Advice Please!!!!!!

[Little Panda RN, ASN, RN]

I am getting ready to start night shifts and I am nervous. I will have 3 cna's (if I am lucky) working the night shift with me. They have been using agency nurses for this position. There is only one other night nurse, so I will be picking up this shifts that she doesnt work.

I need advice on building a relationship with the cna's I will be working with. I do not have much expeirence in LTC so I am afraid that they might try to chew me up and spit me out, as the saying goes. I have heard that some try to run the show. Of course I was not told this after I was hired. So what do I do, how do I take this position of charge nurse without stepping on toes.

I have been working the day shift for the last couple of days and from what I was told was to be trained the right way. I was told that it is was beleived that room checks were not getting done at night and some other things. Residents found soaking wet in the am.

I feel like I have been put in an akward position and expected to make things right. But agian how do you do this without stepping on toes.

My plan is to lead by example. I hope this works because I am very nervous.

Any and all advice is welcome!

[sunny261]

I earned my CNA's respect now they give me 110%....you can't run right in therre and expect to change everything right away. Helping them and them seeing that you follow up to what they tell you is very important. It doesn't come right away. But you can't let them do whatever they want either. Think of yourself and them as a team to get a job done. Thank them cuz it means alot to have someone appreciate their work. Good Luck!!

[ellen 12]

Show them your passion and love of nursing.

I used to make my nurse assistants a strong cup of coffee to wake them and me up - this also helped to put us in a positive mood for the night. Have lots of laughs.

Respect their ideas and work together as a team.

Be gentle with them and provide ongoing verbal education, but only if they are interested. I think if they understand why you need to check every room, they may be more accepting of change.

Some minor things you just have to let go for the sake of maintaining positive relationships with staff.

[maryloufu]

Good luck.:anpom::anpom::anpom:

[husker_rn, RN]

Don't expect to get things turned around right away; that is not realistic. Leading by example does work but it takes time. I started days at a faclilty a year ago and things are good....when we have enough staff, but they weren't in the beginning. I told the CNAs to tell me if they needed help and when they did I jumped right in. Mean what you say. And I told them how good they were even when they weren't and ended each shift thanking them for their help. Everyone needs to feel valued. Keep in mind that they will watch everything you say and do. I set high standards for myself and everyone else. And if you treat CNAs like they don't do much that's what you get....not much. Good luck.

[sdcradius]

see below

[sdcradius]

I have wored in LTC for over 8 years now. It is hard to staart off on a new shift. My advice is to be involved with as much as you can with the CNA's. I have worked agency in LTC also and I do know the chew me up and spit me out really good. From the beginning, have a report time with them and let them know what you need and stress teamwork. I always tell them we are a team and the team works together. I try to give my meds and treatments as they do rounds so we do not have to wake up the patients as much. I think if you stress you will be a team and give them that at the beginning you will be okay! Hope this helps.

[sharlynn]

I earned my CNA's respect now they give me 110%....you can't run right in therre and expect to change everything right away. Helping them and them seeing that you follow up to what they tell you is very important. It doesn't come right away. But you can't let them do whatever they want either. Think of yourself and them as a team to get a job done. Thank them cuz it means alot to have someone appreciate their work. Good Luck!!

This is very good advice!

Help them answer lights if it's busy

Follow up on what they tell you

Remember to say "thank you"

When you work as a team it can be awesome! Good luck!

[diablo]

Well good luck!! Some aides are good, some are bad !! Usually the bad ones influence the good ones. Then you're up the creek!! You do what you can to get them to do their job, then you write them up. That's when you realize your D.O.N. is useless.... Who suffers? Residents.

[Little Panda RN, ASN, RN]

Well good luck!! Some aides are good, some are bad !! Usually the bad ones influence the good ones. Then you're up the creek!! You do what you can to get them to do their job, then you write them up. That's when you realize your D.O.N. is useless.... Who suffers? Residents.

Wow, sounds like you have been around the block! How long have you worked LTC and what shift do you work?

[Little Panda RN, ASN, RN]

I have worked 2 days and 3 nights so far. The aids on the day shift are awesome, but the aids on nights seem to have some attitude.

The first night I worked it was with an agency nurse and one of the aids told me first thing that if you want to make it here you need to be laid back and not be strict!!! Of course I am thinking WTH! Some balls on that one. I just kept my mouth shut and did not say anything, hoping my silence said it all.

The second night I worked 2 of the aides went to sleep!!!!! They were sleeping on the job. Of course I was working with an agency nurse who had only been there 2 other times so I knew more than she did. What a night that was. I had a resident whose bipap was not hookedup correctly and their sats dropped to the 80's. I had to call a staff nurse to come in and help me figure out the equipment because I had not been trained on it. It turns out the O2 was not hooked up!!!!! We finally got it all figured out, thank goodness. Residents sats 96 and resting.

The sleeping aides would have the other aid wake them for rounds and then back to sleep. I kept my mouth shut for the time being.

Night three working with agency nurse from night one. The agency nurse was approached by someone who had walked through the building and noticed the sleeping aides. This person told him about it and more than likely it will get back to the DON. He told the aides what was said and they were very nervous as they should be. This shift ended with a resident falling and splitting open their head!!!!!! I was thinking to myself "what next".

So all and all it has been eventful and a little dissapointing at the same time. Not sure if I will continue for the long haul.

[Little Panda RN, ASN, RN]

Update: I did leave this job and I am going back to my old psych position. At least at this job I know that we work as a team. My co-workers are awesome and I missed them so much. I am glad to be leaving this other place and going back to what I consider home.