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.

[nurseleigh]

Please, please, please tell me WHY the CNA was doing Accuchecks!!!!! Am I working in a facility in the dark ages or what, because where I work the nurse is responsible for all accuchecks and to be totally honest, I was never trained to do this in school until I got into the LPN program.

And second, regardless of what the "rules" are in the institution, the nurse has the right to ask for things to be done at different times if she so wishes and since it is her license that is on the line and not the DON, it should be done when the nurse wants it unless it is absolutely impossible to do at the time requested.

I know, i rambled. Sorry, I get like that when i am confused. :)

Leigh

[Flo1216]

You make comments about CNAS " talking back" and not " doing as they are told," . It makes me wonder how you approach them. Remember they are nurse's assistants, not nurse's slaves. Nor are they your children. Is this particular CNA'S hostility in response to being bossed around or patonized? That being said, no one should be telling pts to "shut up" or doing blood sugars whenever they feel like it. It's not about US, its about the patient. So she was wrong in that respect. Did you explain to her why the sugars had to be done later? Maybe she just didn't understand . I am a student/CNA and some of the nurses I work with treat me as though I am their personal slave or beneath them. There are times I have been the only CNA for 25 pts and I am expected to do vital signs, clean pts, answer lights, feed the pts, check sugars, empty foleys,empty hampers,transfer pts, play " fetch", provide emotional support, stand on my head and juggle a dozen flaming porcupines. With no help,no please and no thank you. Sometimes I have to BEG someone to help me boost a pt up in bed. Some floors have CNAS emptying the trash on the med carts(which we do not use) or disposing of the empty IV bags or cleaning up the pantry(when the nurses have piled up pt trays instead of returning them to the dietary cart) I refuse to do this because like I said I am an assistant, not a slave.

[Flo1216]

Nurse leigh-CNAS doing accu checks is pretty standard. It doesn't take a rocket scientist to stick someone in the finger.

[Flo1216]

Its me.....I didn't attend the CNA training because I was already a student and the first semester is mostly CNA stuff, but yes, CNAS ARE trained to do accuchecks and yes, CNAS ARE taught to report the out of range results STAT. Why take the sugars if the don't plan on reporting them? For the hell of it? They are taught the ranges during their 6 week training. Also, the machine gives a prompt. Like a blood sugar of 40 would flash " Critical low result" That sort of thing. Seriously, it's not that difficult.

[Q.]

Originally posted by Flo1216

Nurse leigh-CNAS doing accu checks is pretty standard. It doesn't take a rocket scientist to stick someone in the finger.

Same here. Most CNAs or those who got "advanced training" can do accuchecks, even newborn hearing screens where I work. Cripes, patients can do their own accuchecks; why couldn't an aide?!

[Flo1216]

Exactly. AS a cna I was a little offended by the insinuation that a finger stick is way too involved for a CNA to comprehend or the question, " Do CNAS knows to report out of range accuchecks STAT"? Duh, no we just wait for the pt to go into a diabetic coma before we say anything.

[jdomep]

As a student - the other week my pt was diabetic and our CNA's do the accu checks - I was really hopping to get to do it sometime but - we, as students, don't even get to learn them ) Her blood sug was 80 and "Mary" said nothing and within 10 minutes my lady was having as she put it "one of my diabetic things" and I got her juice we laid her down then she came around - totally freaked me out...this CNA really acted like she hates us students - if we would nicely ask her not to take our pts V/S (which the instructors claimed the aids know to let us do them) she would do them anyway...

[itsme]

flo, I was not meaning that CNA's dont have the brains, where I am from they havent got the training. Also as far as that goes, patients at home can give themselves or there own kids or parents meds, but once in a facility, it is the nurses job to give those same meds. I have seen more than one time where someone comes in with a multitude of pills in one bottle and said " this is how i do it at home" . My post was not intended to offend anyone. i was once a cna too.

[nurseleigh]

I, too, was in no way insinuating(if any of ya'll took it that way) that CNA's aren't smart enough. I did not take "CNA" classes either but the accuchecks aren't included in the LPN training until the second semester here. I know the facility I work at does NOT let CNA's do them and just thought that it was a universal thing that nurses do their own accuchecks.

itsme has a great statement regarding pt doing thier own, a patient can give themselves OCD's but not when admitted to the hospital. Even a simple tylenol that they may have in stock in thier bathroom requires a doctors order in the hospital setting.

In the hospital that I am going to work at Lab does all accuchecks.

My only point was that in my training the finger sticks were taught later in the game and therefore would not be done by CNA's. Anywho, thanks for educating me that CNA's are doing them elsewhere. I find it very interesting that the same job title holds many different job descriptions around the country :)

Leigh

[Gromit]

Originally posted by itsme

what training does a CNA have for accu checks? Is she aware that she needs to tell the nurse STAT if it isnt in normal range? Just curious, because where I am at a CNA doesnt even do vital signs (except temps) let alone an accu check.

Wow. I thought they all got similar training. At the facility I work at, we do vitals, as well as accuchecks, (and yes, we are trained to drop the rocks and tell the nurse when its a critical reading). Granted, the techs get extra training and can therefore do other things (like start IVs, place foley catheters, straight cath a pt, dressing changes, etc. -makes it more interesting. Well, at least >I

[Ortho_RN]

Originally posted by l.rae

l might wonder too, what critical thinking skills are you employing when you determine if a request is being made for convenience or pt benefit?...

hehe.. Its not that hard when the nurse comes up to me and says "Can you go ahead and get that CBG, I know its early but I am going downstairs for awhile"... So I am not assuming anything :)

[mlolsonny]

OKay, I'm an LPN student who's graduating next week. I work as a CNA/ Medication Aide in a LTCF. Where I work, even the TMAs don't get trained to do Glucometers until the DON thinks we're ready. CNAs don't do VS, Glucometers, etc. They're busy enough.

All I can say is in the same situation, I'd have done the glucometers myself and reported the CNA's attitude when the boss was in. For the safety and comfort of the resident, it would be worth the extra 30 seconds of my time.