Incompetent nursing assistants

lidleanjel · Jul 10, 2011

This is very interesting topic. And I have seen good/bad CNA and good/bad RN. I am currently a CNA working at a hospital (and have worked in LTC) and currently in nursing school for my ADN.

First thing, I think some of the education depends on the state you are trained in. For my CNA in Iowa, we tested out of each "task" we perform, such as vital signs, transfering, bathing, etc. These were all complete within the class room then in clinicals, then for state boards we had the written exam and skill exam (contained 4 "tasks"). I feel that the education I recieved as an CNA was very good and also learned the importance of the proper techniques and rationales.

Now for nursing school, CNA "tasks" are poorly taught in my opinion and you do not test out on each "task." this is very interesting to me because you can get a CNA with some of the nursing school education.

I have CNAs that I work with that I think are good coworkers and so that are bad. and I am talking about the way they take care of people in general. I think CNAs can easily get burnt out because we do NOT get recognized for our good work. I also think that sometimes CNAs are asked to do way too much, because the nurse is "too busy." CNAs are just as busy just in different terms of a job.

CNAs typically have anywhere for 6-18 patients vs 3-7 a RN will have. and I have had to take care of 36 patients by myself on numerous occassions. sometimes, I feel RN believe use us to be their Maid.

I also believe that nursing school has made me a better aide, but it is related to the extra knowledge that has been aquired through classes. I also have problems with nurses when things are odd or out of the normal for patients, where the RN has ignored what I have told them. such as increased anxiety and shortness of breath where the patient had a PE. instead of assessing the patient, the RN continues what they are doing. after bringing concerns to the RN and feeling like nothing is done, i dont even like "bothering" the nurse, even though I constently bother the RN about things.

also think so CNA just dont care. the pay can be good and the job can be satisfying if all personal help each other and recognize the work a CNA does. we are the primary care of patients and most of the time can tell when the patient is not their normal self which should be a red flag sometimes.

hopefulwhoop · Jul 10, 2011

Yup, I have definitely seen this on my floor as well. RRs are ALWAYS 18-20, even when the Nurses document the VS themselves! My last shift, I went into a pt's room and counted her resps. It was 26. Guess what the tech wrote--18! I guess, it's not just my hospital.

DizzyLizzyNurse · Jul 10, 2011

Gotta be honest....when I go to the Dr's I've never had my pulse actually taken but it's always written down as 78 or 74. I know my pulse is actually in the 90s. Never said anything. Probably should...?

highlandlass1592, BSN, RN · Jul 10, 2011

Hi nurses.
Anyone else feel like many of the PCAs/CNAs/LNAs- whatever, do not have approriate training and competency for their job?? I did while I was working on a medical/tele floor for almost 3 years. Fortunately, I'm in the ICU now, and we do all of our VS and such. While on the med/tele floor, I encountered EVERY PATIENT had a RR of 18 or 20. I repeatedly told my manager about this; she addressed it in staff meetings a few times and sent out an email or 2, but it was never resolved. The problem continued. It annoyed me soo much because the interns/residents/attendings go by the patients vital signs. They are so important. One of the attendings actually said, "when the RR is different from 18-20, then I worry". I counted many pts that were in the 30s-40s and informed the PCAs about this; or vice versa, one patient had RR 10.
Another issue was one of the CNAs forgot to record the diastolic for my pts BP. I told her she forgot to write down the diastolic and she replied "what is that?" I explained it was the bottom number ( I guess that is all they know, about bottom or top number on blood pressure). I always thought they had much more training and understanding of what they were doing!!
I'm venting---but when it comes to patient care, safety- I can't stand the fabrication and laziness. It was absolutely ridiculous!:mad:

I've read this entire thread, including your posts. I have to tell you, there is a level of condescension in your posts..at least as I read it.

What you attributed to CNA's or PCA's can actually be said about anyone who is a "professional". There are many practitioners who don't do a good job, for whatever reason. It's not really prudent to generalize all based upon a limited sample.

One thing I noticed in your posts was a lack of information as to how you tried to change things. Did you try to mentor some assistants, improve their training? Try to make sure they felt included, a part of the team? Take them by the hand and show them how what they do is also important? Did you help them do all their work any chance you had?

I worked as an assistant for 6 years before I became an RN, back in the stone age. :-) I remember plenty of nurses who thought I was a maidservant, to be on call for their every whim. I specifically remember one nurse who came out of a patient's room and told me the patient in bed 2 needed help. When I went in to see the patient, he was sitting in bed with his mouth open. You see, he had asked the RN to hand him his tooth brush in his bedside table and instead of reaching in there to hand it to him, had simply walked out and gotten me instead. He couldn't believe it and neither could I. If I had a nickel for everytime something like that happened, I'd not have to work now!

Nursing assistants are generally under paid and over worked...sound familiar? As a nurse, I STILL experience the problem..I am over worked and under paid for all I do. Yes, I work with some staff who are real doozies.....they don't work to the accepted standard of care. They don't provide quality patient care. I do all I can to impress upon those I work with why this is so very important. But I"m not going to generalize about the entire profession.

Just some random thoughts......................

KBRN413 · Jul 10, 2011

The RN's are obligated to obtain their own vital signs at my facility. I would rather do this for myself; I can get a conversation started and start my assessment at the same time. Sometimes, I do ask a CNA to do admission vitals for me and every time, the RR is 18. I go meet the patient and check for myself! Many on my floor are on PCA's, and there RR is 12-14! Scary, but they should know how to do the basics! Many however, are wonderful and do a really amazing job!

ICU, RN, BSN, B.S. · Jul 10, 2011

Yup, I have definitely seen this on my floor as well. RRs are ALWAYS 18-20, even when the Nurses document the VS themselves! My last shift, I went into a pt's room and counted her resps. It was 26. Guess what the tech wrote--18! I guess, it's not just my hospital.

It's def not just your hospital. It annoys me so much. How can these people be taking care of others?? It scares me. I would never want some of the PCAs at the hospital I was at taking care of my family member. They are just so lazy, uncaring, going from task to task until the 8 hour shift is done. It's disgusting! :mad:

ICU, RN, BSN, B.S. · Jul 10, 2011

I do not think you should generalize, not all nursing assistants are like this, I know that at my former job I was anything but incompetent. I happened upon another thread that you made a comment on and saw that you disrespectfully called nursing assistants "task monkeys". Just remember that just because you might have more education than someone does not make you better or more intelligent than they are, a little humility and graciousness goes a long way.
Sincerely ,Task Monkey

sorry, wasn't out of disrespect...more just huge frustration with many bad PCAs I've had to deal with. I always thank the good ones...the crappy ones, I wish would get fired. I'm speaking for myself with the PCAs i've had to work with...they are very uneducated, and it's really difficult to try to get the msg across that we are dealing with life and death...they don't seem to get it, nor care about people. They walk around miserable. Not sure how they even got hired.

Anyways...I just started in the ICU...and so far, the aides in there are always willing to help. Positive attitudes, happy, and caring.

ICU, RN, BSN, B.S. · Jul 10, 2011

I once caught one of the LNa's just writing the weekly vital signs in the charts at the LTC I worked in. I confronted him on it and instead of just going to do them he apent 20 min complaining to everyone, residents too, he didn't have time to do them, Oh and he didn't have to listen too me as i wasn't the regular nurse just the floater. One wonders why he didn't make it through nursing school.

That makes me so nauseated hearing that. How are these people being hired? and not getting fired? If they were flying a plane, everyone would be dead! I like your last sentence, LOL!!!

ICU, RN, BSN, B.S. · Jul 10, 2011

The RN's are obligated to obtain their own vital signs at my facility. I would rather do this for myself; I can get a conversation started and start my assessment at the same time. Sometimes, I do ask a CNA to do admission vitals for me and every time, the RR is 18. I go meet the patient and check for myself! Many on my floor are on PCA's, and there RR is 12-14! Scary, but they should know how to do the basics! Many however, are wonderful and do a really amazing job!

It is sooo scary. The good ones do a very good job. Always thanking the good ones, they help you out so much!

joanna73, BSN, RN · Jul 10, 2011

I am always thanking my good NAs, and I would bend over backwards for the good people. I recently told the regional NM that she has at least 3 NAs who should be fired. Some of them...I have no idea how they've lasted. Maddening as hell!

allnurses Guide · Jul 10, 2011

I sure appreciate good CNAs!! Especially after watching the action during a hospitalization of my own for asthma a few years back. . . I had no real complaints about the nurses but over the course of my stay I observed one particular CNA (I was in a 4-bed room) who consistently did more than the bare bones - she obviously had been there long enough that she was fast -- but she was upbeat, came back if she said she was going to, etc etc. I also noticed hardly any of the nurses talked to her, though it didn't seem to matter much to her - she was there for the patients.

So about day 4 I said "you know, you are really good at your job". Didn't think much of that comment myself, but she stopped in her tracks and looked at me like I had 3 heads - then her eyes filled with tears seriously. Nobody had ever told her that before, she said. Maybe it was my perspective - busy nurses don't have the vantage point I did. But I was so glad after I decided to say it.

anotherone, BSN, RN · Jul 11, 2011

Hi nurses.
Anyone else feel like many of the PCAs/CNAs/LNAs- whatever, do not have approriate training and competency for their job?? I did while I was working on a medical/tele floor for almost 3 years. Fortunately, I'm in the ICU now, and we do all of our VS and such. While on the med/tele floor, I encountered EVERY PATIENT had a RR of 18 or 20. I repeatedly told my manager about this; she addressed it in staff meetings a few times and sent out an email or 2, but it was never resolved. The problem continued. It annoyed me soo much because the interns/residents/attendings go by the patients vital signs. They are so important. One of the attendings actually said, "when the RR is different from 18-20, then I worry". I counted many pts that were in the 30s-40s and informed the PCAs about this; or vice versa, one patient had RR 10.
Another issue was one of the CNAs forgot to record the diastolic for my pts BP. I told her she forgot to write down the diastolic and she replied "what is that?" I explained it was the bottom number ( I guess that is all they know, about bottom or top number on blood pressure). I always thought they had much more training and understanding of what they were doing!!
I'm venting---but when it comes to patient care, safety- I can't stand the fabrication and laziness. It was absolutely ridiculous!:mad:

Ha, reminds me of where i work. Some are awesome, some are useless. They do not have to bed "certified" we hire people off the streets and they are trained by other cnas. should be trained by rns/lpns i think but oh well. IF we complain to our manager we are told something similar to " the NURSE IS RESPONSIBLE "..................... ok................ apparently you are supposed to do all your work and their work and keep up with everything they do in real time.