Advising Upwards: How to Advise Nurses as a CNA

CBlover, BSN, RN · Feb 29, 2016

Ok. Let me make sure I'm understanding...you're a CNA that wants to help nurses learn how to do their job better??

bugya90, ASN, BSN, LVN, RN · Feb 29, 2016

I would suggest you speak with your manager regarding your concerns and let them handle it. It's one thing to say "hey don't forget when you go in to give Mrs. Smith her meds she wants you to check out her toe" (just an example) but it seems like what you are referring to is much bigger than that and should come from the nurse's manager, not the CNA.

allnurses Guide · Feb 29, 2016

I think the best way you could help would be to become a nurse yourself. Then you can eventually precept new nurses. :)

blackvans1234 · Feb 29, 2016

If you become a nurse and work in that environment you will eventually understand why there are lapses what you believe should be done.

BonnieSc · Mar 2, 2016

Huh. This isn't what I was expecting to read when I opened up the topic. I have been fortunate to work with some great CNAs/techs, including some that I probably undervalued when I was a new nurse because they barely had high school education and did not have a traditionally professional way of presenting themselves. Being a nurse has absolutely shown me never to underestimate others--much more than friends I have working in other fields.

But I've learned by example or in the moment from those people. And I never hesitate to tell a CNA, "I've never done this dressing before" or ask "what's the best way to help this patient?" and they never hesitate to tell me. If we know each other well, the CNA will just take charge in many situations if they know the patient better than I do.

But CNAs who become nurses have told me, over and over, "I had no idea. I thought we did all the work." The exception is those CNAs who tell me they'd never want to be RNs because it's "too much"... they see that for themselves. CNAs work their behinds off, make no mistake, but the work is different.

CNAs do often know who's good at time management and who isn't, but they don't necessarily know why or don't know the best way to help that nurse. They know who's nice to the family and who isn't. Sure.

You will never, ever be the first person to tell a nurse that s/he should bring all the supplies to the room before beginning a procedure, or to provide family-centered care, or that patients are people. Those principles are taught from the first day of nursing school to the last.

All three things you describe simply take time to learn. The nurses know the principles. A new nurse can usually only do two major things: keep everyone alive and get the medications out on time. It's a source of great frustration to all of them. You graduate from school wanting to provide patient- and family-centered care and be the most efficient nurse ever and you find out that at first all you are is a glorified pill-pusher. It takes time. And sometimes as a new nurse it feels like everyone is telling you you're doing everything wrong, all the time. Please, don't be a part of that.

Set an example of being kind to patients and families, offer help with tasks when you can, give feedback IF it's asked for, talk to your manager if you have a real concern about a specific incident (but be prepared to find out that you misunderstood it or that it isn't as big of a priority as you thought).

LadyFree28, BSN, LPN, RN · Mar 2, 2016

Huh. This isn't what I was expecting to read when I opened up the topic. I have been fortunate to work with some great CNAs/techs, including some that I probably undervalued when I was a new nurse because they barely had high school education and did not have a traditionally professional way of presenting themselves. Being a nurse has absolutely shown me never to underestimate others--much more than friends I have working in other fields.
But I've learned by example or in the moment from those people. And I never hesitate to tell a CNA, "I've never done this dressing before" or ask "what's the best way to help this patient?" and they never hesitate to tell me. If we know each other well, the CNA will just take charge in many situations if they know the patient better than I do.
But CNAs who become nurses have told me, over and over, "I had no idea. I thought we did all the work." The exception is those CNAs who tell me they'd never want to be RNs because it's "too much"... they see that for themselves. CNAs work their behinds off, make no mistake, but the work is different.
CNAs do often know who's good at time management and who isn't, but they don't necessarily know why or don't know the best way to help that nurse. They know who's nice to the family and who isn't. Sure.
You will never, ever be the first person to tell a nurse that s/he should bring all the supplies to the room before beginning a procedure, or to provide family-centered care, or that patients are people. Those principles are taught from the first day of nursing school to the last.
All three things you describe simply take time to learn. The nurses know the principles. A new nurse can usually only do two major things: keep everyone alive and get the medications out on time. It's a source of great frustration to all of them. You graduate from school wanting to provide patient- and family-centered care and be the most efficient nurse ever and you find out that at first all you are is a glorified pill-pusher. It takes time. And sometimes as a new nurse it feels like everyone is telling you you're doing everything wrong, all the time. Please, don't be a part of that.
Set an example of being kind to patients and families, offer help with tasks when you can, give feedback IF it's asked for, talk to your manager if you have a real concern about a specific incident (but be prepared to find out that you misunderstood it or that it isn't as big of a priority as you thought).

Well said.

As a tech, I NEVER "schooled" nurses that I worked with on what to do, how to talk to families, etc; maybe because I was in school at the time, and knew what other aspects of the role that I didn't think twice to even think about it-everyone has their own way and background in starting out as a novice nurse.

Kiki1970 · Mar 2, 2016

Teaching or educating an RN would be out of the scope of practice for a CNA. Wait until you have passed NCLEX, your valuable experience will be better received then. Right now it may not have the outcome you desire... Plus, you'll be a rockstar nurse then! :yes:

packersfan1590 · Mar 2, 2016

I want to thank all of you for your feedback. As I develop as a caregiver and continue my education I am made aware of many new things constantly. The English language can be difficult in written and verbal from. For example with seven comments so far each are valid and come from different viewpoints. Not every person will interpret a piece of writing the same and a writer may incorporate words or phrases intended one way but they unknowingly use incorrect things blocking what they intend to convey.

Until I become an RN and even farther into my career there are going to be many things I will not know or understand until I get to that point. What are good ways to earn a nurses trust? This would be helpful on many levels. My goal is to help as much as possible in my current role as a CNA. I don't want to step on anybodies toes, and there are times where it is difficult to be in what feels like a powerless position. When I am working with someone at any level higher or lower and they are struggling with something that is of my skill set I want to be able to help them. I openly accept and seek the advice of those around me because it is my belief they we are a team with a common goal which is taking care of the patient. So if there are any more hints, tips, pointers on assisting my team in a friendly way without stepping out of my designated zone please share. Thanks again!

cleback · Mar 3, 2016

I agree with other posters. There's probably a lot going on that you're not aware of. I know this from having worked as a CNA before becoming a nurse. For this reason, I would not even touch on time-management skills. However, with the right approach, you can make a difference in the other issues you mentioned:

1. For supplies, feel free to ask, "Hey, do you think we'll need ____ before we get started?"

2. For respecting the dignity of patients, don't be afraid to call people out on their bad behavior. Also, if you know specific ways how to connect with a particular patient, feel free to communicate that with the nurse.

Also, is there a reason why you're focused on RNs? What you mentioned applies to other CNAs and axilliary staff (e.g. dietary and housekeeping). They may be in even more need of your expertise since they do not get the training that nurses or other clinical staff do. Maybe approach your manager with your desires to be a resource to these staff.

packersfan1590 · Mar 4, 2016

It is not that I am focused on RN's more so then that I am asking their advice. There are many CNA's that I have worked with that are better then I at either certain things or just completely as a whole and put me to shame.

I am currently and what seems like not much longer in my current situation. Yet there are many times that I can pass along helpful information and I just want to do so and be heard and validated as a part of the care team.

LadyFree28, BSN, LPN, RN · Mar 4, 2016

It is not that I am focused on RN's more so then that I am asking their advice. There are many CNA's that I have worked with that are better then I at either certain things or just completely as a whole and put me to shame.
I am currently and what seems like not much longer in my current situation. Yet there are many times that I can pass along helpful information and I just want to do so and be heard and validated as a part of the care team.

If you want to feel "validated" as a part of the care team, once you hit the floor and you what nurses are assigned to you assignment, establish a rapport by getting report from them; if you know the pts, give information that you have-be clear, concise; also remain in communication with your nurses throughout your shift.

I was a tech on a telemetry floor many moons ago; that was my method; it worked pretty well and did help for a smoother shift, especially the ones that were ran like a sinking ship.