Am I wrong to think... - page 2

by rmarz | 2,231 Views | 17 Comments

... that CNAs should do what the nurse tells them? I remember when I was a CNA, if a nurse asked/told (to me there really isn't a difference) me to do something. I went and did it. Tonoc I had the lovebirds working, and a... Read More


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    Write them up. All of them. Once they figure out that you are serious about pt care they will either step up and do the job they have been hired to do or move on. I don't ask a lot of my aides, so they know if I say "I need this done", they know to get it done ASAP, because I WILL be back to check in a few minutes. We also have sign-out sheets for breaks. They are to sign out and back in if they leave the floor, and they are required to tell nursing if they are leaving. If they are found to be on break without signing in/out, they are wrote up. It sounds harsh, but in order to run a tight ship we have to be tough on them. Nurses are also required to sign in/out as well to keep it fair. I smoke, so I forgo the standard 1x 15 min break for 2 shorter smoke breaks so I am not off of the floor any longer than what is allowed. My aides are allowed the same if they choose. That way, all are accounted for at all x's. It has only taken 1 or 2 write-ups for the whole staff to get the message that slackers will not be tolerated. Good luck with your crew.
  2. 0
    Thanks for the replies. I've had to deal with this time and time again... but I actually would like to keep this job. Being an actual nurse who doesn't turn a blind eye unfortunately puts you on the outs in most places. Its a little LTC, 27 residents, not many people work there~

    These CNAs were 2-10. Aides work 8s, while nurses work 12s. Its pretty easy to see what the CNAs left on the previous shift cuz I'm still there when they are gone, helping the 10-6 with bedcheck.
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    This is such a universal problem- as my husband says- you pay peanuts- you gets monkeys!! I guess in your case they pay birdfeed and you got da lovebirds.
    You've got lots of good advice here- nothing you didn't already know. Sounds like you can use a vacation. charge up your batteries.
    I never cease to be amazed at the way some of my staff can try to get away with (almost) murder. Why should I have all the fun---and YES i write them up=- all of them!!!! as I want to protect my license ( and u know what) and at least try to prevent a recurrence.
    I'd love to hear how this ends- any improvement?
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    I'm still tryin to get the DON to put out some disciplinary action forms...

    If the money and hours weren't awesome I'd run as fast as I could... team leaders think 0.125ml = 1/4ml. No TAR created for someone with a problematic SP on admit... ugh.

    As my dad says, "Collect 200 dollars and pass go." I guess so! Not like it would be any better if I left. Just watch my hours get cut now that I've spoken up =P
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    Keep your own diary- many DON's just want quiet and don't care what is really going on- it will eventually catch up to her- just do your job to the best of your ability- never let those lovebirds keep you from being professional and doing what you are supposed to be doing. I'm sure your patients appreciate you!
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    Today,

    It was a horrible day at work. My shift 3-11, at 3:30, I found my patient on the bathroom floor. He is on chair alarm. The worst of all is when the 7-3 Cna puts patient on the toilet and takes off without informing anyone. Even if she informed anyone, still she should not have left him alone. I had do neuro because we were not sure if banged his head. I also to do inservice because of that. It was 4:45 and another ten people to medicate. The food truck comes up at 5pm and then we cannot give any meds except PRN. The lights were blinking like a Christmas tree. Nurse here, nurse there, nurse everywhere I heard. It gets worst from here, but that is o.k. I'm glad I'm home.

    Raquel
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    Quote from rmarz
    ... that CNAs should do what the nurse tells them?

    I remember when I was a CNA, if a nurse asked/told (to me there really isn't a difference) me to do something. I went and did it.

    Tonoc I had the lovebirds working, and a new girl they were supposed to be training. The lovebirds already ran off the one good CNA I had on evenings, now who is gonna do all the work? lol They like to take about 5 30 min smoke breaks in an 8 hour shift. They did no bed check before they left, didn't take out the trash, didn't pass snacks, and thats just what I noticed!

    Now what really hacked me off... we have a res with a belt in his WC that beeps when it is unhooked. When he starts unhooking it, it usually means that he is wet. The lovebirds know this, as they are the ones that told me about this correlation. So I tell the lovebirds he needs changed, while they are at the computer charting (which is a one person job, but they are joined at the hip so they both have to sit there). I go pass some meds and come back, they are still sitting there.

    I get the wet res's meds ready and tell them they can go change him after I give him his meds, I then push him out of the DR and up the station where they are sitting. They say they will do it after they are done with the person they are charting on. "Ok, that works." I think. I go pass some meds, do some BS, come back... still sitting there, res in same place as before. Now his brief is saturated and I can tell he's wet by the smell and the big wet area on his gray sweat pants.

    I then look at the computer to see what res they are on, maybe they are just realy slow... go pass some meds, give some insulins, come back... they are on a different res on the computer and have not moved. I think my head started to spin around at this point, but I tried to hold back the anger... I asked them what the problem was, what part of what I asked them to do they didn't understand, I know what res you were charting on last time I left the desk, "If you have a problem I can call the DON and she can come up here and let you know what your real problem is." I asked them if they were wanting to be written up for insubordination, neglect, or both.

    They went and changed him after that. The hall smelled of terribad urine after this. I think I might have made them mad cuz they didn't talk to me the rest of the nite.

    We are short staffed as 2 CNAs have just quit, one dt her being tired of doing their job, and this place pays CNAs horrible wages. I let them get away with murder already, but this obvious neglect of residents just doesn't fly under my radar.

    What to do

    I'm wondering why you just didn't go ahead and clean the patient yourself?
    You've stated above that you had the time to come and "check" the pt. over and over to see if he had been changed, yet you would not change him.

    I know that it is the CNA's job to "assist" the nurse ( I worked as one for 3 yrs in a LTC facility) but if YOU see neglect happening your first action should not be to handle their stupidity but to fix whats going on with the patient first! Then move on to them. The entire time that you were "checking" to see if the aides were doing their job, heres the patient sitting in urine (probably getting the beginnings of a pressure sore) and not being attended to by the aides or YOU!

    It is not JUST the CNA's job to help patients, just like passing meds is not YOUR only job!!
  8. 0
    Quote from OncologyRN23
    I'm wondering why you just didn't go ahead and clean the patient yourself?
    You've stated above that you had the time to come and "check" the pt. over and over to see if he had been changed, yet you would not change him.

    I know that it is the CNA's job to "assist" the nurse ( I worked as one for 3 yrs in a LTC facility) but if YOU see neglect happening your first action should not be to handle their stupidity but to fix whats going on with the patient first! Then move on to them. The entire time that you were "checking" to see if the aides were doing their job, heres the patient sitting in urine (probably getting the beginnings of a pressure sore) and not being attended to by the aides or YOU!

    It is not JUST the CNA's job to help patients, just like passing meds is not YOUR only job!!
    OncologyRN23,

    When you work in a Nursing Home/geriatric the patient to nurse ratio is High, My ratio is 24:1 so when you have anything like the CnA comes in Hand. The CNA's in my facility cannot do vital signs, CBS., The nurse does it all. In my facility the CNA's sit on the dinning watching TV and waits for a call, but sometimes they don't even answer a call light. Mean while I don't even get a chance to have my break. Last night I ate my supper at 12:30am. I had 10 patients that need immeadiate attention, from neb tx, toilet, neuro assessment q 15 minutes for the first hour, 3 people that had pain (prn narcotics), One Patient lost eye glasses, the other one lost upper denture, With all that I had 3 skilled patients that I had to have the vital signs with the firts hour of work, so I can assess them. The other patient has the G-tube and needs to go on and we do have to do patient teaching with hime because he is being discharged. This happen in the first hour of work. I also have to give scheduled meds to 24 residents before the meal truck arrives at 5pm when the meal truck arrives we cannot give any meds except for prns. So don't emidiatly think because is not only a CNA's job because we do have full plate in our hands when we come in to work.

    Raquel


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