SleeepyRN 13,105 Views
Joined Oct 26, '11.
Posts: 1,095 (54% Liked)
I have a CNA who "checks" the IVs on all my patients, then will bring me into the room and tell me that "it needs changing." It'll be over something like having some dried blood around it, or if it's at a weird angle or looks like it's pressing into their skin. The patient and their families get all upset, thinking I knew something was wrong and just left it there.
She's driving me crazy!
Please... stop with all the disclaimers. Loving CNA's is not required.
You have pinpointed the problem. The CNA's are telling YOU what THEY want.
Be assertive, look them straight in the eye and say exactly what you said here.
I hate hate hate "this nurse, this writer" and only use it when absolutely necessary.
I'm not saying this is correct, but below is what "this writer" does lol. I have yet to have anyone tell me I can't chart this way.
Ex. I charted on an unwitnessed "fall" the other day and simply wrote "observed patient sitting in front of wheel chair...." (She had had to use the BR but didn't use her call light,) so I also stated in the charting, "reinforced need to call for assistance...patient verbalized understanding..." Notice I'm avoiding pronouns altogether.
In this case the nursing supervisor was right there with me, so in the charting I wrote (not verbatim) "transferred patient to bed with assistance of on sift supervisor. Complete body assessment performed. No injuries noted...."
Whenever I use passive verbs, I'm referring to myself. "Observed," "reinforced..."
Occasionally to void confusion, I will state "this writer," but I limit the usage of such. Ex: CNA reported patient found lying on floor during rounds...this writer and CNA used mechanical lift to transfer patient to bed. Complete body check completed, no injuries noted, no c/o pain, neuro check implemented...
In my experience I would say no. We all rely on eachother and work as a team. For example I started at a new place 2 months ago. When I asked questions, the other nurses happily helped me. Because if I'm not well trained on the job, then I won't be able to help THEM later when they are swamped and need help when I can offer it.
Now, that being said.... Workplaces have their own unique environments. This place is a positive place. One place I worked for, there WAS a lot of lateral violence (bullying) by some LPNs (I'm an RN) especially when it came to asking questions. This particular group of nurses did NOT like having to train a new grad RN who right off the bat makes more than they do when they had years of experience. So some of them pretty much refused to help. I could almost hear their thoughts...."You're the RN making the big bucks, figure it out on your own."
I want to make it clear that I am speaking of specific LPNs and NOT LPNs in general. LPNs taught me so much of what I know, and I am so greatful.
I remembered another nutty thing the same manager said. At a staff meeting we were discussing the fact that 99% of the time we did not get a lunch break. At best, you might get to gulp down a few bites on the way through the nurses station. A nurse had finally gone to HR about it. HR told us to clock a "no lunch.". Manager said we should just think about a day when we didn't have a patient, or maybe got an entire hour, and "it would all even out." Excuse me, but it does not. I am not allowed to run to Target if I don't happen to have a patient. That time is not my own. I asked her what the Labor Board would say about her theory (it is such a pain when one of the nurses you are trying to screw is a lawyer!). We got an email shortly thereafter stating that we should write out a "no lunch" on the clocking error sheet.
Becoming an MA or a CNA is NOT a step toward becoming a licensed nurse. The rest of your post is so unintelligible, I cannot even begin to respond.
My fb friend I was speaking of earlier just called herself miss nurse. Ugh I'm so irritated. I did just ask if she was an lvn/RN because that's an "awesome accomplishment". I da*n well know she's a CNA and there's nothing wrong with that!
This is what I did yesterday when I was sitting on my butt.
- write and send the referral for the patient who is cognitively declining, so much so having previously been very tidily dressed now wondering around naked. (30 minutes)
- write up the wound documentation from the day before for the patient with a grade 1 pressure ulcer (20 minutes)
- write up the wound documentation from the patient with bilateral leg ulcers (30 minutes)
- Clinical review of patient B, approx 90 minutes for the review. Started rewriting the care plan which needs to be done (30 minutes)
- Interrai review assessment (approx 50 minutes)
Total time 4 hours and 10 minutes. Not necessarily getting at you persay. Many of my HCAs also complain about these pesky nurses who sit on their butts. They dont seem to understand exactly what we are mandated to do in our roles as RNs and assume that any sitting down time must be "nurses being lazy time).
Add to that 4 hours and 10 minutes admin, another 90 minutes to declog a badly clogged catheter, liasing with the doctors because of the patients acute condition and having to write those notes.
We havent forgotten about the patients, its simply a case of we are drowning in all the admin we are expected to do for the patients. I could easily fill up my entire shift with required admin without doing any hands on nursing care
Oh I think you are worrying about something silly,focus on you and not them,especially if they are a patient,do not confront them,they may be performing some duties which we real nurses are doing and feel like they are in the field of nursing,which some are actually not but its not the time and place to have the showdown,just find out as much about what they know and take the teaching from there,never assume even if its a RN that they already know.
I sometimes run into people who, when they find out I'm a nurse, say something like "I'm going to nursing school".
Translation - I'm thinking about probably logging on to the school's web site and looking at some classes I might take. Maybe.
Or on a good day they are taking a prereg.
I have to agree. When I worked in LTC the CNAs would love to pretend to be nurses. I remember one time, very distinctly a CNA came up to me telling me about a resident who was constipated. She told me to give said resident MOM. I was so irritated that she was telling me exactly what to give the resident.
"Why do you feel the need to put down other professions? I worked in a clinic that did not employ nurses on site so yeah, I was the one administering first aid. without another clinic at the very least OR hospital or urgent care less than 9 miles radius. I have been very important in the role of caring for patients assuming because it's a clinic it is equipped for any medical problems. People walking in with PE's, lacerations, shock symptoms, burns, chest pain, bacterial meningitis, the list goes on."
- Seems unlikely that (what as you are describing, sounds like an emergency clinic) there would be no nurses in a setting as described above. If so, I'd take my chances in a true emergency by traveling the 9 extra miles to where nurses are actually employed. This sounds VERY dangerous. That being said, I like the emergency clinic I have gone to before where great MAs are employed along with at least 1 nurse. However, the MAs know their role well, are productive valuable team members, and know they are not performing in the same role as the nurses.
"Medical assistants are the ones that first see the patient and get a general sense of their condition when they come in, and a good medical assistant will be aware of concerning signs and symptoms and take further steps. Many times I've positioned patients to help with breathing, obtain EKGs before the doc even has to ask, start running labs that are pertinent, and set up procedure rooms stat for lac repairs or casting or whatever!"
- Assessment is a nurse's role, not an MA's. (Funny though, how in another post you claim you do not do this. But I see many inconsistencies with your bating posts.) And unless there are strict written protocols for starting labs and EKGs that have yet to be ordered, you are greatly stepping outside your role, and I wouldn't let someone with such poor judgment so much as check my temperature let alone start performing workups at your discretion. As for setting up rooms....Great job. THAT is your role. Not assessing patients, but gathering data through obtaining v/s. Not ordering your own labs, but following orders by the practitioner and THEN drawing blood for labs. This is a valuable, important role, but NOT nursing as you state below. I'll get to that.
"Medical assistants and LPNs play the same role in every clinic I've ever come in contact with."
- Therein lies the problem. Many MAs truly think they are playing the same role as a nurse with no clue of the brains behind the tasks at hand. You are either diminishing the role of an LPN, or you are saying you perform nursing responsibilities. It sounds to me like you are doing both.
"In my state, LPNs DO NOT work in hospitals AT ALL so I could say the same "not saving lives" mumbo jumbo that you said right back at you. But I won't "
- A direct quote from you basically saying hospitals are the only places nurses save lives. Which you deny saying. I'm not making this quote up. LPNs (and RNs) are employed in many settings where we save lives on a regular basis. Whether it's with a code and humping on a chest, or notifying the practitioner of s/s of a patient close to circling the drain. Thus getting the patient tx before that even happens. Doing CPR is not the only way to save lives. The general public is taught CPR, it is certainly not a special skill if done as taught. NURSING ASSESSMENT saves lives. You pass along v/s to a practitioner who THEN assesses the patient. An important role, no doubt, but certainly not a job where I'd ever say you save lives for a living.
End rant, and end of debate with you. I have completely had it with your posts. Please, leave Allnurses if we "All Nurses people" offend you so much. Because I am SO DONE with your outright offensive and outrageously defensive posts based not on facts but your emotions. Report my post. Don't care. DONE
For some people I think it is because they want to be a nurse or perceive that they do the same things that a nurse does.
For others, it is just easier to say nurse then explain, or try and discuss the different tiers in health care.
When I was in nursing school and working as a CNA. I would answer CNA when asked the question, and people would then continue to ask what is that? how is that different? so it is like a nurse? I would get so tired of explaining, I would sometimes say when asked if I was a nurse, I would answer "almost" (this was in my last two semesters of school). Once I answered that, there was no follow up.
It is one thing to intentionally deceive someone, especially if there is something to gain. As for the MAs, if the doctor in the clinic is calling them their nurse, then even though it is wrong, I see how they might be confused, or just answer yes out of habit
How is bedside nursing hurting your marriage?
Why are there so many negative theads by certain individuals on this board, aimed at lecturing new grads? It's always the same theme, the same people posting it.
Contrary to most of the sheepish comments here, I applaud the facility in the OP for being one of the few who are so willing to hire large numbers of new grads.
Are people afraid of their unit's power structure being threatened or something? Drop the complex already, guys. New grads are the future. The new graduate nurse's role today is more skilled, more technical, relies on a larger body of knowledge, and it is quite honestly way more difficult now than it ever has been. Here's for a change of pace: I applaud all the new graduate nurses who are starting fresh on their orientations. All of them rock, and the more young faces we have, the better off the profession will be, regardless of whether they are thin or not. I know some people resent hearing this, but the young, new nurses are the ones who bring about change to the profession and they are truly the heart of nursing. New grads shouldn't change to the stale culture of their workplace. Instead, they should be actively encouraged to make the workplace change more to their liking.
It is my belief that their young, vibrant personalities and skill with technology will make them far superior nurses than their predecessors have ever been, and I applaud them for that. To all the new grads out there: Holla. Rock on, and continue to show your confidence. You're doing great, and you are fine the way you are.
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