What do you expect of a CNA?

pebbles, BSN, RN · Sep 12, 2002

I'd like to add that the tasks and mental work that are expected of you will differ depending on the unit where you are hired. Anything that isn't in your training, you'll be oriented to "on the job". Some wards in our hospital, the NA's don't empty colostomy pouches, some they do (for example). I work on a trauma unit, and I recently found out that "logrolling" technique is NOT part of the NA course here... we have to teach all the new ones on the job about how to do it and the importance, etc.

Also some wards, you'll get more of an atmosphere of teamwork than others. Some places you'd literally be treated like a menial servant to do the tasks that nurses feel are beneath them. (Not on my unit - I was an NA before, and thats part of why I chose to work someplace else as a nurse, I like teamwork.) Your best bet is to shop around, talk to other CNA's in your area and find a work environment that suits you.

What you'll be allowed to do, and what you'll be responsible for - that is a product of your state's nurse practice act (dictates what you have to be an RN or LPN in order to do, so some things can't be delegated to CNA's), plus your hospital's policies.

NA's in my hospital can't do vitals or blood sugars. They do personal care and hygeine, toiletting, they help pt's mobilize as advised by the nurse (assisted walks in the hall, etc). They assist the nurses and physios with activity and mobilization. They help us get pt's on and off stretchers to go for tests. Change bed linens. They are responsible to mark down intake and output. They deliver trays, and measure what pt has eaten or had to drink. They empty and measure foley catheters, urinals and hats. Turning and changing pt's every 2 or 3 hours as needed. Plus other things that may come up, as long as it doesn't require a nurse. (Night shift NA's do a lot of restocking as well).

My pet peeve is NA's forgetting to mark down a pt's urine output, and I have to ask them later, hoping they remember. On the whole, I love our NA's though... they are terrific with the pt's and it's a pleasure to work in a team with them. :)

peter73 · Sep 12, 2002

My expectations are simple, I think.

I expect no less from my CNA then I expect from myself or any other nursing staff on the floor.

1. Professionalism. Treat the patient/resident as a person, be available to questions and concerns. Know when to refer them to another team member for answers outside your practice area (even if you know the biopsy was malignant it is not for a CNA to break the news). Carry yourself as the vital part of the nursing team, and never refer to yourself as "just the CNA" If you say/believe that, expect others to as well.

2. Responsibility. Accept and act on your duties as assigned and/or outlined in job description. Know your duties and plan your shift accordinly. If somthing is found outside the "normals" bring it to my attention. If you miss somthing or do not fully complete it, tell me. Do not "cover things up" I will find it. Every one gets bogged down at times and gets behind.

3. Duties. Ask for help. If you get behind tell me and ask for help. If you are ahead of schedule offer help to others. If you do not understand somthing or don't know how to do it ask. Know one knows everything or can do everything unassisted.

4. Conduct. Behave as a professional. No talking about other staff, MDs, patients at the desk or in a room. Arrive at work on time and in uniform. Breaks as assigned or as allowed (I don't care how many breaks you take if your work is done and done well and I know where you are), and let me know when you go. Don't fuss when I ask you to do somthing, there is a reason for it. Do not think that the nurses "sitting" at the desk are just in social hour. We are charting, calling MDs, reviewing labs, planning care, or looking up information etc. Even if you do not like someone personally, always be polite and professional. You are not here socially, you are here for the patients/residents.

5. Knowledge. Ask questions about conditions, proceedures, history, etc. The more you know about your patients/residents, the more you can understand why they may behave or respond in a certain way. That will help you to get your duties done, let you know what to expect and how to interact theraputically with them as well as avoid potential problems. The more you know the more effective you are.

well, I think that is the basics I have learned so far in my travels as a CNA, LPN and Rn student (nursing home and hospital)

peter

alwaysthere · Sep 12, 2002

Where do you guys work??

quote:

'Can I please come work with you nurses? At my LTC i am a CNA and am treated like I have an IQ of 6 and the nurses would never help me in fear they would get BM on their uniform that has never been soiled.

And that is why I am becoming a nurse, so I can treat CNA's with the respect they deserve (those of us that do deserve it anyway). I think it should be a requirement to be a CNA before becoming a nurse so you will learn what we go through. Thanks for letting me vent

Jessica'

Been doing this for five (or so) years now, have worked psych and HH, and due to working HH know more than the average CNA, work on a rehab floor right now and am still treated like i have no sense....I know my job....you do not need to explain to me why the pt needs to be turned every two hours...and you do not need to remind me every two hours to turn them....i have a watch and a report sheet...if something is amiss with one of my Pt's beleive me i will tell you..i know that 160/20 needs to be reported and i do so ...because more than likely i know them better than you (our floor is usually staffed entirly agency different ones every night) and if i have ANY question I WILL ask you, i want you to tell me what you know, so i can better help my pt's. i always want to learn (thats why im in nrsing school)...when i tell you what is wrong with a pt listen to me! dont just say ...oh i saw her/him the're fine... if I tell you of a complaint they have pay attention! i know when it is just anxiety and when it is not...

quote

' i expect a cna to WORK with me.

work being the key word. we are a TEAM.

at our hospital they take vitals, put in foleys, draw labs (unless its from a line) accuchecks, specimen collection, and hygiene.

i dont expect them to do more than they are supposed to.

i DO expect them to treat our patients and their families with respect. i do expect them to come to me and tell me what the status of our patients are. if there is anything abnormal or unusual for the patient in their vitals.

i expect them to assist the patients in the adl's as needed.

i would far prefer to do things with them ...like changing a patient, turning and repositioning, WITH them rather than tell them what needs done.

i DO expect them to know what their jobs are and i DO expect them to tell me where they are. i dont care if they go outside and have a million cigarettes as long as their work is done and i know where they are.

i dont appreciate having to look for them for hours at a time. '

you my dear are a rare and unusual creature....I was always taught that nurse and aide were to be a team ......unfortunately it seems that those who taught me missed telling the other nurses and aides.....i love when a nurse will be team with me ... it makes life so much easier for me AND the nurse....not to mention together we can adress any patient concerns right then and there... and if you smoke for heavens sake get your work done before you leave me to cover for you ( i am the only non smoker on my unit) and wether your a nurse or an aide let me know where you will be so i can get a hold of you if i need to......(we dont have a evening shift charge for our floor)...

quote

'Also some wards, you'll get more of an atmosphere of teamwork than others. Some places you'd literally be treated like a menial servant to do the tasks that nurses feel are beneath them. . '

Im here to learn and to take care of my pt's and while things that some people would consider meanial are part of my job they are only part of it....useing me strictly in that capacity are a waste of what (little comparatively) skill and experience i do have...

quote

3. Duties. Ask for help. If you get behind tell me and ask for help. If you are ahead of schedule offer help to others. If you do not understand somthing or don't know how to do it ask. Know one knows everything or can do everything unassisted

asking for help generally getts the response....im busy...from both nurses and aides...your expected to manage your own section by your self... i hate when the nurse that is assigned with you wont even help his/her own pt's.... your not doing this for my benefit your doing it for your pt's!!

5. Knowledge. Ask questions about conditions, proceedures, history, etc. The more you know about your patients/residents, the more you can understand why they may behave or respond in a certain way. That will help you to get your duties done, let you know what to expect and how to interact theraputically with them as well as avoid potential problems. The more you know the more effective you are

which usually evokes the response.... your just an aide you dont need to know that stuff.....just get em in to bed and keep them clean....like i said earlier i want to know as much as i can about my patients it makes me a better caregiver....and will make me a better nurse (once i finish all this studying!! :eek: )

this can all be a very disheartening attitude and if i didnt know that nursing is my lifes work then i would probably have gotten out a long time ago.........

Oh well despite all of this i still love it.... :rolleyes: :kiss

rebelwaclause, ASN, RN · Sep 12, 2002

Great thread. I'll be back later to post a rather long response.

brown rice · Sep 13, 2002

Hey Wendy,

you started a great discussion. I have been working as a C.N.A. for two years now and I have had to deal with some poor treatment and back-breaking work. Plus we are way way underpaid! Cause like someone above pointed out sometimes there are 10-15 patients to one C.N.A. I refuse to do that work for the pay of $9-10 an hour. you are literally running around for the entire shift and frankly it is not worth it, I'd rather work for less doing something less challenging so that I am not tired for two days afterwards. SO my point is it is good that you are doing this in the middle of nursing school so you won't get stuck being a C.N.A. - or find a private job. On a more positive note I have learned some very helpful skills, -how to be quick, firm and gentle when moving someone-key word is firm grip-which use to scare me, but you have got to have a good hold of the patient, also how to talk to people and many more helpful skills that will be less things to learn when I am finally a nurse. good luck to you!

live4today, RN · Sep 13, 2002

What I expect from a CNA is no more.....and no less......than they were trained to give as a CNA. And having been a CNA Clinical Instructor before.....no CNA can fool this nurse about what they can or can't do. :nono: :chuckle

Keeping it short, cause it's late. I'll do better tomorrow. Nighty night all!

TheLionessRN, RN · Sep 13, 2002

I absolutely love having a good CNA! You can make my job so much easier when you know what is going on and try to do a good job.

I expect my patients to have a pitcher of water handy at the bedside before I start passing meds on my 10-12 patients, so I don't have to stop what I am doing and get them the water.

When I am setting up and passing meds, I expect you to be out there, on the floor, answering bells and either do what is asked or decide what I need to know immediately. I want you to use your judgement and not say you are "just an aide", because you are too important to the team!

I want to know when there is something abnormal about v/s or if you notice a change in the patient from baseline. I want you to chart what you do, because your input on that chart is important!

When I get a new admission, or 2 at the same time, I dont' want to have to ask or tell you to go get the room ready and get an initial set of v/s. You know you are supposed to do this already.

I have always been loved by my aides because I help in direct patient care whenever possible. I am not too good to clean up a patient, or run and get them something if the aide is busy. I do have a problem with seeing aides sitting around the station while the licensed folks are in the middle of chaos. ASK if you can help, you will be suprised at how happy it makes someone when you simply offer to help.

Even if you are not working with the greatest bunch of folks on a particular day, make sure that you always seek excellence in your practice. Never underestimate your ability to be a good example that will spread to others.

Sleepyeyes · Sep 13, 2002

I was a CNA for many years, and a nurse for a few. Occasionally, we do primary care on our unit, which only means that we don't have a CNA, so we get to do it all.

All I ask is this: cut us some slack. You guys can leave on time; we go nowhere til we finish that paperwork and call that doctor about that unclarified medication.

I enjoy doing patient care, I'm not "afraid to get my hands dirty," and was considered a stellar CNA when that was my job title (with up to 30 pts in LTC on 11-7), but it's annoying to hear a bed alarm go off and see the CNA's (sitting at the desk gabbing) expecting the nurses to stop what they're doing to jump up and prevent a Pt. fall.

Or when I have to ask a CNA to do something and I get that "I'll get to it when I get to it" thing. :rolleyes:

I'm really not this grumpy to work with, honest. :chuckle

adrienurse, LPN · Sep 13, 2002

Please, I am not your mother. Don't make me remind you of when your shift is supposed to end and to take your jacket off and please answer that call light.

nursenoelle · Sep 13, 2002

I was a CNA for 3 years, became an LPN, now becomming an RN, Funny I felt more like caregiver back the. You will be the voice of those who cannot speak for themselves. My CNAs are the gaurdian angels of the residents. You see things that the nurses running all over the place don't. It is a bigger responsibilty than most acknowlege. Good Luck in your new career

ktwlpn, LPN · Sep 13, 2002

Originally posted by teddybear
WENDY,
HI MY NAME IS MARIE, AND I AM A CNA.I WORK AT A NURSING HOME RIGHT NOW,BUT I TOO AM PLANNING TO GO TO LPN SCHOOL NEXT SUMMER.I WILL TELL YOU SOME THINGS WE ARE EXPECTED TO DO.WE ARE TO LISTEN TO THE REDS. CARE FOR THEM BE THERE MOTHERS AND DAUGHTERS AND THERE BEST FRIEND IF NEED TO BE.WE CNA'S KNOW MORE ABOUT THESES REDS THEN THE NURSES DO,BECUASE WE ARE WITH THEM ALL THE TIME.I CLEAN THERE BM'S IF THEY WET I CLEAN THEM UP,I ALSO CLEAN THERE BM BAGS ,THOSE WHO HAVE THEM,( I KNOW WHAT THERE CALLED ,JUST CAN'T SPELL IT......HAHA).I HOLD THERE HANDS WHEN THEY HURT ,AFRAID AND WHEN THEY ARE DYING.AND YES WE HAVE NURSES THAT WON'T DO A DANG THING BECAUSE THATS OUR JOB,NOT THERES.I THINK THATS BECAUSE ALOT OF THEM HAVE NEVER BEEN A CNA BEFORE THEY BECAME A NURSE.AND THERE ARE A LOT OF CNA'S THAT THINK THEY ARE BETTER THAN YOU AND THEY JUST WON'T DO ANYTHING TO HELP YOU BECAUSE THEY THINK THEY ARE NURSES.I DO I& O'S ,VITAL SIGNS,MEAL CHARTING,AND IF THER IS ANY SKIN BREAKDOWNS I TELL THE NURSE.I L9OVE WHAT I'M DOING,BUT IT DOES GET DISCOURGING AT TIMES.GOOD LUCK IN GETTING YOUR CNA'S LINC.
LET ME KNOW HOW YOU DO.
MARIE

>>>>>>>>>>#1-GET A CLUE-you must first realize that the nurses have very different responsibilities then the cna's.When a cna may think that the nurse is sitting at the desk not doing a darn thing the nurse is actually completing the mounds of paperwork required by the agencies that govern us (I am speaking specifically of long term care ) When the cna's are leaving my unit at the end of my shift I usually have a few more loose ends to tie up-I have been trained and am capable of doing their job however they can not help me complete mine...The staff on my unit are my eyes and ears-and need to come to me right away and report any changes they may observe...I know what to do when there is a problem....the cna's probably know more about each resident's routine (who wears a bra as opposed to an undershirt) but I know their diagnosis,meds and possible side effects...Many of my resident's would say that eating bathing and dressing and getting to the bathroom are way more important to them then getting their meds on time-but the state says differently.I believe that both of our jobs are equally important=fighting with each other just tears us down.We need to work together and build each other up-for the good of our patients....I also do not refer to the grown men and women of my unit as "my girls or my cna's"I find that demeaning. They are not children and they are not mine-they are there for the residents.I prefer calling them nursing technicians.....