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.

[Furball]

Yup, pts do catch on fire. Witnessed one about 5 years ago go up in flames in her room, o2 on. Ewww... She DIDN'T have dementia. She was just horribly addicted, stubborn and incredibly stupid.

[Q.]

Originally posted by austin heart

i too have never worked at a facility were i had time to do this , must be nice to have all that down time. and suzy, you say you worked ob and that your pst came to the hospital to have their babys, right? what were these people smoking for anyway? by you taking them out to smoke, it makes it look like you advocate smoking in pregnancy. i thought that was a big no-no? even if these people just had their baby, if they have to go right out and smoke, prob meens that they smoked through their pregnancy. looks like that would be a good time to start the pt education. ie:smoking is bad for both the pt and the her baby.

Ok for one, I have a cold so I am a bit punchy. But let me start off by stating I am getting awfully tired of people insinuating that because we escorted patients out to smoke, that I must've sat on my a$$ or that we were a cushy floor or fat-staffed or had down time. We did what we had to do and got it done with TEAMWORK, hence my questioning about refusing to do things in the first place. None of us refused to do even the shyt aspects of patient care.

Secondly, Austin, patients couldn't smoke during labor; I was talking about POST-PARTUM. Sometimes, you need to prioritize things a bit here. No, we don't advocate smoking and yes we educate on quitting, however, we're not going to win that battle at that given moment so WHILE ESCORTING THEM DOWN TO SMOKE, some of us would use that time to educate on other pressing issues at the time.

Now, enough of this already? Yeesh. We did what we had to do and got it done. If I hear one more backhanded comment about how much downtime I had I think I might have a coronary.

[mario_ragucci]

Originally posted by SmilingBluEyes

far as I know, Mario, we are all flamable as carbon-based living things.

This is false because, though our dermis is carbon based, it will not ignite, like wood or cloth. No PT could ever produce a flame hot enough to set fire to skin. It has to get ReALLY hot first, like >600F B4 an organic substance, like a PT, would ignite. The introduction of O2 to any "burning" substance could produce such heat, as furbal mentions. Smoking at or near any compressed O2 should be strictly prohibited because the compressed gas could cause some burning to occur REALLY fast, causing an explosion to harm everybody.

[mattsmom81]

I could tell someboring 'old nurse' stories here...cuz I remember when patients and visitors smoked freely all over the hospitals (nurses too)..I remember nurses and docs smoking at the station way back in my younger days..hehe)

Wastebasket fires, bedclothes fires, 3rd degree burns...lots of this from patients smoking in bed/falling asleep. And yes, 3rd degree burns from the o2 cannula too...and the molten tubing burn lines on their faces...

I remember putting out many wastebasket fires in patient rooms and hallways before the anti smoking policies came about. Hospital fires almost always involve patients smoking according to even most recent fire safety training data. And many dementia patients will have fire mishaps (among others) at home which lead to their move to LTC.

[Sleepyeyes]

Originally posted by mattsmom81

And many dementia patients will have fire mishaps (among others) at home which lead to their move to LTC.

heh...

reminds me that I, for one, am really glad that the Alzheimer's pt who wandered into the unit kitchen, did not first turn on the oven before he pulled open the door, sat down, and used it for a commode.....

eeeeeeeeeewwwwwwwww! :stone:

[Q.]

Originally posted by mario_ragucci

This is false because, though our dermis is carbon based, it will not ignite, like wood or cloth.

Actually, we are flammable. We are not combustible, which is what you are referring to. We are not flammable at normal room temperature, however, given the right temperature (such as fire) we will ignite.

In the general sense, we are flammable.

Just like asking: Can we breathe? Yes. Can we breathe with a truck parked on our chest? No.

Can we fly? Yes. *qualifier*: if you put us in a airplane.

In the most general of senses, yes, we are flammable.

[opalmRN]

Michelle95,

I think there are several issues going on here.

It is EVERYONE's responsibility for patient care. And every facility does have a chain of command whether it is obvious or in the background. As I'm sure you are aware, the reason behind this is not just for use during a conflict but more importantly for times of delegation. CNAs or NAs which ever term is used in each facility are under the guidance of the nursing staff. They have pre-assigned responsibilities according to the facility where they work which can vary greatly. One thing that does not vary however is the direction from the nursing staff. CNAs must follow the direction of RNs and LPNs and all follow direction from the supervisor. If someone has a conflict or discrepancy over there responsibilities, than they need to go through the proper channels BUT not at the time the directive is being given. The only exception to that would be if the directive was in any way going to harm the patient.

Whether or not the CNA agrees with your decision about acu-check timing or not is NOT for him or her to decide. The CNA is to perform the function as directed and take up the personal gripe later.

I agree with you as far as the refusal of your directive. The CNA should have done as instructed.

I know that many who read this will disagree with me. You really need to keep the patients first and foremost. Having been in the military, a CNA, worked in long term care, hospital, woman's clinic and home health care I have learned to keep a perspective. The care comes first the questions and disagreements later.

I loved my work as a CNA. It was the hardest physical work I ever did besides PT in boot camp but I really felt appreciated by the residents as well as the rest of the nursing staff. In all my years I only ran up against one nurse with an attitude for which I later learned was towards anyone with less education than herself. I killed her with kindness. For the rest I never was treated any different than the nurses towards each other. When I needed a hand many a nurse would come to my aid and vice versa. I don't know if we were considered short staffed or not. As a CNA I had on the average 14 residents on second shift in a LTC facility. We all worked together as there was little time for bickering.

I do hope that you can get this resolved. Your immediate supervisor should be contacted and a meeting with the three of you must take place. Perhaps if the air can be cleared things will be better for all.

And Kudos for you concerning your relization of the patient's being someone's loved one. That was the first thing I was taught when I went through CNA class. It stuck with me and always will.

Good luck

C

[SmilingBluEyes]

Thanks for the education Mario, but I was being tongue-in-cheek in my reply. Much in the manner of your post that I was answering. and my friend, as Suzy says (and she is right), we ARE flammable, just not combustible. WE **support** combustion when we combine, gases like O2, people, and LIVE cigarettes, lighters, or fire.

[Flo1216]

Mario...we had a blind pt light her sanitary napkin on fire trying to sneak a cigarette in the bathroom.

[Flo1216]

How did we get on this topic anyway?

[mattsmom81]

We digress..

[nurs2bhopefully]

I listen to all the nurses in charge over me, whether they're telling me to do something politely, or beligerently (because I can see how stressful their job can be and I know the tone of voice is not always something personal against me.) Only nurse I dont' bother listening to is the one who wants me to "bring her a cup of coffee back on my way back from hall 6" or "to run and crank her car so it can be warming for her" or "to run the Avon book over to the other nurses station so her order can get placed in time"! And I agree, I work with some other great CNA's that I really look up to and learn from, and others I would not even want taking my family's order at McDonald's, much less helping to take care of them!