[NancyNurse08]

Our aides don't do end of shift vitals (many of them refuse to do vitals at all). I&Os can be charted in the half hour prior to shift change. CNA charting takes very little time. It can be done in short bursts between call lights. The deadline for CNA charting should be shift change, leaving the off going shift available to answer lights.

Another thing that would be helpful is if the aides would do periodic rounds with the nurses, checking in with each nurse to see if there is anything that needs to be done. If I could count on an aide checking in with me every once in a while, I wouldn't have to go tracking them down.

[pebbles]

Originally Posted by chadash

Just wondering, could we be struggling with functional fixation? Maybe we need to rethink the roles in healthcare totally. If we don't, who will?
I am not a student either, I am a Nursing Assistant.

Well, no. Aides will always be aides. They will always have less education and be required to do tasks rather than problem-solving and decision making. They will always have less responsibility. That does not discount the hard work they do. I worked as an aide in school, and I saw both sides many times over.

On my unit, the aides used to be able to do vital signs, etc - and now they aren't because that is something that should be interpreted and understood AS it is happening. Some of them are resentful of that - "They took that away from us and told us we were stupid.". Some people do have esteem issues (and that is easy to deal with by giving them respect for what skills they do have), but for some it is a crutch. An excuse to launch attacks against another group of staff.

I don't think it's possible to change the role or function of a set of employees in most settings. And I don't think that's the answer to disrespect on either side of the fence.

I think as long as there are differences, there will be resentment. It's up to the managers and leaders on the wards and in hospitals to create a climate of respect - and to tell people to pull their socks up if the aren't respectful to others.

[chadash]

Originally Posted by pebbles

Well, no. Aides will always be aides. They will always have less education and be required to do tasks rather than problem-solving and decision making. They will always have less responsibility. That does not discount the hard work they do. I worked as an aide in school, and I saw both sides many times over.

On my unit, the aides used to be able to do vital signs, etc - and now they aren't because that is something that should be interpreted and understood AS it is happening. Some of them are resentful of that - "They took that away from us and told us we were stupid.". Some people do have esteem issues (and that is easy to deal with by giving them respect for what skills they do have), but for some it is a crutch. An excuse to launch attacks against another group of staff.

I don't think it's possible to change the role or function of a set of employees in most settings. And I don't think that's the answer to disrespect on either side of the fence.

I think as long as there are differences, there will be resentment. It's up to the managers and leaders on the wards and in hospitals to create a climate of respect - and to tell people to pull their socks up if the aren't respectful to others.

So, rethinking what the nursing assistants do in your workplace did not go over real big. Hmmm.
Actually, the nurses doing vitals make alot of sense. They do our first post op vitals, and sometimes I wish they did the first four, but I know time is an issue, with so many post ops coming in. I end up tracking them down anyway to report, they probably could do them just as easily.
It really comes down to the best and safest care....
I do not agree that there needs to be resentment because there are differences.

[Ms Kylee]

As a nursing assistant in my facility, I do vitals, baths, I&O's, beds, bum wiping, turning, positioning, emptying Foleys and other drains, and anything else that the nurses ask of me. I also answer call lights and play waitress for those demanding family members who think their loved one is the only one on the floor.

What I do not do is pass meds, anything with IV's, dressing changes, etc.

And when you have 17 patients to chart vitals and I&O on, it isn't a short burst in between call lights. It's a good 30-45 minutes of charting depending on how fast the computer wants to work.

[pebbles]

Originally Posted by chadash

I do not agree that there needs to be resentment because there are differences.

So where do you think the resentment comes from?

Our CNA's must not be as well-trained as yours. I can't see most of them safely doing vital signs. Sure, taking a BP. But knowing whether it's a safe BP, or whether the condition of the pt needs to be evaluated further... that's a lot of responsibility.

[jackson145]

Originally Posted by chadash

That is a great point, that management has the responsibility to set the tone in the workplace. Any ideas of how management can "manage" the team better? Education?
punitive measures? rewards?
What guidlines in hiring practices, and orientation could help?

At my place the techs have a different department head than the nursing staff does. That is the only person who tells us what are duties are. We are also reminded that we are there to do a specific job, not to make the nurses life easier. We aren't supposed to ask them to do any tasks for us and they aren't supposed to ask us. We are all expected to do our own jobs. When a worker needs help with a certain task they are to ask someone from their department. Techs get help with tech work from techs and nurses get help from nurses.

So far, it seems to work pretty well. Of course, there are a few issues, but no system will ever be perfect.

[chadash]

Originally Posted by Kylee45

As a nursing assistant in my facility, I do vitals, baths, I&O's, beds, bum wiping, turning, positioning, emptying Foleys and other drains, and anything else that the nurses ask of me. I also answer call lights and play waitress for those demanding family members who think their loved one is the only one on the floor.

What I do not do is pass meds, anything with IV's, dressing changes, etc.

And when you have 17 patients to chart vitals and I&O on, it isn't a short burst in between call lights. It's a good 30-45 minutes of charting depending on how fast the computer wants to work.

Is this med/surg? What kind of unit do you work in>

[Tweety]

Originally Posted by Kylee45

As a nursing assistant in my facility, I do vitals, baths, I&O's, beds, bum wiping, turning, positioning, emptying Foleys and other drains, and anything else that the nurses ask of me. I also answer call lights and play waitress for those demanding family members who think their loved one is the only one on the floor.

What I do not do is pass meds, anything with IV's, dressing changes, etc.

And when you have 17 patients to chart vitals and I&O on, it isn't a short burst in between call lights. It's a good 30-45 minutes of charting depending on how fast the computer wants to work.

It is indeed tough demanding and backbreaking work. Thanks for the reminder.

[chadash]

Originally Posted by jackson145

At my place the techs have a different department head than the nursing staff does. That is the only person who tells us what are duties are. We are also reminded that we are there to do a specific job, not to make the nurses life easier. We aren't supposed to ask them to do any tasks for us and they aren't supposed to ask us. We are all expected to do our own jobs. When a worker needs help with a certain task they are to ask someone from their department. Techs get help with tech work from techs and nurses get help from nurses.

So far, it seems to work pretty well. Of course, there are a few issues, but no system will ever be perfect.

That is an interesting idea, having separate supervision for techs and nurses. Do the supervisors interact and manage resolution of conflicts? You must have a clear demarcation of tasks....
We tend to overlap a bit.

[Ms Kylee]

I'm not complaining. I love my job and the opportunity it provides me to spoil my patients a bit. BUT I get sick and tired of being hunted down by other nurses that make me do the other NA's on the wing's job because they can't find them. This happens 3-4 times a shift.

In my review, this was brought up to me that while I'm helping the nurse out, I'm essentially taking myself away from my patients. I understand that, but if a patient comes back from a procedure and they need postop vitals Q15 for an hour and they're not done, then we're all in trouble. I've had my nurses for the day tell me don't do them, and let the nurse do them. *Rolls my eyes* It's just easier for me to take them than it is to argue about it, and my wing's patients won't fall apart if they have to wait 5 minutes for a glass of water.