I find a lack of understanding on the part of some of our aides as to what the nurse's view is on certain things.
The aides think we do too many vitals, weights, I & O, rounds, etc. and decide, on their own, that they are unnecessary and do not do them. One of them was in the habit of removing IV's she thought were unnecessary. I reported her after she continued doing this after I'd told her not to. We had to stick the patient 5 times to restart his saline lock for antibiotics. Family was quite angry and I don't blame them. Another nurse told them the truth, though, which made them livid and they c/o to the DON, who fired the tech.
They want to sleep on duty while they are supposed to be watching to make sure nothing happens to mental patients and have a complete lack of understanding, apparently, that the patients will not wake them up to say, "OK, I'm going to kill myself now, or swallow scissors now, or cut myself now, stop me if you can." They do not seem to grasp that not only are they going to be fired and maybe prosecuted, blackballed, whatever if the patients suffer harm but that they are also jeopardizing my license and livelihood and ability to support my family if some investigator decides I was not properly supervising the aides - although how I am supposed to ride herd on them and still accomplish my own work is not totally clear to me.
I spend a lot of time and emotion on trying to make clear what I expect of aides, one thing being that they need to tell me if they need to leave the floor, other than for a quick potty stop. And if I say that they need to wait until their peer returns from his break, they need to wait. Some are wonderful, some get huffy, I hate all the upset and anger they toss my way at times. They do what I say, though, like it or not, as I have made it clear that I will do the write-up's that are sometimes necessary if they don't. They might not like me but I have earned their respect and they know not to cross me. Actually, I think they like me well enough and I even like them.
How about you? Do you have such troubles? Do you have the respect and cooperation of your techs? Do you like being in charge? Do you enjoy working with unlicensed staff?
as with any job there are the good and caring and the slackers that just want to get to end of shift with minimal effort. this goes for nurses and techs/cnas. the stress on the nurse is we are ultimately responsible for all patient care and the tech/cna is there to assist. if the vitals are not done or recorded, ekg not obtained, or the i & o not documented it falls on the nurse to answer why.
i think today with our increased patient loads we depend and count on having a good tech to help us out. i also think alot of techs/cnas don't realize are that the tasks we ask them to do have been done by the nurse many times, it not exclusive to them. i have heard techs in my unit talk amongst themselves and complain that nurses don't know what it is like to transfer x amt patients a day, do x amt of splints, or countless other tasks. yes we do know, we have done them and most nusres would not ask anyone to do anything they themselves would not do if they had the time.
nurses are very aware that techs/cnas loads are heavy at times. when one is busy just say "i am helping (insert nurses name), is it ok for (insert task) to wait?" on my unit we have techs that come back to the desk after done with a task and we have several that just vanish (break room, outside, chatting away from line of sight with each other or other dept people, on a computer away from the hub googling, etc). i feel bad for the ones that return to the desk as everyone bombards them with things they need help with. i often see the hard working techs/cnas upset that the others are slacking.
we need to work as a team for "the patient", it's not about the nurse, the doctor, or the tech/cna. we also need to recognize the deadbeat workers and get rid of them. sometimes just having a warm body is not enough, we need people who will do their jobs. we are all in this together so be a team player.
The ones that are in nursing school, I just smile and remind myself, "You'll see when you're a nurse!!!!".
We had two long term techs, meaning they were techs for about four years before finally going to school and becoming nurses. Both were hard core techs giving us a hard time. When off orientation both came to me and apologized for giving us a hard time "I had not idea!" with a deer in the headlights look.
Just try to remember how very little a tech makes when you wish they were doing more. It's very hard to make minimum wage and have a $30/hr nurse say "My job would be so much easier if you'd jump in and help me". Yeah, I bet you'd like that. Truth is, I have specific duties and so do the nurses. It takes my whole shift to complete my work and they certainly don't jump in and help me. That would be beneath them.
I don't care how little a tech makes, they have a job description and they've accepted the pay and the job. If they don't want to perform at the job description level regardless of the pay, then don't take the job. I don't care if I make $100/hour if it's your job to help me, then I expect you to do your job. How much I make is inconsequential to you doing your job.
However, there are lazy nurses out there that will sit on their butts and when a patient needs a bedpan will look 20 minutes for the tech to do it. So trust me, I know what you're saying.
As a nursing student, I worked as a tech my last year of college. The majority of the nurses were mean and incredibly lazy. I used to walk in the door and before I could get my coat off(literally),I was besieged with a list of tasks, most of which could have been accomplished prior to my arrival. My shifts were filled with grunt work, running errands, performing hygienic care and basically being at the beck and call of anywhere from 2-7nurses. If I found myself with more than a 30-second break, some nurse made it her business to find something for me to do because God forbid that an aide should not have something to do for even a minute. Worse than that, they were patronizing and insulting often referring to me as "my aide" as though I belonged to them. Furthermore no one seemed to appreciate the work I did, I was basically invisible to the physicians and other disciplines.......that is until something didn't get done.
A few of them treated me differently after finding out that I was actually a nursing student but most of them could care less. A few of them treated me worse upon learning that I was a BSN nursing student. I can't imagine what it must have been like for career aides and because of their treatment, the backbreaking labor and the low pay, it is no wonder that some of them do not exhibit the devotion to the job that some expect.
I know a few of you are going to chime in that they chose that job and thus they just have to accept their status as low-level employees but I wonder how many of them truly understand what their job entailed. I don't know about other areas of the country but here, there are daily television ads pleading with people to join the "exciting" field of healthcare where you will learn complicated skills, get to "make a difference" and you will get to work with physicians!(as if that were a perk of the job). Imagine how disheartening it must be to find out the truth. After a while, they walk out. No wonder there's such high turnover and we always seemed to be short a tech.
We nurses love to complain that we are at the bottom of the totem pole but that's not true; housekeeping and aides are truly at the bottom. I have now been an RN for almost 17 years, I've had ample opportunity to work with aides of all stripes and work ethic and I have never forgotten this. NEVER.
And no I don't know what the solution is. You couldn't pay me enough to do that job again. So I guess we will just have to keep coming to allnurses and griping about them and the beat goes on.......
The thing is, I've never been mean NOR lazy. I work my tail off, and I ask nicely. If I ask an aide to do something for me, it's because I truly need their help. What I find frustrating is that I am expected to understand things from an aide's point of view (which I do because I was one), but I don't feel that the nurse's point of view is understood by the aides. It's like a one way street. That's why I can shake my head and smile that the aides that are in NS will someday understand. And most likely, they will be embarrassed at their lack of understanding when they were an aide.
I do believe that we should treat all of our coworkers with respect. But there is a difference between respect and placing them on a pedestal. The fact is, the aides are there to help the nurses. Period. To get attitude or noncooperation simply for asking that a simple task be done is not respectful.
Specializes in Community Health, Med-Surg, Home Health.
I remember one time, a nurse that supports CNAs told me that a patient rang the call bell, and when the aide responded, the patient requested pain medication. Before the aide can answer, another nurse came in and said "She changes the diapers, I AM the NURSE, and I give the medication". My friend told me that she knew the aide felt very degraded, and she told that nurse that this was very rude.
Unfortunately, moving up is like a pyramid...the higher you go, the more people are behind. Not everyone is able to or even wants to be a nurse of any kind...LPN or RN. But, if a person is doing the best they can towards the patients, is being a team player and making an honest living, don't browbeat them. Try to include them in WHY their influence is so important towards patient care and the health care team. It does not work for everyone (I witnessed that as well), but for those that do try hard, give them the credit they are due. They may save our butts.
Specializes in Community Health, Med-Surg, Home Health.
I don't care how little a tech makes, they have a job description and they've accepted the pay and the job. If they don't want to perform at the job description level regardless of the pay, then don't take the job. I don't care if I make $100/hour if it's your job to help me, then I expect you to do your job. How much I make is inconsequential to you doing your job.
However, there are lazy nurses out there that will sit on their butts and when a patient needs a bedpan will look 20 minutes for the tech to do it. So trust me, I know what you're saying.
Nurses and techs should work as a team.
That is a true statement...the description says: "Assistant"...it is not a bad word or a curse, but it does say what a person is supposed to do within that scope of practice. A person determined enough to change this can do so.
I do try my best to give the good ones the respect that they have earned. Many times, they remind me of what I am supposed to do.
I can see how that might be degrading. When I was an aide, at the beginning of my shifts when I went room to room to check on each patient and introduce myself, I made my role clear to them by telling them that I am the one who brings snacks and warm blankets and helps them to th bathroom. Your nurse brings the medications and takes care of treatments, but I can check with your nurse if you have any questions. I didn't feel degraded at all because I accepted that my role was different from that of the nurse and went out of my way to let the patients know. I didn't feel that wiping butts was beneath me, because that was my JOB. I knew the nurses were too busy to do it, and that's why I was there. The way I see it, the patients have all these people that come and go, and it's hard to keep track of who does what. If I can explain to them at the beginning of my shift and make things easier, then why not?
Specializes in Community Health, Med-Surg, Home Health.
Yes, it was degrading. It's unfortunate that we can't express the tone of the comments we share with each other on these forums, because I know the RN that said this to the patient and I know the CNA. I got the story second hand, but heard many of the comments made by this nurse and I know it was said with malice and disgust. Not a nice thing. This is also a person who doesn't call LPNs nurses, either...but we give medications, hang IVs and do treatments. Go figure...
When I was an aide, I overheard a patient asking the nurse if she could help the patient with their HS care. The nurse said "That's not my job. I'll get an aide to do it.". She then came out of the room and asked me to do it. That felt pretty degrading. At the same time, now that I am nursing, when I'm behind on my med passes and have a zillion things to do, and I go in to give a patient a pill and they want to go to the bathroom, brush their teeth, need a specific amount of ice to water ratio in their pitcher, and a clean gown, etc., when all I went in the room to do was give them one pill so that I could go attend to my other patients, I find myself understanding that nurse a little better. Of course, I have never said that's not my job, and I always stay and help the patient until they're settled, but I'm just saying that I can understand where that nurse was coming from.
Another time, I had a patient explode (poop all over the place) no less than ELEVEN times in my eight hour shift. And I had twelve patients. The final time, as I was coming out of the room with a bag full of soiled linen and washcloths, a nurse stopped me to tell me that so and so in room such and such needed her dentures soaked. I could not believe it. Why, I thought, if you were there, could you not put the dang dentures in a cup????? What do you think I've been doing all night, sitting on my butt?????
I can well understand the CNA's point of view. But what I get now is that that nurse might have had a lot on her plate too, and the few minutes it would have taken to put those dentures in a cup might have been a few minutes that she didn't have, and the other tasks she had on her plate were probably not tasks that she could delegate to a CNA.
I think, all in all, it will ever be thus. All I can do is be respectful of every coworker, from CNA to lab tech to EKG tech to transport, to house orderly, to MD, to charge nurse, etc. We are all on the same team and need to remember that. Happy New Year, everyone!
I'm new here and just wanted to add in my 2cents :). I've been a CNA for almost a year now and while I may gripe about the grillion things I have to do at once, I do my best to not give attitude to the nurse who asked me to do something. I KNOW that the tasks that are given to me have to be done and I do them without complaint (I gripe in my head lol). You don't have to be a nurse to know that nurses are busy even with 4-6 patients. I work with them everyday and they barely take a breath as they're going down the hall to do this that or the other for patient X. And if I truely need assistance from a nurse when another aide isn't available, they come in and help me even though they're busy and I always thank them for their help. And it makes me feel good that when a shift is over, and I'm about to leave, at least one staff nurse thanks me for my help for that day (I'm an agency aide, so I don't work the same floor everyday most of the time).
One of my problems is that if a nurse needs a small task done that would only take a minute, yet she went and searched for me for about 20, then why could she have not done it herself, whether I was busy or not? That's what doesn't make sense to me. If you have time to look for someone for about 20 minutes, then you have time to say put dentures in a cup for a pt. That's my biggest concern. I see how much the nurse has to do during the day and they've got a lot of charting to do, etc and some end up staying almost 2 hours past their shift to work on it. I'm very thankful for the wonderful nurses I get a chance to work with. The majority of them are great! You've got good and some not so good nurses, and you've also got your good and not so good techs/CNAs. Either way, thank you all for the service that y'all do! Sorry if I rambled, it's been a long day.
Toquay
128 Posts
as with any job there are the good and caring and the slackers that just want to get to end of shift with minimal effort. this goes for nurses and techs/cnas. the stress on the nurse is we are ultimately responsible for all patient care and the tech/cna is there to assist. if the vitals are not done or recorded, ekg not obtained, or the i & o not documented it falls on the nurse to answer why.
i think today with our increased patient loads we depend and count on having a good tech to help us out. i also think alot of techs/cnas don't realize are that the tasks we ask them to do have been done by the nurse many times, it not exclusive to them. i have heard techs in my unit talk amongst themselves and complain that nurses don't know what it is like to transfer x amt patients a day, do x amt of splints, or countless other tasks. yes we do know, we have done them and most nusres would not ask anyone to do anything they themselves would not do if they had the time.
nurses are very aware that techs/cnas loads are heavy at times. when one is busy just say "i am helping (insert nurses name), is it ok for (insert task) to wait?" on my unit we have techs that come back to the desk after done with a task and we have several that just vanish (break room, outside, chatting away from line of sight with each other or other dept people, on a computer away from the hub googling, etc). i feel bad for the ones that return to the desk as everyone bombards them with things they need help with. i often see the hard working techs/cnas upset that the others are slacking.
we need to work as a team for "the patient", it's not about the nurse, the doctor, or the tech/cna. we also need to recognize the deadbeat workers and get rid of them. sometimes just having a warm body is not enough, we need people who will do their jobs. we are all in this together so be a team player.
toq