t convince them of that fact. After my CNA training, I worked in a home for the developmentally disabled of all ages but then decided to take a position as a home health aide. The two positions couldn’t have been further from each other. They actually had nothing in common. At the facility I worked according to a schedule and routine, patients knew what to expect, and there was always a charge nurse or floor nurse to help with difficult situations. As a home health aide I had a patient who was an absolute joy to work with. Suddenly, after a bout with the flu, she became unable to stand or walk to the toilet. It just happened one day. She was determined, at that point, to sit in her chair in the living room and live out her days as if nothing was wrong. Unable to use a bedpan from a recliner, she simply decided that using the chair was an option. Greatly distressed, I spoke to my supervisor and also the patient’s daughter (who was the adult in charge of her).

We decided to call EMS to get her to a hospital. No deal. According to the laws in my state, any person who is in charge of their own faculties, coherent enough to speak and make sense, and alert can refuse medical treatment or being transported to a medical facility of any kind. There wasn’t a chapter in my CNA training that covered this.

After CNA Training – Learning to Effectively Communicate

Finally, what we decided was to barter with the patient. We made a doctor appointment for her the next day with a physician that she trusted and approved of. We then let her know that if she was unable to stand to get to the car, we would have her transported by ambulance. Thankfully, she agreed. We got lucky. Otherwise, according to state law, we’d have to wait until she was unconscious to have her transported to a hospital. We both remained calm, spoke to her like an adult using a soothing tone and sentences she could understand. We were very clear about our intentions so she would not feel betrayed or apprehensive. This part (how to communicate with a patient), I did learn in my CNA training. So, although I wasn’t necessarily prepared for that particular situation, my CNA training did teach me effective communication skills.

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