How would deal with these type of CNAs?

[Born_2BRN]

I am one among the newest RNs on a busy floor. Every shift I am struggling to help pt's ADLs with minimal CNA assistance. A few CNAs are plain horrible. They won't answer my pager or when they do they would tell me they are with another pt. I told them when they finished with the pt then come help me. Most of the time they don't so I ended up doing it all myself. At other times when they didn't come and help me they complaint that I left dirty linen on the floor. I told them I helped this pt and changed all her linens after she pooped or puke on herself and yes in between I also passing meds while another pt paging for pain medication as well. When they hear that they don't like it.

[RNsRWe, ASN, RN]

I also find a lot of CNA's saying that all RN's do is paperwork and never clean up puke or poop or take vitals. Maybe if you had the time to explain your job requirements to them it would help...but if their attitude is that bad, then it probably won't change a thing.

Had a VERY good laugh over this one. I wonder just how many times over the years I worked in hospital care that I had to explain my job to a clueless "assistant" who huffed and puffed over my "not doing anything/enough to help her"? And for those who have had that explanation from multiple nurse sources, what could possibly explain their inability to change--other than 1) disregarding said explanations as valid or 2) inability to retain the information?

Mostly, I found, it wasn't an inability to learn the differences in the jobs, it was the unwillingness to do so. After all, if complaining that she (the aide) wasn't getting enough help was enough to get her out of another task, well, that's the way to go, isn't it?

"Explain" until you're blue in the face, and all you've got to show for it 99.9% of the time is a waste of five minutes of your life.

[jadelpn, LPN, EMT-B]

I spent 14 years as a CNA before becoming a nurse. Routine was patients vitals, got up, or turned, peri care or bathroom, washed, dressed etc. It was far easier if each CNA had a distinct assignment of patients so that it wasn't willy-nilly everyone is everywhere. Perhaps it is time to talk to management on each shift having a "lead" CNA--who assigns patients/halls/rooms accordingly with a specific nurse, and is a go to for CNA's and nurses, and floats to be sure patient care is completed. If I have multiple meds, documentation, someone that needs to go for an xray, someone crumping, and someone who needs pain meds, and I need to document same before the doctor hits the floor for rounds, plus I need a boatload of orders, then NOOOO I am not above changing bed and washing up patients, I am prioritizing what I need to do accordingly. And no, because I am at the nurses station going through MARS, orders and documenting does not make me lazy, it is what I have to do before I can impliment a lot of what my duties are. I think that most of us try not to be condecending or rude or "above" any CNA, but the duties are far different and each requires organizing one's shift accordingly--with room for the unexpected. As a CNA, direct patient care is what you do. It is your job. It is not easy or simple, and sometimes just generally sucks. And direct patient care is just a portion of my job. Which isn't easy, or simple and sometimes just generally sucks.

So OP, until you can help to make changes on how CNA's are assigned (if you are successful in trying to make those changes) I would be clear and concise to the CNA's that are on the floor--could you take vitals and sit people up or chair for breakfast? That type of thing. If you are not the charge nurse on the floor, ask charge for some pointers on how you can delegate so that the patients' needs are being met accordingly.

[annlewis]

I like the idea of a lead aide person, we have that now but it's not official..she helps immensely keep things organized..she is respected by all, but has to do this as you say under the table...I rely on her greatly and try to help whenever I can

[Fearless_leader]

gcupid aug 7 by gcupid a member since dec '08. posts: 205 likes: 256

awards:

meet one or two of them in the parking lot after work....

lmbo (laughing my butt off):rotfl:

[uRNmyway, ASN, RN]

I'm sorry but it doesn't matter that you changed 2 of your 4 pts beds and had other things to do. It is never acceptable to leave dirty soiled linen on the floor. If yuo can not see why then I suggest you review universal precautions and your facilities infection control protocol. As a CNA of 8 years and a nursing student in my second year, I understand that there are lazy disrespectful CNA's. I also understand that as a nurse it is a lot to do the meds, charting, and assessments on 4 patients but try doing vitals, bed changes, toileting needs, the nurse's grunt work, plus running to get drinks and snacks and all the personal little things patients needs for 12-15 patients. I can not stand when a nurse thinks she is above and beyond what I do. If I am not busy tending to someone else that is one thing and if that is the case that person does need to be approached but don't leave a room that you are doing something in to come and get the CNA because you feel that is there job or leave dirty linens on the floor for the CNA to pick up because you are busy. guess what we are busy too!

I totally get having a bunch of stuff to do and needing to hurry up to get back to your scheduled tasks. However, you were already in the room. It is not much to simply TAKE the linens out with you as you leave the room. You have to leave anyways. You might as well have something in hand.

My mother was a waitress and told me the secret to being a good waitress (and I think in this case it applies to nursing too) was to never be going anywhere empty handed. If you are walking around your section to check on clients, take a jug of water to refill glasses (waitress example of course, but you get how it applies!).

[uRNmyway, ASN, RN]

I'm sorry but a CNA's job is not only physically demanding but it is also emotionally and mentally demanding. CNA's are allowed to be abused, spit on, slapped, scratched etc. Yes that can happen to a nurse to but CNA's are providing more ADL, hands on care for a patient so they are more likely to endure this type of abuse. To say that a CNA's job is not emotionally demanding is really diminishing what we do. There have been times where I have been totally spent and burnt out. At least nurses have the incentive of great pay. CNA's are overworked and underpaid. There are lazy CNA's and then there are CNA's who are just burnt out. Just like there are lazy nurses and nurses that are just burnt out. Truth is everyone has to work together. Nothing in my job description is beneath an RN. In fact, I had no problems in fundamentals of nursing class in my first semester of RN school because it was all CNA type stuff. Just like a nurse has to set boundaries with CNA's and delegate tasks, CNA's need to set boundaries with nurses that think toileting someone or changing bed linens are beneath them.

Just thought Id point something out...I get that RNs make more than CNAs, but they in NO WAY make great pay lol! Simply wanted to make that clear. A lot of CNAs seem to think that about nurses, and it is absolutely not the case. Where I was working, as a new RN, they were paying just a little more than 20$/hour. That is after 3 years of school. And it would be the same whether I have an ADN or BSN. BUS drivers were making more money, had more benefits, and could actually go on strike if they wanted more, which RNs cant do. So, yeah....jus' sayin'

[uRNmyway, ASN, RN]

i spent 14 years as a cna before becoming a nurse. routine was patients vitals, got up, or turned, peri care or bathroom, washed, dressed etc. it was far easier if each cna had a distinct assignment of patients so that it wasn't willy-nilly everyone is everywhere. perhaps it is time to talk to management on each shift having a "lead" cna--who assigns patients/halls/rooms accordingly with a specific nurse, and is a go to for cna's and nurses, and floats to be sure patient care is completed. if i have multiple meds, documentation, someone that needs to go for an xray, someone crumping, and someone who needs pain meds, and i need to document same before the doctor hits the floor for rounds, plus i need a boatload of orders, then noooo i am not above changing bed and washing up patients, i am prioritizing what i need to do accordingly. and no, because i am at the nurses station going through mars, orders and documenting does not make me lazy, it is what i have to do before i can impliment a lot of what my duties are. i think that most of us try not to be condecending or rude or "above" any cna, but the duties are far different and each requires organizing one's shift accordingly--with room for the unexpected. as a cna, direct patient care is what you do. it is your job. it is not easy or simple, and sometimes just generally sucks. and direct patient care is just a portion of my job. which isn't easy, or simple and sometimes just generally sucks.

so op, until you can help to make changes on how cna's are assigned (if you are successful in trying to make those changes) i would be clear and concise to the cna's that are on the floor--could you take vitals and sit people up or chair for breakfast? that type of thing. if you are not the charge nurse on the floor, ask charge for some pointers on how you can delegate so that the patients' needs are being met accordingly.

lmbo i swear, i just got the mental image of one of my lol crumping in the hallway of a hospital. almost spit my coffee out on my computer screen!

[annlewis]

Just thought Id point something out...I get that RNs make more than CNAs, but they in NO WAY make great pay lol! Simply wanted to make that clear. A lot of CNAs seem to think that about nurses, and it is absolutely not the case. Where I was working, as a new RN, they were paying just a little more than 20$/hour. That is after 3 years of school. And it would be the same whether I have an ADN or BSN. BUS drivers were making more money, had more benefits, and could actually go on strike if they wanted more, which RNs cant do. So, yeah....jus' sayin'

I know what you mean, and most of the aides on my floor and in the building make more than I do as an LPN....they will always be ahead of me in pay...but they deserve the pay

[Candyn]

I am having trouble with CNA myself. I like to do most of things by myself because I find it is quicker to just do it myself. However, when I ask CNA to help, it means I run my A off. No eat or restroom and I had to stay back 2 extra hours that day. The response that I got from rarely asking was it is not my patient (I can not find my CNA, on the phone with doctor, and my patient was going bad). I hate the "NOT MY PATIENT" sentence. Also, you are too bossy (yet the CNA spent half of the shift talking, fb, and only have 5 patients). The only time I need help is those times or need some muscles to turn patient because I am small. GRR!!! If I am big and I can do it myself, I rather do it myself.

[chevyv, BSN, RN]

I agree with asking nicely and saying please. I work in psych and will even take the time to say "Please get the restraints on the bed stat!" That was until last night when nocs came on and asked who had so and so because they were soaked from head to toe in urine. Of course I was busy with a mountain of work and the CNA's were sitting behind the station talking and waiting to punch out. I am so tired of trying to be respectful to coworkers who fail miserably to do the very basic cares. I have one, mind you one, pt who is incontinent. Come on now, how busy can you be to neglect the very basic of cares!?!

So I found the CNA and told them what was passed onto me and then said that they had 7 minutes on the clock and had better get on it now. She replied how rude I was and it went like that for a bit with me finally telling her she didn't have to do it but to let me know what her decision would be. I finished my work (getting out late per usual), check on the pt, and found the head of the bed up at 80 degrees, bright overhead light on, dry with a sheet (no blanket) over him. Really!? Guess she got me hey?

This is the same CNA who walks away when I politely ask her to do something. Thought I'd try rude.

[caliotter3]

Write them up. Administration will need your write ups when dealing with them for disciplinary actions.

[BrandonLPN, LPN]

I am having trouble with CNA myself. I like to do most of things by myself because I find it is quicker to just do it myself. However, when I ask CNA to help, it means I run my A off. No eat or restroom and I had to stay back 2 extra hours that day. The response that I got from rarely asking was it is not my patient (I can not find my CNA, on the phone with doctor, and my patient was going bad). I hate the "NOT MY PATIENT" sentence. Also, you are too bossy (yet the CNA spent half of the shift talking, fb, and only have 5 patients). The only time I need help is those times or need some muscles to turn patient because I am small. GRR!!! If I am big and I can do it myself, I rather do it myself.

If an aide came up to you and said another nurse's pt needs pain meds wouldn't you say "not my patient" and tell the aide to find that patient's nurse? Why is it different for an aide to say "not my pt"?

Also remember that aide is assigned to at least two or three nurses and their patients. When I was an aide, and I was running around and a FOURTH nurse stepped up and asked me to clean up a pt that wasn't even mine, I'd have had an issue with that.

As I said in an earlier post, there's two sides to every story. 99.99% of the time you can't blame just one side in any dispute. But I've noticed nurses just love to play the victim and/or martyr card. Im sorry, but i just don't buy that so many nurses work with aides who are this lazy. Most of you are only telling one side of the story and are refusing to see the role you play in this. Why do the aides give another nurse a hard time, but when I'm charge I don't have any issues? It's not because everyone is "picking on her", it's because she is annoying as heck and driving everyone crazy.

As I read the posts here from

nurses complaining how the aides don't respond fast enough, I can't help but think it's their own bossy, prissy attitude that's rubbing the aides the wrong way. And stop assuming the worst. Why do nurses do that? If a pt is soaked head to foot in urine, it doesn't necessarily mean they've been neglected. I know from personal experience that I can change a pt only to have them pee 5 min later and soak the bed in a matter of minutes. Water spreads fast, you know. Think about pouring a glass of water on the floor. Does it take hours to spread into a big puddle?? That's a pet peeve of mine. Give your coworkers the benefit of the doubt and just chill out.