[Katie82]

I have not been in acute care for several years, but the Nurse/Aide issue is as old as nursing, and takes place in any setting where you have professional/para-professional staff. The key is mutual respect, and we do not command respect simply because of our degree. I have always gotten along with my para-professionals because I realize how valuable they are to me, and I treat them accordingly. Take the time to give them report, don't assume they are out of the need-to know-link. I made use of any "teachable moment" I could find to help them understand why some issues are important. Teamwork is important in healthcare, even if it's a team of two. I know a little attitude gets in the way,but I have always tried to ignore it. I try to remember that they work with us, not for us.

[longhornfan1]

Got my RN because I was tired of breaking my back for minimal pay, but I sincerely enjoyed what I did and found that I was really good at it. Barely cracked a book during school cause patho was something I could just wrap my brain around. I agree it is about respect. I am a weekend supervisor at a LTC/Rehab and there are fewer complaints and incidents on the wknd. Took some time to educate the nurses to their job of "patient care" and disabled the overhead page system for a weekend. Nurses went crazy cause they could not page "CNA to 314." They had to get up and ensure patient safety at the minimum if not actually assist the patient. I take pride in the fact that the patients are happier when administration is not in the building. Still working on my own ability to delegate though.

[RNperdiem]

I was a CNA for 4 years before I was a nurse, and the approach to the work is very different, and misunderstandings common.
As a CNA I approached my work as a series of checklists to be completed. Vitals-done, breakfast trays passed-check, baths started-check, and so on. There was not a lot of critical thinking beyond common sense, and no goals in patient care.
As an RN, I approach my patients with goals in mind. How can I move this patient forward? Can I wean that Oxygen? When was the last BM? What do these trends in vital signs tell me?

[lvlissl2ebecca]

I am now working as an LPN at the same facility I worked as a CNA for 2 years. I now supervise some of my co-workers. One of the questions on my interview to return to the facility was "Say one of the CNA's you used to work along side of did something wrong, would you have issues with reprimanding them?" I said no, but at first I felt a little out of line.. although I wasn't.

After a while it got easier I just had to keep in mind that this is for the pt. my feelings are not what matters, and eventually those feelings disappeared. I'm lucky. I work with some very very good CNAs. Although, I can say that the OP is right in that they (nor did I when a CNA) fully understand WHY THE HELL we needed alll the vitals and It was sooo frustrating when the nurse would say "Hey we need vitals every 15 minutes for the first hour on this person then every hour for the rest of the shift". My thoughts were OMG this nurse is just being anal .. the pt is clearly not hurt. Now, working as a nurse I know why, so I explain to the CNA's why each and every thing they're doing is being done.. just so they know its for a good reason.. seems to work fine, and they respect me more than just saying here.. get these vitals../end.

I also want to add that I've backspaced a lot because I keep wanting to type "My CNA's are wonderful...or w/e". I made a similar post not too long ago and got jumped on for saying My CNA's .. although we all know they are not our CNA's, they work with us. I don't feel like getting jumped on.

To the OP.. I would just continue to do your best. Perhaps discuss with your manager those you are having problems with.. state the effort you make that way if something ever did come up, someone would know about the issue. GL.

[sunnydaydream]

I've been a CNA for 9 years and just recently graduated with an ASN and will soon be working as a graduate nurse in one week... So my opinion is only that of a CNA in a LTC.

It seems that CNAs have changed a lot over the past 9 years. JMO. It use to be get the work done and get it done good and I agree with another poster as a CNA everything is a task that needs to be completed. Now though it seems that *some* of the CNAs that I work with are more concerned about how fast they can get the residents up, dressed, and to breakfast to get them out of their hair. May I repeat myself in saying *some* CNAs.

Then, though, there are the CNAs that go above and beyond. Ones that work hard to get everything done and extra so that the patients feel good.

As a CNA I have no problem doing anything that the nurse asks me to do, but sometimes the nurse doesn't realize that I'm not just walking down the hall, but I'm on a mission to do something, but if the nurse was to say I really need this done now it would make things a lot clearer. I think that the lines of communication between CNAs and nurses are often neglected and it keeps the CNA from reporting something that the nurse may find useful as an assessment as is the same for the nurse. I think the one thing that bugs me the most is when I as a CNA (pre-nursing school) saw something different in a patient and reported it to the nurse and the nurse didn't look into it. As a nurse that I have worked with said-- your CNAs are your eyes and ears to your patient because they sometimes have the ability to spend more time with the patient that that of the nurse.

I think the thing that I will try to remember when I become a nurse is what I looked for when working with a nurse. Open communication, gratitude for a job well done, and understanding that we are working together.

[graduatenurse]

Originally Posted by ceresk

To whom nurse it may concern.

Dear,

I cannot believe that, after finishing chewing each other's and eating your young's, you decided to take on CNA's and Nursing Students. That's very courageous of you. Maybe the DOCTORS are right, when they tell you that they are the ones with the Big Degree.

What?????? Do you think she is eating her young????? Who do you think is responsible if something happens to her patient, for example if aide take lunch break without telling a nurse and patient falls and hit head on the floor and dies because of it? This nurse can lose her license because of that!!!!! Or in this case, this aide took IV catheter out because she think this patient does not need IV. What rights does she have to decide patient does not need IV? If patient becomes septic and dies because she keep pulling iv catheter out, who do you think is responsible? If this aide wants to have a right to decide this kind of things, then she need to go to nursing school.

[mianders]

I worked in a very busy ER for a long time. We had a lot of problems between the nurses and the PCA's. My director at the time gave me the challenge of finding a solution to these problems. I decided to have a monthly meeting with the PCA's to discuss their issues with the nurses, and yes they did have some legitamate issues just like the nurses did. These issues were then taken back to the nursing staff and the nurses issues were taken to the PCA's. Over the next few months we worked out the problems and came up with constructive ways to resolve them. If there was a particularly hard problem that we could not find a solution that both groups felt was fair then several people from each group would have a meeting with the director and myself and the solution that was best for the dept. was used. As a nurse one of the best things I got out of this whole experience was seeing things from a different prespective. The nurses and PCA's involved in it said they did not realize how the other group actually seen things either. Sometimes we have to see things from the other side before we can solve a problem.

[longhornfan1]

Aren't we all introduced to the foundations of conflict resolution in grade school? Even as young adults and college students, we are thrust into a society that requires compromise. I bet if you researched it, you would find that those professionals with the skill and fortitude for problem solving are the same people who have similar success in their personal relationships. At work I am referred to as the "problem solver" and at home the "peace maker". If we just keep our emotions in check, respect each other and keep an open mind about alternative paths to the same goal, then most anything can be resolved. Assuming that both sides are flexible and most importantly, willing to admit fault or flaws in their plan. But as nurses, I feel, a large part of my responsibility revolves educating myself and others. I can not effectively argue a point if I am ignorant about the subject. Most problems at my job are easily solved by giving either parties knowledge about the subject and several potential resolutions.

[chadash]

Lately, I have been wondering about the use of nursing assistants in the hospital setting. Do you think it would benefit patients to have total care from a RN who has a lighter patient load?
It is true, the NA must take a task focused approach, and it is easy to lose sight of goals for individual patients. Some times there are just so many patients, so many needs, and so many details, you just feel like you have addressed only a portion of what you legitimately should. A nurse will approach and ask: "did you remember Mrs. so and so's whatchimicallit?" and I smack myself on on the head, apologize, and go do it. I go home and feel like I have neglected someone....just impossible not to, even going at a full clip.
So, I feel it would be better to have nurses with lighter loads do it all...soup to nuts...and the patient would have more personalized and better care.

[lindarn]

You are correct. That is the reason that I went into ICU. I was able to manage my own two patients, with minimal help from the CNA's that we had on the unit. I hated floating to Telemetry because we had more patients (4), and I had to depend on aides to do some of the work (V/S- etc). I would rather have my own two patients, and do it myself if I am going to have to be liable for unlicensed assistive personnel.

Lindarn, RN, BSN, CCRN
Spokane, Washington