New LPN troubled with CNA's

Marie_LPN, RN, LPN, RN · May 26, 2004

that would work if the patient load would be 3-4 per nurse for med- surg. anything else is just not safe.

Depending on the kind of pts. (even on med-surg) 3-4 could even be too much.

BRANDY LPN · May 26, 2004

I can kinda see how getting rid of CNAs in ER might be doable, but the original post is referring to LTC and when you have anywhere between 30 and 60 pts that is just not realistic. CNAs are a valuable part of the healthcare team when they are mature, responsible and well trained, and thankfully most of the aides I have had the pleasure of working with have been.

Darlene K. · May 27, 2004

The solution is to get rid of all CNA's...they never have, nor ever will, be worth the effort to keep...I got rid of a boat load a few years back at an ED that I directed, and with the money saved, gave all the full time staff raises to the tune of $8-10.00 an hour per RN. The complaints about never knowing where the aids were were gone, and the RN's did not mine doing the additional scut work, since the hefty raises more than made up for the abscence of no loads.

Not all CNA's are "no loads". :uhoh3:

RN34TX · May 27, 2004

That's my suggestion. This is similar to a previous discussion I remember about CNA's. The ER nurse had a great solution for that type of setting but I guess we are talking about LTC. How you would phase out CNA's in that setting I couldn't begin to imagine. As many great CNA's I've worked with in LTC, there were just as many bad ones, sad but true. I got out of the business altogether because the liability scared me. Working in an ICU setting where I do everything myself and not have to keep track and depend on a CNA made a world of difference to me. I remember my last job in LTC where the DON said it like a broken record when something wasn't done - "The nurse is ultimately responsible!!"

The end of my career in LTC was my reply to her and all DON's in LTC's across the country:

"If the nurse is so ultimately responsible for the CNA care provided or not provided, why do I have no say as to who works here and who does not?

It's my license on the line yet I'm basically forced to allow whatever bottom of the barrel CNA you hire to put their hands on my patients and I'm supposed to constantly babysit them and take their abuse. If you want to hire them, you can be responsible for them."

TBLPN, LPN · May 27, 2004

Finally, someone who really put it out there the way I feel!!! It's crazy. I have such a hard time being "responsible" for everything and anything the CNA's do. I love LTC, I don't want to leave it, but I'm not sure I have much choice. I really thought I could make a difference there. And to top off all that went down between myself and the CNA's now the DON and ADON have called a meeting with the 4 CNA's involved and the two nurses involved (one of them being me). It's scheduled for tomorrow. I'm hoping the DON backs us up and let's them know that we are the one's in charge and responsible. But I'm not sure that is going to happen. The ADON is already mad at me and the other nurse because we said we didn't feel like she backed us up, and truly she didn't. She allowed the CNA's (all of whom are supposed to be grown women) scream at us (the 2 nurses) and at her. You could NOT hear yourself think in there. And I decided that I was not stooping to their level. If a meeting could not be conducted in a mature, professional, and rational manner, then I didn't want to be a part of it. The only thing that truly was reinforced was that they were "good" CNA's. That's it. Nothing about you need to deal with these issues with the charge nurse and they are in charge, they are responsible for the unit, nothing. Our DON is a little more "vocal" and she has promised me this will go well and all will be fixed. She kept telling me not to "bail" on her and to give her a chance to fix this. But what was even more upsetting was that she told the other nurse who is involved that she is tired of these CNA's running off her good nurses........how is that even possible????? How can 4 CNA's be let to run amuck like this and no one say anything??? I just don't understand. As I said, I was a CNA before I was a nurse, and I would have never dreamed of speaking to any of my charge nurses the way these 4 spoke to us and the ADON. I'd like to say it's the age, but they are all in their mid 20's except one, who is 40+........I even had another nurse that works days tell me these CNA's are the reason she left weekend opt in the first place.......:angryfire I just don't get it I guess. But what it boils down too is that I really like my DON, she's been more than helpful and understanding with all my questions being a new nurse. She always tells me to call her if I need her, and I do, and she is soooo nice about it. I just hope she is going to do the right thing. I worked 3-11 Mon-Fri up until about 2 months ago, and I never had a problem. I loved working there, I loved my job!! No so now!!

That's my suggestion. This is similar to a previous discussion I remember about CNA's. The ER nurse had a great solution for that type of setting but I guess we are talking about LTC. How you would phase out CNA's in that setting I couldn't begin to imagine. As many great CNA's I've worked with in LTC, there were just as many bad ones, sad but true. I got out of the business altogether because the liability scared me. Working in an ICU setting where I do everything myself and not have to keep track and depend on a CNA made a world of difference to me. I remember my last job in LTC where the DON said it like a broken record when something wasn't done - "The nurse is ultimately responsible!!"
The end of my career in LTC was my reply to her and all DON's in LTC's across the country:
"If the nurse is so ultimately responsible for the CNA care provided or not provided, why do I have no say as to who works here and who does not?
It's my license on the line yet I'm basically forced to allow whatever bottom of the barrel CNA you hire to put their hands on my patients and I'm supposed to constantly babysit them and take their abuse. If you want to hire them, you can be responsible for them."

pgrsctrn2be · May 27, 2004

Been there too! :crying2: I left LTC because of CNAs with attitude. Where I worked the night crew was so lazy, took breaks way past the time allowed, complained about everything and everyone on the other two shifts. Left long notes to the DON and ADON about everything the charge nurse (me) did or didn't do. Most if the time if my work wasn't finished it was because I was turning and drying the residents instead of pencil pushing (so bad of me). Finally I started keeping a log of everything and documenting each time I made a request of one of the CNAs as well as loging my activities during the shift. Anytime the DON called me into her office I took the log book, didn't take long for things to change. Of course had a whole new crew to train on the shift but things went better for a while.

Another theory on the behavior of some CNAs is jealousy (sp). They want your job but not the hassle of going to school to get it.

Betty_SPN_KS, LPN · May 27, 2004

I'm also a new nurse, a GPN, working night shift in LTC. I dread conflicts like this.

I remember one day at Med-Surg clinicals, there were no aides on the floor that day for some reason. Each student nurse could take a couple of pts. and the nurses did TPC (total pt care) on the rest. It worked that day (as far as I know). However, I can't imagine nurses doing TPC in LTC. How many nurses would be needed for 30 or 40 residents? There are some great aides, thankfully.

NursesRmofun, ASN, RN · May 27, 2004

I am a new LPN. I have had my license for 8 months now. I have worked at my current facility (LTC) for 7 months. But I recently changed shifts. I now work weekend opt. I love the hours and being able to be at home all week with my kids, but the CNA's that work my unit, well, basically are horrible. They have worked this shift for (most of them, there are 4) at least 2 years. They are good aids for the most part. They only work 16 hour shifts Sat. and Sun., which in my opinion is too many hours for any CNA to work. Being a CNA is hard work, I know, I was one before I became a nurse. I have a lot of respect for CNA's, but only for those who have respect for their charge nurses, which they do not. They truly feel they run that unit and anything the charge nurses ask them to do, they take great offense too. Unfortunately about 2 weeks ago, I had a horrible experience with a patient who climbed out of bed and fell face first and hit the floor. This patient suffered some pretty serious injuries. I felt horrible, had to endure a lot of paperwork and sit in on many meetings with my supervisors, luckily the patient is fine, and is back with us. But now I am even more cautious and aware of what is going on on my unit.......

I feel your pain, but it is true that you have to take the upper hand immediately....and you can only do this effectively if you have the backing of your supervisors/managers/DON! The supervisors/managers/DON have to be willing to say that if you write these CNAs up for insubordination or anything else say 3 times, that they are OUT. Fired. Period. If they think they will lose their job, that may work.

Betty_SPN_KS, LPN · May 27, 2004

Another theory on the behavior of some CNAs is jealousy (sp). They want your job but not the hassle of going to school to get it.

Reminds me of an aide one day during clinicals. She told a classmate of mine that she was checking our work (water pitchers, etc.) because we were working under her license. When I heard this, I thought: Excuse me, I thought I was working under my instructor's license, not a CNA's. :chuckle

Our theory was she may have been jealous because she had applied for our school and didn't get accepted. Oh well, no reason to get upset at her.

Marie_LPN, RN, LPN, RN · May 28, 2004

Quite honestly i can't agree with the jealousy theory. Jealous of the job (nurse) that has a similar kind of understaffing issues as NAs, yet 5 times the responsibility? Please point out what's to be jealous of, because i am not seeing it.

Betty_SPN_KS, LPN · May 28, 2004

Whether it's jealousy or not, many of them just don't see the load we're under. To them it looks like our job is easier than theirs. Many of us have been aides before. How many of them have been nurses before? (I know of one.)

I can't speak as one with a lot of experience because I'm just getting started as a nurse, but I know there's a lot more involved than I realized when I was a CNA.

Being in charge is going to be a difficult part of my job, because I'm not naturally assertive. I avoid conflict whenever possible.

unknown99, BSN, RN · May 28, 2004

The solution is to get rid of all CNA's...they never have, nor ever will, be worth the effort to keep...I got rid of a boat load a few years back at an ED that I directed, and with the money saved, gave all the full time staff raises to the tune of $8-10.00 an hour per RN. The complaints about never knowing where the aids were were gone, and the RN's did not mine doing the additional scut work, since the hefty raises more than made up for the abscence of no loads.

Are you for real?????? I just cannot imagine that you really mean that!!!!

The CNA's that I work with are a real asset to our hospital. They can work circles around most of us nurses.