Major venting about some CNA's - page 11

First, let me say that I am not venting against all CNA's or even most...I've been one myself. I know how hard they work. I applaude the good ones. My problem is the majority of the ones at... Read More

  1. by   cargal
    Mmm Mario, I don't know if you are kidding or not, or just posting under the influence again. Just kidding. LOL
  2. by   mario_ragucci
    I am light-hearted about this, of course. I dislike reading this strife amongst us and am trying to understand it by interacting with some great people willing to discuss. I learn a new perspective I could otherwize not know/understand. Lol!
  3. by   Flo1216
    mattsmom-when I am the only CNA for a floor where almost every patient requires complete care, I am expected to do vitals for the whole floor, including BPS(manually),waters, chem strips , changes, bedpans, empty foleys and all of the errands(get blood, go to the lab, pharmacy, etc) I often do not sit down the entire shift, let alone sleep. So imagine how busy the nurses are. Hey, if they want to do their own chemstrips, empty their own foleys and do their own vitals, far be it from me to deny them. I find however, that usually that is not the case because they are busy enough and I DO understand. And while I do not expect a nurse to do all of my PM care with me, if I am the only CNA on the floor and the pt wishes to be pulled up in bed or weighs 300lbs and doesn't move, I shouldn't have to BEG for help. I do as much as I can on my own but I cannot do it all. I would rather not hurt myself or the pt. We recently had an incident where a pregnant CNA asked the RN for assistance in turning a pt so she could clean him because he was very soiled. The RN refused and said to get the other aid to help her(I was off the floor at the time because I had to take a pt to catscan) and went back to READING HER MAGAZINE. If the primary concern is the pt, then the pt should not have to lay in his own feces and urine because no one will help turn him because "it's not my job," The aid didn't ask the nurse to clean him , just help turn him because he was very heavy. Another time, a pt became very combative and violent while I was cleaning him and I put on the call light for help because I was afraid to leave him alone but of course no one came because a lot of nurses won't answer call lights. So I put on the emergency light and the nurse came and I just wanted help pulling him up and getting him situated. He was already clean. She actually left and got an aid who was on her dinner break(which she should not have to apologize for taking) to help me. It would have taken 2 seconds to pull him up. I am sorry that many of you seem to work with such rotten CNAS but please appreciate the good ones. They ARE out there and they care about the patients just as much as you do. And if CNAS doing vitals and foleys and chemstrips doesn't make your jobs easier, than feel free to do these things yourself. But even if we can't help you with your job, somtimes we DO need help with ours.
    Last edit by Flo1216 on Dec 19, '02
  4. by   ktwlpn
    Originally posted by KellieRN
    I replied "excuse me dear, but I don't do anything im TOLD to do, but everything im ASKED NICELY to do, I do with joy. I told her I don't smoke and I won't be taking them out and sitting int he middle of twenty residents puffin' it up. Especially when im way behind on my patient care. So she mouthed off a few other things , and i simply reminded her that she does not sign my paycheck and that I don't work FOR HER but WITH HER. If LVNS want respect, they need to gain it. Just as CNA's , if we want respect we must give it. But Ill be the first to admit, I don't care if your the CEO of the company, if you disrespect me, you might as well fire me, because I don't stand for it.

    In your situtation, i dont know the whole thing, but all i can say is most CNA's will give respect if they feel respected. Some CNA's have Bachelor degrees, shoot some more than that, so just because your an LVN doesn't always mean that your any more smart than a CNA. CNAS ARE HUMANS TOO !!!!!!!!

    TAKE CARE AND GOD BLESS.
    With all due respect I would like to draw your attention to a few misconceptions I see in your post...You ARE working under the direct supervision of your charge nurse-whether she is an LPN or RN-it is her responsiblity to insure that you carry out all of your duties and anything else she may delegate to you within your legal scope...Team work is great for all involved including the patients but the reality is that she is legally held responsible.It is her license that she is protecting while monitoring you-even through you are trained she must make sure that you know what to do and are doing it properly....Another problem I see and one that has been mentioned in other posts is the problem with"telling" someone to do something or "asking" someone to do something....One can give direction in a clear,concise,authoritative and polite manner and another may take offense to it....The reality here is that the nurse may not always have the time to "handle" or "coddle" the staff...I don't think it is ok to talk down or bark out orders to people but hey-usually the requests I make to my staff are well within their usual routine-just something they "forgot" to do....After all-I am told to do things by my supervisors and the docs every day-and believe me-they are not always polite...I just suck it up and move on-I don't have a problem with authority and I realize that I am not seeing the bigger picture-I only know what is going on in front of me on my unit-I don't know what the doc or my supe is also dealing with when I am talking to him or her...
  5. by   ktwlpn
    Originally posted by mario_ragucci
    [B] I know a little about RN /B]
    LOL!!! You make a great point there,dude...and it's VERY little at this point...just wait-you ain't seen nothing yet -just kidding ;>) I don't think anyone has stereotyped anyone here(it is tough to type a disclaimer with every post-maybe we should put them in our siggie line---" The following post is my opinion only-based on my personal experiences-etc,ect yada yada yada) I think it's great to have a mix of nurses and cna's here to learn from....Maybe we can take something from this nursing board and apply it to our nursing practice....
  6. by   SKM-NURSIEPOOH
    originally posted by ktwlpn
    with all due respect i would like to draw your attention to a few misconceptions i see in your post...you are working under the direct supervision of your charge nurse-whether she is an lpn or rn-it is her responsiblity to insure that you carry out all of your duties and anything else she may delegate to you within your legal scope...team work is great for all involved including the patients but the reality is that she is legally held responsible.it is her license that she is protecting while monitoring you-even through you are trained she must make sure that you know what to do and are doing it properly....another problem i see and one that has been mentioned in other posts is the problem with"telling" someone to do something or "asking" someone to do something....one can give direction in a clear,concise,authoritative and polite manner and another may take offense to it....the reality here is that the nurse may not always have the time to "handle" or "coddle" the staff...i don't think it is ok to talk down or bark out orders to people but hey-usually the requests i make to my staff are well within their usual routine-just something they "forgot" to do....after all-i am told to do things by my supervisors and the docs every day-and believe me-they are not always polite...i just suck it up and move on-i don't have a problem with authority and i realize that i am not seeing the bigger picture-i only know what is going on in front of me on my unit-i don't know what the doc or my supe is also dealing with when i am talking to him or her...
    ...because if you hadn't, i was going to. i don't know, maybe it's my military background or something but i too noticed all of the "i ask nicely" or "i tell them to do....nicely". it's not about asking the staff would they do their jobs nicely, it's about effectively getting the information out that the staff need for their shift. in otherwords, when you read the shift report & know then that certain extra duties or tasks are required of the staff...it's up to the charge nsg to delegate...or shall i go so far as to say...dictate who has to what in order to get that job done...but she/he has to tell the individual(s) at the start of the shift...you just can't spring it on them because you might've forgot yourself until you actually see someone start to do something. that's not going to fly either...people can tell. you have to consider that the staff have staggered breaks & therefore, will have to make accomendations if say they have to do something that might be time consumming or in the case of the fbs that is required to be taken during their normal rounds. that would mean that this cna would have to start their last round at least 1/2* earlier than normal...providing that they didn't have last breaks that shift. things like this have to be planed & worked-out at the beginning of the shift.

    for example, if mrs. doe needs to drink at least 1,500cc of fluids per shift, wouldn't it be feasable as the nsg to tell the cna that they will have to give mrs. doe approx 190cc per hour (during the day) or 400cc q 2*(during the night shift) & not try to give mrs. doe her fluids near the end of the shift (so that she doesn't wet the bed or her diapers up too much). believe or not, i actually caught a cna giving a renal pt 800cc of water at the end of her shift...she had the nerve to say that she wasn't going to be changing her sheets all night & that it was going to be the day shift's problem...not hers. she went on to say...what difference did it make whether she got the damn water throughout the shift or at the end of the shift, so long as she got it. obivously, this individual has no concept of how the kidneys works nor did she care to know for when i explained it to her, all she could do was shrug her shoulders & leave. it was my fault that i didn't make it clear that i wanted this lady to get her fluids over the course of the shift...i assumed that the cna staff had enough knowledge & common sense not to try to dump all this fluid into this lady at the last minute...my mistake was assuming that they "knew". from that point on, i made it my business to ask the staff if they understand the assignnments being given...if not i tell them right then & there what i need from them...what they need to look for...& have them tell me in their own words what i've just explained to them...i make appropreiate follow-up rounds, & have the staff report to me after each of their rounds are done. many have said that they hate me for it...said that i was too controlling...that none of the other charge nsg put them through this...but i will be damned if i'm going to have my license jeopardized because the staff that i have to supervise aren't doing what they're trusted to do because they don't like the fact that i told them that they have to do it, or they don't feel like doing it. it would be nice to work on the honor system...but too many folks would take that for granted.

    the only thing to do here is give out the assignments & tell the staff just what is required of them (have them sit in chairs in the hallway where you can readity see them in case of emergencies - usually applies to 11pm-7am shift), follow-up on the staff throughout the shift to make sure that they're not overwhelmed or forget to do those extra tasks (or not wondering off their units to visit other units or take extra smoke breaks), & document everything that was or wasn't done (make sure they tell you when they report off if there was something that didn't get done & the reason why so that the next shift doesn't have a bird about it). make the staff more responsible for what they see & do...have them write things that they find down on paper & have them give it to you (either keep it on you or attach the paper to the 24* report sheet so that when you do your notes, you'll see it)...that way...you won't forget to check it out during your rounds.

    there is no reason for back talking from any one...all hospital personnel are adults & they should know the difference between being giving an assignment & not liking the extra duties that might come with it. if the same individuals keep getting the extra duties, then have a pull book of sort where they sign their names everytime they get heavy assignments...this should be equally distributed among the staff throughout the week. the same person(s) shouldn't always get the sh*t assignments all the time...that's not fair either.

    as charge nurses, we shouldn't have to beg, borrow, or steal just to get someone to perform duties (whether assigned or tacked on) they are assigned to. but everyone should be spoken to with dignity & respect. you know, i find that ever since people stop using their co-workers' sir name & just address them by their first names, people have become quite familar...in the military, everyone is addressed by their rank, then sir name. it keeps it more professional...it's been too long since i've heard any one being addressed by their last names except for those few foriegn nurses, some whom happen to be supervisors at my civilian job...they still believe in that familiarity breds contempt. must be something to that...just a thought...when did we stop being nsg. doe??? guest that went out with the caps & capes - but physicians are still referred to as: dr. so'n so - funny that - moe.
    Last edit by SKM-NURSIEPOOH on Dec 20, '02
  7. by   2banurse
    Originally posted by ktwlpn
    I think it's great to have a mix of nurses and cna's here to learn from....Maybe we can take something from this nursing board and apply it to our nursing practice....
    I've got a long way to go before I have my RN, but I find these posts quite valuable. I definitely see the points of Moe and Mattsmom which seem to emphasize the many tasks of RNs that some CNAs might not be aware of.

    Quoted from Stargazer: I'm sorry, but as the previous posters have stated, this only serves to demonstrate profound ignorance of the nurse's job description and responsibilities. Paperwork may not look like "real" work to you, because it doesn't get one's hands dirty and is done sitting down, but it is extraordinarily tedious, time-consuming, and absolutely critical for safe patient care, compliance with federal regulatory laws and guidelines, and protecting the nurse's own license.

    I also see the valid points of Flo1216. I know that when I am working as an RN, when I have a CNA that is as attentive as Flo is, if my assistance is needed, I am there for her, as she is for me.

    I see that this is a very active thread and while it is idealistic to say we should all work together for the patient, unfortunately reality shows that there will be good attentive RNs/LPNs/CNAs and there will be some that don't care to work as a team. I just know that for myself when I am an RN, I will make every effort to do what I can to be a good nurse and a good teamplayer.

    JMHO,
    Kris
  8. by   mattsmom81
    Kris, I am sure from reading your posts that you will be a wonderful RN and will also be a great leader and teamplayer!

    Facilities will love to have you!!! Best wishes in your course of study!
  9. by   mattsmom81
    Kris, I am sure from reading your posts that you will be a wonderful RN and will also be a great leader and teamplayer!

    Facilities will love to have you!!! Best wishes in your course of study!
  10. by   2banurse
    Thanks Mattsmom, I definitely plan on doing the best that I can.

    Kris
  11. by   mario_ragucci
    And it's a great feeling to earn the trust of an RN. For example, I brought this thread up at work, and told them what could go wrong with CBG's. I realized, because of this allnurses portal, the RN's where i work trust me to take a CBG for them. It is very possible to take a CBG wrong, or forget about it. If I made a gross error, it would look bad on me, but also the RN, worse.
  12. by   mattsmom81
    Originally posted by ktwlpn
    LOL!!! You make a great point there,dude...and it's VERY little at this point...just wait-you ain't seen nothing yet -just kidding ;>) I don't think anyone has stereotyped anyone here(it is tough to type a disclaimer with every post-maybe we should put them in our siggie line---" The following post is my opinion only-based on my personal experiences-etc,ect yada yada yada) I think it's great to have a mix of nurses and cna's here to learn from....Maybe we can take something from this nursing board and apply it to our nursing practice....
    Wonderful points!! We can only say "some CNA's' so many times...but that isn't enough for 'some' posters is it...LOL!!

    Obviously we have worked with WONDERFUL CNA's or we wouldn't be so hard on the poor ones...we know it can be done. and good leadership involves noticing when the CNA is overwhelmed and overworked...and doing something about that.

    And Flo, teamwork is essential of course. another obvious I guess I forgot to mention. If a nurse sits on her bum and allows the CNA to kill themselves with the workoload, she is poor leader and a bad team member, IMO.. And I know there are 'some' bad nurses out there because I've worked with them. If I'm in charge it doesn't fly...

    I am THRILLED when I have a CNA to assist me!!! It is nice to have an extra hand even in ICU settings believe me! But *SOME* (note disclaimer) are there to get out of work and collect their check. I even had one who wanted to sit down in the nursing station the whole shift... because she was 'sick'...then got angry when I sent her home! She thought she should be able to 'sit' and get paid.

    Sometimes management assigns a CNA to one huge unit and there is NO WAY one can do everything the nurses want! I've seen this happen on the floors and you are right. It is not fair. The nurse in charge should step in and redistrubute duties fairly, and this issue should be addressed appropriately with management too.

    I post my experiences in response to questions and postings by others..and I hope it helps others to discuss these things in a public forum. I know it helps me. :roll
  13. by   renerian
    I think the post just shows frustration. I would be frustrated. I would try to talk to the CNA on the side. If hostilities were present work on trying to get past them for the good of the patient. Health care is so hard I know.

    renerian

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