Nurses - Leading your subordinates (Nurse Aides, Nurse Techs, Med Aides) - page 4

With the stressful nature of the field it would be no surprise that nurse subordinates feel the pinch too. Nurse subordinates (those who work under you) are usually Nurse Aides, Nurse Techs, or... Read More

  1. Visit  jackson145 profile page
    0
    Where I work, techs aren't subordinate to nurses and the nurses aren't in charge of anyone but themselves. You have to be a member of administration to delegate to another employee.
    Techs have a job description that they are expected to fulfill and the nurses have one as well. We work side by side doing our seperate jobs. Sometimes we will inform each other of something that is due to be done, but that is only because we are the one who noticed it was due, not because we are giving orders.
    In the past, the Docs have treated the nurses as subordinates, and boy did it hit the fan!
  2. Visit  lpn1972 profile page
    0
    What I keep reading over and over is that there are a lot of RN's that really do feel that Aides, LPN's etc truly are their subordinates. How sad! If only they could realize that if they would show some respect and acknowledge those as equals then they wouldn't have the issues that they speak of. I am an LPN and proud of it. I chose to become an LPN because I wanted to, not because I am not good enough to be an RN. I was told the other night that LPN's are there to "help" the RN's, that is our job!! Well let me tell you, that did NOT sit well with me! My job is not to help the RN's but to work with everyone to make sure the pt's are getting the best possible care! I have my own pt load and is still expected to help out on the floor. This particular RN is one of the many that while they are "charting" are sitting there chatting with others, watching TV etc. and then cry that they are so busy and cant possibly get their 6 charts done on time. So then I am expected to make sure that all VS are done, I&O, PRN's, answer all the call bells plus look after my own pt's which oddly enough I never get any help with. I am notoriously assigned the total care pt's, the fall risk, or the confused combative pt's. I had one RN look for me for 15mins (I was doing a hour long dressing at the time) to do a BS for her. When I explained that I was busy at the moment (in with the pt, totally exposed) she proceeded to tell me that she didn't have time and that I had to do it!!! The RN's that actually show me respect and are willing to do some of their work I will gladly help, and wil go out of my way to help them. Treat me as your "subordinate" and I will be BUSY and unable to help! Treat me with respect, and you will get respect back!
  3. Visit  mom4jesus profile page
    0
    Quote from jackson145
    Where I work, techs aren't subordinate to nurses and the nurses aren't in charge of anyone but themselves. You have to be a member of administration to delegate to another employee.
    Techs have a job description that they are expected to fulfill and the nurses have one as well. We work side by side doing our seperate jobs. Sometimes we will inform each other of something that is due to be done, but that is only because we are the one who noticed it was due, not because we are giving orders.
    In the past, the Docs have treated the nurses as subordinates, and boy did it hit the fan!
    This may be the rules of the facility, but licensed nurses are supervisers of unlicensed nursing staff. Unlicensed nursing staff such as Cna are working under the LPN's or Rn's license and the LPN has to work under an RN. Licensed staff are to delegate either directly or indirectly to other unlicensed nursing staff but the licensed nurse is responsible for the patient care.
    "Are you aware that indirect delegation (such as the performance of tasks listed in a nurse aide job description) does not alter the responsibility of the nurse for appropriately assigning and supervising the unlicensed persons performing the tasks? "(KBN)
  4. Visit  ShyGecko profile page
    0
    Quote from jackson145
    Where I work, techs aren't subordinate to nurses and the nurses aren't in charge of anyone but themselves. You have to be a member of administration to delegate to another employee.
    Techs have a job description that they are expected to fulfill and the nurses have one as well. We work side by side doing our seperate jobs. Sometimes we will inform each other of something that is due to be done, but that is only because we are the one who noticed it was due, not because we are giving orders.
    In the past, the Docs have treated the nurses as subordinates, and boy did it hit the fan!
    This is exactly how it is at our facility also. I am a CNA, and the only person at my work that can tell me what to do is the charge nurse and the management. The nurses are not in charge of us or above us in anyway, and are actually just as equally responsible for the CNA duties as we are! Nurses are expected as much as we are to do vitals, and feed babies, and change diapers, and everything else. I'm sorry, but I would NOT take kindly to someone calling me their "subordinate". I am as much friends with the nurses (and charge nurses) as I am with my fellow CNA's, and we all treat each other with the same level of respect. Besides our job duties and our level of education, to each person at my facility we are all considered equal as humans. We are told this from the front from the high management of the hospital, and are expected to act that way. Treating each other with anything less than respect is highly frowned upon.
    Last edit by ShyGecko on Mar 11, '08
  5. Visit  FireStarterRN profile page
    0
    I generally don't like the term 'subordinate', it sounds condecending.
  6. Visit  ShyGecko profile page
    1
    Quote from mom4jesus
    This may be the rules of the facility, but licensed nurses are supervisers of unlicensed nursing staff. Unlicensed nursing staff such as Cna are working under the LPN's or Rn's license and the LPN has to work under an RN. Licensed staff are to delegate either directly or indirectly to other unlicensed nursing staff but the licensed nurse is responsible for the patient care.
    "Are you aware that indirect delegation (such as the performance of tasks listed in a nurse aide job description) does not alter the responsibility of the nurse for appropriately assigning and supervising the unlicensed persons performing the tasks? "(KBN)
    At our facility, the ONLY people that can delegate to CNA's are charge nurses and management. Nurses are not our supervisors, and are not allowed to delegate to us at all. This is said up front to everyone in general orientation, directly from the mouths of high management.
    ChristineN likes this.
  7. Visit  buddiage profile page
    2
    Quote from ShyGecko
    At our facility, the ONLY people that can delegate to CNA's are charge nurses and management. Nurses are not our supervisors, and are not allowed to delegate to us at all. This is said up front to everyone in general orientation, directly from the mouths of high management.
    Then everything I've been learning in nursing school is a lie?

    As was previously mentioned, RNs butts are on the line if a CNA makes a mistake.

    I am a tech (an equivilant of a NA) and OF COURSE we are all playing for the same team. We all have important duties with the common goal in mind: the pt's well being. I would never work at a place where nurses were not "allowed" to ask their CNA to do something while they draw up a med. I also have a great working relationship with the nurses I help, and don't feel like they are a dictator to my day.

    As far as what nurses can or can't do, the ultimate authority that rides over everything else is the Nursing Practice Act for the state you reside in. This is a legal "what nurses can do" guide. Like it or not, nurses CAN and SHOULD delegate if possible- not to pass the buck, but to accomplish the most things for the patient. I don't know nurses on my unit that are "above" wiping a butt. They can and do if I'm not there. This isn't a battle for egos or a "you're not the boss of me" arguement. If you have awesome CNAs who already know the routine (for example, go get suction equipment in anticipation for a patient to be suctioned by a nurse), then obviously, there isn't much guidance needed. The team will work like well oiled machinery.

    I don't understand why everyone gets so upset over "authority." Nurses have their butts on the line for medication errors, even if a physician writes it the way the nurse gave it, and they are also responsible for the errors of their NA's. It's a "when in doubt, blame the nurse" scenario (appealing, isn't it?)

    We all know we are ALL important for the patient's well being and input a lot to the outcome of a patient. I am going to graduate nursing school in two months, and I anticipate that I WILL delegate something if I must do something that the CNA cannot do to accomplish more for the patient. The patient is who we serve.
    bollweevil and leslie :-D like this.
  8. Visit  bollweevil profile page
    1
    Quote from vamedic4
    perhaps it's just me, but referring to people as "subordinates" is a good way to alienate yourself. i realize this is good for the heading of the post, but i've seen nurses do this and use that specific terminology when talking to others --that's a huge no no.
    i'm not trying to start a fight- quite the contrary. but whether you're a nurse or an aide, your goal is the same...to provide the best care for your patient. and just because the nurse is the only one with the legal responsibility for the care doesn't mean she's the only one who deserves the credit for it.
    rule number one: if you need something done...ask. "can you get a stat cbc on 436 and then take him down to xray? sure, i'm all over it. not: you need to do a stat cbc on 436 before taking him to x ray. that will automatically have your aide headed for a long trip to the bathroom. respect goes a long way, and remember...we can't read your minds.

    rule ii: remember, as others have pointed out, that while you may have 5 patients (or more depending on your facility), the aide may have 2-3 times that many. and having all that responsibility is a lot, that's a lot of manual labor that you're not having to attend to, so patience is a must.



    your recommendations ring true - especially the one about sharing credit. make sure you thank those who help you - you never know when you'll truly need their help again. and believe me when i tell you - if you just "expect" people to show up when you get in the habit of not thanking others for help - you're going to be left alone, doing whatever it is - by yourself.

    vamedic4
    going to nap soon
    if you ask somebody to do something, are you willing to have them tell you "no"?

    and if someone is expected to do a certain job, why do we have to bend over backwards to not ruffle their feathers so they won't hide in the toilet or leave us alone? they need to do their jobs.

    nothing wrong with being nice, although people often interpret it as weakness and try to take advantage of you. good to give credit where it is truly due, and the like. but i work for the pay and so does almost everyone else. no one has to be extra nice to me, they never share credit with me and sometimes have stolen it from me but i have learned to speak up when that happens, and i think others should do their jobs and not expect me to thank them all the time. i do thank them and praise them but their good work should not depend on me doing that. they should work because it's their job.

    aides are our subordinates. we tell them what to do, like our bosses tell us. we are responsible for their behavior to a large degree, thus we have to have the authority to assign them, teach them, monitor them, and correct them.
    Virgo_RN likes this.
  9. Visit  bollweevil profile page
    0
    Quote from ShyGecko
    At our facility, the ONLY people that can delegate to CNA's are charge nurses and management. Nurses are not our supervisors, and are not allowed to delegate to us at all. This is said up front to everyone in general orientation, directly from the mouths of high management.
    A Charge Nurse is the direct supervisor, although there could be a supervisor over her.

    And delegating work to you is certainly a function of a supervisor.

    So I'm not sure which nurses are not your supervisors.

    What exactly did high Management say to you in Orientation?
  10. Visit  bollweevil profile page
    0
    Quote from jlsRN
    I generally don't like the term 'subordinate', it sounds condecending.
    We are subordinates, too. We are subordinate to doctors, managers, etc. Life is full of ranks. Why is it so distasteful?

    That, as I see it, is a major problem with nursing today. The aides don't know we are their bosses and we are afraid to let them know becaue se want them to like us and sometimes because Management won't back us up.
  11. Visit  Virgo_RN profile page
    1
    Quote from vamedic4
    But whether you're a nurse or an aide, your goal is the same...to provide the best care for your patient.

    snip

    Rule number one: if you need something done...ASK. "Can you get a stat CBC on 436 and then take him down to Xray? Sure, I'm all over it. NOT: You need to do a stat CBC on 436 before taking him to X Ray. That will automatically have your aide headed for a long trip to the bathroom. Respect goes a long way, and remember...we can't read your minds.
    I know this post is almost a year old, but I am really bothered by this. You mean to tell me that you would walk away from a patient who needs care because you didn't like the way the nurse asked you to do your job?

    And you want respect?

    Any nurse who walked away from a patient because they didn't like the way the doctor spoke to them would get slapped with a charge of abandonment. If you want to be treated like you are on equal footing, then act like it. Understand that your obligation to the patient supersedes your ego.
    Last edit by Virgo_RN on May 1, '08
    hotmama2be likes this.
  12. Visit  Okami_RN profile page
    0
    I understand what you mean NancyNurse but I have seen many NA's do just that, the nurse tells them that they have to do something and they will walk away and do it whenever. It truly is a shame but it does happen.

    I myself just clench my teeth and grab the blood draw kit when a nurse talks to be in a demanding voice. but the patient is first so in I go with a lavender top.

    BTW our BOH says we cannot have blood draw kits anylonger... what a bummer.

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