Major venting about some CNA's - page 9

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   Streamlined
    Just to add another way to look at this particular sharing of duties: (I'm not ignoring the attitude issue, but others have already made several good points). Why should your end of shift care be so fragmented? Why can't the licensed person check blood sugar AND give the insulin closer to 0700? Why should the nurse's duty to regulate glucose control be delegated to an unlicensed person when the latter could be doing last minute fluffing and buffing, mouth care, re-positioning for meal,etc. If the CNA just filled the fricking water pitchers I, for one, would be so grateful. I quit a hospital job where the care was fragmented this way. Some genius decided that taking vital signs was a duty to be delegated to CNA's. So there I was filling up water pitchers, clearing off bedside tables, re-arranging the furniture, doing poop patrol while the CNA's were attaching a Dyna-Map to all and sundry. If only I could have had a clear path to the patient, I would be happy to perform assessment along with vitals, knowing I had taken them accurately, interpreted them on the spot, forged a relationship with the patient that would have lasted the entire shift. But no, I'm "busy" waiting in line with the other RN's for a crack at the ice machine, so the patient will have water when I bring the 0900 meds at, say, 1130. I digress. The point I'm trying to make is: instead of agitating about a co-worker's attitude, perhaps what is needed is a collegial re-distribution of duties that would make more sense for the unit, thus the patients. It doesn't take much more time for the nurse to trundle in the glucometer, the insulin, the patient record/sliding scale/whathaveyou and get the whole process taken care of in a streamlined manner (please note my moniker). While the nurse is waiting for the machine to read the BS, she/he could inquire about pain control, could teach a little, could exchange a pleasantry, could help re-orient. I say divvy up duties in a way that makes sense, make sure all involved understand the rationale for how work is delegated, do what you can to keep from walking back and forth, and for crying out loud, get along.
  2. by   Stargazer
    Excellent points, and excellent post, Streamlined. Welcome to the board!
  3. by   RN auditor
    I think the nurse on the team has a responsibility to set an example. If you work as a member of the team, treat the residents with respect as well as the CNAs, they will respect you back. When you have free time do you ask the CNAs if you can assist them with anything? Do you give patients a bath or paint their nails just because you have nothing else to do. If you take the time to do this, the CNAs will respect you and want to work on the same team as you. Lead by example, not barking orders demanding compliance.
  4. by   Stargazer
    When you have free time
    Do you give patients a bath or paint their nails just because you have nothing else to do.
    The who in the what, now?

    Seriously. Does any bedside nurse have this kind of time anymore?
  5. by   RN auditor
    I did hav ethat kind of time when I worked in a nursing home. I loved it and truly felt I could give individual attention. Maybe I worked in a place that was better staffed.
  6. by   lateblumer
    I can understand your point. Some of the CNA's at my place, won't do anything I ask them to do because I started out there being trained by some of them. I got my license and now work as an LPN in our unit. They are rude and disrespectful about everything. If I ask them to help me do something, they look at me as if I asked for their firstborn. If I say Please and Thank You, they ask me why I'm being so nice to them. If I tell them to do something for the second or third time , they say I am a -----well you know. I can't win either. They swear, eat, and flat out say they won't do something in front of our residents.
    Management???? What a joke! She is only concerned about filling the beds. If the CNAs go to her with a complaint, she listens and reprimands those accordingly. If one of the nurses' goes to her with a complaint, we are told that we are being to hard on them, or maybe we don't realize the complexity of their positions. (?)
    Any suggestions for this?
  7. by   Riseupandnurse
    There are definitely two different issues here. The first issue has to do with lack of cordiality and proper intraemployee relations. This is a matter for administration. The second has to do with the duty of a nurse towards a patient. If a nurse believes a patient must have a blood sugar done at a certain time, and has good reason to think a CNA won't do it, then the nurse must do it. The welfare of the patient comes first, and the nurse owes the patient the performance of the duties that secure that welfare. This is totally independent of what a facility does or doesn't want a CNA to do. The nurse is physically present, has assumed care of the patient, and must make the minute-to-minute decisions for that patient, based on education and experience and founded on what specifically is going on with that patient at any given time.

    The standard here is your state Nursing Practice Act, not what a nurse personally believes, or even what a facility's policies are. A nurses's right to practice is granted by the state Board of Nursing, and a nurse's duties and responsiblities are strictly defined according to the Nursing Practice Act. All job classifications addressed in the Act are clearly related in terms of who is responsible for supervision.

    I used to be a CNA and now have been a nurse for 11 years. Some nurses are rude, and so are some CNAs. None of this really matters in terms of what the duty to the patient is. A CNA may not abrogate the determination of what a patient needs from the nurse, and the nurse remains personally responsible for the appropriate delegation and execution of all nursing functions that involve a patient's health and welfare. This includes functions that either the nurse or the facility have delegated down to the CNA. It's still the nurse's patient, and the nurse must accept that all acts directed toward the patient by nursing or nursing assistants are ultimately the nurse's responsiblity.
  8. by   rebelwaclause
    Originally posted by gojack
    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!
    Advise? Remember its all about the patient, and really not about us at all. We get a paycheck and the thought that we can walk outta some heinous looking stuff we see in nursing people - With our legs, eyes, heart, blood and all working just fine. Patients aren't this privileged, so it makes me a little more humble when I don't get "props" for the work I've done during my shift.
  9. by   cargal
    Originally posted by lateblumer
    I can understand your point. Some of the CNA's at my place, won't do anything I ask them to do because I started out there being trained by some of them. I got my license and now work as an LPN in our unit. They are rude and disrespectful about everything. If I ask them to help me do something, they look at me as if I asked for their firstborn. If I say Please and Thank You, they ask me why I'm being so nice to them. If I tell them to do something for the second or third time , they say I am a -----well you know. I can't win either. They swear, eat, and flat out say they won't do something in front of our residents.
    Management???? What a joke! She is only concerned about filling the beds. If the CNAs go to her with a complaint, she listens and reprimands those accordingly. If one of the nurses' goes to her with a complaint, we are told that we are being to hard on them, or maybe we don't realize the complexity of their positions. (?)
    Any suggestions for this?
    You took the words right out of my mouth.
  10. by   michelle95
    RN auditor, did you even read my post? I believe I said that I take people to the bathroom, put them on the bedpan and have even put every one of my patients in the bed because the CNA couldn't be found. Please reread what I wrote. I think I see a lot of 'communication problems' on this board.

    jan, as a matter of fact, the next day, I made sure to get my own blood sugars to keep any confrontations from happening. The CNA? I think she was a little upset about that. Oh well. I didn't have to bother her, now did I?
  11. by   michelle95
    Rn auditor, did you happen to be a floor nurse when you were painting nails or were you a supervisor, by any chance?
  12. by   Ortho_RN
    michelle95.. if you reread RNauditors post she said the she was able to paint nails when she worked at a Nursing Home..
  13. by   kids
    Originally posted by nurs2b
    michelle95.. if you reread RNauditors post she said the she was able to paint nails when she worked at a Nursing Home..
    Having spent my first 6 years as a nurse in nursing homes I have to ask...why does it make it different if she was working in a nursing home when she was painting nails?

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