Aides giving the "new nurse" problems

ckh23, BSN, RN · Jul 1, 2005

Just remember that you are there for your patients and not to make friends. If they want to act that way so be it, but I think you should tell them about it and let them know that you're not going to take it. Just remember the patient.

leopold · Jul 1, 2005

I was an aide for two years and it never occurred to me to interrogate the nurse like that about meds or conditions. Really, it's not supposed to be my business (according to our facility interpretation of HIPAA). I would suggest that you just tell them you're busy and to look it up. The fact is you probably are.

Also, worked with an aide who one time did vitals for about 20 residents and each one of them had a b/p of 100/64 (including the one we had just sent out with a b/p of 220/180) and resp. of 20. Oh, one temp of 92.5. :rolleyes:

Mandylpn · Jul 1, 2005

Be strong, do not show any sign of intimidation or weakness. You know your stuff! I think the age difference thing is hard, but you are the nurse, and you are in charge! you already earned your stripes!

live4today, RN · Jul 1, 2005

I agree with everyone else's advice here. One thing you can do to ensure they are taking vital signs instead of making them up is to go behind them one day and retake the vital signs of a few of them to see if you get the same or close to the same vital signs. If you really feel they are making up the vitals and ignoring the residents, it's time for a meeting with your nurse manager. :)

UNFBSN2B · Jul 1, 2005

Let's see..... I am a new nurse, started working 4 months ago in LTC. I am 23 years old. The problem is: Where I work, there is 1 nurse on the floor, and 2 to 3 aides. They are all older than me, and doing this for years. I love my aides(I really do, I was an aide for 5 years), but sometimes I feel like they walk all over me.
The one night, after I had made the temp board out, they took it and withiin 10 minutes, they had it all filled out(7 pts TPR). The numbers were all so close. But I didn't see them make them up, so I asked them: Wow, that was quick. Are you sure these are the real temps? Well, as you can guess, they were PO'd.
They constantly try to get out of assignments and work. They skip over residents during rounds, and when I say something, they ALWAYS have an excuse.
Then this one is the best one yet. They will ask me about a condition or a med, and when I don't know the answer, they will give that look(you know the one, it's like well you're the nurse, so you SHOULD know everything). Then they giggle. It's so childish, these are grown women I work with.
Sorry so long, just needed to vent. I hope I am not the only one who has ever had this happen to. Some nights, I just feel like maybe nursing is not for me. But then that one patient who kicked your butt earlier gives you a hug, and it's all worth it.

I'm a BSN student, and I was attempting to do an assessment/history plus get vitals on my pt., when the housekeeping lady tried to make me leave the room. She said she was busy, and didn't have time for me to be in the room "visiting" with my pt.!!! I did NOT leave the room, nor did I respond to her. I just looked at her and continued what I was doing.

ZASHAGALKA, RN · Jul 1, 2005

Just think about it through this lens: you are a supervisor.

That's right. A supervisor. If they don't take a temp and a patient suffers because the fever they have doesn't get diagnosed until it becomes septic shock, it's not the aides responsible - it's you. Under the nurse practice act, you are delegating your authority to every act done AND you are accepting responsibility.

If you accept shoddy work, then you can't complain about shoddy work.

Next time you think it's too fast, tell them to do it again, and you are going to check 3 of them at random and your results had better be within a degree of theirs.

You don't have to answer to them; they have to answer to you. Don't accept being baited.

Snide remarks and giggles and stares get one warning (in private) and a severe reprimand that, if they undermine your authority again, you will write them up and see to it that they are looking for another job.

2 quick rules of management:

1. You are the boss, not a friend. Friendship is a mutual relationship, Boss/Worker isn't.

2. Praise in public, criticize in private.

It's human nature to test the limits of anybody in authority over you. You do it too. The question is simply this: how elastic are you? Because if you don't stand, you will fall.

hmmmmm, this is the second time I've said tough things on this site in as many posts. but then, when you are talking about the care of people with whom you have a professional contract, my take is let people call me a hard a** as long as they equate it with the excellence that I feel is mandated.

You stand your ground. It is your hard earned ground to stand on.

~faith,

Timothy.

NurseforPreggers · Jul 1, 2005

Just think about it through this lens: you are a supervisor.
That's right. A supervisor. If they don't take a temp and a patient suffers because the fever they have doesn't get diagnosed until it becomes septic shock, it's not the aides responsible - it's you. Under the nurse practice act, you are delegating your authority to every act done AND you are accepting responsibility.
If you accept shoddy work, then you can't complain about shoddy work.
Next time you think it's too fast, tell them to do it again, and you are going to check 3 of them at random and your results had better be within a degree of theirs.
You don't have to answer to them; they have to answer to you. Don't accept being baited.
Snide remarks and giggles and stares get one warning (in private) and a severe reprimand that, if they undermine your authority again, you will write them up and see to it that they are looking for another job.
2 quick rules of management:
1. You are the boss, not a friend. Friendship is a mutual relationship, Boss/Worker isn't.
2. Praise in public, criticize in private.
It's human nature to test the limits of anybody in authority over you. You do it too. The question is simply this: how elastic are you? Because if you don't stand, you will fall.
hmmmmm, this is the second time I've said tough things on this site in as many posts. but then, when you are talking about the care of people with whom you have a professional contract, my take is let people call me a hard a** as long as they equate it with the excellence that I feel is mandated.
You stand your ground. It is your hard earned ground to stand on.
~faith,
Timothy.

I agree wholeheartedly.

Nancyec+32 · Jul 1, 2005

Debbie, I just wanted to say keep hanging in there.I am also a new nurse but unfortunately I am not 23, I just turned 45 today.And I see what you are talking about all the time at work.Most people treat new nurses like they should know everything when they really know that we don't yet.We have to become seasoned nurses like them.But for some reason they like to push our buttons and make us feel inferior.I just wanted to say I am pulling for you and to let you know that there are others out there in the same boat.And if you ever need a friend to vent with I am here always.I also started as a nurses aide, actually our hospital calls them PCA's, patient care advocate, big words huh??Anyway keep in there girl and you ARE special and some of us know that.I for one know exactly how tough nursing school is and only those who really are dedicated become nurses.

BGSRN · Jul 1, 2005

It is frustrating to see complacency in action. I enjoy what I do and my patients are my focus. When I see co-workers (both nurses and clinicals) sitting and there is still so much to do it really irks me. Going through proper channels does nothing. So I just keep very busy all day and am exhausted BUT my patients are well cared for and I can go home feeling good about my practice.

So don't then them get you down - stand up for yourself and your patients in a professional way and even of that is all you can do, at least your advocating.

z's playa · Jul 1, 2005

Debbie, I just wanted to say keep hanging in there.I am also a new nurse but unfortunately I am not 23, I just turned 45 today.And I see what you are talking about all the time at work.Most people treat new nurses like they should know everything when they really know that we don't yet.We have to become seasoned nurses like them.But for some reason they like to push our buttons and make us feel inferior.I just wanted to say I am pulling for you and to let you know that there are others out there in the same boat.And if you ever need a friend to vent with I am here always.I also started as a nurses aide, actually our hospital calls them PCA's, patient care advocate, big words huh??Anyway keep in there girl and you ARE special and some of us know that.I for one know exactly how tough nursing school is and only those who really are dedicated become nurses.

Happy birthday and welcome to allnurses ! :balloons:

Z

pricklypear · Jul 1, 2005

Debbie - there is another thread around here just started recently by someone with a problem very similar to yours. Lots of good advice there. I'll just say (like everybody else has) that you need to make it clear right now what you expect from the CNAs. They may be "testing" you to see how much they can get away with, or have just always been allowed to do whatever they want without being questioned. You're just out of school, so all your "therapeutic communication" skills should still be fresh - use them. It's tough being put into a supervisory role so soon, but don't forget you're the one who went to nursing school.

I wouldn't advise you to go at this with all your guns firing...that will only make them resent you - then they'll try to make you miserable. If you find out they are not really taking temps, ask them why. If there's truly a problem, work with them to fix it. If they have no excuse, you'll know right away, and they'll know they've been cornered. If it continues, you may need to sit them down and let them know the steps you will have to take if the problem is not resolved between you and them - involvement of YOUR supervisor. It might be helpful for you to keep some discrete notes on what's being done, what's not being done, and what you have done about it.

Also, try some positive reinforcement - it's amazing what people will do for you when you notice and show recognition of their efforts. They probably won't be expecting it! You DO catch more flies with honey than vinegar!

Good Luck..