Major venting about some CNA's

[michelle95]

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 where I work. They talk back, they leave people in messes...it's really making me mad. Just this morning, I told a CNA that was going to get my blood sugars at 5:30, to wait until at least 6:00 because I didn't feel comfortable giving insulin at 7:00 on a 5:30 accucheck. I had originally told her 6:30, but, after she explained to me that she couldn't at that time, I told her I would compromise and make it 6:00. (Sometimes our patients don't get their breakfast trays until almost 8:00 and 11-7 is responsible for the insulin at 7:00) She flat out refused. She told me that the boss said it was ok. I told her, she's not here right now, is she? You're working on MY license, not her's.

She told me no and went and got them at quarter of 6 in defiance.

I told the 'boss' when she came in, but, this is the same boss that let another CNA get away with telling me to 'shut the hell up', as well as, telling a patient to shut up. (Which is why the CNA told me to shut up...I was getting on to her for doing that)

I am so SICK of not being backed up when I tell a CNA to do something. I know I am just a little 'ole LPN at this time, but, I still expect the CNA's to do what I tell them.

I try to be fair. Like I said, I was a CNA, I know how hard the work can be....but, I didn't talk to my nurses any old way I feel, much less, tell them no when they told me to do something.

If the big bosses won't do anything, what am I to do? Go over their heads?

This is my last night tonight. I've done decided that the next place I work, I am not going to be so nice. I've got an interview tomorrow and I am going to explain to the administrator that I DEMAND back up. If I tell someone to do it, and, they snap off, I EXPECT there to be repercussions.

I hate to be so down and dirty, but, I had an spiritual experience a couple of weeks ago that made me see that every patient I come in contact with, is someone's loved one. I don't expect to see them laying in pee or dried food for hours. That is soooo undignified. If I don't take up for them, who will?

Any advice? Should I go to the ombudsman if the bosses won't do anything about these CNA's with an attitude?

I hope any CNA's that read this don't take offense. If you do your job honorable, I am not talking about you.

[Brownms46]

I'm sorry I have to agree with Kellie. I don't believe a non-smoker should have to take pts. out to smoke. I feel this is violation of what most hospitals and businesses have enacted. To provide people with a smoke free environment inside their facilites. Most pts. in this part of the country who smoke and enter into the hospital, are offered a patch/stop smoking aids. Those who refused to try to stop, wait for visitors, and or those who smoke to take them out.

If the pt./resident needs to smoke, and there are no smokers...or those willing to risk their health. So be it! I have never asked anyone to do this task, and never would direct anyone who didn't want to do it!

Merry Christmas

[hapeewendy]

well I avoided this thread for awhile , but like the gory accident you just cant help but looking at , I returned. I was on nights last night (yeah yeah merry xmas I know!) and I was speaking with the nurses on shift about their ideas about the skill mix on our unit. We work on a busy crazy med surg unit and have noticed a huge increase in the acuity of the patients we are recieving. We have RPN's and RN's and it seems like the RPN's are able to get away with not doing work that is within their scope of practice. This is where the problem occurs, if the RN is busy and asks the RPN to do something , the response tends to be (not always , there are some DAMN good RPN's where I work, so much so that I would trust them over several of the RN's I work with!) that they are somehow doing a favour for us or bending over backwards. That simply is not the case. It is within the scope of practice of an RPN to do a drsg, check the blood sugars and do vitals!

The RN's on our unit are never able to say "thats not my job!" or "someone else will have to do that" or "I'm going for my break RIGHT now"....this leads to so much frustration and a breakdown in the teamwork and professional relationships. I am not anti anyone, each person has a specific role in the health care setting. However each person also has responsibilities and expectations of practicing within their role, whatever that role may be. If you're not happy with the work involved in your "role" then change the situation by furthering your education or working in a facility that better suits your needs...

*phew* feel much better now, sit down and pass the turkey! merry xmas!

[jenac]

" I don't know about your facility, but at mine, if we would all quit thinking about what job is the cna's and what job is the nurses', and just do whatever it takes to care for the people we are in this profession to care for, we might even make a difference in some lives. We, too, can't seem to stop the bickering about what who does what and why.

Perhaps we should re-read the job description. especially the part that says...."MUST BE ABLE TO DO ALL ASPECTS OF PATIENT CARE!!!"

Ok- I've been on both sides of this fence, as a CNA and now as an LPN. I'm sorry, but I can't help but respond to this one. If I spend 8 hours doing someone else's job- how will I get mine done? If I have to interrupt my med pass 25 times to help so-and-so do everything how can I possibly be the nurse my resident's- and the state- expect me to be? I will always help out, when I can- if I can, but I work hard at my job. I do what is expected of me- and I get paid for it. I expect everyone working with me, and recieving a paycheck along side me, to do their jobs as well. Yes- my responsibilites are patient care- but if I have to do all the bathing, dressing, and care- how am I do to all the nursing too? I will do what I can for my aides- every day, in whatever way I can- all I ask is that they do their jobs. Period. If not- than McDonald's is always hiring. We're dealing with people here- not Big Mac's. And it's a team effort. Either be a productive member- or get off my team. I don't expect to have to ask people to do their jobs. I'll give some leeway- and I don't ride them if they just do what they were hired to do. For the record- as a CNA- I expected the same thing of every other CNA and nurse I worked with.

[Flo1216]

What the heck is an RPN? And speaking of breaks, I hate when I have a pt screaming in pain and the RN says, " He'll have to wait-I'm on break" and the covering RN says, " Wait until Nancy gets back from break," and the pt blames ME. That's not cool.

[SKM-NURSIEPOOH, BSN, RN]

a rpn is equivalent to lpn/lvn in canada & possibly the uk. the rpns in canada don't have the same scope of practice as many of the lpn/lvns have in the us. the rpns seem to be limited in their craft...i think.

merry xmas to you too hapeewendy!!!

cheers - moe.

[mattsmom81]

Originally posted by Brownms46

I'm sorry I have to agree with Kellie. I don't believe a non-smoker should have to take pts. out to smoke. I feel this is violation of what most hospitals and businesses have enacted.

I agree with Kelli and Brownie.. The patient's 'right' to smoke ends at my nose, IMO.

This got so bad at my last facility (patients demanding the staff take them outside to smoke) that we created a specific policy for it. The doc must write an order " patient may smoke in designated areas"...BUT it is up to the family to provide an escort if one is needed. The policy states it is NOT up to the staff to escort; the patient and family sign this in agreement and it is placed in the chart.

Some smoking staff don't mind taking patients to smoke, but the patient must understand this will be at the staff member's discretion and availability.

I understand smoking residents may be managed differently at LTC centers but I think the above policy is a great way to manage the issue in acute facilities. :roll

[mario_ragucci]

This is so cool. On my Oregon CNA exam there was multiple choice question about this subject of taking out an altzhimers PT at a LTC to smoke.

I don't know if I got tht question wrong or not.

\Accroding to the State of Oregon BON criteria for CNA, if a w/c PT (under my care) @LTC facility with altzhiemers rightously asked me to go out on the patio to smoke,...what is right to do????

a. refuse them access outside and document

b. hide their cigarettes and ask the RN to med them

c. open the door to the patio and let them outside and come back in 10 minutes to check on them

d. check their clothing, accompany them outside and stay with them and make sure the PT is safe.

What could you do? answer is D, right?

[SKM-NURSIEPOOH, BSN, RN]

...in the backward state of nj...residents in ltc facilities have a right to smoke as these places are their homes.

i've seen many staff member fight over whose turn it is to "light them up." even the smoking staff get a bit hot under the collar because where i work specifically, the residents have a smoke room which is suppose to be filtered...but it quite horrible for those who aren't smoking at that particular moment. smoking staff aren't even allowed to have a cigarette while they're watching the smoking residents if they want to....grrrr.

fortunately, the smoke room has these huge windows where one can light-up all of the residents' cigarettes & watch them from just outside of the room...with them inside & the door closed. the irritating part of it is that if staff have asthma or a common cold, they've got to hold their breaths, light all the cigarettes, & then make a dash for the door. god help any of them if something happens inside that room right in the middle of all that smoking.

i personally don't think that non-smokers should have smoking duties, especially those with lung problems...i strongly feel that goes against those individuals' personal right to work in a hazard-free environment. in addition, i don't feel that the smoking staff should have to expose themselves to more lung damage by inhaling second hand smoke...if they don't wish to be...despite them being smokers. if people are made to work in hazardous conditions (this qualify as being such), then they should be compensated some how...but no about of money in the world is worth developing lung ca from secondary cigarette smoking...jmho.

ciao - moe.

[mattsmom81]

Flight attendants have won class action lawsuits against airlines that forced them to be in smoke filled cabins (before the clean indoor air acts) and led to the development of lung disease.

Healthcare workers forced by job description to inhale resident's smoke should also have the right to challenge this in court. If what Moe describes is 'state mandated' perhaps a suit against the agency mandating this is order. When will nurses stand up for nurses rights and stop sacrificing their own health and wellbeing???

Sorry...this is a bit off topic but is a hot button for me. I have never smoked but have mild asthma/chronic bronchitis due to exposure to chain smoking parents and smoky patient and report rooms over the years. It pizzes me off.

Yes, Mario, 'D' is probably the correct answer, as I know LTC residents' rights are a big issue today.

[Love-A-Nurse]

interesting thread.

[Furball]

Cig smoke makes me nauseous. If I had to go home ill every time then I would think "they" wouldn't ask me to take pts out to smoke. Silly......a hospital is there to help sick people get BETTER not worse.

[Q.]

Here's my question.

Say you work with a bunch of non-smokers who refuse to take patients out for smoke breaks? Then what? Who does it then?

Isn't it along the same lines of refusing to take care of a TB, AIDS, pneumonia or other infectious patient because it's bad for your health?