How do you do this, day in/day out?

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    I am a new nurse working 3-11 on a unit where I generally have 30-60 residents depending on the night. Multiple tube feeders, diabetics, coumadins..you know the whole shabang. I have got my routine down and get through it on the nights I have 60 residents..and have perfected the nights I have 30. Stressful, overwhelming but it gets done...unless someone gets a skin tear or a fall...then goes out the window.

    The biggest problem I have is aides. Some really great ones, but the few are making my nights horrible. I want shower sheets before 10:30 pm with abnormals, so I'm not stuck doing assessments and IR past when I should be leaving. Vitals by 8pm, and for god sake...TURN THOSE BEDFAST residents every 2 hours. The eye rolling, huffing, smart little comments......breaking me down.

    I can take the crazy busy nights, things going to hell in a hand basket...I got the focus for that....but I can't keep up with aides that just don't want to do their job, or want to half a** it( excuse my language but no other way to put it). What makes it hard is that the other nurse has been on the floor for 3 years and basically has let the aides run the floor and acts like they are all "bff's". So I'm the new girl coming in expecting them to do their job, and I'm the big bad nurse.

    Tonight, I spent more time answering call lights, turning residents, toileting, changing linens because of vomiting from the stomach bug....and I didn't get to pee at ALL, no break...but had to hear an aide tell me "im resting my feet" when I asked her to grab a snack for someone. And of course, I stayed 2 hours after shift to finish charting. Do you think a single aide was there that late? nope.

    I'm emotionally wearing down.....then our DON's tell us to write them up...that these things need to change..aides should not be running the floors like they do. But so difficult writing up an aide, cause for the rest of night...they make it miserable because they all got each others back...so is it worth it dealing with 5 attitudes now? half a year in and I'm burnt out. And I worry about keep going to the DON's about it because I fear they would look down on me because I can't deal with the aides. They are great DON's though, have complimented on me on doing a such a great job and they are happy to have me at their facility.

    How do I survive this? This the LPN field, LTC and since I don't have experience yet this is really my only option.
  2. 16 Comments so far...

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    OMG, I had to check and see if I hadn't written this post myself! I lasted a year in this h_ll you describe. I had some horrible women who were just dreadful to me. If I as much as questioned if something was done when they were standing around talking, I got all-up-in-my-face attitude. Once one CNA wouldn't go help in another dining room because she was mad at another girl in there who wouldn't help her earlier. I told her she needed to go and she refused. I asked her to please cooperate bc I would have to write her up. She told me to do what I had to do. I did, and wow, did things go downhill after that. She was mad at me for not backing her up and supporting her in getting back at this girl who clearly wronged her.

    It's a fine line between being their supervisor and being their "friend", because being their "friend" keeps them happy and they do more that way. It's sort of a backwards way of being an effective supervisor and getting things done! Things grind to a halt when the CNAs decide they don't like you. If CNAs were paid better, they'd be able to hire from a better applicant pool, people who might actually understand what professionalism is.

    Unfortunately I don't have any magic to bestow on you, just empathy. Get your year's experience, and run away! And then someday pay this empathy forward to another poor future soul on AN! For what it's worth, even bad experience is very worthwhile in the long run.
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    I've been through the ropes too many times with Aids when I was a charge nurse LPN at an LTC facility. Thank goodness most of the Aides knew their jobs and DID IT! It's hard because its so many of than and they will try to walk all over you, if you let them. I totally agree with the previous poster Sue, except running away. Most times LPNs get stuck in the nursing home with not that many options. It's sad. I did it for nearly three years as an LPN and I found LTC to be annoying and sad. You have to stand firm with your Aides because when push comes to shove, it's the patient's well being that's most important.
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    I had these problems when I first started out too. It's now been 4 years and I have earned the respect of my aides we work together. Don't try and demand they do anything but let them know that you are serious about the care and well being of the residents. I was an aide before I became an LPN and I know that has helped me to fully understand what they have to do. It's a tuff job and unfortunately the pay is crappy so there are a lot of uneducated people who can do the work but their attitudes are poor and the residents sense that. My advice to you would be to work with them don't be above them let them know that you are a team and you are both here to do the job and if they can't then write them up and send them home so what if they are get ****** and team up together then write them all up then they will know you are serious and then the administration will see there is a problem because if you just keep talking about it then you are just ****** you have to take action and don't let them run you
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    I want to clarify that I didn't run away in defeat, nor did I simply back down from the CNAs. I realized that I was at the point in my life where I didn't have to keep returning to a place where I was met with abuse from all angles. Plus I was overworked at at unsafe level and felt like crap every day, knowing what a lousy job I did because I didn't have the time to do everything right. It was either do a great job and leave work undone, or do a half-a** job with every task but complete everything. I gave a month's notice and I left in good standing. There is a lot of work out there for LPNs in many fields, it's not all LTC, although there's plenty of those. I am now working with peds in their homes, and made $15K more last year than my year in LTC. I consider running away a very smart move in my case.
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    Ok, I'm gonna play the devil's advocate here. Don't be so sure the other LPN (who's been there 3 years) is letting the aides get away with not doing their job. I've been in my job about 3 years and I've seen half a dozen "counterpart" nurses come and go. One thing most of them tell me is "the aides like you better because you let them get away with things" Well, no, not exactly. I just pick my battles. It just isn't worth it to try and "change" a floor that is already set in it's ways. I learned early on that sometimes I just have to do a lot of it myself. Constantly nagging won't get them to do it and, frankly, I don't want to be "that" nurse. By becoming the "laid back" nurse I can actually get more results than by being the "naggy" nurse. I get way less eye rolling and whispered comments than my fellow LPNs. And, when I ask for something, chances are they will *do* it. I bet the nurse you work with can get the aides to obey her better than you can. Stop and think about why that is.
    LTCangel likes this.
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    When I worked in LTC I was a lot like Brandon. I have always been laid back and a team player, picking my battles and I got a lot of respect from CNAs. I always went out of my way to remind them that there was no way I could do my job without them, and if they needed help and I was available, they could count on me to either pitch in and help or find someone who could if I was busy with something else.
    I encouraged and allowed the CNAs to team up and would make sure the work was divided evenly, IOW, one CNA didn't get all the heavy workload while another CNA got the lighter workload. I made things as fair as possible and was always ready to listen and try my best to resolve any issues.
    I wish you success in finding a way to get the CNAs to respect you. It's tough when you feel like nobody has your back.
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    For the life of me, I've never understood why anyone would want to be a CNA if they didn't like it or didn't want to work. What the crap is that all about?!?! I am darn good at what I do and i love it but I've seen aides that just want to do the bare minimum if that or who hide all day. There is NO money in it so what gives? I'm sorry you have to work with crappy aides, please know some of us actually see the value in making the nurses jobs easier.

    "No day but today"
    LTCNS likes this.
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    As a matter of record, disciplinary actions like "write-ups" are the responsibility of supervisors and managers such as the ADON/DON and not for new nurses on the floor. That kind of delegating should not be going on-you don't have any management experience. I think the advice of the other nurses who posted here about gaining the CNAs respect is a better way to go. You still have to work with these people every day. Delegating the task of disciplinary action to someone who is not experienced or confident enough to deal with it is a set up to fail, IMHO.
    BrandonLPN likes this.
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    Quote from cienurse
    As a matter of record, disciplinary actions like "write-ups" are the responsibility of supervisors and managers such as the ADON/DON and not for new nurses on the floor. That kind of delegating should not be going on-you don't have any management experience. I think the advice of the other nurses who posted here about gaining the CNAs respect is a better way to go. You still have to work with these people every day. Delegating the task of disciplinary action to someone who is not experienced or confident enough to deal with it is a set up to fail, IMHO.
    Sadly, au contraire. In my national chain facility, every nurse had the word "supervisor" on their nametags next to their credential, ie: RN supervisor or LPN supervisor. We were ALL the CNA's supervisors. If you made everyone management, no one could be eligible for union membership. We all were responsible for writing up the people directly under us.

    True story.


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