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

Claire de Lune · Apr 1, 2009

i've been an RN since 1971 & your post disturbs me on many levels.

1- because i spend less bedside time than a CNA you are critical to me; i cannot do my job effectively w/o you! i always try to have a good working relatioship w/CNS's wherever i work. of course i fully assess each pt, but you are my eyes & ears while i'm occupied w/RN duties. we learn which CNA's are trustworty/caring & those that are i trust their observations completely, but depending on the problem i might want to reassess a pt. ppl like you are so valuable to me & it's ALWAYS such a pleasure to work w/someone such as yourself!

2- communication between team members is vital in giving/doing excellent pt care. i always give report to my CNA's how else can i depend on you to do such things as obtaining specimens, having a pt ready for surgery @ the appropriate time, how many times to ambulate them/get OOB in chair. even tho you rec'v report from the previous shift, my report to you may include thing you already know. i'd rather overlap info than not give enough.

3- i ALWAYS try to help the CNA's on my team w/bedside care when possible: it promotes the sense of team, & most importantly it gives me the opportunity to build a good rapport w/the pt as well as more opportunities for further observation.

4- you should NEVER perform tasks that are outside of your scope of practice & any nurse directing you thusly is putting her license on the line. bottom line, you are responsible for protecting you job.

all that said, you are a DREAM CNA & i wish i could clone you! good luck w/your education plans!

SchoolNurseBSN · Apr 1, 2009

I hope no one takes offense to this but I feel I must say it. Techs are there to help support the nurses NOT the other way around. Nurses are the ones putting their licenses on the line when they delegate.

When I worked on a med/surg floor with 7-8 patients - I hardly ever ate lunch or went to the bathroom (which I didn't need to anyway because I never had anything to drink). I had a lot of sickle cell patients with IV push pain meds q1-2hour PRN. I would barely get one round of meds passed before the next were due. I would have been happy to give my tech report - but, I would have to find her first!

I usually stayed 2 hours after the end of my shift to chart - then, had a 45 minute drive home. 3 days / week I did not see my kids. On the other hand, the techs always had their breaks and their lunch and breezed out the door right on time. One of the many reasons I left and will never return to the hospital setting!

margom · Apr 1, 2009

I have worked as a CNA and as now currently as an LPN. I have encountered much of the same that you have at certain times. BUT.... I have also encountered the nurses who worked right along side me, helping me with whatever task I happened to be performing. I have found that wherever I go, and no matter what job I am in, there will always be people that give nursing a bad rap no matter what. I personally for one, have made a committment to myself, my patients, and my employer, that I will give 110 % of myself to my job. The patients and the quality of care they get are what matters. Without them none of us would have a job. BTW It is wonderful that you have a connection with your patients! That is what gives nurses and nursing a good rap.

Aquamarine · Apr 1, 2009

Dear CNA, I felt like you did my first job as a RN working with other RNs and I have changed a few jobs because of it. It was the saddest day when I found out all of us were not in it for the same reason, with the same goal in mind...patient CARE. Secondly...all I can say is do your best in whatever your given situation is. If they don't direct you, try to direct yourself but making a little cheat sheet on all your patients and writing down all their needs, etc. for yourself for the shift. You will learn more and you will have more experience when you become a nurse. And never forget this experience. Be kind when you are a nurse, do no harm? that means to co workers, friends, family, patients, doctors, fellor nurses, family of patients. I take it seriously and practice kindness in spite of any other person in my environment. As far as the patient with Aids...universal precautions are the best, the very best habit you can practice and it is rare that you would get it if this is practiced. Read about it and your protection and your fear issues will benefit.

I never forget why I got into this field of nursing...it is to provide CARE. I won't work for a facility that won't allow me to do this for my patients. I am a patient advocate. I will act on their behalf all the time, and every time. I get all the facts first as many patients are staff splitters so watch out for that.

It could be the cleaning lady, that makes a difference in a patient's life going in a room to clean, the title doesn't mean as much as where the person comes from and if they operate from the heart.

There are times that if a nurse helps with everyone elses job, her job isn't getting done but in most cases we can always help each other. If I have to chose to give a med on time, or help an aid, you better believe I give the med on time.

When you become a RN you too will see how you constantly have to prioritize your time, choices have to be made all the time, and some make you feel sick but it is tough sometimes. I don't think there is any time where nastiness between any staff of any title is acceptable. Shame on them is all I have to say.

A good CNA is valualbe, a good RN is also, a good floor manager...it is team work all the time. There has to be divisions in job responsibility for order and efficiency, but if there is time I would help the cleaning people. I am there to work, to be kind, not to pass judgement on patients, cna's, etc.

I am on my third job in 3 yrs. I finally have finally found a place where the staff treats each other with more decency than I have ever seen. The boss is respectable, the CNAs have been there for yrs and are pretty good.

I also left a job because the CNA was never to be found and the RN/Patient ratio wasn't safe for the level of acutiy...so that goes both ways. The CNA took a drink break, a dinner break, and a I think I will disappear break. I was doing some of her work and she criticized me for what I did when she finally came back. I was there 8 1/2 hrs without a break, thirsty and hungry and stressed. I found out that was acceptable bad behavior and I won't work in those kind of places. The pay was extraordinarily high...there was a reason, the place was horrid to work in.

So look at what you can do that is positive, if it is bearable for you, if you can make a difference, keep a pad of what you do in your pocket, or make up those work sheets and keep them so you can discuss them when you get your evaluation. If you are reasonable usually the boss will understand. I do think there are some places that are poison to work in. If that is the case...get out and look for something better. The healthcare field does need CNAs also.

If your long term goal is to be a nurse and give good care...you might want to stick it out where you are? I have done that.

Remember about HIV+ and AIDs they are patients also. Don't hold a grudge, there are other diseases worse and more contagious anyhow. We take that risk when we are in healthcare and when we take an oath, it is serious. Protection is universal.

Be happy on the job in spite of the RNs who aren't. You will get good feedback from the patients. Don't side with the patients when they complain. That is bad for them and everyone on the floor.

Just some loving advice for you. Take care...A RN that cares from the .

~RN67~ · Apr 1, 2009

with my last pregnancy at age 40, i was hospitalized for 12.5 days due to severe preeclampsia... as a former patient i have to say the nurses who took care of me inspired me to go back to school (i'm a pre-nursing student at the age of 42). the cnas were wonderful too... but when no one was "watching" it would be my nurses who would "pop-in" just to see how i was doing after their shifts were over...

everywhere you go you'll find people who don't like their jobs... even some nurse... but the most important thing you have to remember is the job you are doing :) you sound like a wonderful cna and because of your life experience as a tech you are going to be an awesome nurse!!

good luck to you :wink2:

FixThebody · Apr 1, 2009

My experience is that there are quite a few nurses who have plenty of time to tell you that they work too hard and/or the hours are too long. Hum, this is the job, right ! Nursing is a LABOR of caring. You have to love it or you should leave it. I just hope that the nurses who don't like it and complain about it are not caught in the same hospital as a patient wondering where the nurses are. My two cents. I see myself as a true nurse. I care about the patients and I undestand that every other person besides the patient is there for the sevice of the patient and not themselves. There is always enough time to communicate!

Aquamarine · Apr 1, 2009

Not all nursing jobs are good, however, it isn't evil nurse academy putting out evil nurses who eat bon bons on the job. Often it is the administration that disrespects the nurses that make them complain out of frustration because they aren't able to do more for the patients.

And often they have a right to complain.

Not all CNAs are good either...but if we try our best..we can all do a better job. Walk a mile in my shoes? ever hear that? it is true. YOu don't know until you have been there.

I because a nurse because my daughter ...when she was alive, just loved her nurses. My sister when she was dying said"if I ever get better I am going to be a nurse" that rang in my ears all the time. I became a nurse to be that kind of nurse and in honor of that kind of care and my family members that were lucky enough to get those kind of nurses.

I am kind, often it is against the grain...because administration doesn't respect that. It doesn't seem to be a requirement.

I am true to one person, that is myself. I know what I want to do, what I want to do for the patients and what my moral code of ethics are. No one can make me change or make me different.

finding solutions to the problems on the floor is the answer, not blaming this group or that group of professionals.

Dragonfair · Apr 1, 2009

I was a CNA in the very beginning and found it waaayyyy back in the days of old before becoming an RN. I have been a nurse for 30 years and each time I work with someone who was never a CNA in the beginning they seem to be closer to a desk the a patient. Do your own survey and see if that is true for you. Now there is a rarity when someone with no nursing experiences stay with their patients alot. I'm not trying to be a bad dog, it is true. I just left a job because of staff sitting on their buttocks and not being with the patient. I almost lost a patient due to them not getting up to help me even after I yelled my lungs out. I developed a real hate for this place and the administration because they could not or would not do anything. I now work in a area of another hospital where it is a 360 degree change. Hang in ther and be a teach to others and maybe they will follow

Peggyd · Apr 1, 2009

When I was a CNA, I thought the same thing about the nurses I worked with. Now 32 years later I know differently. You too will realize that nurses just have other work to do. One thing about this subject that bothers me is the patient and their family may also think that we don't do much for the pt. becasue we aren't physically in the pt.'s room. I wish I had more time to be there with the pt. I also wish I had the time to teach pts. and their famiies all that we do.

Aquamarine · Apr 1, 2009

I was a CNA in the very beginning and found it waaayyyy back in the days of old before becoming an RN. I have been a nurse for 30 years and each time I work with someone who was never a CNA in the beginning they seem to be closer to a desk the a patient. Do your own survey and see if that is true for you. Now there is a rarity when someone with no nursing experiences stay with their patients alot. I'm not trying to be a bad dog, it is true. I just left a job because of staff sitting on their buttocks and not being with the patient. I almost lost a patient due to them not getting up to help me even after I yelled my lungs out. I developed a real hate for this place and the administration because they could not or would not do anything. I now work in a area of another hospital where it is a 360 degree change. Hang in ther and be a teach to others and maybe they will follow

Funny I left a job because people were on the internet, at the dollar store in the plaza, 10 smoke breaks a day and the boss was with them or right next to them with a cigarette hanging out of her mouth too. One day a sun tan contest. When I complained that I also would like a break in the sun, she said to take them. THe night I left or made the decision to leave.....she sat next to a tech who was on Match.com and Jobgrabber.com all night. The three of us working. One was moving...can you guess which one. I liked my job, my patients but it was ridiculously unfair so I left. It was the best thing I ever did. And you know what? I am making 5.00 more an hour, better benefits for less money on my part, nice people, a responsible boss and co workers.

joyouter · Apr 1, 2009

The new CNA's posting contained valid points, but as an RN, BScN, with many years of clinical patient care in all areas of Intensive care nursing, third world nursing and presently working with First Nations, one of the overriding faults in the health care profession at the nursing level is the incredible lack of effective communication skills. Communication skills development is generally not considered part of health care education, rather it is relegated to the back burner unless you are involved in management ( even then, it is far from ideal). The outcome of poor communication affects team efforts, sapping morale, understanding of patient care tasks and impacts the overall quality of team functioning, particularly today where all health care teams are challenged by the desperate need for basic, good nursing care, severe shortages and traditional cutbacks. Nurses are always a target of cutbacks, irregardless of the level of knowledge, expertise and patient care which they bring to patients. This also implies a lack of nursing political power which is splintered and does not encourage nurses to act cohesively to protect the profession and its members, including the role of the CNA. .. Because nurses are rarely able to champion the profession at govt. levels, consistently and cohesively, they are placed in a limelight as convenient scapegoats and are the first to be cut, irregardless of reasons.

Teaming up with a good, knowledgeable nurse can be a mine of opportunity for ongoing teaching and learning for CNA's. Because of a profit margin, a highly subjective opinion evolves where criticism of a nurse is traditionally the chosen way to vent frustrations and anger because today, nursing and healthcare has evolved at their own expense ie. loss of staff who see the profession as high risk, an easy target. The quantities of paperwork a nurse fills out today, is mandated through legalities and the real risk of a nurse being sued. We all need to take a closer look at the paradigm of health care, the present and future needs and to have a voice as to whether this will be a sustainable profession in the long run, Health care pundits have long touted the need for degree nurses, PhD's and post docs. Where are these people and what have they done to protect nursing for our futures? So, I do empathize with your difficulty, and yes, there are very good nurses, there are also some who are either burnt out or overwhelmed. Perhaps a new approach to team work and communication needs to be voiced by someone like yourself?

Aquamarine · Apr 1, 2009

you really need to know about the patient who has mrsa, vre, c. diff or tb so you can isolate them properly. you really don't need to know about the patient who has aids -- casual contact won't pass that one along. you're wearing gloves and adhering to universal precautions, right? that's why universal precautions were developed.
and with all due respect, you really don't get it. you clearly don't understand what nurses do on a daily basis -- and saying that we delegate what we are able to delegate to a cna is not an excuse. it's the legitimate reason we ask you to do the peri care while we're "sitting at the desk, playing on the computer" while on the phone waiting for the doctor to take us off "hold" and deal with our question. if you can show me a "patient care" task that i can help you with in the "two seconds" i have between paging the pharmacist and his returning the page, i'm happy to help you. but i cannot page the pharmacist or the doctor or the social worker or whomever, then go into a room at the far end of the hall to help you change a poopy diaper because if the person returns the page and i'm not there, i'm going to have to start all over again.
i'm getting really, really tired of cnas (even the ones who are attending or planning to attend) nursing school spouting off about what terrible nurses they work with because the nurse doesn't have time to help them do their job. you don't get it.

exactly...very well put. you can't do it all and that is why we have job titles, not to be snobs but to get the job done and for who? the benefit of the patient. sometimes you have to walk in those nursemates to know what is going on, but you shouldn't have to. thanks...a rn