Nurses who let NAs Boss them around - page 11

When will nurses ever learn to delegate? When will nurses ever collectively stand up and get some backbone--Fight for higher wages, and better benefits like a company matching 401K plan? I get sick... Read More

  1. by   tiroka03
    Take a picture.
  2. by   SRobinson
    What is it with Nursing Home DON's and Administrators? I worked in LTC for about 10 months a few years ago as a Weekend Supervisor. The DON was afraid of the Aides. The thinking of those in Management is just appalling. The situations I encountered with staff was horrendous:

    1) I sent an Aide home, suspended her, because she attacked another Aide that she was angry at over an assignment. The DON practically apologized to the offending Aide and she was back at work the next week with NO penalty.
    2) Aides constantly left their assigned area to talk to their buddies.
    3) They all wanted to take breaks/lunch/smoking times together.
    4) They came in late, and left early.
    5) They had their buddies clock in and out for them.
    6) When I stood up to them, let them know what I expected of them...just to perform their job....I received harrassing phone calls at home and at work. Made it a point to contact the police and file a report. I had them come to the facility and made sure that everyone I suspected of being involved knew what was going on. Of course, I "played" the victim and just couldn't figure out WHO was doing this to me. The phone calls stopped after the police made their visit.
    7) The DON was a relatively "new" RN, she had about six years experience, not any in management before this position, and was intimidated by any suggestion I made. The remedy for any problem was creating another piece of paper that the Professional staff or the Aides had to fill out.

    It became evident if you came to work on time, did your job, had good rapport with residents/family members you were a problem. On the other hand, if you came and went as you pleased, called out frequently, slept thru part of your shift and didn't give a hoot about the quality of your work you were held in high regard and they would practically beg you to stay...of course you had to threaten to quit on a regular basis.

    My venture ended when Administration decided that Supervisors and Unit Managers weren't needed any longer (I guess they thought the Aides were doing a great job running the place!). They were in a scramble to make up for lost revenue when the facility lost their ability to admit new residents under the govt programs due to too many problems following a state audit. They turned to the LPN's in the facility after I left and had made them rotate doing House Supervisor responsibilities. Another management decision that was met with opposition.
    I would not go back to LTC. The bottom line for these facilities is making a profit for those at the top....is why I won't work at most hospitals either.
    Sorry to be so negative but it won't get any better til those at the top change their mindset. Most mgt looks at those giving bedside care as being expendable/disposable..."a dime a dozen".
    Last edit by Jay-Jay on Dec 10, '04 : Reason: Comment re race of CNA's
  3. by   Hellllllo Nurse
    Quote from SRobinson
    ....It became evident if you came to work on time, did your job, had good rapport with residents/family members you were a problem. On the other hand, if you came and went as you pleased, called out frequently, slept thru part of your shift and didn't give a hoot about the quality of your work you were held in high regard and they would practically beg you to stay...of course you had to threaten to quit on a regular basis....
    This has been the case at most facilities where I've worked, be they LTC, hospital, hospice units, or dialysis.
  4. by   flashpoint
    I do PRN in an LTC and some of the CNAs are WONDERFUL...others, I wouldn't let take care of my cat. However...there are nurses I work with in my regular job in the ICU who I feel the same way about. I think a lot of the problem with laziness is that most people know that if they don't do their job, someone else will step up to the plate and get it done. If they ignore a call light or a cry for help, someone else will take care of it. I don't think that payind CNAs more is the answer for two reasons, #1...as a nurse, I am not going to do what I do for just a couple dollars mroe than the CNAs...at night, I do everything that they do, plus meds, wound care, assessments, etc. I am paid not only for what I do, but for what I know (or am supposed to know!) through formal education. I am also paid more for the responsibility that I take. #2...no matter what job you do, you should give it 100%. If you're going to slack off and do a poor job for $7.50 an hour, you're likely to do a poor job if you're paid $20.00 an hour. Attitude is what makes you stand out...not aptitude.

    The last night that I worked in LTC, I worked with a CNA who had only been at the facility for about 3 months. She crawled into bed shortly after 10 PM rounds and I couldn't get her out of bed until shortly before 6 AM rounds. I wrote her up and the DON informed me that when the CNA did well, she did very well, and that since no one suffered because she slept, they would let it go just this once. Sigh...I am not going to that LTC again!
  5. by   ktwlpn
    In my experience in LTC care this is quite common.I believe that all nurses must take their supervisory role very seriously and when we are dealing with a problem staff member( cna or another nurse) we have to document it and take it through the proper channels. I have watched problem staff terrorize other nurses and cna's and I can only speculate what was going on with the residents...Many of my co-workers would not start a paper trail.Anytime anyone takes a problem to the DON her first reaction is a big "Oh-crap! What's YOUR problem?" and many feel it is just not worth it....I have been through it and it does not endear you to the rest of the staff but that is not what we are there for -we are there to see that the residents get the care they require...I have also found that most of our cna's will slack when they know you are busy and also the more you "help out" the less they do.I have lately found myself rounding at shift change and discovering alot of crap left around after I have hopped around at the beck and call of the cnas- and worked without a break while they get their lunch,smoke breaks and leave promptly at the end of the shift...I will interrupt my med pass if a resident has an urgent need-but not if all 3 cna's are eating breakfast and watching TV in a resident's room....And to try and explain "prioritization" Fugeddaboutit......Don't get me wrong-I work with a lot of excellent staff but there is always a select few that can make your life miserable...When I have worked in acute care I have usually been primary nursing and not had to put up with that type of hassle...
  6. by   ibnrn
    " and I see the Nurses aides doing whatever they want when they want--"
    Oh, do I totally agree! I've seen that here in TX, too. And just let them be smokers...then they've GOT to have their breaks. Many times I have worked through lunch because these slugs won't even answer a light or get a patient some water, but no-o-o-o. Management acts as though they are afraid of them. And try to find one to ask them to do something. Good luck! :angryfire
  7. by   stbernardclub
    Its Like I Have Been Saying... This Aide Situation Has Got To Get Better. I Am Sick Of Their Lazy Arses !!!!!!!!!!
  8. by   LPN1974
    Looks to me like it is pretty common. I agree with aLOT of what other posters are saying. It sounds like we all are experiencing the same old crap. Doesn't matter where you're from it's all about the same. I do think administration is afraid of the aides. I certainly got that feeling where I worked in LTC. It's like they thought , "Well it's a warm body here tonight, so let's just not say anything." The aides know they can get away with it because if they get fired from one nursing home, they just go right down the street and get another job at the next facility. It happens right here in my three nursing home town of about 10,000. They just make a circle every few months.
    The difference in the nursing homes and my primary job is that in nursing homes the benefits are practically nil, but when you work for the state, you get better benefits, cheaper, better health insurance for you and your family, and generally better wages. I know the aides on my primary job get about 1.00/hr more than nursing home aides.
    Now on this state job, believe me, they put up with no crap. You either do your job, or else. They don't care. You will go thru several warnings, from verbal all they way to firing, if it doesn't improve. But at nursing homes, what do they really have to keep them there? The benefits are next to none....there's not much to hold them and to encourage them to try to do better and discipline doesn't exist. Some of you may agree with me on this or not. I'm just saying that I see the difference in the two different types of jobs that I have worked. If you have a job where you know that you are getting something that you need and you want to continue possessing that benefit, you will work hard to keep it.
    These nursing home jobs themselves are a dime a dozen. I am not a lazy nurse. I know I am not too good to wipe somebody's butt, and I will do it, if I need to. But I'm not going to do the aides' work for them. When I was in LTC I had a med round to pass of about 40-45 people. I started my 8:00pm med pass at 7 or 7:30PM, as soon as I got to work and got report and got my cart set up and it took me until midnight some nights to get thru. I am not kidding. When you pass to that many people, and chart each and every med like it's supposed to be charted, it takes a long time. After a few months I did get some faster, but most nights it could be 11-12midnight. After I got thru passing med then I charted for several hours, the computers shut down at 2:00am, so that's when I tried to take a 30min break. In between all this, I had to take care of emergencies. Then when 5am rolled around I was busy for two hours with early morning med pass, finger sticks, insulin, etc, and oh yes, don't forget tube feedings and changing out bags and tubes on a half doz or so people, not to mention treatments that the dayshift didn't get done and left for me to do. And of course you have meds to sign in that were delivered by the pharmacy, change outs to do on certain nights. I stayed busy every night. I did NOT have time to be making rounds with or for the NAs, but I did do MY rounds to check on people to make sure everyone was still breathing. This is not all of what the night nurse had to do either. And the day nurses were just as busy. They had different things they had to do.
    The nurse aide situation is what helped push me out the door. The rest of it, I could deal with. On nights it's best to stay busy, but in a facility with a census of around 70 patients, 2 LPNs, and only 2 NAs show up, what do you do? You do the best you can and pray nobody gets sick or falls.
    I think I would rather pick s*** with the chickens that go back to LTC.
    Last edit by LPN1974 on Dec 11, '04
  9. by   EMTI19
    OMG I can't believe some of the posts that I have just read on this thread. I am sorry that some of you have to work with people like that. I work as a part time CNA on the medical floor of a small hospital and I would NEVER say no to a nurses request or order. I treat all of my nurses with respect and in turn they treat me the same and even go beyond that to teach me and answer questions I have about nursing school. Since they know I am in school, some will call me in to observe procedures and explain everything if there is time. I love working there and love all the experience that I am getting. I see how hard they work because they allow me to see it and explain why they do things certain ways. It gives me an appreciation for them and I would do anything to help them and the patient.
    I'm sorry, I wasn't trying to talk myself up. I just can't believe that some of these people are even in health care, AND that some of them are allowed to stay in health care. Very, very sad.
  10. by   LPN1974
    Quote from EMTI19
    OMG I can't believe some of the posts that I have just read on this thread. I am sorry that some of you have to work with people like that. I work as a part time CNA on the medical floor of a small hospital and I would NEVER say no to a nurses request or order. I treat all of my nurses with respect and in turn they treat me the same and even go beyond that to teach me and answer questions I have about nursing school. Since they know I am in school, some will call me in to observe procedures and explain everything if there is time. I love working there and love all the experience that I am getting. I see how hard they work because they allow me to see it and explain why they do things certain ways. It gives me an appreciation for them and I would do anything to help them and the patient.
    I'm sorry, I wasn't trying to talk myself up. I just can't believe that some of these people are even in health care, AND that some of them are allowed to stay in health care. Very, very sad.
    I don't think you're "talking yourself up" You're an excellent CNA, you have good work ethics, and you will make an excellent nurse. We need more like you. You continue to set the example for other CNA's as long as you are an aide.
    But there are bad nurses out there, too. While I was in LTC, there was a nurse there, and I did not actually witness it myself, but I heard that she didn't give all of her medications. I know for a fact she did change the times around on the medication sheets alot to suit herself, and she would also initial things for other people that she thought they forgot to initial. I told her not to be putting my intials on anything, that if I forgot to initial something to call me and I would come over and do it myself. If she did those things, no telling what else she did. Anyway, I'm just trying to be fair. Not all CNA's are bad.
    I had two on the night shift, that I didn't know what I'd do if they weren't there. They were my best two CNA's, but they got tired of bullcrap, too, and quit. We have people in all walks of life, who are good; some who don't give a hoot and those are the ones who can make your life miserable.
  11. by   boulergirl
    Believe me, lazy NAs can get on other NA's nerves, too. Just this morning, we had one waltz through the door at least 30 minutes late with no apology. :angryfire She tends to show up whenever she wants, and has an attitude. I try to avoid her. She's been written up several times, and just came back after a two-day suspoension. Thankfully, we have a new nurse who is cracking down on things.
  12. by   LPN1974
    Quote from boulergirl
    Believe me, lazy NAs can get on other NA's nerves, too. Just this morning, we had one waltz through the door at least 30 minutes late with no apology. :angryfire She tends to show up whenever she wants, and has an attitude. I try to avoid her. She's been written up several times, and just came back after a two-day suspoension. Thankfully, we have a new nurse who is cracking down on things.

    I bet it does. You have to help take up the slack when the lazy ones slack off. They hurt all of us. :angryfire
  13. by   curleysue
    I agree with most of you guys that there are some really bad NA's out there that do crap. But you also have to realize there are some good Na's that work their butts off to help the RN's. We cannot forgot about that. Before I was a nursing student as a CNA I made sure I did everything and anything to assist the RN who I know has there hands full with other things the NA's cannot do.

    Imagine how hard it would be for an RN without a good reliable NA. That is an important point too. And sometimes the NA knows more about the patient than the RN does if the RN patient load is so many, the CNA is with the patient often times more than the RN.

    Just thought I would defend the NA's position too.

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