aides that put your job on the line - page 2

I had an aide blurt out in front of another patient and his family that I had just given a drug that a patient was allergic to. Horrified, I felt stupid and looked in the chart to verify this. It was... Read More

  1. by   hollykate
    Hi There again,
    I have been following this discussion with lots of interest. Good Aides are so hard to find, having thought about it a little, let me know what you think of these thoughts.
    First off, I worked as an aide, right after I graduated, my paycheck literally doubled (which I think is appropriate) another aide said, gee, I wish I could transfer departments and make twice the cash....She just didn't get it.
    Here is what I think the trouble is: Aides have minimally 6-8 weeks training/clinical of maybe 120 hrs. They then go to work in a job with very few external rewards. The pay is often BELOW poverty level (thats inexcusable) and they get no respect when they tell people yes, I am a nursing assistant. In addition, patient's may be rude and unappreciative of efforts made by aides. As with Nurses, manageement sees aides as disposable workers. Most people cannot work only on intrinsitic rewards (knowing you are doing a good job, without anyone ever saying so) this is also a problem, I believe for nurses.To gain some external rewards, many aides attempt to take on the nurses role- you may see this by refusal to wear the "aide" uniform, or an ID badge that says AIDE, or you may see the aide adjusting drips etc.
    If an aide stays and is somewhat observant, their knowledge about certain illnesses increases. Unfortunately, it is an incomplete knowledge. The aide does not have the training to understand why a treatment for one pt is not appropriate for another pt even thought they have the same main disease. So the aide may feel he/she know what they are doing, when in fact, they do not. The copy what they see- but they do not see all the knowledge/critical thinking behind the action.
    Professionalism is something that is taught- we were"socialized into nursing through 2-4 years of school- yet we expect Aides to display the same amount of professionalism without that education (some hospitals are now offerring CE's that address this for aides and the nurses say they have seen great improvement.)
    I don't have any solutions to this problem. But I am wondering if my thoughts about where the problem is coming from are on the right track. Now, I am opening myself WAY Up to criticism but what do you all think? Where is the problem coming from?
    Oh I should add, I think Nursing also has similar problems - the lack of external rewards etc, but I do think that this is oen of the big problems for CNA's and thats what this thread is discussing....
  2. by   moonshadeau
    I don't know where buttwiper works to think that s/he can do as much as an RN. I was an aide for several years before deciding to go on to nursing school. Yes, aide work was very hard. But it makes you appreciate your aides more if you have done the work yourself. On my hospital floor, I am very fortunate to have very good aides. However, one thing that I would like to point out is that an aide usually gets to leave the floor for smoking breaks, lunch and other various breaks. Plus, almost always have I seen aides leave at their scheduled time. Myself, lunches are a 5 minute stuff your face and breaks are non-existant. So yes, aides do have a hard time, but let me tell you that in comparison to the responsiblity of the patients in administering 10-15 meds to one patient at a time and having to watch for interaction/allergies. Making sure that the patient is safe in all aspects. Because if something goes wrong with that patient it usually is the nurse that they go after not the aide. Just food for thought.
  3. by   bluesgirl
    no comment


    [This message has been edited by bluesgirl (edited October 03, 2000).]
  4. by   JillR
    Butt Wiper,

    There is way more to passing medications than just giving them out. You need to assess for effectiveness and watch for side effects, reactions between medications and have an understanding of how the medications work on different body systems. I agree that just passing the medications is a fairly easy task as long as you don't have all of the interuptions that goes along with nursing.

    Nursing requires education to be able to pull it off successfully and as an aide, you just do not have it.

    If you think that EVERYTHING you need to know about a medication is written down on a little piece of paper for you, then I will bet you are sadly mistaken and this just illustrates how much you don't understand about nursing and the nursing process.

    You sound bitter and angry and maybe need to find a different job or go back to school so that you can gain some knowledge and real understanding of what nurses actually do.

    Jill
  5. by   divinenurseM
    Originally posted by Butt Wiper:
    Some of the things you nurses say about Aides, Makes me sick! Hey actually in case you didn't know most aides seem to know more than nurses, and it's just me but I think it's pretty sad that Nurses make more money than aides....Hey I can pass pills everything you need to know about what medication to give is written down on a piece of paper and everything is in a compartment with their name on it...oh that is so hard!



    Thank you for enlightening us all. It may look easy "just passing pills." and all. But, sweetie get a grip. "passing pills" ain't as easy as it looks. There are things you must know. For instance will this one tiny little pill have any adverse reactions with the other ten tiny little pills That were given? Hmmmmm Don't know do you! Well, Nurses have to know these things. Our Careers depend on it. One piece of Good advice; Go, to school and show some respect for the ladies and gents who have gone to school.
  6. by   Birdie
    This is my first time to see the site & I hope I offend no one with my comments. I have been a CNA for 26 years in a small rural hospital. I find myself agree with both sides of the issue. When I first started as an aide we were allowed to adjust IV flowrates, we were often sent to the ER to see patients with the doctor and at that time had responsiblities that were overwhelming. Since that time many changes have occurred, but I feel the one thing that has changed for the worst is the lack of teamwork between the aide & the RN. The aide does see more of the patient because the RN is buried in paperwork (not by their choice). Therefore the RN must trust & rely on the aide to report accurately any oddities that the aide notices with the patient. But the aide must also remember she is there to assist the RN, not make her job more demanding than it already is. With teamwork the combination can make for the best care given to a patient. I hope I have not been confusing, I find it hard to put in to words something I feel so strongly about.
  7. by   JillR
    Birdie,

    While it may be true that in LTC the aides see and know the patients more than the RN's do, this is not true on our med/surg unit. If we do have a CNA (maybe once a month) I still do the majority of my own cares mainly because I need to assess the patients anyway, and having been a CNA I realize that they are often needed by the other RN's on my floor.

    I remember all too well what it felt like to be pulled in may different direction by three different nurses and how frustrating this was.

    I reacted as such to butt wipers post because I feel I am constantly sticking up for the Aides in our hospital and I see such a misinformed post as this and I feel I need to set the record straight.

    You certainly have not offended me by you post as it was very informative and true.

    In regards to respect, I am a true believer that you get what you give. I try to always thank the CNA's for the little extra things they do for my patients. I know that I do not always have time to do these things and soemtimes the little things mean alot to the patients.

    I do not think it appropriate for the aid to adjust drip rates. I also do not want an aide to pass my meds. I understand that they may have been taught the basics of medication administation, but there is way more to know about medicaions than just how to do it and the basic side effects and such.

    The bottom line is that there are some nursing responsibilies that are just not appropriate to delegate and medication administration is one of them.
  8. by   Birdie
    Originally posted by JillR:
    Birdie,

    While it may be true that in LTC the aides see and know the patients more than the RN's do, this is not true on our med/surg unit. If we do have a CNA (maybe once a month) I still do the majority of my own cares mainly because I need to assess the patients anyway, and having been a CNA I realize that they are often needed by the other RN's on my floor.

    I remember all too well what it felt like to be pulled in may different direction by three different nurses and how frustrating this was.

    I reacted as such to butt wipers post because I feel I am constantly sticking up for the Aides in our hospital and I see such a misinformed post as this and I feel I need to set the record straight.

    You certainly have not offended me by you post as it was very informative and true.

    In regards to respect, I am a true believer that you get what you give. I try to always thank the CNA's for the little extra things they do for my patients. I know that I do not always have time to do these things and soemtimes the little things mean alot to the patients.

    I do not think it appropriate for the aid to adjust drip rates. I also do not want an aide to pass my meds. I understand that they may have been taught the basics of medication administation, but there is way more to know about medicaions than just how to do it and the basic side effects and such.

    The bottom line is that there are some nursing responsibilies that are just not appropriate to delegate and medication administration is one of them.
    I agree with you totally and am glad that you do see your patients & do the majority of their care. It's nurses like you who I enjoy working with the most not because they have relieved me of work but because they want to know their patients. With the nursing shortages it isn't always possible for the Licensed Nurses to go the extra that they want to for their patients. That's when the CNA has to help, but I would never say we should be changing IV rates or passing meds, which I have done as a CMA in a LTC, and would not like doing again.
  9. by   Mijourney
    Hi posters. I agree with all your assessments regarding Butt Wipers post. It sure lit a fire under this topic. As a former aide, I can appreciate the frustrations expressed by Butt Wiper. However, as an aide, I never felt a need to overstep my boundaries regarding my role limitations or felt that I was more equipped for comprehensive coordination of patient care then the nurse. I respected the nurse and because of my attitude and caring, the nurse respected me. When I became a licensed nurse, I proceeded smoothly, because I didn't have to worry about saving face with any staff that I may have offended as an aide. As a nurse, I've had excellent collaborative relationships with some wonderful aides in my career. I applaud them. But Butt Wiper, your post indicates you have a huge chip on your shoulder for whatever reason. I'm with the poster who suggested additional education and training to become a licensed nurse.
  10. by   rncountry
    I cannot help but wonder why we expect CNAs to have a level of professionalism that nurses do. They go through a quick course that emphasizes only the basic needs of the patient without training that lends itself to teaching how to behave professionally. Often, at least in my experience, this is the first job they have held that demands any type of accountability. What type of rewards are there for those that do behave responsibly? More of a load, to pick up for those that are not being effective in their position, while little if anything happens to those that are unable to do the job right. Why? Because any body is better than no body, at least that is the way administrators believe. Then we wonder why some aides have attitude? The vast majority of CNAs I have worked with are good people, some are better at what they do than others, though I have worked with nurses that I could say the same thing about. In any case if the CNA is given respect as a member of the team, you will most always, have someone you will want to work with. When orienting new nurses I would put it this way. The aide is to you, what you are to the physician. The physician in the LTC enviroment relys heavily on the nursing staff to be the eyes and ears of the physician who usually only sees the patient every 60 days, though some come in more frequently than that. The nurse is heavily involved in passing meds on 30, 40 or more patients, as well as the tx and charting, therefore the nurse must rely on the aide to report anything unusual. If an aide tells you something about your patient then go look, do an assessment. Do not ignore what is told to you. How would you feel if the physician ignored you when you just offered what you felt was important information. Take the time to round and know your patients beyond what meds they are on. If you have an aide who you feel is inappropriate than take a minute to do some education. Not a chewing out session. Explain how they could have handled that situation better, why it should have been handled in a different way, what your expectations are in the future and how you can help them achieve that goal. Nor would I ever ask an aide to do something I myself was not willing to do. Buttwiper, I am sorry that you feel the anger that you do, however if you label yourself as a buttwiper and nothing more than how to you expect to earn the respect you feel you deserve? Yes, you are capable of giving someone medications, anyone is, however when you do it in a health care setting you must be prepared to take the responsiblity that comes with giving that medication, and have the knowledge of what you gave, why you gave it, what is it expected to do, does it interact with anything else, is it an appropriate medication for your patient? There is much more to it than watching the patient swallow them. As a CNA, you are an intergal part of the health care system as it stands, I fully expect for that to continue, it is unfortunate if you have been treated badly, but if you are taking on duties that open yourself or the nurse to liabilities than you should be reprimanded. In Michigan a couple years ago a CNA gave a patient an enema while the patient was sitting on the toilet, the nurse felt she did not have the time to do it and instructed the CNA to. The patient ended up with a perforated bowel and died. BOTH the nurse and the CNA was charged with negligent homicide. I do not know whether they actually ended up in jail as it dropped out of the news, but I am sure that both lost their careers, as well as the financial issues that would go with having to hire an attorney. With more education that CNA would have known to never give an enema to the patient while on the toilet, she should also have felt comfortable in saying that was out of the realm of her practice and declined to do what she was told. So understand that if you do procedures outside of what you are certified to do you may harm a patient and you may find yourself in a great deal of trouble. Many CNAs are more intimately familiar with a patient and their feelings and it is imperative for the nurse to listen to the CNA, those that do not do a disservice to the patient. I often feel that nursing homes will never change unless the CNAs are given the opportunity of better education. The system sucks for them as much as it does for nurses. I also believe that the CNA that is not suited for the job should be asked to move on. Am I special Buttwiper because I am an RN? No, but I do have a knowledge that you have not yet gained, and for you to state that you could do what I do is wrong. But then I would not ask an engineer to start an IV or adjust an IV either. That engineer has a specific set of knowledge that is not nursing knowledge, you have a set of knowledge about your patients that your nurse may not, but your knowledge is not enough to do what the nurse does either. To believe so hinders your working relationship with all of your coworkers. If you want to act like a nurse than put forth the effort it requires to be a nurse.
  11. by   nsyrRN
    I think I need to clarify myself alittle. I work with aides and student aides every day that I work. I was a student aide myself at one time. I think that the problem may lie in that people are so short handed that they are working outside the scope of their practice. There are many aides and students that I am very happy to see when I'm about to start my shift. I can trust that they understand what their responsiblities and duties are. That we are working so short now I would not want to loss their help and support. I just would appreciate that everyone understand that I am ultimately responsible for what they do and they need to understand their scope of responsiblity and practice.
  12. by   J Nurse Supporter
    Originally posted by nsyrRN:
    I think that the problem may lie in that people are so short handed that they are working outside the scope of their practice.
    I think you are close when you define the problem, but don't really hit the nail on the head. The problem is that you continually accept to work so short handed and continue to accept taking on more and more patients. Who do you think is going to say no the nurses can't take on any more patients it would be unsafe? Management? They are the ones who put you in that spot in the first place. Nurses have to start deciding what is safe and what isn't. It's your license. And nurses have to start doing this together.

    I am continually baffled by the fact that nurses work in the conditions that they do and get paid what they do. Tell me what other field there is where there is a continuous shortage of workers that require significant training and a license to practice and yet overall their wages don't go up? It's a supply and demand thing only the nurses don't demand anything.

    When are the 2 million nurses in America going to unite and be the force they should be?

  13. by   njdawn
    Let me say, the 2 Million nurses in this country should come together may 5,2001 in their state capitol and march!
    I also worked as an aide on the midnight shift. We had from 2-4 aides taking care of 67 clients. And 2 LPN's passing meds all night. Let me say, that was 6 yrs ago. And when it was me and another aide with 67 people, it was a nightmare! I knew that if anything went wrong, the nurses would take the blame and had respect for them. But it also made me mad that the 2 LPN's sat on their butt and watched tv until it was time to pass meds. And when the movie "It's a wonderful Life" came on around christmas, and they sat and ate M&M's all night, suggested I watch some tv too, that was irritating. If they helped out, maybe we all could relax a little. Now as an RN, I remember this and hope to never act like that or be disrespectful.Although I won't hesitate to write someone up for disrespect or getting paid for not doing their job. I agree we are all understaffed and need to help each other out. Education is the only way i know besides incentive programs for jobs well done or exceeding their duty.

close