What's a nurse to do ?

  1. Sorry if this runs a bit ....Anywho I work LTC , have been at the same facility for 2 years . I am the med nurse on my unit . The charge nurse is very good friends with all the CNAs . It seems to me she is more concerned about their friendship then running the unit .As of late quite a few problems have come to light , she has covered up for them in the past .Pts are not getting fed , turned , or given showers .Vitals are forged , as are weights and the like . The DON seems to be aware of all these problems . The CNAs do not like me at all. They give me a hard time when I have to do charge because I expect them to do their jobs .Now the DON is leaving she comes to me today and says they are going to pull the nurse off of charge would I be interested ? here are the issues .
    1. She (ex charge nurse) will then be on meds .And probably be resentful
    2.The CNAs will be upset with me as I am the one who makes them do their jobs and I now have the job their friend used to have .
    3. There is no where else in the building on our shift for either of us to go . All other positions are filled with long time permanant nurses.
    4.Even if I declined the postion I would still be acting charge all the time until they hire someone (which they wont )
    5.This DON as I said is leaving , which then the years of mess that will have to be fixed will now be on me .
    Basically a no win situation , what's a nurse to do ????I
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  2. 13 Comments

  3. by   LoriAlabamaRN
    It sounds to me like she is calling you on the issues you have reported to her. I would definately take the position, and work to clean up the act of the CNAs.
  4. by   luvmy2angels
    I too would take the job. If the CNAs end up not respecting you then they will eventually leave and hopefully you would end up with new CNAs under you and have a fresh start! I have seen this situation repeat itself over and over again. I have worked as a CNA for 18 years and trust me, it doesn't matter how long they have been there, if they don't like the new changes they will leave!! Good Luck to you!!!
  5. by   EphesianGirl
    Been there done that! I've been an RN nurse manager in my facility for 2+ years,as the result of a very bad state survey, I was asked to take over the skin care team, after being cleared for those deficientcies, I was then moved back onto a unit as manager again(the unit with all the problems) I hate what I am doing, I feel like the cleanup crew. The CNA's are loud, abrasive, and lazy. It's a constant battle. The new leadership, Administrator, DON treat the nurse managers as if we are stupid, with no redeeming worth. After putting in my resignation, they asked what they could do to keep me. I requested the full time supervisor position and was told as soon as they could replace me I could have it. In the meantime they want me to cover the supervisor shifts they need to fill. I'm trying but, yesterday I learned they have hired a part-time RN to cover some of these shifts and are offering her the full time position (she has accepted). I'm ready to walk, having nightmares, the works. Good luck!
  6. by   SFCardiacRN
    Take the job. Set a goal of one year. If things don't improve, move on. It will really beef up your resume!
  7. by   Jessy_RN
    Take the job! Shape it up little by little. Document everythig, and report things if necessary. You can do it.
  8. by   pkeyrn
    All you need to do is ask yourself some questions...(1) Are you there to be a nurse and care for residents or are you there to be popular and everyone's favorite? (2) Do you think that you know what the problems on this unit are? (3) Do you have some ideas on what can help it improve? (4) Do you have the guts to try it? Answer those and then you will now what to do.
  9. by   prmenrs
    I'd take the job and do a LOT of "team building" kind of work. State problems to the CNA group and get their input re: solutions. See if you can get them to "own" or "be a stake holder" in some of the care issues.

    "It seems like everytime I go into so-and-so's room, s/he is on their R side. When I turned her, I found a red spot on her hip." "If Mr. [ ] were your dad, how would you make him comfortable?" If the CNAs offer suggestions, write them down and implement them. Go out of your way to support and credit each one of them. They should 'get' that you see the contributions as well as the deficiencies. Credit the other nurse, too.

    You'll have a rough time @ 1st--nobody likes change. But, who knows, it might work.
  10. by   lovingtheunloved
    I'll tell you this. Change hurts. It's hard. You will not be popular. But think of who wins in the end. The residents. Our new ADON (who, yes, is a close friend of mine) is working hard to clean the joint up. And you know what? It's hard. But it's working. Her management style is perfect. You do your job or you're gone. Even if that means the rest of us are short. Which means a lot of them are shaping up or shipping out.

    And, if that nurse were worth her salt, it wouldn't matter who her friends are. My ADON is my friend, but our residents are the priority, and you can bet your buttons if I did something wrong I would face the consequences. I hope that nurse learns that if she can't separate friendship from work, she shouldn't have friends who are her subordinates.
  11. by   BigB
    The patient to CNA ratios have a lot to do with patients not getting turned every 2 hours and other adls and showers not being done. Try doing all that with 15 patients on a busy PM shift. It's not gonna happen. The ratios must be lowered for proper care.
  12. by   rouqie
    Well you need to just do your job and she will be forced to do hers. I have been a nurse for approx. 3 years before that I was a cna for 5. I mostly worked on the dementia unit as a cna. I made lots of friends as a cna. Most of my friends still work there are now taking orders from me. I'm not saying that they like taking orders from me but they do it. I have some friends who give me grief about giving them orders but my true friends understand my position and realize that I try to do everything I can for my patients. They understand that I have a job to do and I understand they have a job to do. I think together we have a very successful unit. We always have our work done and typically on time. with nursing nothing is ever on time. Give your med nurse a little credit, as long as she gets her work done the let her do it. But if she starts to slack in a little part you need to make sure you are all over her because if you let her slack even a little everyone will know. You need to stand your ground and make sure that everyone else is doing theirs. You aren't here to make friends you are here to care for patients.
  13. by   kat911
    Take the job, you want to make sure things are done right, now you have a chance to make that happen for allyour patients. I worked as a CNA years ago, the new night charge nurse talked to me the first night and told me how it was going to be, she would be checking behind me to make sure I had turned the patients. And she did, and we had a great relationship. She was excellent and our patients had excellent care. If you take the job have a staff meeting with them all and lay out your expectations, specifically. Then followup behind them. Be nice, be professional and matter of fact. And document everything in writing. Note any verbal counselings so you can keep up with who is doing or not doing tasks. Then go to written counseling. They will either come around or you will have the documentation to get rid of them. Good Luck.
  14. by   Nikki69
    I would take the job if I were you. Try not to care what they think of YOU. Those residents deserve to have good professional care. And if the DON is leaving, maybe the one that replaces her will pay more attention and help you turn this into a better place. Maybe you could give your DSD some suggestions on what to inservice about to the CNA's. Where I work, we have a turn schedule, such as 10:00am, left side, 2:00pm, right side, and they actually walk around the facility and check. We have stickers with the schedule that are on the back of our name tags. As for the weights-if there is a significant difference, make them re-weigh when you are present (if you have time), or send someone you trust.
    Keep on working for the greater good, and look at this as an opportunity!!

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