Depending on CNA's in LTC setting - page 2

I have been a nurse for 9 years. I have been away from direct patient care for the last 5 years. For the last 4 months I have been in the LTC setting - 12 hour shifts on weekends. I beleive that it... Read More

  1. by   Sleepyeyes
    PS
    If you read the response of the CNA, this was NOT about nails.
  2. by   Sleepyeyes
    Dear Vicki,
    I apologise for the above post and its annoyed tone. You need to know a few things about me:
    I was a CNA for over 12 years in LTC.
    I worked on this girl's hall the night before, and I wanted to comfort a Resident during my last med pass. I held her hand. Her fingernails were pretty dirty. I checked the other Residents and most of theirs were too. Days had been working with less people than usual, and we all knew it. I don't just give the CNA's nit-picky (stupid) little chores to do just to keep them from napping for 3 hours in the dining room, and I'm not trying to make their lives miserable. I'm trying to make sure that the CNAs do their job, and somehow they may have forgotten that we wash whatever is dirty, whenever it's dirty on any resident, by any caregiver. Although I had absolutely no down time because of the incredible amount of charting that I have to do (I have to check 30 charts' orders and then chart completely on another 19, in addition to 2 med passes), I did a couple of people myself.
    My mistake was, I thought the CNAs would be OK with that request. The one who fought me the hardest only had 12 patients. Even if she spent 1 hour doing nails (which she needn't have, since they weren't all bad) she still had 2 hours of down time.
    I had worked with this group for many months, and frankly, their reaction only told me that they don't really care about having clean, well-cared for residents.
    Although that made me upset and disappointed, I know that I did the right thing.
    Someday when you are in a nursing home bed, and can't do things for yourself, lying in a puddle for what seems like hours, and along comes someone--anyone--anytime--to give you the proper care and attention, you can be absolutely sure that the CNA did it because some nurse insisted.
  3. by   Vicki30CNA
    I understand what you were saying, I was just curious about the time. No CNA should ever get snippy and beligerant about any care needed to be given to the residents. It sounds like the facility isn't very caring about the residents if they keep CNA's that have that kind of attitude.

    I have to disagree with your last statement though, I give care and time to the residents because I genuinely care about all of them and the lives they have led. No nurse has to tell me to do this. I do it because I chose this job for that reason. No one on my shift, my resident or not, lays in puddles,has wet clothes, dirty nails, uncombed hair or no dentures in to eat meals. I have skipped breaks and lunches to make sure. When I'm in my 90's I hope my family looks deep into the care and love other residents get in a facility before they choose it for me.

    Good Luck!!
  4. by   135ctv
    You should not have even had to tell them to clean the nails. I feel that it is my responsibility as a CNA to keep residents clean. In other words, if I were doing my job, a nurse should not find any of my residents "dirty".

    The fact that the aides had to be told to do this amazes me. The behavior of the aide who stood up to you is inexcusible.

    Welcome to the world of long term care! As long as this is tolerated and as long as management looks the other way it will continue. AIDES NEED TO BE HELD ACCOUNTABLE FOR THEIR ACTIONS.

    I have worked with aides similar to the one you describe. Aides who bully coworkers and even nurses, who are loud, and even a few who make threats. (Are these the type of people we want working with frail, defenseless people?)

    You did the right thing by asking the aide to leave the shift, the ADON should have let you follow through. As this person's supervisor, you have the authority to tell her to leave.

    I wish there were more nurses like you, it would make my job as a CNA a lot easier. Have you ever thought of becoming a DON?
  5. by   nursedawn67
    I too am a night charge nurse, I'm a LPN. The CNA's in any facility are most definately the eyes and ears of the facility! Many times I have heard from the "higher ups" telling us floor/charge nurses to remind aides to wash their hands, how do peri care and various other jobs in the CNA scope of practice. I feel I should not have to do this, they were trained for their jobs and if they cannot do it then (like any one else in any job) they should be let go. I do not belittle my aides by telling them things they already know. Now don't get me wrong, if an aide doesn't do something (give res call light, wash hands, lower the bed back down, replace personal alarms....etc) then I do catch them and tell them about it. But I do no go up to an aide and drag them into a room to show them how to wash their hands or the such. If they ask how to do something, that's different then I show them. I am always sure to say please and thank you to my aides too, I want them to know how much I appreciate them. They are my eyes and ears!
  6. by   jccarolina
    I think this is a good topic to come up with. I have been a cna for 10 years and am now entering an adn program @ 37 years old. Alot of the cna's i have worked with and mentored to just dont care or have the heart. Look at all the abuse we see nowadays. I really feel there should be stricter requirements to becoming a cna like there are for rn and lpn. You usualy don't just make anyone off the street an rn or lpn with a few classes and a little hands on training. I know that may sound unfair but maby then we would get more caregivers in facilities who will be more commited to what they do. I also agreewith a little cna and rn/lpn pow wow other than work, work, work. Cna's learn alot from rn/lpn interaction which steer them into a nursing program. YOU HAVE GOT TO LOVE YOUR WORK AND THE PEOPLE YOU WOKK WITH, along with the patients you care for. Just my .02c:kiss :kiss
  7. by   sandigapeachlpn
    i also am charge over noc shift in our facility. there are so many aspects in this thread that i hope that i don't get too sidetracked. first of all, in regard to the management deal; yes i of course have a couple cna's that think they are royalty. from time to time i pick my battles and stand firm, disrespect, insubordination is major with me. patient/resident care cannot be compromised. the best approach i have found so far with our crew is this: if i can jump in and help you when the going gets tough then you can jump in and help me when the going gets tough. my concept to everyone on noc's is that we are there for our residents and we are there to help each other get our work done. since we have less staff on noc we have to have this philosophy or people would be on the floor. if i help change a resident or assist the cna with their rounds then they feel that i understand their world. on the same token when i am having a bad night and drowning i might ask them to run and get a 02 sat or make copies, etc. things i normally do myself. if they have a problem with this then i look at them and remind them of how i answered their 15 call lights, bed alarms, and changed people last week when they weren't feeling so hot. anyway, this has worked very well for me. i also take breaks with them, and interact more at times with the aides than i do the nurses. alot of this is also due to the fact that i am married to a cna. the other cna's respect me more because they know for a fact that i don't look down on them or belittle them. don't get me wrong i am not saying that you do that. i am just saying that like the cna's in this thread i have seen it way too many times at my own facility. due to my repoire with the cna's many of them feel that they can tell me about issues or problems with other staff and they know they have an adversary. on the other hand i have as i said my two aides that will refuse certain things. i have one in particular that has actually said ' I AM NOT ANSWERING THAT LIGHT IT'S YOUR TURN.' " i don't do baths" " i don't feed" i have worked on her ego a long time, and she is doing much better. first and foremost the number one thing that works for me is leading by example. unfortunately, some of the other nurses lead by the worst example. and those nurses just make me look a lot more attractive as a supervisor.
  8. by   sandigapeachlpn
    i also am charge over noc shift in our facility. there are so many aspects in this thread that i hope that i don't get too sidetracked. first of all, in regard to the management deal; yes i of course have a couple cna's that think they are royalty. from time to time i pick my battles and stand firm, disrespect, insubordination is major with me. patient/resident care cannot be compromised. the best approach i have found so far with our crew is this: if i can jump in and help you when the going gets tough then you can jump in and help me when the going gets tough. my concept to everyone on noc's is that we are there for our residents and we are there to help each other get our work done. since we have less staff on noc we have to have this philosophy or people would be on the floor. if i help change a resident or assist the cna with their rounds then they feel that i understand their world. on the same token when i am having a bad night and drowning i might ask them to run and get a 02 sat or make copies, etc. things i normally do myself. if i have a problem with this then i look at them and remind them of how i answered their 15 call lights, bed alarms, and changed people last week when they weren't feeling so hot. anyway, this has worked very well for me. i also take breaks with them, and interact more at times with the aides than i do the nurses. alot of this is also due to the fact that i am married to a cna. the other cna's respect me more because they know for a fact that i don't look down on them or belittle them. don't get me wrong i am not saying that you do that. i am just saying that like the cna's in this thread i have seen it way too many times at my own facility. due to my repoire with the cna's many of them feel that they can tell me about issues or problems with other staff and they know they have an adversary. on the other hand i have as i said my two aides that will refuse certain things. i have one in particular that has actually said ' I AM NOT ANSWERING THAT LIGHT IT'S YOUR TURN.' " i don't do baths" " i don't feed" i have worked on her ego a long time, and she is doing much better. first and foremost the number one thing that works for me is leading by example. unfortunately, some of the other nurses lead by the worst example. and those nurses just make me look a lot more attractive as a supervisor.
    Last edit by sandigapeachlpn on Feb 25, '02
  9. by   135ctv
    sandigapeachlpn:

    As I stated earlier, there are many nurses who, while they may have excellent nursing skills, lack the skills needed to function effectively as a supervisor. You definitely understand what is required to be a good supervisor, and you practice this.

    First, you treat your subordinates with respect. The same respect that you expect from them. You don't look down upon them or belittle them for their career choice, you understand and respect what it takes to be a CNA.

    You realize that success on your shift depends upon a team effort. You are not above jumping in and assisting when needed nor are you afraid to ask for help when you need it. You understand that teamwork involves give and take.

    You don't lose focus on the fact that your shift's main goal is to "be there for the residents". You don't tolerate behavior that compromises or detracts from resident care.

    I'm glad to see that you take breaks with your aides. Sometimes in an informal setting, people relax and open up more. I have worked in facilities where the nurses sat away from the aides at breaktime and did not even acknowledge them. They are missing out on an opportunity to get to know there staff better, a chance to informally discuss problems or obstacles and bounce around solutions, or a chance to bring up ideas on how things could be improved. It also lets you see each member of your staff as an individual and not just a generic and interchangeable aide. I'm sure your aides appreciate this.

    Finally, and perhaps most importantly, this is not just talk. You demonstrate this in the way that you work and the way that you interact with your staff. You set the example.

    I hope that other charge nurses read your post, as many could learn from it. You seem to have a good handle on what it takes to be a charge nurse.
  10. by   Michelleroth1
    Im a lowly CNA I take patient care more seriously than most Other CNA's They go home at 1100pm Rounds start at 1000pm for sixteen patients at least. Im never finished before 1100pm Then I got my charting its 1130p till Im done. Maybe I am slow but I talk to the patients while I work asking things like Is there anything I can get you before I go? Im studing to be a real nurse LPN/RN At times between 12hr shifts and keeping up my studies I feel so beat down My Nurses are great (RN/LPN's)they show me things about nursing I dont get out of books. They ask and I do immediately I love nursing I would only question if I thought the patient safety was at stake But thats just me I think at times Im a dying breed There are good CNA's out there but out of thirty or so I bet i am one of five cleaning up others messes If not me then who? I have got to keep on To all the RN/LPN's out there watch out for the good ones they are there ( I talk to much LOL )

    Michelle roth CNA
  11. by   kathy_79
    i am nursing student now, but i still work as cna. i have never had any trouble with my pts or staff. i do the best i can b/c i know that all people are equal and all of us deserve to be treated w/ respect and dignity. i have had really hard pts to care about, i have really hard staff to work with at my last job(cnas). i did 24 pts they did 10 so you can imagine how was there. i resigned after two months and now finally i got accepted at hospital as pct. i love what i am doing. i am not ashame that this is not tthe best work in a world, but it needs to be done no matter what. i report any changes to nurses and only once i was opposed like one of viwers, " so what you want me to do, it' s not my buisness" she was from agency, one night. my last work was really horrible, but i am survivor and never give up . especially, when someone thinks i will give up, no i am going to show you who i am. i am very pleased from that experience. i learned not to let anyone use me. i know what is hard work and i am not scared to do that. even if i was treated as housekeeper for most of my time there, i now my pts loved me, nurses liked to work with me, and i am good cna.
    there are good and bads in al life, but that is how life goes on. god know why it is happening to us and my trust to Him help me do what i need to do and to do it the best i can.
    you will meet lots of different people. i cannot stand unethical and irresponsible behaviors of some of cnas. i think there should be done somethink with that. maybe inside facility should be given courses and services how to treat not only each other but pts also with respect and dignity. i just tell to myself that God sees what people do and He will judge when the time comes up.
    take care, kathy
  12. by   Chad_KY_SRNA
    CNA's take a lot of crap from everyone. As they say $hit rolls down hill and it piles all over the CNA's. Some of us are doing the very best that we can and the few "bad" CNAs make us all look horrible. A part of the problem is the incredibly dangerous CNA-resident ratios in most facilities. In my facility, we are assigned bathing, feeding, incontinent care, perineal care, washing out BM from linen, nail care, bed checks every two hours that can run back to back. Not to mention that the housekeepers are not allowed to clean up bodily fluids and they wont let us use their mop to clean that up. Not to mention some of our nurses. We have one who is a jewel. You can be in the middle of bedcheck and she decides that you need to go around the unit then and make sure everyone has their bed alarms, lap buddy's, heel protectors, whatever she can think of and she will ask you every five minutes if you have checked yet. Plus her sister who is a CNA but believes she is the DON. Very angry with her.:angryfire Treat your CNA's good. For the love of God don't make their lives any harder. I almost had a breakdown in front of the actual DON last week because the Nurses and CMAs were making me crazy . Please by all means check your residents that you think are not getting proper care and see if they are being changed and repositioned during bedchecks. Make sure that showers are being done make sure that the residents are being shaved but don't make it seem like everyone is not taking care of them. There are some of us who like I said are working very hard for our residents despite the horrible working environment, pathetic pay, miserable benefits and horrible retirement plan. Work with them to ensure proper care is being done because after all it is all about the residents.
  13. by   Blackcat99
    I was a CNA before I became an LPN. If a person cares about their patients they will take good care of them no matter who the supervisor is.
    I have worked with some great CNA's. :hatparty: Unfortunately, I have also worked with some CNA's who just don't care period. It makes me angry when I have to work so hard in a LTC and then I have to spend extra time I don't have "babysitting" some CNA's who just don't care about their patients. :angryfire Thank Goodness most of my CNA's are wonderful,caring and hardworking people.

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