Difficulty with a CNA - page 6

I am an RN and I view myself and my CNA as team. Most of the time it works out... I treat the CNAs with respect. At the beginning of the shift I go over our patients with the CNA and at that time... Read More

  1. by   squeakykitty
    Quote from chadash
    In LTC, some of the NAs come from different facilities, and just never learned. Many would ask me to do their vitals for them, some faked it.
    The dirty little secret is this: there is alot of false documentation by some NAs, and often these are the same NAs who are considered the best in the nursing homes. They don't do it all, so they are done with their work sooner and are considered more efficient with their time management. Scary s....
    I wouldn't mind showing someone how to do BP if I had time and they were willing to learn, but faking them is just plain wrong and dangerous.
  2. by   hecete
    [font=book antiqua]i work in ltc and have had similar problems with cnas. for the most part, they are really good, but the younger ones coming on board now, have a mouth and attitude and know how to use it. they are constantly ******** about being overworked, breaks, lunch times and on and on. they do so much ******** they can't get their work done. i've actually told several to clock out and go, but then extra stress and work is on the good remaining cnas. it's really a no win situation you're damn if you do and damn if you don't.:angryfire
  3. by   nitewarrior
    For right now I am a CNA, I should finish my LPN in 14 weeks. I can see both sides of the fence. We have CNA's that would not move if their own behind on was on fire. But we also have had, notice I said HAD, a nurse, who was just doing a breathing round, that would walk past 15 rooms to tell a very good CNA that a urinal needed emptying. The insulting part of that was that the CNA was on change/turn/check rounds and working toward that patient. I think that people need to pitch in and be part of a team. I hope that I never forget how to empty a urinal, but at the same time, I hope that the aides wont forget that if I ask them to do something, it is because I have another priority at the time not just because I am "too important" to do it myself.
    This subject also brings up a concern I have myself. Have any of the nurses here transitioned from CNA to LPN while working at the same facility? My current employer has offered me a position, but I worry about getting respected when I ask aides that I have worked beside of to do something. I worry that they will think that they can just brush me off because not too long before I was one of them. Any experience with this or suggestions?
  4. by   scrubsnhugsRN
    Quote from nitewarrior
    For right now I am a CNA, I should finish my LPN in 14 weeks. I can see both sides of the fence. We have CNA's that would not move if their own behind on was on fire. But we also have had, notice I said HAD, a nurse, who was just doing a breathing round, that would walk past 15 rooms to tell a very good CNA that a urinal needed emptying. The insulting part of that was that the CNA was on change/turn/check rounds and working toward that patient. I think that people need to pitch in and be part of a team. I hope that I never forget how to empty a urinal, but at the same time, I hope that the aides wont forget that if I ask them to do something, it is because I have another priority at the time not just because I am "too important" to do it myself.
    This subject also brings up a concern I have myself. Have any of the nurses here transitioned from CNA to LPN while working at the same facility? My current employer has offered me a position, but I worry about getting respected when I ask aides that I have worked beside of to do something. I worry that they will think that they can just brush me off because not too long before I was one of them. Any experience with this or suggestions?

    My experience has shown me that with some CNA's it will be a problem, and for others it wont. Some of the CNA's that I work with now as a nurse, I was a CNA with. I try to do alot of my own work, even though I dont have a problem asking them to do it, they sometimes have a problem with me asking. So I do alot of it, and then they come around once they see me doing it, and start doing it themselves. If I ask them to clean a room from a patient who was just discharged I give them 10 min to start, at least in my mind, then I go and start doing it without asking again. Oh and then they show up! I was never a lazy CNA, and they know that. I did have one CNA say out of the blue, "Well don't treat us like we are stupid because WE decided to stay CNA's."
    I was totally taken aback by that statement, and was very clear that I would never say or think such a thing!
    As far as blood pressures go, it is somewhat an art to get them, and you have to encourage your CNA to become proficent in doing it, sometimes, the beat is faint, wrong cuff size etc...teach teach teach and empower...if it doesnt seem right then it most likely is not! This is what I teach my CNA's who are new out of school.

    Good luck, just be sensitive, show them you are still a team member and dont treat them differently on the personal level and they will listen to you, and work with you!
  5. by   PeachPie
    Quote from VegRN

    One particularily difficult issue I have come across is when the person that is doing the crap job is of a different race than you. I have had this problem several times. The above confronting, reporting and talking with nurse manager take sooo much longer to get results. And sometimes the lazybones NA is accusing people of racism anyway! Um, it's not racism if you are actually not doing your job and people are speaking up about it with documentation to boot. The organization is so overly cautious in this situation because they don't want to appear discriminatory. In the meantime, patient care is crap and your workload multiplies because you have to do your job and the NA's job.

    This makes me so mad.
    I have seen sooooo much hypocritical racism. While working LTC as a CNA, I was one of two white people. Even though they were quick to accuse the one nurse with a backbone of racism, I sometimes got comments of, "I know this little whitey is not trying to tell me what to do," if I asked for help. Management wasn't much better. The truth about working in a place with majority ethnic minorities is that the minorities will often occupy the management positions as well. While this appeals to the ethnic minorities because they feel like they are with their own, downsides like favoritism and reverse discrimination may occur. I know this sounds horrible, but it does occur, and I am speaking from experience. The manager was just like the difficult CNAs. While they respected her and didn't consider her requests to be orders from a slave master (this is why they made her manager, because they could relate), racism was rampant. When I put in my two weeks, a lot of the nice coworkers and the residents' family members expressed condolences, saying, "The white girls never get a chance and never last."

    Unfortunately, the racism card does work in the whiner's favor and makes it hard to properly discipline. Point in case: My dad is a teacher. He saw a kid of a particular ethnic minority steal something. He tried to take action, but the principal didn't want to risk an angry mob to accuse him of being racist, so the kid got off scot-free. I have a friend who is in a management position. He has an employee who refuses to wear a necktie, saying, "It's a leash that a white man forces me to wear." My friend has offered to let this employee wear traditional clothing, but this too is turned down. Even though dress code is enforced and most people would have been fired, HR let it go because they didn't want to face an ugly discrimination suit.

    I don't get the mentality of people who use victimhood of racism as a shield and an excuse to be lazy. I don't see how having a good work ethic, doing the work that they are paid to be doing, and following the rules would make them, "white." Hmmm I'm a victim of racism too. My Japanese side was in the internment camps during World War II and my Scottish side was prosecuted by the English, yet I don't act obstinate and disobedient toevery request and reprimanding.
  6. by   Daytonite
    Quote from nitewarrior
    This subject also brings up a concern I have myself. Have any of the nurses here transitioned from CNA to LPN while working at the same facility? My current employer has offered me a position, but I worry about getting respected when I ask aides that I have worked beside of to do something. I worry that they will think that they can just brush me off because not too long before I was one of them. Any experience with this or suggestions?
    I went to work as a new grad RN in the nursing home where I had been a nursing assistant. Because I worked as a new grad on a different shift I didn't come into contact with any of my old nursing assistant colleagues. My problem was with the LVNs rather than with the nursing assistants. They were very much more experienced as charge nurses and were not willing to extend any empathy or help to me at all. They continued to treat me like a nursing assistant. They would also constantly report anything they felt I was doing incorrectly to the DON who would, in turn, call me into her office to talk. And, the DON was getting tired of it. She became their pawn and go between person telling me what they wanted me to know in their one-upmanship "game" they were playing . Looking back now I can see that the DON didn't have enough management skill or backbone to deal with what these LPNs were doing. It made me very aware of the power that game playing can do to people.

    My advice is to find your first job somewhere else or, if you decide to stay at the facility where you are currently employed, make it clear to the DON that you want to work on a totally different unit of the facility where you won't come into contact with your former colleagues so you can avoid this kind of thing happening. I would also bring this concern up with the DON so he/she is aware that it might be a potential problem and will indicate he/she will back you up if things do occur. The problem of becoming the supervisor over CNAs that you previously were a coworker with, and that's what you will be is a supervisor of their work, is that some of the CNAs will expect special treatment from you or expect you to treat them like a favorite child. When that doesn't happen they get testy and pouty, just like children. Some just flat out resent that they now have to take direction from someone who used to be their equal. Just so you know, the problem is not you. The people who do this are, for lack of a better word, dysfunctional and never learned good citizenship or good work ethics. Unless you are ready and prepared to deal with this kind of behavior I really don't recommend that any new graduate nurse, LPN or RN, put themselves in this kind of position because it is often too overwhelming to deal with along with all the other things a new graduate has to learn. Something else. . .the people who turn on you like this are most likely not going to be the kinds of people who are likely to go back to school to better themselves. It took me many years to realize that not everyone in the workplace has the desire or the ability to want to improve themselves. That, unfortunately and sadly, is just a fact of life. As you will learn, not everyone shares our enthusiasm and joy of learning. Some people are perfectly happy to wallow in their negativity and misery and spend much of their unimportant lives trying to suck others down into their abyss of futility and hopelessness. DON'T FALL PREY TO PEOPLE LIKE THIS. They get their jollies out of seeing others fail.

    Keep up your studies! Congratulations on your upcoming graduation!
  7. by   DarciaMoonz
    In this situation. I would pull the NA to the side and have a conversation with her to find out why she doesn't do what is asked. Let her know that you don't ask anyone to do something that you don't feel they are capable of doing. Make note of the fact that you talked to her, and let her know that if it continues that you will go to the supervisor, and address your concerns. You just have to follow the chain of command, but start with the source first.
  8. by   caliotter3
    I worked at a facility where I went from CNA to LPN. As I could have suspected, I was not successful. The place was a disaster area to begin with. My DON treated me like I was supposed to be superwoman and get people to work when they were not only allowed to, but encouraged to, sleep on night shift. All the CNAs would do a half-way first round then pull out geri-chairs, pillows, blankets, into the hallways, or other favorite places, and sleep the night away. I was told that the DON encouraged this b/c she was sympathetic to everyone's need for two jobs. Of course, residents would spend the night in their own wastes, most CNAs would not even clean them up on first rounds. If they cleaned their residents at all, it was done on the last rounds in the am. Etc. etc. etc. Then the DON came down on me when I witnessed pt abuse by a licensed nurse (one of her favorites) and reported it up the chain of command. I did not last long after that. Why I stayed in that fac as long as I did, I will never know. But you can get very desperate when you need a job. So my from the hip advice to anyone who is working at a fac as a CNA, go somewhere else when you get your license. Unless, of course, you are at one of those one in a million places where there actually is a good working environment, where mgmt backs up their nurses and most people effectively work as a team.
  9. by   Jelli_Belli
    My clinical group has been having problems with the PCT's at our clinical site. This is the first semester we have been on this floor (surgical max) and I don't think they really understand what the term NURSING student means. They seem to have this mentality that if we are assigned to one of their pt's that they shouldn't have to see that pt. all day. I have absolutly no problem pitching in and doing aide work or answering call lights if I have downtime, but I am there to learn RN duties, and when it comes right down to it I need a lot more practice passing meds or inserting a NG tube than I need dumping bed pans for lazy PCT's.
    The other day I was pulling up AM meds with my instructor and getting insulin coverage for my pt whose BS was in the 500's when the aide for my pt. came up to me and said, "Your pt's call light is going off and she is dirty. You need to take care of that.", then she walked off. I looked at my instructer kind of shocked that she was so rude about it and my instructor said, "Here's lesson #42 for you: Delegation. Show me what your made of." So I walked over to the aide and (very nicely) asked her if she could take care of that for me because I was getting ready to pass meds and only had a small time frame to get it done in. The aide launched in to this tirade about how incompetant nursing students were and how I shouldn't be a nurse if I couldn't even keep up with the needs of 1 pt. when she was already taking care of 5 others. At this point I was losing my cool with her, so I just smiled real big and said, "Here's how I see the situation, Mrs. so-and-so needs someone to clean her up and she needs someone to give her her insulin coverage. Which one are you qualified to take care of?"
    Long story short she shut up and took care of her job but I certainly didn't make a new friend that day. Now she is trying to start this war between the students and the other PCT's. The whole thing is rather childish in my opinon. Oh well, what are you going to do. You can't make everyone love you!
  10. by   caliotter3
    This sounds like something that should be discussed in your clinical conferences. I'm glad that your instructor took the steps she did with you that day. The earlier you learn to delegate, and get practice, the easier time you will have all along. I used your retort about the differences in job duties. One CNA, who had a negative attitude, did not like it when I told her point blank, that I could do her job but she could not do mine. I got less lip from her after that.

    Be careful during the rest of your schooling, that your clinical instructors make it clear about the differences in expectations. Our clinical instructors always made it clear with us and our nurse preceptors, where the lines of resp were. I had a primary assignment one time where I was resp for all care and I knew it. Never ran across snooty CNAs or PCTs. Most of them went out of their way to be helpful to us students.
  11. by   firstaiddave907
    when i was a cna i was taking car of 10 to 12 patients a night and all of the other cna's when they got done with there assigment they went to the nurses station and sat there and not one of them came to ask do ou need any help and i was like could one of you help me and all they did was sat there. so then Finaly a nurse hear me asking for help and she came and said i would be glad to help you and a another cna came to help me. So i can see both sides of it CNA's beging helpfuil and some being darn right lazy. But after that night the nurse harpped on the other aids to go and check on the patients and just have the new adios do all of the work.
  12. by   WinksRN
    I do believe that if you think what you just stated, well, they may be able to see through the attitude if your genuine or not, and I'm not making excuses but your the professional and dont expect them to be, so you need to be more assertive and get your point across straight forwardly and to the point, tell them I'm need this at such time, try to educate them on the seriousness of their duties as brief as possible and, if they still dont comply not only document it for yourself but verbally confront them on how you cant tolerate not having the appropriate help they are suppose to give. After that I would report it to the supervisor everytime and dont forget to keep your own Journal. I do believe that CNA's should be held to some accountability and many times employers treat them as if they dont know better and arent suppose to know better just because they lack schooling, Yea bull to me too. You dont want to be agressive or stir up friction but try and empathize with them and at the same time tell them that you if you have to do it all by yourself then management will have to get involved. I
  13. by   PeachPie
    Honestly, this is what you get when you utilize barely educated people to do such important jobs. Don't get me wrong, I was a CNA once, and I knew many wonderful CNAs, but I've met too many who couldn't even grasp the concept of the importance of wearing gloves or washing hands. Many had attitudes that made it obvious why they couldn't get jobs anywhere else, and took advantage of the fact that the nursing home was too short staffed to fire them. Don't ask me how they passed a CNA course. Yes, there is no shortage of people who need jobs, and there are constant shortages in healthcare facilities, but I wish that standards of being a CNA would be raised.

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