A few observations about the nurses I work with from a new CNA...

Equinox_93 · Apr 3, 2009

Yes- absolutely agreed. However, there is the reality that not everyone who is a nurse, or an assistant (or insert any other medical or other professional here) is a hardworking person who cares about the quality of care they give. Many to most probably do. But like it or not- it seems there's at least a couple in each facility who truly are lazy or disrespectful or lacking communication skills etc. (And this goes for ANYONE). I don't think (most) people are complaining about the ones who are doing the best they can and being a "good co-worker"- they're likely talking about that one irritating little snot of a CNA who txts all shift and leaves work undone or poorly done or the nurse who would rather talk about her recent vacation with another nurse than offer a bedpan when the other aides are busy- resulting in a complete bed/clothing change/unscheduled shower/bedbath... The obnoxious exceptions rather than the rest of the folks who are doing the best they can. I think it's easy to focus on the "bad" and take the good for granted- especially on message boards where people go and tend to let off a little steam because they can't at work. MHO.

I sat here thinking how can a CNA fully appreciate all the nurses do as they have never had to do all that they do. How can I an LPN fully appreciate all that an RN does as I am not responsibile for the multitude of things only they can do which I can not.
I believe this is the point of this thread realizing we all work hard, the CNA, the LPN and gosh knows the RN .
Each of us are to do the best for the patient within our own Scopes of Practice. I do for the patient that which a CNA and an LPN can do. I do for the patient and the RN that which helps the RN as she helps me with that I can not do.
Think about it where does the buck stop.

AnnaMary · Apr 3, 2009

I can't believe this thread. I didn't know what hard work, responsibility and all encompassing fear was while I was a CNA. I just thought I did.

Now that I am an RN I get it.

I wish I was a CNA again, having 10 people shouting at me to clean up patients and grab urine samples. Bliss.

nursemike, ASN, RN · Apr 3, 2009

I can't believe this thread. I didn't know what hard work, responsibility and all encompassing fear was while I was a CNA. I just thought I did.
Now that I am an RN I get it.
I wish I was a CNA again, having 10 people shouting at me to clean up patients and grab urine samples. Bliss.

Me thinks you exaggerate. A little. I'd be bored silly in my old job (which, admittedly, was often easier than an aide's.)

lpnflorida, LPN · Apr 3, 2009

I think legal right has little to do with access to Kardex, it most likely is institutionally based more than anything else. All of our nurses and all of our aides receive at the beginning of the shift what is call the PCP it is a computer generated print out which is our Kardex.

mochabean · Apr 3, 2009

I always take my lunch and my two breaks. I'm not letting myself be worn out and exhausted from working. I like to leave work, knowing I accomplished a lot and made a difference in someone's day. It's not supposed to be about me feeling bitter towards the patients and nurses or about not getting a chance to sit down for a few minutes. Regardless of where I work at, I am my first priority and I will go out of my way- like I do for everyone else- to make sure I have nourishment and peace of mind for at least 60 minutes in a twelve hour shift. If I don't advocate for myself, who will? Maybe when I become a nurse I'll have a different perspective, but I'll cross that bridge when I get to it.

lamazeteacher · Apr 3, 2009

The following is copied from the CDC recommendations to which Virgo_____RN directed us:

"Universal precautions do not apply to feces, nasal secretions, sputum, sweat, tears, urine, and vomitus unless they contain visible blood. Universal precautions do not apply to saliva except when visibly contaminated with blood or in the dental setting where blood contamination of saliva is predictableUniversal precautions do not apply to feces, nasal secretions, sputum, sweat, tears, urine, and vomitus unless they contain visible blood. Universal precautions do not apply to saliva except when visibly contaminated with blood or in the dental setting where blood contamination of saliva is predictable"

Therefore, Equinox 93, the situations wherein you want to wear a gown, do not require that. I've responded to several of your posts about the need not to treat HIV patients differently, so you'll feel safer with them. Yet you persist in your belief that they are highly infectious and require extra effort to protect yourself. When AIDS was first an issue, in 1989, nursing staff responded exactly as you have, and it was difficult to persuade them about the lack of concern needed for procedures NAs do.

If you still have the belief that you need a gown for working with all patients, please discuss that with your supervisor, Infection Control Nurse, or Nurse Manager.

netglow, ASN, RN · Apr 3, 2009

wow.

i think coming into this profession from years in another... that... rns and techs both are suffering from the same thing, and end up beating each other up for it in the end. when you deal with life and death situations nearly daily, it takes it's toll.

everybody "acts out" in a different way. a wise person told me that we are all in this "for the patient", not ourselves... i have decided to remind myself of this when working. for me this re-sets my mind and puts it in the right place. everybody needs to find some kind of outlet outside of work that is just "for them" but remember what your focus is when at work. if you start to focus too much on yourself in nursing, that is when you open yourself up to making errors, and having feelings that you are not appreciated, etc. which starts a neurotic process. i think it would be wise if staff were provided some group counseling on this on a regular basis. hey you psych nurses, maybe you could start some therapeutic interventions on this thread, give everybody some tips. :icon_hug:

Vito Andolini · Apr 3, 2009

I've been working as a tech on a med-surg floor for about 3 months. This is my first real job as a CNA and I've been kinda surprised by a few things. Just wanted some feedback as to if these things are typical of nurses in general, or maybe it's just where I work. I work with some really sweet people--nurses and techs--I've just noticed a few things that surprised me:
1 - I didn't realize how little time nurses actually spend with their pts.
Since I do the actual pt care, of course I end up spending a ton of time with my pts, getting to know their likes/dislikes, ailments, family etc, especially when I work 2-3 days in a row and see the same pts over and over. But the nurses I work with don't seem to be nearly as familiar with the pts. In fact, oftentimes they'll seem surprised by half of the things I tell them. It seems like my pts have more trust in me since they see me most of the time. They'll let me know if something is wrong and when I say "Okay, I'll let your nurse know" I usually get a smirk and an eyeroll, like "yeah right." It's a little scary how little faith these pts sometimes have in their nurses, as if they think the nurses don't care about providing them with care/relief. Is this normal? Just a wrong perception maybe?
2 - I don't understand the lack of communication b/w the nurses and techs when it comes to pt info.
Out of all the nurses I've worked with over the past 3 months, there are only 3 who actually give me a report at the beginning of the shift about each pt. On my unit, the techs give each other report, and the nurses give each other report. It's not often that a nurse will also let a tech know what's going on with their pts. To me, this doesn't work out most of the time b/c I'm usually clueless as to labs/specimens that need to be collected (ie what, how many) as well as any diseases these pts may have. Just the other day I had a pt that had AIDS, full blown AIDS and I didn't even know it until my 3rd straight day of working with him. And I only found out from the night time tech, not the nurse I'd been working with for the previous 2 days. I have to admit that ****** me off. I asked the nurse did she know he had AIDS, she said "oh yeah, he does." Hello? Perhaps it's just me who's missing something here, but I think a nurse should let her tech know about stuff like this. I know I would.
I also find it entertaining when a nurse will ask me 1 hour before my shift is over if I collected any specimens yet. Ummm, specimens for what? How many?? I wasn't aware that I needed to get them. You never told me! Total lack of communication.
3 - I am amazed by the aversion to pt care and the lack of pt care skills that some nurses have.
A couple of the nurses I work with (and by couple, I literally mean 2) will actually do pt care for their pts. They don't wait on the tech to do everything. If they're in a room with a pt who has a dirty diaper, they change it, or they call me and together we clean up the mess. How sweet these ladies are! I understand that nurses are busy, but so are all the rest of us. And sometimes, I need help with pts, especially larger ones who I can't move by myself.
With the exception of the 2 nurses mentioned above, I have never seen a single one of the other nurses on my floor help out with pt care. They leave every single thing to the techs. There is this one nurse, bless her heart, who will at least offer, but when she attempts to help, she never knows what to do and just stands there looking at me and asking ME (the relative newbie) how to do basic things like getting a diaper under a pt or putting new sheets on an occupied bed or scooting a pt up in the med. Isn't that stuff Nursign 101?? At least this nurse OFFERs to help. I appreciate that since several of her colleagues wouldn't even think of it.
4 - I don't mind helping nurses with things that are out of my scope and part of THEIR job, but please don't expect me to do it simply b/c you ask and can't get around to doing it yourself. It's still YOUR job!
I am taking prereqs for a BSN program, so I am trying to get all the experience I can. I pimp my job to the fullest and take advantage of every opportunity for learning and exposure. I'm always there for wound cleanings, all the nasty stuff, anything that'll help me learn more, I love it and I usually don't mind doing it. But sometimes I don't have the time to indulge myself. I have this one nurse I work with who is always behind on her work. i know this because she constantly informs me of this throughtout the day, every day that I work with her. So what she does is throw as much of her work on me as she can get away with. "Can you clean so-and-so's wound?" Sure, I'm a tech and it's out of my scope of practice but I am more than happy to do it if I have time (as a tech, where I work I am supposed to only be able to apply clean dressings to a wound, not actually clean it, that's the nurse's job). "Can you look up so-and-so's lab results and tell me what they are?" Wow, sorry, Mrs. Nurse, not only do I not have the time to do that today, but I don't even know what the heck I'm looking for. No can do! "I need you to find out if there are any dr orders to d/c that foley today!" I have no clue how to even begin doing what you asked. Where do I look? What am I looking for? I'm new, I'm a tech, and this industry is new beans to me. WHat where why HUH??? I'm afraid you'll need to do that yourself sweetheart. Maybe take the time to show me next time? Thanks!
With all that said, I enjoy working with the team I work with and at this point probably wouldn't trade them for the world, but it has been an eye opening experience to say the least. I'd love to hear you all's thoughts on this!

The good, the bad, and the ugly.

Dont judge too harshly; someday, your techs will say the same stuff about you! You won't, as an RN, have as much time with your patients as you have now, so enjoy it while it lasts.

If you are working outside your scope of practice, you're asking for trouble. Stop doing this at once, unless you do not value your job, your income, and your future.

Some nurses dump on techs, some techs evade, shirk, and otherwise avoid as much work as they can. It's real life.

If asked to do something you don't know how to do, you could ask for instruction. Don't get mad that none is given, just ask for what you need.

Things are not always what they appear to be. Keep an open mind. Best wishes. There's nothing worse than a tech who thinks she knows it all. Stay above assuming that.

johnsboo · Apr 3, 2009

Why can't we suffice it to say, we all work hard, and we have all worked with people of all certifications, licenses, training etc. that are just not up to par, and that it really makes us angry when they complain or blame others. We also have all worked with genuine caring, giving, hard working people we wouldn't trade for anything. It's ok to vent, we need to sometimes, but putting a generalized label on the one we are venting about, hurts the ones that are genuinely good and caring. The good ones get offended and quite frankly , the bad ones, really truly don't care and will never change.

So... Vent away, but lets try to do it in a way that doesn't hurt others.

Equinox_93 · Apr 4, 2009

Please see recent replies to Virgo- as I'd say the same to you here. :) After having a couple close encounters with fluids unexpectedly due to poor communication (combination of HIV infection and seizure/combative behaviour) I'm more inclined to be extra cautious in certain circumstances.

As to discussing it with the aforementioned- I have- and have discussed in depth with a variety of seasoned nurses IRL who virtually all agree with me and agree that there is no PPE police. They said if I were going in with a mask- then that would be a bit much and would raise the issue of putting the patient in an uncomfortable place of feeling a sense of isolation- which I agree with- but with just a gown (and no- not with all patients- but as a matter of personal assessment dependant upon what I'm doing with them, their medical situation etc.) it's a matter of personal preference- and particularly if a patient has a history of unexpected or possibly unexpected movements which can cause accidents to happen- particularly in a couple of the instances that I had mentioned such as nail care (unexpected movement= accidental clip to skin- bleeding plus combative behaviour or seizure causing possible blood exposure) that there is certainly precedence. So- again- you have your opinion- I have mine- we will agree to disagree.

The following is copied from the CDC recommendations to which Virgo_____RN directed us:
"Universal precautions do not apply to feces, nasal secretions, sputum, sweat, tears, urine, and vomitus unless they contain visible blood. Universal precautions do not apply to saliva except when visibly contaminated with blood or in the dental setting where blood contamination of saliva is predictableUniversal precautions do not apply to feces, nasal secretions, sputum, sweat, tears, urine, and vomitus unless they contain visible blood. Universal precautions do not apply to saliva except when visibly contaminated with blood or in the dental setting where blood contamination of saliva is predictable"
Therefore, Equinox 93, the situations wherein you want to wear a gown, do not require that. I've responded to several of your posts about the need not to treat HIV patients differently, so you'll feel safer with them. Yet you persist in your belief that they are highly infectious and require extra effort to protect yourself. When AIDS was first an issue, in 1989, nursing staff responded exactly as you have, and it was difficult to persuade them about the lack of concern needed for procedures NAs do.
If you still have the belief that you need a gown for working with all patients, please discuss that with your supervisor, Infection Control Nurse, or Nurse Manager.

Valerie Salva, BSN, RN · Apr 7, 2009

We all know that in the real world, nurses and staff are under a great deal of pressure to do everything as fast as possible, and corners do get cut.

I do dialysis, which can sometimes be a bloody, messy, procedure.

If a pt has a transmittable infection or disease, I always tell the PCTs. It's a professional courtesy, and just plain looking out for your co-workers.

If I am carrying an emesis basin with vomitus in it, you bet I'm going to have a gown on- I could trip, get bumped into, or jostled- it's not going to end up on my uniform- visable blood or no visable blood.

BTW- wearing long, disposable lab coats or gowns is required at all times in dialysis.

So put that in your "evidence based" pipe and smoke it. :smokin:

Virgo_RN, BSN, RN · Apr 7, 2009

I would imagine that working in dialysis, the odds of coming into contact with blood are quite high, so gowning up would be reasonable, and wearing a gown to protect one's clothing from spillage is quite different from wearing one simply because a patient is HIV positive.

~Puffing on my evidence based pipe.~