Nurses who let NAs Boss them around

Nurses Relations

Published

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 when I work at institutions (I am an agency nurse) and I see the Nurses aides doing whatever they want when they want--unlimited breaks, breaks all at once together leaving the floor uncovered, flat out refusing to answer lights or doing a task.

Its no wonder nurses are leaving the profession in droves. Management appears to be scared to approach the NAs too, but have no trouble when it comes to chastizing an RN. Whenever I ask an RN why they tolerate a situation, the response is always the same--management lets them get away with it. I have returned to Nursing after 13 years of working in a business setting. Not much has changed. PT, Pharmacists, and OT have all manged to get substancial financial increases while many nurses are still making $21 bucks an hour. I don't allow NAs to get the best of me, and all I get for my trouble is even more resentment. Not all NAs are like this but I will go out on a limb and say the lack of RN delegation and management skills are detrimental to the professionof nurses.

Phe Phe, RN, BSN, MBA

Specializes in Alzheimer's, Geriatrics, Chem. Dep..
Originally posted by PhePhe

here? This is not an issue to be swept under the table. NAs can start their own thread, "NAs who feel RNs Boss them Around".

I have been thinking it would be good for the RN's to say what they would like from their CNA/other. Also for the CNA to say what they need from their nurse.

For example:

I would like the CNA's/etc. assigned to my patients to be either at the desk or near his/her assignment, or tell me when they are on break, so I know where to find him/her.

I would like my CNA/etc. to let me know when vital signs they took are out of whack rather than just write it in the book.

I would like my CNA/etc, if instructed to wait for v/s on a patient that is sleeping, that they take the v/s if the patient DOES awaken ie for a bedpan, med, etc.

*********************

Kind of insulting isn't it? But these are issues I deal with all the time. There are some obviously who don't NEED the instruction manual!

I'm sure the CNA's/etc can come up with stuff that's equally insulting. GOOD! Sometimes people can be oblivious. Even me, sometimes!

Zoeboboey,

I like your style. I can guarantee you would get major atitude if you spoke those simple clear requests! :nono:

I am with you all the way! I'll try it at work today :eek:

Specializes in LTC,Hospice/palliative care,acute care.

I think this thread is great and am glad that it has opened a dialogue between nurses and cna's...I hope we can keep it civil(I think we can) and continue to learn from each other....I think Zoe gave the first important lesson-we have to make our expectations very clear-we can't expect anyone to read our minds and know what we want them to do or expect them to automatically do it all.....We can avoid many problems by strictly following this guideline.But when you ask? tell? instruct? staff that you are supervising to do something and get attitude it is tough to remain cool.... it's a learned skill and I don't think many nursing programs spend enough time on it...I have several awesome cna's on my unit and a few that need a bit more motivation and instruction.I also work with a borderline personality(I know because I recognize many of my own borderline personality characteristics in her:chuckle ) She is a very disruptive influence on the unit.It has been interesting to watch the power shift on the unit in the time I have been there-the pack mentality has been very evident.It's the "ME show all the time" with her-she really is a text book case-very interesting.And she is a pathological liar-smart and manipulative.A real challenge-but tough to manage...

Great comments! I have seen all of the above examples expressed. There are not enough hours in the shift to complete all of the ADL's for your patients, medications, and documentation. I have worked for civilian hospitals and I have had to stay over my shift many times to complete charting while the nursing assistants clocked out and left on time. I have said many times, the nurse can do the CNA's job, but the CNA can't do the nurse's job! Now I work at a military hospital. The only differrence is there is a lot more paperwork than the civilian sector. The nurse/patient ratio is lower, and most of the time there is enough staff. The only problem is no communication. There can be a truckload of staff, but if there is no communication things don't get done! I make rounds on my patients regularly. It is frustrating to find the CNA's sitting around and only going into rooms when the call light comes on. There are really good CNA's out there and I have worked with a few of them. I can't stress that team work is the key. After getting report a game plan should be made between the nurse and the CNA.

Specializes in Community Health Nurse.

I work with some really terrific nursing assistants. I've only encountered a couple problems in this area, but for the most part, I give a thumbs up to the many nursing assistants I have met and had the pleasure of working beside in my 16 plus nursing career. I use to be a nursing assistant myself during my final year of nursing school, so I've never forgotten what they do, or how they feel on the job, etc.

Here's to all the nursing assistants who work their buns off on their jobs and get very little recognition for it: :balloons:

From a former Nursing Assistant turned RN :nurse:

Specializes in LTC,Hospice/palliative care,acute care.

I'm resurrecting this thread because I had a lousy experience today and need to vent .I have gone back and re-read many of the other threads on this same topic...It's the song that NEVER ends....I am one of 3 fulltime nurses on a 42 bed unit-and am only in charge once a week(or more when the charge nurse is on vacation-as she is this week) I am so tired of asking people to do something and being mouthed off at....Yesterday and today 2 different staff members gave me attitude.The situation involves a demented and often combative resident.We have been working hard-care planning galore and even consulting staff development about her and are trying to come up with ways to provide care to her and insure safety for ALL....I can't have staff screaming at me in the hall "She scratched me and tore my shirt-She can just stay in bed all day" She's in her 90's and can give you a good hurting when she pinches a hunk of meat but I don't think she can break anyone's bones....She is a 3 person HOyer lift now-and due to NUMEROUS skin tears the care plan has been discussed with the staff over and over...I told them this am to try to give he am care early but not to go back to try to get her up until close to noon-hoping that she would settle down and be more amenable...The cna FREAKED on me-Finally he did go in the room and work the lift while another cna and I put the lift seat under her-I held her hands as we turned her around and sat her in her recliner and it worked well....I was not even going to go to the supervisor because it seems that in the end the DON does not really want to hear it (unless it is an abuse situation) They just want the status quo-and other times I have had this kind of problem I have had MY professional manner called into question-and have been told to not be as "friendly" The charge nurse works 12 hour shifts-by 7 am she has all of her routine paperwork done and has much more time to help out on the floor then the other nurse and I do-and she does do more but we all 3 do ALOT.It's a dementia unit and we have all stepped in and taken over a shower when a resident was escalating-we toilet,feed,etc........A few of the cna's have the attitude that if they try once then tough luck-they are done...So-I went to the supe-I had to....She promptly went to the DON and the cNA was called to the office and down there for quite awhile-In the meantime she had told me to counsel everyone about the careplans and this resident in particular...Of course-another cna (she is a borderline-nut) had to start and make it all about her and her problem with one of our horny old men and switching assignments,etc...I abruptly told her that we were not going to talk about anyone else's situation at that time and wound up the meeting...At the end of the day they were all at the back of the unit b*tching about me...I did shut her down in front of everyone but I feel that I was taking control BACK because her and another cna were trying to monopolize the conversation and saying things like they were told in training that they don't HAVE to take care of anyone that they feel "Uncomfortable" with...NOw -all of the cna's that have a problem with this woman are black and she is white.I have seen them often show favoritism towards the black resident and be less then kind to the demented troublesome white ones.....I KNOW that when I get back I am going to be in that office and chastized-it will end up being MY FAULT somehow...I told the cna during the episode the rationale for what we were doing-I told him all about the many approaches we were trying and why it was important for ME to witness her behavior and document it so we can get her medicated if we need to...The cna that gave me lip yesterday "I ain't getting her azz out of that bed" Told me to make up a note for the chart after I insisted WE (her and I) try to get her up...Per the doc's direct orders-he noticed she was in bed one late morning and the charge nurse told him of the difficulty we are having and he ordered us to get her up(within reason-If I see her ripping and tearing and am concermed for her safety and the staff's she will stay in-but I'll have good documentation on it for the Doc when he reams my azz....and the family when they find her in bed AGAIN or when I call them to notify them of ANOTHER skin tear.....I CAN'T keep working like this-my health is starting to show it-I can not deal with the tension and stress...It gets to me to the point that I am almost afraid to tell ANYONE to do ANYTHING because they see it's OK to be insubordinant to me and a few of them like to get under my skin and get me rattled so they are looking for the chance to get lippy.....I am SO angry and upset and SAD...I want to get along and I want these residents to get the care they deserve.If I am the sourc of the problem I need off of that unit because it is not good for the residents to be around the screaming and yelling....And it's always ME-when I am in charge-I get attitude...I have been in th office with a few of them (one was let go for admitted abuse) and the DON backs me usually and always in front of them-after they leave I come under attack and I hate it and dread it...I don't seem to have any problems asking anyone esle to do anything on other floors.....I HATE TODAY

Stand your ground! Please don't fold. You are doing what you are supposed to be doing. Grab the job description and sit down with the supervisor as a witness and ask the aide just what she is REFUSING to do in conjuction with that patient. Also hint to your manager that you have had it with not being supported and for now on you will document all refusals when patients are not gotten out of bed. You can't fight city hall! This place sounds like one where the NAs think they are going to boss you around. You may have to start looking for another job. Or ask for a transfer. When will nurse managers realize that it is this kind of non-support that drives a nurse to quit!! I feel for you honey. Again, stand your ground. They are challenging you. I know you can come up with a workable solution.

Gettin an AZZ out of bed, indeed! How unprofessional.

It sounds like that whole heap of troublemakers needs to be scrapped. But since that is very unlikely to happen, you might want to start looking at the job ads. There are too many available positions out there for you to continue at a job where you're being stressed out like this. The job is stressful enough without having to constantly fight with the nursing assistants and management. There's only so much you can do before you have to stop beating your head against a brick wall and move on. Good luck to you.

GEE, I DON'T UNDERSTAND HOW A CNA OR ANYONE UNDER AN RN WOULD BE SO DISRESPECTFUL TO HER/HIM. I AM 36 AND AM WAITING TO BE ACCEPTED IN THE LPN PROGRAM. I'VE DECIDED TO APPLY AT THE LOCAL NURSING HOME/ASSISTED LIVING CENTER, WHILE I WAIT. THEY WILL CERTIFY ME TO BECOME A CNA. I'VE HEARD SO MANY BAD THINGS ABOUT ASSISTANT'S CLASHING WITH RN'S ETC BUT THAT WON'T BOTHER ME. I WILL GIVE THE RN OR THE PERSON ABOVE ME THE RESPECT THEY DESERVE. IN RETURN, I HOPE TO GET THE SAME RESPECT.:roll

Originally posted by PhePhe

You know, I have heard nurses aides say that the nurse HAS to help, and just because they are an RN doesn't mean they don't have to do patient care anymore.

Reminds me of when one of our CNAs, after being 'reminded' to do her vitals said....."When I am a nurse I will do MY own vitals." Ahem..... her job is to do vitals and draw blood. Period. That is why she was hired. I wish I had time to sit and eat dinner and do my nails instead of my work.

I agree that the managment is responsible for LAZY NAs. I used to work on a surgical unit where the NAs were wonderful. They worked hard just like the RNs. The nursing manager expected this from RNs and NAs and we all complied. Both the RNs and NAs would get spoken to if necessary. We all accepted this and worked well TOGETHER. Now I work on a cardiac/respiratory unit and the NAs are lazy and help those that are thier friends. The NA with seniority makes a lot of motion of being busy but really does very little. I find that it is so heavy and other than making a problem (and making enemies of long time staff) it is better to just ask for help and if I don't get it, do it myself when I have time. The nursing manager of this unit thinks the NAs are wonderful.

hi to all who responded to the post i too am a cna. i work long hard hours we are always short every day of the week i get called everyday to go in early. i consider my nurse my mentor i have learned alot from her. i have worked with all 3 shifts i primerly work 11-7. i feel for u nurses who dont get support i see how my nurse sits at the desk all nite doing paperwork and all her other duties! i would like to become a nurse but i havent been able to pass the entrance exam. and alot of what y say is true we get slackers but i give them heck! im not another cnas crap. i too havee had the gamit from doing 40 residents my self all nite to rounds! so yes the street goes both ways! i pride my self in my job and although many times there are no smiles but i rember every thank you i get and it helps me to move on into the next day

:) we were told no raise for 2 years :( im sad about that so i hope the ones that y do depend on you give a thank you too cause it really helps us too ! i may add what happened to hippa! we were told no disscusing residents! i dont get but 2 breaks and 30 min supper so where do these people work!!!! i dont understand it.

+ Add a Comment