Working as a team

canada · Sep 9, 2003

I'am an RN in LTC facility and I've seen the disrespect for HCAs at all levels. DOC diown to RPNs and this disgusts me. Without our

HCAs we wouldent even be open. They work non-stop and risk injuries day and day out. I try to give all my HCAs recognition every day. The few that don"t work hard are weeded out to other shifts thus making it more fair for my hard workers.

Hats off to HCAs and tons of hugs............Thanks

maeyken · Sep 10, 2003

Wow... I really gotta read this when I have a bad day!!! I worked as a HCA this summer, and I loved my job most of the time... And I gotta say, most of the nurses I worked with were great to work with.

There was one day, that the other HCA for my floor called in sick, and so I was basically by myself! Fortunately, the nurse was wonderful and helped out so much! I couldn't have done it without her (and the girl from activities!) So, thanks to all you great nurses who respect us! That's the kind of nurse I wanna be!

~ mae

barb4575 · Sep 10, 2003

...as a CNA of three years and a RN of 21 years. I started in LTC as a CNA and have worked in the roles of supervisor and DON as well. I have also worked in Medical-Surgical and ICU nursing in hospital settings. I believe that you are going through exactly what you say you are in relation to nurses too.

This is my first suggestion...when a nurse tells you to provide O2 or turn it up...nicely inform her that O2 is a drug and you do not have a license to administer drugs.

My second suggestion is that you make an appointment with yoru DON...she has to know what is going on there and if you don't tell her, perhaps she is unaware?

I was so deeply saddened yesterday by some care that I witnessed regarding oral care...and I saw this in a LTC setting yesterday and all summer in hospitals. For some reason, oral care just seems to be a thing of a past and when people tell me that they have provided it, I am curious how they have done that when there are no supplies at the bedside. When nurses and nursing assistants cannot make the time to provide oral care, we are in a sad state of affairs. Now, this is where I can see that the nursing shortage will only worsen with the baby boomers...we will demand that our teeth be brushed and not wait for someone to come and do it one week later.

In regard to getting residents up out of bed in the am...I have done it as a CNA, RN and DON... I simply cannot get more than 11 residents up-that is my max. I do not understand how people can get up more...also, has your facility looked into having five meals per day? In this manner, the night shift would not have to get up so many residents because the main breakfast would be served at 10am.

I hope these suggestions help you in some way and above all, hang in there, we need compassionate assistants and nurses.

Have you thought about returning to school to become a nurse?

Good luck,

Barbara

LTC Experts · Sep 11, 2003

CNA's are the eyes, the ears and the life blood of a facility. If they are valued and respected enough to be included in dialog, they are one of your richest assets. This is where vertical communication is needed! (Communication from the top to the bottom and then back to the top) I have not met many CNA's that know what an F-tag is or how it relates to them.

wif411 · Sep 21, 2003

I have been an RN for 17 years. I was a CNA at 18 and did not finish RN school til I was 23. Cleaning dookey everyday from all kinds of crevices, turning patients and doing all the CNA duties inspired me to keep going to school. It made me hope that I would not have to use my back quite as much and my hard earned nursing knowledge more. I was right.

I have more respecet for the CNAs that I work with then most of the nurses. The CNA's know when someone is declining faster then the nurse who just gave me report. I let them know that I respect them because I have walked in their shoes.

I think it is important to educate them about their patients. They are also under the confidential ethical and legal rule. The CNAs need to know more than the pt in room 5050 is not feeling well today. She needs to know that she is building up fluid in thier lungs and then I try to review basic things to look for to help me keep a close eye on them as they decline or progress. Did they cough up such and such? Did they pee more? Are they using their belly muscles when they are laying down breatihing? You get my point.

The CNA's that I work with say other nurses do not tell them these things. I am not asking my CNAs to diagnose. I am trying to educate them so that they can be a better set of eyes and ears. I also find they feel impowered and appreciated...not for their ability to clean poop...but for their ability to notice and report important changes.

What do you all think about this?????????????

Nursie30 · Sep 22, 2003

When a CNA is given respect, and praise, you will usually see a person that will go above and beyond the call of duty. There are some that refuse to toilet, turn, oral care, all of that, but once they see you are serious about that residents care, they in turn begin to get serious about resident care. I see much interaction from the CNA's, laughing joking, dancing with the residents, out administrator sees CNA's sitting behind the desk and hits the roof, sees one standing by the desk and hits the roof, I say give a little and you will get alot, I get alot of respect and give a lot of respect to my CNA's, the deserve, Ive been there, very hard work and underpaid, what keeps them coming back everyday? I often wonder that, I guess just knowing your their for the residents...

califgal930 · Nov 3, 2005

Hello Everyone, I am a DON of a 134 bed LTC facility. I have been in the position for less than 2 months. I have a lot of challenges in my future and I am needing a little bit of guidance. I am wanting to start the CNA's working in pairs to get thier assignments done. They seem to be receptive of the idea but are wanting some defient guidelines to go by. My thought is to go into a room together and have one to one patient and one to the other patient while Teaming up on the patients that are heavy care. Everyone does not work at the same pace and i don't want them squabling because one feels they do more than another. Does anyone have any experience with having the CNA's work as a team and any suggestions for me. Any help will be appreciated.

I have been an RN for 25 years, I worked as a care giver on the floor and I know how hard their jobs are. I also know without them it would be impossible to keep a facility running. It is a juggling act to try and keep everyone happy and functioning as a unit [wishful thinking at this point].

CoffeeRTC, BSN, RN · Nov 3, 2005

Is that for all shifts? Some of our aids do that on 11-7 shift when everyone is in bed. How would that work during the day when eveyone is spread thru the building? I liked doing that when filing in as an aid, but sometimes it takes more time since some residents may require more assist.

paacollins · Nov 3, 2005

I have been working as a PRN CNA in a LTC since February. First I thought I'd get my certification simply because it was required for the nursing program and dreaded it. Then I decided I wanted to get it so I could work part-time after being a SAHM for 7 years. Well, after my first clinical I realized I loved it. I adore my residents, get along well with the majority of my fellow CNAS, (now that I switched to 2nd shift; we won't discuss those on 1st shift lol), and some of the nurses are really nice. We have a few that I don't care for but most of them are pretty good and realize what an important job we do. It would be a physically demanding job for a younger person but I am 41 now and have neck problems and arthritis. I am so sore and stiff after working the weekend that I can hardly move on Monday and I only make $8 an hour for doing this. I haven't been paid so poorly in years, nor have I worked as hard. But, I can honestly say that I have never felt so satisfied at the end of a shift either. I know I am performing a valuable service and those sweet residents let me know that on a continuous basis, even if my coworkers don't.

I had a very bad shift last week. One of my favorite residents died. I had grown very close to her, her husband who visited her daily, and her grandaughter. It was the first time I was there when someone passed, the first time I prepared a resident for the funeral home, and the first time I helped a resident's family pack up belongings. Her husband of 65 years was openly weeping and I spent the majority of the time with my arm around his shoulder telling him how much he loved her and how much she knew that, how good he was to her, etc. One of the nurses who responded when I called for help when she was dying acted like a royal butt. She made it sound like the woman was choking and no one did a thing. The truth is the woman either choked or had a heart attack in the room with her husband and was already dead when he wheeled her chair out into the hall to ask for help. I saw what happened; the nurse didn't, but she knew it all. I really felt like crap that night for numerous reasons. Well, I was off for 2 days and when I went back in I still felt awful. I was only there about 10 minutes when another resident's spouse came up to me and put her arm around my shoulder. She said she just wanted to thank me for being so nice to her dh that same day the other resident died. All I had done was wheeled him out to his car, helped him get in, made sure he didn't bump his head, and made small talk about the weather. I consider it being normal for me to be nice to these sweet people but I know some people aren't nice to them. She told me I was a special person and that she very much appreciated what I did. Well, needless to say that restored my faith and reminded me why I do what I do. The snotty nurse doesn't matter; it is the residents and their families that make the job worth it.

Plagueis · Nov 8, 2005

Good luck with getting the CNAs to work as a team. Based on the stories that I have been told by CNAs, the conclusion is that many CNAs seem to feel that having someone help them is an insult of some kind. They think that a good CNA should be able to work by herself, and that something is wrong with the aide who asks or needs help with a resident. One of CNAs that I know told me that at her place, aides will not even ask for help with a resident whose care plan requires a two-person assist. I can't understand this thinking at all. I guess they feel that having help slows them down in some way. I thought we were there to help the residents. I think that DONs should be aware that some CNAs, in order to be done quicker, don't get help with residents, and that this puts the resident at risk. Of course, the CNA staffing problem may contribute to the lack of teamwork.

LoriAlabamaRN · Nov 9, 2005

I know this has been said said and re-said, but with CNA week coming up and our facility going through this celebration in our honor because we are "the eyes and ears" I can honestly tell you that instead of a picnic lunch or scrub shirts, what we really would like is respect and understanding.
I want to work with the nurses as a team. I do not want to hear one more nurse say to my back to another nurse "they just don't get it" I do not want to hear the boss telling us that we are wasting time in the morning when we are all racing around sweating because there is no time to waste. I told one nurse when she asked why we couldn't have everyone up by 7:30 that it takes an average of 15 minutes each resident. She told me it could be done in 6 to 7 minutes. They want no more bed baths in the morning and want us to make residents beds after breakfast.
If everyone would stop and look at the numbers down the halls, how many are two people transfers, how many must be layed back down after breakfast how many showers have to be done and how many shower stalls there are before assuming that we are slacking off that would ease alot of tension. Instead of telling us how to do the job look at why we are doing it the way we are would be a big help. We want to be done with breakfast too, we want to be able to do all the baths too, we would love to go home when we are suppose to instead of always staying over because we did not have the time to get to it all in the 8 hours we are scheduled!
I hate telling the nurses anything at our facility anymore. I have posted before so some of you know I have only been a CNA since last July. Every time I tell a nurse about a bruise or skin tear or chipped denture they are ticked off. It adds to the paper work the hassle of the day. I see blood in urine they have something else to do. If a resident sends me to ask the nurse for a pain pill or a question I get sarcastic remarks or am told in a very hostile manner that it's going to have to wait I have 20 other things to do.I told a nurse about a resident that had feet so swollen we could not get her shoes on. She came down rolled her eyes and said it was probably arthritis. Two weeks later we found out she had blood clots in both legs! Hey, I'm just doing my job.
The worst thing was this weekend. A resident on oxygen had me push her to the desk so she could ask her nurse if she could increase her oxygen because she was struggling for every breath. The nurse said"I don't care what you do...it's your oxygen...turn it all the way up" I gasped audibly and the resident turned her chair away to leave without a word. To our back the nurse said to me to turn it up to 5.
I understand the nurses are stressed out. They complain all the time that they need a third nurse to help pass meds. We complain for bath aids. But the care of the residents and the treatment of them should not get in the way. And I realize S--- rolls down hill, but pitting us at each other doesn't help.
Last week one of the nurses said loud enough for us CNA's to hear that "if we couldn't get things done then maybe we shouldn't have a break or lunch anymore" With that kind of attitude towards us makes everyone resentfull and angry. Alot of the girls want to leave.
I too hate the crap, but every hug or wink or squeeze from a resident reminds me why I'm there and why I still love my job.
How can we get back to working as a team????!!!!

I would run, do not walk, to your supervisor (or HER supervisor if your supervisor is the problem) and tell her your concerns. I know I would want to know if this happened in my facility.

squeakykitty · Sep 11, 2007

Good luck with getting the CNAs to work as a team. Based on the stories that I have been told by CNAs, the conclusion is that many CNAs seem to feel that having someone help them is an insult of some kind. They think that a good CNA should be able to work by herself, and that something is wrong with the aide who asks or needs help with a resident. One of CNAs that I know told me that at her place, aides will not even ask for help with a resident whose care plan requires a two-person assist. I can't understand this thinking at all. I guess they feel that having help slows them down in some way. I thought we were there to help the residents. I think that DONs should be aware that some CNAs, in order to be done quicker, don't get help with residents, and that this puts the resident at risk. Of course, the CNA staffing problem may contribute to the lack of teamwork.

This is so messed up. Those people who are 2 person transfers are that way for a reason. They don't need to be dropped during an unsafe 1 person transfer. I did overhear one brag that she could transfer everyone in the facility by herself. We had quite a few 2 person assists, too.