Certified Nursing Assistants - The Nurses think we have it so easy.

[hfullerCNA]

Let me start off by saying that a Certified Nurses Aide (CNA) are the backbones of every Nursing home. Without our assistance, the Nurses job would be way more difficult than it is. Apparently CNA's have it so easy and our job is 100% stress free according to some Nurses that I work with. If our job is so easy then why are we in such high demand? Also if that were to be true, then why can't the Nurses (RN and LPN) handle their work plus ours in a 12 hour shift?

Responsibilities of a CNA;

1. Get residents dressed for the day.

2. Shower and or bathe residents.

3. Toilet residents.

4. Assist residents with eating if applicable.

5. Assist residents with Physical Therapy needs such as restorative walking or passive range of motion.

6. Provide emotional support to residents and residents family members.

7. Answer each and every call light as soon as it is noticed and accomodate resident with their requests.

Although the responsibilities of a CNA versus a Nurse differ vastly, and the nurses resposibilities listed look noticeably longer - a CNA encounters much more physical and mental stress in an eight hour work day than a nurse does in a twelve hour day.

Nurses want to *****, moan, and complain about how they have it so hard. To be quite honest, a nurse in a nursing home setting mostly does the following;

1. Pass medications when a QMA (Qualified Medications Aide) is not on staff for that shift. 5% physical work*

2. Residents treatments (ex: wound dressing changes) 10% physical work**

3. Check blood sugars (when a QMA is not on staff for the shift) 2% physical work*

4. Deliver insulins. 1% physical work

5. Resident charting. (medications, behaviors, vital signs, etc.) NO PHYSICAL WORK REQUIRED

6. Resident assesments. NO PHYSICAL WORK REQUIRED

For the most part, the above list is about all a Nurse has to do in a nursing home setting. The CNA has to lift heavy people in and out of bed, on and off the toilet, up and down out of a wheelchair...and get around 11 or more residents ready for bed each day. We only have eight hours to take care of 11+ people and have to provide accurate care following every step correctly according to nursing guidelines with no leway whatsoever at all.

I'm sorry but our job definitely involves way MORE physical and mentally stressful work than a nurses does, and whoever disagrees with me, so be it. I know first hand.

*Estimated percentage of physical work

**Estimated percentage with the assistance of a CNA or QMA

[Salisburysteak, BSN, RN]

I agree with everyone else. When I work the floor as an aide to help out...it's an amazing mental/emotional break from the stress of being the charge nurse...the *responsibility* is so much lighter....You cannot judge what the nurse does until you have walked in her shoes...just like I could not judge what a CNA does until I walked in their shoes.

Years ago when I worked at my first CNA job, and if we were short an aide and had an extra nurses the nurses would literally fight over who got to work as an aide!

I now know why they did that!!

[orthonurse55]

I have worked as a nursing assistant, LPN, and now an RN. I am now teaching CNA classes. While I don't agree with the OP when it comes to comparing all entities without having been in each other's shoes, I do agree with a lot of what was said. There are some very lazy nurses out there. I have personally seen nurses sit at the nurses sations reading magazines while call lights are going off and page the CNA's to the desk to tell them the lights are ringing! Or they just sit there like they are deaf, dumb and blind. It amazes me that they do not realize how hard the job of a CNA is and that if the light is not being answered, it is probably because the CNA's are busy! In our state, it is a law that you have to have two staff members to use a hoyer lift. Since we often only have two CNA's working together on a wing, if they are together in a room, it only makes sense that they are both busy at the same time!

One of the things I always teach my students is to remember that these are "OUR" residents, not just the one person that is assigned to them for that shift. And if they become nurses or doctors, they should never forget how hard the CNA works and how miserable life would be without them!

[SHGR, MSN, RN, CNS]

Working as an RN at a nursing home was physically, mentally, emotionally, and spiritually stressful. Demands are high, meds have to get given on a tight time frame, treatments were not done by other shifts, residents cried, had pain, had dementia, people were mean to each other, CNAs would get into screaming matches with each other or talk back. There was minimal support from leadership. The main doctor was unsupportive and mean and seemed to really dislike his patients. I got sick all the time when I worked there, like never before or since.

Yes, we did have some excellent CNAs too. I appreciated all that they did, believe me. CNA work is physically difficult and demanding. But please do not tell me that my work there was not also demanding, physically or otherwise.

[thesundowner]

Holy crap CNA's have one of the hardest, most physically demanding jobs on earth. And they make *****. You are correct, physically CNAs have it much harder than RN's. But responsibility wise, yeah RN's have it worse - we are ultimately responsible for every single thing that happens to the patient. The two jobs are apples and oranges.

However, any nurse who tells his/her CNA that he/she has an easy job should be forced to work a few CNA shifts. That will shut up the high and mighty RN!

[wooh, BSN, RN]

Certified Nursing Assistants - The Nurses think we have it so easy.

RNs and LPNs- The CNAs think we have it so easy.

[Kittypower123, BSN, RN]

Both jobs are hard - each in their own way. Nurse who have not worked as CNAs can't truly understand how challenging the job can be. But, CNAs cannot truly understand how challenging the nurse's job is. There are days I miss being able to get the nurse, now I hear "I'll get the nurse." and I just cringe. I miss being able to leave at 10pm when the shift is officially over. A CNA's job is physically demanding, and stressful (especially when several call lights are going off and the nurse wants you to three different things). I understand, I do, but as a CNA, you have no idea what I have to deal with on a daily basis.

I have to review labs, call doctors (and let me tell you, I'd rather clean up a messy BM than deal with some of those docs), call family members whenever a new medication is ordered or something happens to their loved one, obtain urine samples from incontinent residents via straight cath, deal with new orders, answer questions from residents and family members, schedule transportation for appointments, deal with the pharmacy, complete incident reports whenever a resident falls, has a skin tear or new bruise, do what I can to keep a resident in house when he/she suddenly goes south on me, give PRN medications when needed (which I have to go retrieve from the medication machine which is not on the hall), fix a resident's oxygen tank, monitor all kinds of resident information (how much are they eating, when did they last have a bowel movement, etc.), and much more. Sorry, but your list was far from comprehensive.

As a nurse, I don't spend nearly as much time doing personal care, but I do toilet people, change clothes, remove and clean dentures. Sometimes, the aides are busy and a resident needs to use the toilet (or whatever). Or, I go in to straight cath someone for a urine sample and find they've had a bowel movement. I'm not going to go find an aide, make the aide change the person, then go back in. I will put on the call light to alert the aide that I need assistance getting the person changed if needed, but I am not above doing the work myself. When I am very busy (and probably a little behind), I will let an aide know that Mrs. X needs thus-and-such rather than take the time to do it myself. I am not "above" doing anything I ask an aide to do, I just don't generally have the time.

I'm not trying to be a witch, but I'm responsible for what I do and what you do. The buck stops with me, and some days that really sucks. I appreciate the aides I work with and do everything I can to be a team player, but ultimately, I'm responsible for ensuring my nursing duties are completed, not whether or not I helped out the aides.

[LTCangel, ADN, BSN, LPN]

I hve never been a CNA but I was an LPN before becoming an RN. The hospital I worked in for 14 years used a direct patient care model. I was responsible for EVERYTHING that my patients needed. That included baths, toileting, exercising, filling water pitchers, turning and repositioning, and meds, dressing changes, charting, IV therapy...the list goes on and on. We did have CNA's available to assist but not nearly enough and trust me I did everything all day long that my patients required along with admissions, discharges, calling doctors, carrying out new orders, and right down to answering call lights. I now work in LTC and am responsible for 46 residents on 7p to 7a. I really appreciate the CNA's that I work with and make sure they know it and I am not afraid to "get my hands dirty". But it boils down to this, the role of a CNA is within my scope of practice but the role of an LPN or RN is not within the scope of practice of a CNA. A CNA cannot pass meds, do treatments, dressing changes, tube feedings, trach care, nebulizer treatments, accu checks, IV therapy, blood draws, physical assessments, call the doctor, transcribe and carry out those orders, pronounce death, determine changes that require a resident to be sent to the hospital, etc, etc. I am also ultimately responsible for the care that the CNA's provide. In healthcare, we need to think of each other as part of a team that is working together to provide the best outcome for the patients or residents in our care and appreciate each other while we do it. Just saying...:loveya:

[funtimes]

Next time these RNs are going on about how easy CNAs have it compared to them, call their bluff. Remind them that any RN can easily become a CNA. Of course they have to give up being an RN, but that should be no big deal if CNAs have it so much better, right?

Really, if being an RN is so much worse, explain why many LTC facilities go through CNAs like kleenex, while the RN staff remains relatively constant. WHen I worked in LTC, we typically had at least one CNA fired every month, and I dont even know how many quit. We also had more than a few CNAs investigated for neglect or abuse. In all that time how many RNs were fired? ZERO. How many RNs investigated for abuse or neglect? ZERO. This was despite the fact some of the RNs would talk to the residents in ways that would probably get a CNA fired.

[orthonurse55]

Both jobs are hard - each in their own way. Nurse who have not worked as CNAs can't truly understand how challenging the job can be. But, CNAs cannot truly understand how challenging the nurse's job is. There are days I miss being able to get the nurse, now I hear "I'll get the nurse." and I just cringe. I miss being able to leave at 10pm when the shift is officially over. A CNA's job is physically demanding, and stressful (especially when several call lights are going off and the nurse wants you to three different things). I understand, I do, but as a CNA, you have no idea what I have to deal with on a daily basis.

I have to review labs, call doctors (and let me tell you, I'd rather clean up a messy BM than deal with some of those docs), call family members whenever a new medication is ordered or something happens to their loved one, obtain urine samples from incontinent residents via straight cath, deal with new orders, answer questions from residents and family members, schedule transportation for appointments, deal with the pharmacy, complete incident reports whenever a resident falls, has a skin tear or new bruise, do what I can to keep a resident in house when he/she suddenly goes south on me, give PRN medications when needed (which I have to go retrieve from the medication machine which is not on the hall), fix a resident's oxygen tank, monitor all kinds of resident information (how much are they eating, when did they last have a bowel movement, etc.), and much more. Sorry, but your list was far from comprehensive.

As a nurse, I don't spend nearly as much time doing personal care, but I do toilet people, change clothes, remove and clean dentures. Sometimes, the aides are busy and a resident needs to use the toilet (or whatever). Or, I go in to straight cath someone for a urine sample and find they've had a bowel movement. I'm not going to go find an aide, make the aide change the person, then go back in. I will put on the call light to alert the aide that I need assistance getting the person changed if needed, but I am not above doing the work myself. When I am very busy (and probably a little behind), I will let an aide know that Mrs. X needs thus-and-such rather than take the time to do it myself. I am not "above" doing anything I ask an aide to do, I just don't generally have the time.

I'm not trying to be a witch, but I'm responsible for what I do and what you do. The buck stops with me, and some days that really sucks. I appreciate the aides I work with and do everything I can to be a team player, but ultimately, I'm responsible for ensuring my nursing duties are completed, not whether or not I helped out the aides.

I totally agree with what you are saying, and I am also that type of nurse. I am sure there are a lot of us out there, but there are also a lot that would call a CNA to clean that messy bed, toilet a resident, get a glass of water for someone. Seriously, there are some real prima donnas at the nurses station. Apparently you were trained well and have been lucky enough to not run into them. I am sure the people you work with respect you a lot more than the OP respects the nurses she works with!

[funtimes]

@sparrowhawk

I agree with everyone else. When I work the floor as an aide to help out...it's an amazing mental/emotional break from the stress of being the charge nurse...the *responsibility* is so much lighter....You cannot judge what the nurse does until you have walked in her shoes...just like I could not judge what a CNA does until I walked in their shoes.

Of course its going to be a break, you are just occasionally helping out in a role you normally dont do, so expectations are low. Thats a big difference from doing the job day in and day out, and not simply helping out, but being totally responsible and getting all the blame and complaints from patients or RNs directed towards you.

Also, if your the charge nurse, you dont have to worry about the RNs complaining about what a crappy aide you are because this or that didnt get done. Youre their boss, they arent gonna be complaining.

Not that I'm saying being a CNA is harder or more stressful, just that your example of helping out doesnt really equate to doing the job. Now if youve actually worked exclusively as an aide, that might be a more valid comparison, and even then your experience likely depended on what setting you worked in. I know RNs that have worked as aides that said their first job as an aide was bad to the point of being completely intolerable.

[CatheterCathy]

"I'm sorry but our job definitely involves way MORE physical and mentally stressful work than a nurses does, and whoever disagrees with me, so be it. I know first hand."

I am an LVN so I guess I'm between both but as far as I'm concerned, we're ALL nurses. CNAs, LVNs, RNs ALL OF US. A team who have chosen to help people who cannot help themselves. If this is how you truly feel, I'm afraid you may be in the wrong profession. I appreciate the CNA. They bust butt. But some have the attitude that they do more grunt work. Well, I say we all have to do what is in our scope and if you don't like your scope, move up or get out of the profession. The patients/residents are going to feel your tension and it will absolutely affect them.

[simonemyheart]

I was also an aide before I became a nurse and after being on both sides I don't think it is fair to blame the RN for the load CNA's have to do.

STAFFING!!! STAFFING!!! STAFFING!!! Is often the problem. Many facilities higher up's have no idea what we do and how we need help. All they know is that the work is getting done so they don't invest in more staff.

As aide in a SNF I had a load of 16+ patients and for me it wasn't worth killing my body over. I decided to look else where for a job and it took me 8 months to find a hospital where each CNA was taking care of 6 pts.

With that being said as an RN my job is physically and mentally draining. I have seen CNA's who recently became GN's and have said time and time again they had no idea the mental toll of an RN takes. If something goes wrong for any reason (including if the CNA forgot to do something) the RN is reprimanded. At the end of the day we all have to play our roles. As a nurse one of our jobs it to delegate care and that is not saying that we cannot help with ADL's but if I have blood running a one pt and another on a cardizem drip and one on TPN and lipids and all of their labs are coming back critical it is my job to delegate other tasks to the CNA.

I do not like bedside nursing and I am working to find another job in the nursing field and if a CNA doesn't like there job they have the opportunity to chase their dream as well. I can't afford to quit right now but I can work towards my goal.

I adore my CNA's and always lend a hand when I can but if I can't at the time I will delegate. It is the same as me saying to my director as she walks around the floor not helping or answering call light (BTW she was a floor nurse at one time) to stop the meeting she is in to run blood for me.............Even though it is apart of their job to help in that way if the RN is busy but they never do.

Remember that it is all about pt care and if I have a critical lab on a pt and I am trying to reach the doctor it is my job to delegate and request aide to grab vital on this pt. We each have a role in care and it is not fair to blame the RN for the reasons you stated.