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Charge Nurse did CNA work. Learned A LOT.



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No. 10
Old Jun 25, 2009, 10:23 AM

Default Re: Charge Nurse did CNA work. Learned A LOT.
Originally Posted by maxthecat View Post
I wish I had a good answer for you. I don't. But I just want to say that in my opinion a lot of the sloppy care is due to hospitals and nursing homes expecting more of nurses and CNA'a than is humanly possible to do in the time alotted, with the ratios alotted. And it is the routine, not the exception. We've all had days when we had to run like mad to get things accomplished. But when the expectation becomes that you run a marathon every time you come in to work, something is wrong, something has to give. People start taking shortcuts that they wouldn't take with a reasonable workload. People become cynical, "This is impossible and I just don't care anymore." It's the stress response in action. You can run on adrenaline just so long and then you crash. And I don't think saying individual nurses or CNA's don't care and don't give adequate care to patients because they're inherently lazy or uncaring is necessarily a helpful response. (I know you didn't say that, but many do.) Some may be there just to get a paycheck. But I believe many started out with good ideals and wanting to do everything possible for the patient and were turned cynical by a no-win system.

I guess I would just go over what is the minimum standard that has to be accomplished this shift and what would be nice to also get accomplished. That way the CNA's know your expectations clearly. Think of it like working in a war zone. "OK troops, this is the mission for tonight." A good leader doesn't ask the troops to do anything he or she wouldn't do himself or herself, but the leader can't do everything, that is why there is delegation. I think stressing the "we're all in this together" is a better approach than "checking up" on people, for the most part. There may be indiviual exceptions.
I agree most with the above post- and especially that part I bolded.

I think after running at full tilt, maximum ability every shift, and finding that for your great efforts, exhaustion, and no energy left for your own life, all you will get is repremanded by admin, and have even more work piled on you. After a while you just start thinking "I just can't win. Screw it."
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No. 11
Old Jun 25, 2009, 11:16 AM

Default Re: Charge Nurse did CNA work. Learned A LOT.
I think the reason for being slighted by being called "My CNA's" is more to do with identity- the person is more than just her position at work, she is a human, and important etc. To cay My CNA's is to lump everyone together,
I try to individualize whenever possible. Calling people by their names shows you care and they are important to you and not just your staff...
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No. 12
from Nikki69
Old Jun 26, 2009, 08:01 PM

Default Re: Charge Nurse did CNA work. Learned A LOT.
I was a CNA for about 4 years before I was asked to take the job as Staffing Coordinator. I make the nurse's and CNA's schedules, and assign where they work every day(among loads of other things). When I have nurse's constantly complaining to me about certain CNA's that don't do their best, or leave their work uncomlete or sloppy, I have to keep reminding them that they are the supervisor and one small role of their job is to make sure their CNA's know what they expect from them. I know that this may be difficult for some people but it's necessary. That's not to say you should get out the write ups at first but I think the CNA's should realize that what they do and don't do reflects on you and the image of the whole facility. Last week I had to attend a veeeery long meeting on "better management". The biggest message the speaker wanted to get across to us all is that if the employees under us are not succeeding, it is our job to do everything in our power to make it so they can. If they fail, we fail. We can make sure most of them succeed not by writing them up every chance we get, but to encourage and nurture them. This can be done with a passing smile, a "good job", or a "don't forget to___________ before you go". It doesn't take up any time at all, and it might make the CNA's feel recognized because that's one thing that they probably don't feel very often.
One thing I think might help (even in my facility) is to take a personal moment when you're at home or whatever and write down the most important things that you expect to be done by your CNA's-no matter if it's as simple as brushing and soaking the dentures or floating the heels and discuss them with the CNA's at the beginning of your shifts during report. If you don't give report to your CNA's, start. Call them all up there and do it even if they other nurses don't. They will respect you more if they know a little bit of what you know. If you're uncomfortable "telling them what to do", you could always say something like "we've had some complaints about_________, or the DON is going to be checking _________, so can you please make sure you pay special attention to that". That way it will take the focus off you and on to the management or hopefully, their own work ethics.

Good Luck!!
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No. 13
from nkara
Old Jun 27, 2009, 02:00 AM

Default Re: Charge Nurse did CNA work. Learned A LOT.
becoming a nurse doesn't mean neglecting the "cna" work. I understand being busy but assuming that the aides are doing the job falls under your license if it doesn't get done. Protect your risidents and your license and follow up on the cna's.
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No. 14
Old Jul 13, 2009, 02:32 AM

Default Re: Charge Nurse did CNA work. Learned A LOT.
Every morning I have a quick meeting with the CNAs assigned to my residents. I give them any report pertinent to their assignments, confirm what showers they have assigned, let them know if a (combative, agitated, etc) resident has or will be medicated, tell them my expectations (vital signs in by 10 AM, let me know when you are leaving the floor, etc) and ask them if they have any issues they need assistance with. It takes less than 3 minutes, and it makes for a fantastic day. I believe it makes them feel that we are a team and they can come to me with issues, and it also makes them aware that I DO watch to make sure things are done correctly and that I appreciate them.

If a CNA does not meet my expectations I set out, I counsel them, in person or with a written warning. That is usually sufficient to prevent a second occurance.

We call these the morning "Come to Jesus meetings." LOL

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No. 15
from chulaRN2be
Old Jul 13, 2009, 04:13 AM

Default Re: Charge Nurse did CNA work. Learned A LOT.
Arelle-

Your managemant skills are flawed if you are doing your job the CNAS would be doing there job and obviously they are not doing the job appropiately. And by the way you don't own the CNAS they work for the patients not you ,your not writing the checks every month .So please view them as people not slaves who have to complete the impossible during the shift like most floor nurses do also . Be humble and take this as a lesson and manage your staff with a more structured form of management.
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No. 16
from Nikki69
Old Jul 13, 2009, 06:08 AM

Default Re: Charge Nurse did CNA work. Learned A LOT.
StarNurse:
You are communicating with Your Assistants. Good Job!
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No. 17
from LEN-RN
Old Jul 17, 2009, 12:10 AM

Default Re: Charge Nurse did CNA work. Learned A LOT.
This is a classic example of not enough staffing. You saw it and lived it. Maybe you should bring it up to your DON, when basic care is being missed - there is a problem. .

I liked branbran's approach....I should have quoted it.

Ok,
The OP is CONCERNED about the CNAs and their workload and many of the responses are about how calling them "my CNAs" is disrespectful?? Its apparent she cares and it sounds more like an affectionate term. But even so, not sure how it sounds like she owns them and no idea where slave came from. I interpreted that she walked in their shoes and had a whole new respect for their job. AND wants to make changes for the better and was asking for suggestions. And not that it matters, but she didn't say she called them "my CNAs" to their face. Oh should nurses be offended when someone asks the CNA who "their nurse" is??

The fact that this nurse stayed and worked 8 hours after her own shift, SO THE CNAs wouldn't be even more overloaded, shows her character. If she had no respect for them, she wouldn't have done it and certainly not come on here asking for advice in how to do things better.
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