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 a nursing assistant in my facility, I do vitals, baths, I&O's, beds, bum wiping, turning, positioning, emptying Foleys and other drains, and anything else that the nurses ask of me. I also answer call lights and play waitress for those demanding family members who think their loved one is the only one on the floor.
What I do not do is pass meds, anything with IV's, dressing changes, etc.
And when you have 17 patients to chart vitals and I&O on, it isn't a short burst in between call lights. It's a good 30-45 minutes of charting depending on how fast the computer wants to work.
I'm talking about MY facility, where I WAS a CNA, with up to 18 patients on a regular basis. And if it took 30 minutes to do CNA charting, there was something wrong. What I am suggesting as far as CNAs having their charting done by shift change is a realistic goal.
This has been a useful thread! I'm coming up with all kinds of workable solutions. However, they're only as workable as the people involved.
I know I try to help out my nurses as much as I can while at work. I may have a demeaning job, and am not paid well for it, but it is a job that is important and needs to be done. Some of the nurses I have been around, refuse to do any aide work (or at least will take a long time to come asist). Yes, the training is very different, but we both think and try to do a job. We both are task-oriented (baths, vitals, I&Os, turns for the aide, and assessments, meds, drips, drains, vent checks, dresing changes, etc for the nurse). I am going through NS at this time, and am glad to be able to see both sides to this ever running issue, but it will never be resolved, until all aides become nurses, and all nurses work as aides.
I try to be a valuable resource to my nurses, and will do so no matter what the circumstance may be. As a current aide, I personally feel that the nurses need to become an aide prior to, or during, nursing school in order to know where the other side is coming from. IMHO, though...
i had a wound care tech once that helped doing dressingchanges in a very busy wound care clinic, he once dropped sterile gauze on the floor picked it up and wanted to place it on the patient
before he could i told him not to and to throw the gauze away.
he than came later to me yelling why i humiliated him in front of the patient, mind you i just told him to toss it and use a new one
i then proceeded to explain that he cannot use the gauze because there is no such thing as the 5 second rule.
i was a nurse for 4 years in germany before my dh and i moved to the us
when i first started working on a med/surg unit i was following another nurse for some time
the first day i ever worked on the unit, i after doing the vitals grabbed towels and everything you need for a bedbath, i than proceeded to go and ash the patient we were assigned to, my preceptor just looked at me and asked " what are you doing?"
i told here i want to wash the patient so we can get it out of the way
she was laughing so hard and than told me about cna's
mind you in germany there is no such thing as a cna, nope all done by nurses
so i very much appreciate the fact of someone there to help with patient care
i am going through ns at this time, and am glad to be able to see both sides to this ever running issue, but it will never be resolved, until all aides become nurses, and all nurses work as aides.
therein lies the issue...nurses can do the work of aides, however, aides cannot do the work of nurses. it's all well and good to expect the nurse to assist the aides in getting their work done, but not at the expense of the nurse's own duties. yes, i can and do help my cnas turn my patients and i've bathed many of my patients that were supposively "self care" yet smelled to high heavens, but only when my assessments are done, my meds are passed, my orders are taken off, my critical labs are reported to the doc, my charting is done, my patients procedures are scheduled, the consents signed and witnessed, etc etc etc.
too many days i've barely had time for a pee break, yet see some cnas shopping online.
thankfully, i have a few great cnas that i can depend on....that work with me as a team to give great patient care. i make sure to let them know how appreciated they are :)
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 know that nurses have SO MUCH to deal with, and therefore I never mind when one of my nurses asks me to do something when they are busy. However, at the last facility I worked at, I don't even know how many times I would be in the middle of doing a complete bed change or bath on a total care resident or something similarly time consuming and a nurse would open the door, say something like "Mrs. _____ needs the bedpan" and close the door. I'd assume the nurse was really busy, so I'd hurry to finish what I was doing and rush out into the hall...only to find the nurse yapping with someone about the latest gossip or what they were doing that night, or even outside smoking (and not during one of the allotted breaks, either). Sometimes there would be call lights going off up and down the hall, I'd be up to my elbows in diarrhea and the other aide on the hall would be at lunch or otherwise occupied, and still there would be multiple nurses sitting at the nurses station, eating cookies and talking.
Now, I have worked under some really great nurses - ones who treated me with respect and understood that, though my job was different than theirs, I was still very busy and also an played an important role. Those nurses would help me out when they could, and because of that, I was more than willing to help those nurses out in any way possible.
But when a nurse degrades you and is rude, demanding, and disrespectful without considering how much harder their jobs would be if it weren't for the help of aides, how can that nurse expect you to want to go out of your way to help them?
The respect has to go both ways. Teamwork makes things so much easier on everyone involved.
I am an Agency LPN working mostly in LTC--- "my" CNA'a are MY right arm! I rely on them to tell me if mrs. smith in on a regular diet, can walk with one assist and "yes, she does know what she is telling me is the truth" --- I make sure to thank each and every one of them at the end of the shift. I do often find one of them to take someone to the BR, but if I did it myself, I would still be passing 8am meds at 12noon. I do however, answer bells, and do what I can if I am having a good day and time permits. They know that they can always ask me to help with a transfer or boost, and that if I hear a safety alarm sounding, that I will be on my feet, and headed that direction.
Some of the posts here made me cringe, while others made me proud to do what I do.
I'm a tech.
I am 13 credits away from graduating. I don't have a degree yet but I am already paying for my student loans.
I take my job seriously and I like it for the most part. I KNOW how important it is to do all the tasks and to follow the nurse's orders. I consider myself the eyes and ears of my nurses and I do everything I can to do things right and to help all of them in whatever I can help. If I am done with my rounds, I go across the hall and help the others. If I see things that need to be reported (ex: patients carrying meds from home) I tell my nurses.
But I have to say that the worse part of my job is to be treated as if I am ignorant and know nothing about anything. to make matters worse hospitals are hiring just about anyone to do this job. Kids are hired as techs. This DOES bother me, because a lot of them are working on other careers and really see the job as 'just a job'.
Most of the nurses I work with are wonderful and treat me with respect. There are only two of them (I am so lucky!) who are very difficult to work with. One of them belittles everyone (including her fellow nurses). The other shouts at the techs for being the messenger of bad news. For example, a patient had back surgery and was given morphine for pain on top of other meds (lyrica, ambien). I was taking her VS every hour and watching her close. I asked if it would be a good idea to have her on a continous pulse monitor, and the nurse yelled at me and treated me as if I was completely ignorant about these matters. As I walk into the patient's room at 2200 to get her VS, she was blue on the lips, snoring deeply, and non responsive. Her O2 was 68%. I took off like a bullet to get help. It was a code blue. The crash cart came out and nothing we did brought the patient back to conciousness. The patient was then taken to ICU. Had I not done my job and watched that patient like a hawk she would have died. My nurse, instead of recognizing this, was furious the rest of the night.
I respect all my nurses and I am aware of all the responsabilities of the job. I KNOW how stressful it is. We are a team. If one of us doesn't do the job right everyone pays for it.
There are a few techs who think they know it all. There are a few who complain too much about their job, wasting time and energy, sapping the others. There are a few who do a lousy job as there are nurses who do a lousy job as well.
The work enviroment is no different than many others all around us. There is always someone who causes trouble and doesn't do a good job in every work place. No matter where one works, there are always a few people who think they know your job better than you do.
If I was to ask anything from any nursing team, I would ask for a little respect and understanding. Not all techs are completely ignorant about it all.
I work nights (12 hr shifts just like mos of you do), and I do all the routine work that techs do. I also draw blood for lab. Some nights I barely have time to use the bathroom. Some nights I have time to sit down to eat with my fellow nurses.
When my nurses know that I have too many 'completes' and have changed 6+ soiled beds, they come to help. Almost all of them are very good at this. I am never left alone to repositon a 130 Kg patient, or to change soiled linens. Our backs pay the price (you all know what it is like to bend so much that you go home feeling like you can't walk right).
I would not appreciate having to tell/ask any nurse if I need to use the restroom. I would not appreciate anyone following me around to see what I am doing, unless I am in training for something new. I try to do my job right the first time and do everything I am required to do for two main reasons: I take my job seriously, and I want to do everything right as much as I can so I don't have to deal with anyone picking on me all night long.
One of the nurses mentioned above follows me around and can't stand to see anyone sitting down (especially the techs). Now, since I know what she is like I prepare myself for my shift. If I am assigned to the back hall I stay there all night long. I have sat with patients, talking to them (at their request of course) many times. I find extra things to do just so I won't have to deal with this nurse. I do my best to not give anyone reason to pick on me. Most of the time it works.
I am like a secretary to 10+ nurses. I have had to learn the idiosyncracies of each and everyone of them. I've had to learn how to work well and do things the way each one of them likes to be done.
One more thing... I KNOW it bothers nurses when patients address techs as 'nurses'. From my end: no matter how many times I tell a patient that I am NOT a nurse they still want to call me a nurse. It isn't my choice. My ID tag is always in plain view, and yet some patients insist in calling us nurses. I beg all, please don't take it out on us.
On a final note... as I've said before, all I ask is for a little respect. It is easy to feel like we are scum of the earth in this job if no one appreciates anything we do. What would the world of nursing be without the 'Aides'?
I will never forget my experiences as a tech once I graduate. This 'low' job (as many describe it) has taught me more than anyone can possibly imagine...
Good luck with all of you in your nursing teams. Be understanding and respectful of the techs you have that do a good job.
I think both sides feel frustrated because we both have one thing in common: we are both way too overstretched, way too often. However, the one thing I cannot stand is when the CNA, secretary or sitter tells me how to do my job, how my job is sooo easy, how I make soooo much more money than they do. Each time I hear that, I reply that if it is sooo easy, then what are you waiting for, become a nurse, we would love to have you here!
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?
Huh?!?!?!? As an aide, I triple check before I d/c an IV or foley. I do not want to be taking something out that I shouldn't. And I always request to see the dr's order to do so.
I don't give a second thought weights, I&O's, etc, because to me these things help the dr and nurse determine what's going on with a pt which in turn helps the pt heal quicker.
Who does she think she is by removing IV's? Some pt's are getting drips like cardizem and I'd imagine in my aide thinking that some pretty adverse reactions could happen if that was suddenly stopped.
I think you need to request a mandatory floor meeting or hit the road. Sounds like a very disorganized place where the aides are playing doctor.
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.
Boy, it sure would be nice to be an RN making thirty bucks an hour! In another decade maybe! Jeesh, where I am we start out around $20 per hour and if you're lucky, you get $22 in a couple years, then work nights for the shift diff. And by the way, whatever it is that I make, it's worth every penny for the blood, sweat and tears that went into the degree, and there will always be days it's not nearly enough for what we have to endure with our fellow human beings.
Virgo_RN, BSN, RN
3,543 Posts
I'm talking about MY facility, where I WAS a CNA, with up to 18 patients on a regular basis. And if it took 30 minutes to do CNA charting, there was something wrong. What I am suggesting as far as CNAs having their charting done by shift change is a realistic goal.
This has been a useful thread! I'm coming up with all kinds of workable solutions. However, they're only as workable as the people involved.