RN/CNA dynamic where you work?

[backatit2]

what is the dynamic between the nurses and CNA's where you work?

i am getting ready to start an accelerated BSN program as a second degree. i had never worked in the medical field, but nursing had always been an interest of mine - and when i considered doing the second degree program, i thought being a CNA first was a good idea so i could get a little sneak peek as to what it's like working in a hospital and have some idea of what it's like working with patients as well as seeing what the nurses do. i've found that i LOVE working with the patients. it's way more rewarding than my previous career and i believe that i will absolutely enjoy being a nurse.

the ONLY downside to my job so far has been the interaction between myself and the nurses. don't get me wrong - i'm sure they are great nurses, BUT some of them drive me absolutely NUTS.

when i first started my job (i work night shift btw) i was warned about one nurse in particular and was told to "just ignore her," so when i worked with her, i expected it to be hell. i was told she "picks on" the new employees. come to find out - she's the best nurse on the floor IMO. she hasn't "picked" on me whatsoever. she DOES ask me to do things and points things out to me (like if something was supposed to be charted that wasn't) but i appreciate that because i WANT to do things correctly - i took this job to learn. she's the only nurse so far that i've seen who WORKS non-stop. you won't ever find her sitting at the nurse's station. she takes a short break to eat and she's usually the last one to do so. she does things for the patients that i have never seen other nurses do (including help clean BM's).

anyhow - there are usually 4 or 5 nurses working each night and they each have 4,5, or 6 patients a piece. there is one CNA and i have all of the patients which is anywhere from 20-24. i have to do vitals 3 times per shift and i was told each round of vitals "should" take about 1.5 hours. NOT! it seems like every single room i walk into the patient needs something whether it's a drink, medication (so i have to find the nurse), or they need to go to the restroom - or be changed. i'll be working on vitals for these 20+ patients and when i walk by the nurse's station, more often than not, there is a nurse who will say "room 10 needs to be changed" or "room 12 wants some water" and i can't help but notice that they're sitting there texting on their blackberry, eating food, or browsing the internet (yes, i'm sure they're browsing when i see they're on the "coach" website).

the other night i was working and i usually take my "lunch break" around 11:30 but it was so busy i wasn't able to. not a big deal. we get a 30 min. lunch which is taken out of our pay so of course we all take it - and then we're supposed to have two 15 min. breaks (paid breaks) besides that. it was 1:30 a.m. and i didn't have time to take my lunch break, but i had finished getting vitals and such so i sat down for a moment to call and check on my child who was at home with pneumonia (which i was considering a 15 min. break, if that). i had no longer dialed the number before a nurse came up to me and said "room X needs to be changed." of course after he told me that, he went and sat down and was sitting there cutting up with another nurse who was there doing absolutely nothing.

going back to the nurse i was told to "ignore" - when i do my vital rounds, she is the only one who i will EVER find to have done vitals or chart on her own patients. yes, it's not her job and she doesn't have to do it, but i think she does it because she SEES that i have 20+ patients, that i'm ALWAYS working instead of sitting around, and she appreciates that. i think the nurses/cna's who told me to "just ignore her" don't like her bc when she sees them sitting around, she finds something for them to do.

i went into a room the other night and this guy had wiggled around in such a way that his JP had leaked all over his bed. so, his bed and gown all needed to be changed. his nurse handed me a clean sheet/gown and said, "while you're doing that, i'll get his meds." well, getting his meds. took all of about 30 seconds and while i was still there changing his bed, helping him into a new gown, and getting his vitals - she had vanished and i was stuck in that room for a good 20 mins. which would've taken maybe 10 mins. had she helped me. instead, she rushed back to the nurse's station to sit and talk. i'm thinking, "how can i get 20+ patient's vitals in 1.5 hours when i'm in one patient's room for 20 mins?"

fast forward - i had put an elderly lady who was nearly 400 lbs on a bedpan and when she was ready to be taken off of it the nurse was there giving medicine. i'm there trying to turn this lady BY MYSELF and clean her up when the nurse sits down her med cup and says, "there's your meds when you're finished." SERIOUSLY? would it KILL you to put on some gloves and help hold this woman or is the chair and google screaming your name that badly?! i mean, you don't have to wipe the crap, but at least hold 200 lbs of her so that i can! i swear to god there will be 3 nurses sitting at the station with the phone beeping (the call light) and they will let it beep and beep and beep. same concept - you don't have to take them their drink or whatever they want, but will it KILL you to pick up the phone and ASK what they want?! i've gotten to where i'll answer a patient's call light and i won't hit cancel in their room just for fun to see how long the nurses will sit there and listen to the phone beep. another example - a patient needed tele hooked up and a nurse walked back as if she were going to do it, but when she realized she had to put on a mask bc the patient was a possible TB, she came back and asked me to do it. she was initially going to do it bc i was so busy and she wasn't, but once she realized she'd have to put on a mask (suuuch effort) she changed her mind. i could go on and on with examples.

it's to the point where i'm considering telling my supervisor that i'm going to have to switch to a PRN schedule due to my school course load because i'm afraid if i keep working full time and having these encounters i will SNAP on someone and ruin my chances of working as a RN when i finish school.

i realize there are certain tasks that are the CNA's job and certain tasks that are the nurse's job, but when i'm working so hard that i don't get a break and my feet are killing me while the nurses are playing on the internet and cutting up - i can't help but think, "i am the nurse's ASSISTANT. i'm there to ASSIST - not do everything!"

i'd just like to say thanks to all the nurses who appreciate the assistants and pick up the slack, and once again ask - what is the dynamic between the nurses and the CNA's where you work? i hope it's better than mine.

[loriangel14, RN]

Where I work it doesn't work like that at all. Yes the aids are there to assist the nurses but ultimately it is the nurses responsibility to ensure things like vitals are taken and charted. If the aids are too busy then you are responsible for doing it yourself. If you find a patient that is soiled or wet YOU change them you don't go and tell someone else to do it. Ultimately all aspects of patient care is OUR resposibilty. If something is not done you cannot get away with blaming the aids. If you know something wasn't done and you didn't do it yourself you as that patient's nurse are held responsible. Sitting down and taking a break is NOT done if the aids are still trying to get patient care done. You state that certain tasks are the CNAs tasks and certain ones are the nurses tasks, well where I work there is nothing the aids do that is not also our job.

[Crux1024]

Honestly, youre doing too much and there no reason the Nurses cant clean up their own pts or help you change beds and such. I do it all the time. I suggest, if youre not able to change the way the nurses are (it doesnt sounds like it) or speak to management, that you drop your hours for school. Your success is your goal and it sounds like they dont care.

Also, do yourself a favor. When youre on break or lunch, announce it to the charge nurse and then go where you cant be bothered (or found). You deserve your breaks and lunches. Good luck.

[backatit2]

that's awesome. i said there are certain tasks that are the CNAs and certain tasks that are the nurse's because there are things the nurse has to do that the CNA can't do - so while the nurse get those things done (like passing meds) the CNA is doing other things (like vitals). but yes - i stop what i'm doing to let the nurses know a patient is requesting meds which can take several mins. by the time i find them - so i figure if they are finished doing their tasks, they should help do what's not finished considering it's not like i'm sitting down eating popcorn. i've been told i could get my rounds done faster if i told the patients that "it will be a few minutes" when they ask for something like a drink or a blanket, but i don't like to do that. i figure if they don't push their light to ask, but wait for me to come into the room - they have probably been waiting for awhile - and plus i'm afraid i'll forget - so i stop what i'm doing and get what they ask for right then. maybe it's a fault, but i'm caring for people who can't care for themselves so i just can't tell them, "sorry, you'll have to wait." i don't have it in me. at the same time, i think caring for the patients like i do and like anyone would WANT their loved one to be cared for puts me in a bind bc i always seem to be strapped for time. i'm always the last one to take a break and i don't think if i'm still running around like a chicken with my head cut off that the nurses should be sitting down relaxing. with the exception of that one nurse, that's how it always plays out. one thing is for certain - it's given me some good insight and i know it'll make me a better nurse and team player.

[backatit2]

Honestly, youre doing too much and there no reason the Nurses cant clean up their own pts or help you change beds and such. I do it all the time. I suggest, if youre not able to change the way the nurses are (it doesnt sounds like it) or speak to management, that you drop your hours for school. Your success is your goal and it sounds like they dont care.

Also, do yourself a favor. When youre on break or lunch, announce it to the charge nurse and then go where you cant be bothered (or found). You deserve your breaks and lunches. Good luck.

the last night i worked i actually did go to a different floor for my lunch break because i knew if i took my lunch to the nurse's station, they would interrupt me to do stupid things they could do on their own! i'm sure there are CNA's who don't do their jobs like they should, but i'm not one of them so i don't think i'm being unreasonable. like i mentioned - my son had pneumonia and i still went to work - i enjoy work and i want to be there - but even giving 110%, i always feel rushed and stressed to get everything done bc i'm constantly interrupted and asked to do things even when others are sitting around relaxing. it just floors me that someone could sit there and listen to "beep...beep...beep...beep" and be within arm's reach of the phone, but won't answer it because it's "not their job." i heard horror stories before i started, but it's still unbelievable to see.

[CoffeeRTC, BSN, RN]

Wow...at least in our LTC, there are more than just one CNA on per shift (well, two on 11-7 for 50 pts) but they work together.

We have some nurses that will help out and some that don't and some that would love to, but can't help as much because of all the running we are doing.

[Patchouli]

you need to go to the unit manager and address these issues with her. tell her the truth. either things need to change, or these lazy nurses will find themselves without a cna.

[Up2nogood RN, RN]

If the nurse is able to help with her patient than she certainly should. The nurse is ultimately responsible. Remember you are there to assist, not do it all. I've been on both sides of the fence and it really burns me up when 3-4 nurses will be sitting around while call lights are going off like crazy. You will have to learn to be more assertive and speak up for assistance from nurses.

Once in awhile I have to float to another floor and am used as an aide instead of a nurse. If I'm getting vitals I tell the pt that. If they ask for something besides water or whatnot I tell the pt I'd be happy to pass that request on to their nurse (who is sitting on her big ol' butt right now). Don't bust your butt for them when they wouldn't do it for you and you'll survive as an aide longer.

[Traum-a-Rama]

I'm a new nurse, but my preceptorship was on a floor where the dynamic was such as you describe. I know the job market for all nurses, especially new grads, is rough right now, but I really, really am fortunate that I ended up NOT getting a job at said hospital. At the same time, I've also witnessed CNA's who "hide" and are never to be found.

I appreciate the CNA's and let them know that I value them. I couldn't do my job if I didn't have their help. I don't order them to go fetch this or that or change so-and-so. Instead, I "ask" them to "help" me re-position or change Mr or Mrs Paient.

My job as a nurse encompasses ALL aspects of patient care, even the not-so-pleasant tasks of toileting/changing/cleaning patients. CNA's, NCP's, Techs, whatever you want to call them, are here to ASSIST/HELP me, not do all the things I don't find as glamorous as shopping online.

Unfortunately, if you give 110% at your job, there will be people who will take advantage of you. I think it's wonderful that you are willing to get your hands dirty to learn nursing from the ground up (no pun intended). Your patients are lucky to have you. But, you're not superwoman! It's easier said than done, but you need to be more assertive. Walk up and tell them you need help changing "our" patient. I'd do what the above poster advised also.

Good luck in your nursing career and know that there are nurses who do value your help.

[JDZ344]

I work with a great team of RNs. One of them said to me once that "Mr. X needs to be changed. If you bring everything to the bed, I'll meet you there in 5 minutes; I just have to give some meds to someone else". They never expect us to just change someone ourselves. We consider it the job of the person who found the patient wet/dirty to clean them up, and to get help if needed.

If our nurses are really busy, they will say so, so we don't mind. There is not one RN who I have never seen change a code brown.

[tokidoki7, ASN, RN]

I agree that you must speak up to your manager as well as the nurses you work with. If there are no changes I'd cut back on my hours or try to transfer. I work on a similiar unit where the nurses have 2-4 patients (36 total) and most of the time I'm the only tech on the floor. Sorry, but if I'm the only tech on the floor and I see you on facebook or chatting with other nurses about your cruise, then you're doing your own accuchecks or vitals- take your pick. The nurses complain, but I've reduced my hours and they don't like that either. It's just unreasonable and selfish to believe that 1 tech is going to do everything. There has to be teamwork!

And never turn a patient by yourself! If you get hurt that turns into another sticky situation!

[Lovelymo79]

I agree with the others. Definitely talk to your nurse manager or try to put in for a transfer. That is absolutely RIDICULOUS!! I worked as a CNA on the floor before getting promoted to PCT in the ER. And I was lucky..I had great, helpful nurses that pitched in anytime I needed them. And whenever a nurse floated to our floor or I was floated to another floor..I let them know...I'm not moving ANYONE's 400 lb (or 300 or 200 lb) patient by myself. They need to be cleaned, moved, etc...then you need to help me and I'm not going to attempt to do so until you do! I'm not messing my back up at the beginning of my career..no way!

Also, you need to speak up to the nurses as well. Be nice..but also direct and let them know..you need help. If they huff and puff..oh well..they will get over it. You have 2 hands and 2 feet just like them. You are not an octupus.

Good luck!! I find that the nurses who were CNAs first make FANTASTIC team nurses! :)