Am I wrong to think...

  1. ... 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
    Last edit by rmarz on Aug 19, '08
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    About rmarz

    Joined: Jul '08; Posts: 19; Likes: 6
    LTC Charge Nurse


  3. by   Hootnhollern
    As far as I am concerned, CNAs should't need to be told to do anything that is in their scope of practice. It should have already been done!

    How shameful to treat another human being with such indifference...

    Sorry, I don't have any advice, only anger and sadness for you, your situation and the patients/ residents who deserve better.
  4. by   CoffeeRTC
    I'm lucky. Rarely do I have to ask/ tell our CNAs to do anything. But...I've seen quite a few in my day (and worked as a CNA too)

    They need written up. Period. Unless you start the paper trail, nothing will change.
    Do you have your DONs support?
  5. by   crissrn27
    I agree, start the paper trail now. Every time a resident is sitting with a leaking diaper, and they are ignoring them, then you need to write it down, keep a copy and give it to the DON.

    I am so sorry you are having to deal with this idiotic behavior from your coworkers, but I am really, really sorry the residents are having to deal with it.
  6. by   uraqt2
    A paper trail is the right thing to do. The DON needs to be made aware of such behavior and the "lovebirds" should be split up if they cannot work together.

    This type of behavior never ceases to sadden my heart. No person ever deserves to be neglected in such a manner. Charting can be done after the residents are taken care of.
  7. by   TopazLover
    I have walked in your shoes. It is hard to work night shifts when many aides seem to think that night shift is job security, even if they don't do their jobs. Bottom line is that a paper trail has to be started. Make sure you keep it factual, without emotion entering into the writing. Try to note times and how often this happens.
    I agree that the two offenders need to be separated. You might also have other suggestions since you know your situation better than any of us do. If, in fact, these are lovebirds (read lovers) are they acting out in a romantic/sexual way at work? That is a whole 'nother can of worms.
    Sometimes management will ask "what do you think needs to be done". Be prepared to answer this question and give ideas.
    If the facility is unionized you might be able to go to the shop steward and tell this person to get the employees in line. Contrary to many peoples' beliefs, the union does not just represent bad employees. They know that supporting good employees will increase pay as the employees are more valuable.
    Seek support of the day shift nurses. They can document what the next shift finds when these "lovebirds" are working. Basics such as rooms not tidied up, wet residents, etc. are easy to document. Same rules apply. Dates, times, no emotion.
    I feel for you. This process can make you quite unpopular with some aides. Keep in mind that in the current poll here 70% of us don't want loved ones in NH. These lovebirds and others like them are some of the major reasons for these feelings. Your commitment will help to change these numbers.
  8. by   Mermaid in the Sea
    i am so sorry that you have to be subjected to incompetent cna's, they know what they have to do, no reason for you to tell them more them once.. to tell you the truth, you were to nice to them, you should have just told them 'once" that was it! after that you should have written them up, so what if they are mad at you?, to bad!! but they would think twice about it if they want to pull that mess on you again , that is the reason why i promised my mom that i would 'never" put her in a nh, and i kept that promise to the day she passed away.
  9. by   locolorenzo22
    See..CNAs like that gave the rest of us bad names....I always cared about my patients and checked everyone when I had time....Made sure baths were done, things were caught up with, etc.....
    now that I'm a RN, it hasn't changed....but I just have a few more things to do....
    Some people have NO work ethic....just something that is learned or not when they're younger...just depends on the person.
    I'm sorry you have to put up with that....but take a breath and do what you can....
  10. by   pirituba
    I'm with you! The other day patient that has a G-tube disconnect everything and everything was everywhre. I asked my CNA to assist him on getting him changed and bed clean. I went to pass meds 30 minutes later Patient still was in the same condition. I went to the cna and asked againg and she took another 15 minutes because she was doing the books. I have 24 patients 2 Cna and another zillion things to do and nobody helps. Everybody takes breaks and do not let me know. Yesterday i had zero CNA on my side. The other side heard the belt but did not move an inch to check it out, Mean while I am in the middle of something. I felt like should be 3 instead of one. 3 weeks ago I asked the CNA put my patient in bed, she didn't do it. I know that she tired and once you put her in bed with a bed alarn she will relax. So I was writing some notes with my patient view, turn around to get a paper in the fax look at the dinning and saw nobody. I got there my patient had slid of the wheelchair, now I had to feel out an accident report and do neuro assessment q 15 for a hour. Next time the cna did a similar thing like I told her if she wanted to file the accident report and immediatly she took my patient to her bed.

    Boy, boy, boy is tough!!

    thanks for letting me vent

  11. by   pumpkin92356
    I'm a CNA and this kinda sounds like a form of resident abuse? I would think that knowing that a resident is sitting in his own urine would be a dignity issue that could be reported not to mention willfull neglect? If that was my father there certainly would be hell to pay! I wonder if those CNAs realize that letting this resident sit like that is a form of abuse and they could lose their certifications.

  12. by   bluegeegoo2
    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.
  13. by   rmarz
    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.
  14. by   achot chavi
    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?