Major venting about some CNA's - page 8

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   charissa
    I work on a floor that is a little different than regular med surg, our staffing isnt the same, so the nurses are always used to not having a STNA, and as such doing things themselves. So when we do have one we tend to forget and end up doing a lot of the work they are supposed to. However on busy days it seems to become an expectation that we will continue to do the work we help out with more on slow days, I was also a STNA for quite a while and i know how hard they work, i always ask for tasks to be completed and say thank you even if it is their regular job duties whether it is housekeeping, a STNA or the lab, it doesnt matter everyone deserves respect.
    I have found out, however this tends to give many the impression they can take advantaqe of me. Our facility has been giving RN's more and more lately as we attempt to fix a few JACHO things, this in turn has restructured some job duties, like our STNA's doing sugars for the first time. Becvause of this i have gotten a lot of flack. When i am incharge of the entire floor, and i dont have a scretary, and i am covering IV's and have a pt of my own i dont have time to do the CNA"s work that day, it is her job. Everyone on my floor answers lights and so forth, but if we are busy the STNA's tends to think most of the time that she is the only one working if she answers most of the lights. Not taking into account the Dr's I am on the phone with, the meds i have that are late, or the questions i am answering for other staff members. Everyone has a job description, and occassionally if I am having these types of problems with a STNA i will point them out. I dont do it in a rude way, but it usually takes care of the problem, and if not I just get assertive, the key is, this is our livelyhood as well,
  2. by   charissa
    I work on a floor that is a little different than regular med surg, our staffing isnt the same, so the nurses are always used to not having a STNA, and as such doing things themselves. So when we do have one we tend to forget and end up doing a lot of the work they are supposed to. However on busy days it seems to become an expectation that we will continue to do the work we help out with more on slow days, I was also a STNA for quite a while and i know how hard they work, i always ask for tasks to be completed and say thank you even if it is their regular job duties whether it is housekeeping, a STNA or the lab, it doesnt matter everyone deserves respect.
    I have found out, however this tends to give many the impression they can take advantaqe of me. Our facility has been giving RN's more and more lately as we attempt to fix a few JACHO things, this in turn has restructured some job duties, like our STNA's doing sugars for the first time. Becvause of this i have gotten a lot of flack. When i am incharge of the entire floor, and i dont have a scretary, and i am covering IV's and have a pt of my own i dont have time to do the CNA"s work that day, it is her job. Everyone on my floor answers lights and so forth, but if we are busy the STNA's tends to think most of the time that she is the only one working if she answers most of the lights. Not taking into account the Dr's I am on the phone with, the meds i have that are late, or the questions i am answering for other staff members. Everyone has a job description, and occassionally if I am having these types of problems with a STNA i will point them out. I dont do it in a rude way, but it usually takes care of the problem, and if not I just get assertive, the key is, this is our livelyhood as well, OUR LIVELYHOODS ARE OUR LICENSES. WHEN I AM RESPONSIBLE FOR SOMEONE ELSES WORK AND MY LICENSE IS ON THE LINE ULTIMATELY I CALL THE SHOTS. If someone has a problem with it then in the end perhaps we are a bad working relationship and shouldnt be placed together
  3. by   charissa
    We use Lantus in my acute care facility. it is a 24 hr long acting insulin that provides a steady bs coverage over that period of time. It is regularly given in does that high, and almost always in the evening. it should not be mixed with other insulins
  4. by   jude11142
    Originally posted by Susy K
    I think alot of you are assuming alot here; assuming she had an attitude?! Ok, nothing excuses an attitude, but if the nurse asked for a blood sugar at a certain time, even WITH the attitude, then act upon the attitude, DON'T risk the patient's safety by blatantly doing something against what you were told to do. I think you all lost the big picture here. The big picture is that FOR THE SAFETY OF THE PATIENT, her blood sugar should have been checked at 0600, not 0545 or any other time determined by an unlicensed personnel. Take up the issue of attitude (IF there was any) with the individual or the manager; certainly DON'T take out your anger on the patients by refusing to do cares when deemed appropriate by a licensed nurse.

    So...if a physician told you in a bossy manner to give the patient a pain med NOW, would you refuse to give it NOW because he didn't ask you nice, and leave the patient in pain and give the pain med when YOU felt like it? Come on. Grow up. Give the pain med and address the physician attitude separately.

    Take the blood sugar at the requested time, and LATER discussed how it was asked of you. For pete's sake. It all ain't about you, people. It's about the patient, remember?

    That CNA was wrong.

    Hi Suzy,

    I couldn't agree more ....Afterall, our patients are our #1 priority, so that should be the factor here. Not, if or if not there was "an attitude".......If there is a communication problem then absolutely it needs to be addressed at the "right time".........I worked many yrs as a cna, then as an or tech, now as a lpn who is finally going for rn and I know that I don't have to tell you that there are coworkers in ALL areas that just have rotten attitudes. It doesn't have to do with "their titles".........just like any other profession, there are good and bad. Sometimes, I have "bad days", yet, I never let that get in the way of patient care and I am never disrespectful to anyone. So, as Suzy has said, "it all ain't about you, it's about the patient, remember?"......That's it in a nutshell.

    JUDE
  5. by   mattsmom81
    We will all work with people with bad attitudes someday..as has been said over and over here.

    Lazy mouthy nurses, docs, CNA's, lab techs, RT's...one bad apple in every group. We will have to deal with them...and the original poster was venting about this. When an entire group behaves this way, it's nearly impossible to work with them, IME.

    Let's not jump all over each other, pick apart each other's posts, or find fault with one word out of 200. It serves no useful purpose.

    I would bet those of us here who take the time to correspond with other health care professionals and problem solve are NOT part of the problem. If we can discuss ways to deal with these situations productively won't we all be better off?

    Have a blessed holiday season, ya'll!
  6. by   Sleepyeyes
    Sorry; this is OT, but i felt compelled to share

    Originally posted by rebelwaclause
    Yes Lantus is a high dose Insulin. I'm thinking of the sliding scales at my facility (different at every facility - I presume?). Our docs cut off at about 12 units (regular) and specify to notify them, usually leading to an amp of something (D5).

    We do not use Lantus. Is anyone using Lantus in the hospital setting? Expensive, new and a little temperamental for an insulin.

    At any rate, 40 units of any insulin deserves a quick "CYA" peek at the patients chart. Again, this poor 145 pound woman wouldn't have been subjected to a dropped BS if done so.
    In LTC, I had to give 70/30 or NPH insulin to a couple of folks, their doses were about 30-40 units in the morning.

    And yes, I quadruple-checked them because on top of that, they got regular coverage....

    Never given that much Regular insulin though....

    Our hospital orders usually read "If < 70 or >400, call md" and then we have a protocol for <70 to give an amp of D5 (if Pt is unresponsive, but otherwise, just some OJ, milk, and a carb, then recheck in 15 minutes.
  7. by   Flo1216
    mattsmom-

    Right on.
  8. by   gojack
    Not all CNAs work in hospitals. How about us licensed staff working in nursing homes? We have to "depened on" CNAs that have previous prison time and mental health issues taking care of the elderly. They are paid zit by the administration, and have no benefits. In addition, some are taking care of elderly white racists who use racial epithets.

    My "backup"? A chief administrator fired right before Christmas, and a nursing home that hides who are the actual owners! These weasels are more likely to go to the state board, or fire a nurse for legal reasons (to help defray any additional amount in any judgement against the home), than to actually back up the licensed staff.

    And I, cannot actually get mad at the CNAs for dumping on the patients in this madhouse (one aide said it was like the Jerry Springer Show). Any advice from all the experts out there, other than suggesting I just go out and find another job? Actually, I have heard that this is one of the better nursing homes in the area!
  9. by   flutterby
    I have been a CNA for four years now, and I've worked in a couple of facilities where the communication between nurses and CNA's was good and where communication between CNA's and nurses was bad. It also sounds like you may have a slight morale problem as well. Anywhere where people use such language with their coworkers or superiors as 'shut the hell up' raises a serious red flag to me that the problem is a little deeper than just the communication between the CNA's and the nurses. I'm glad to hear you have an interview with another facility, because it sounds like your best action is to just get out of there. If the bosses aren't doing anything about someone who tells their superior to 'shut the hell up', there's a real problem. I'm going to school to become an RN and have vowed not to treat the CNA's assisting me like crap because I've been there and know the phenomenal amount of work they have to do. They are there to assist me and not to be my slave. Good luck with your interview, and I hope you find a position where you are more comfortable.
  10. by   mattsmom81
    I recall a bruehaha between a good RN and a good CNA...the CNA did not wish to help this RN because she 'barked' at her. It was, I feel , a cultural thing...the RN was foreign trained and did not feel she should have to be polite to get the work done by the CNA. I understood both points of view but I finally had to write them BOTH up and let my unit director deal with it because neither would respond to my requests that they be mature and work their problems out!! Their arguments disrupted the unit and patient care suffered.

    Bottom line: we all have to work together to get those patients safely cared for. If that is not occurring the RN has a duty to act. If the RN can't significantly improve the situation, then resigning may be the best option, because he/she is hindered in his/her duty to the patient...which our practice act demands.

    Just how I see it, others may disagree of course.

    I have left facilities where I was not able to impact safe patient care. It's our license and we do not have to remain in an impossible situation IMO.

    If your facilities hire unsavory CNA types there are state regulatory agencies that would be interested in this info.
  11. by   MishlB
    I wish we had CNA's where we are working for clinicals. You don't realize how valuable they can be until you don't have them!!!
  12. by   michelle95
    Before I even read all of the replies, I need to clarify some points.

    First, as I stated in the tile, I was VENTING. I am not the 'queen'...or think I am high and mighty. I do not boss anyone around. As I stated, I even compromised. I ASK nicely when I want something, I don't just come off with a 'tude and tell someone what to do. I am surprised that some of you would make generalizations on how I work based on a 'venting episode'.

    The problem comes when you ask someone to do something that you are supervising and they tell you no.

    The second thing I need to clarify is that I DO NOT EVER sit on my butt and watch the CNA's hump and not help. There have been times that I have put every single one of my patients to bed because the CNA could not be found. The guy with the food caked on him? His CNA had been sitting at the nurse's station for over 30 minutes while he laid like that.

    So, now I am supposed to do my job's and someone's too? I have NO PROBLEM helping out. I have a problem with people thinking they can sit around and I can do their work for them, while my own suffers.

    I'm sorry some of you are so hostile. Like I stated in my original post, I know cna's that are good...and, if you do your job, I ain't talking about you. It's the ones that like to sit on their rump and collect a check for doing less than the best care.

    If I came off as rude, I apologize, as I stated in the first post, this was a vent. The CNA's at the place I just worked had some major attitude problems, and, I am far from the only nurse that has been told no by them.

    And, what about being told to shut the hell up when I was reprimanding that one cna that had told the patient to shut up? I guess I deserved that for being bossy by fussing at her for doing that....
  13. by   michelle95
    I feel a little better after reading some other posts. The first few were just attacking and accusing.

    For the record, I hated when I was a CNA and a nurse would ask me to put someone on the bedpan when they had just been in that room. I, too, swore, I wouldn't be like that. If I am in the room, I always try to put them on the bedpan or take them to the bathroom. I even answer call lights, and, usually the only time I ask a CNA to do something is if I simply do not have the time.

    The problem with the facility that I worked at is that the bosses let people get away with talking rudely to others. According to state regulations, there should have been an investigation for that CNA telling the patient to shut up. As far as I know, there hasn't been.

    Other nurses have left on account of not having an 'authority' and being talked to like dogs by the CNA's at this facility.

    I talked to the DON at the place I interviewed at. I told him, I am not a hard ass out to try to be mean or get anyone in trouble, but, I demanded the respect that comes with my title. I don't expect to be told no if I ask nicely for something to be done, and, I sure don't expect to be told to 'shut the hell up'. I understand that respect is earned, but, there is always a certain amount of respect that should be there from the get go for your superiors. I would not tell and RN no if she told me to do something (unless, of course it jeopardizes patient safety).

    You guys the patients need us to be their advocates. We can't just let anyone treat them any old way.

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