Am I expecting to much from my nurse??

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Specializes in Rehab, LTC.

Ok, I am a nursing student also working as a CNA in a Rehab hospital (not LTC). Our acquity ranges from knee replacement, hip replacement, shoulder replacement, a variety of back surgeries, brain injury, CVA, COPD, ect. (along with the confusion that can come from post op, brain injury, CVA, ect) On first shift CNA's have an average of 12 patients and expected to have all patients showered and ready for therapies, pass meal trays, also get any requests from the kitchen (extra piece of toast, something else to drink, ect) pick meal trays up, take any patients with swallowing precautions down to dinning room for supervision, pick the patient up after eating, toileting, make beds, pass ice water, fill ice machines for surgery patients. This is all before lunch. We use a pager system so when a call light goes off the unit secretary sends a page to the aide or nurse of what the patient needs. Also, if you are toileting a person who is "pink band" (confusion or at risk for falls) then you have to stay in the bathroom with them until finished, also if a person is taking a shower you must stay in the bathroom with them. On my unit the UM does not enforce that nurses help with call lights, so of course the nurses do not help their aides. Is it too much to ask to answer a call light when your aide has 4-5 people at the same time asking to go to the bathroom? We have tried to set up a goal at my facility to go 5 days without a fall, we have only reached that goal once. Of course people attempt to transfer to the bathroom on their own, because they are having to wait 20-30 minutes for the aide to come in. Most people are continent, so I'm not talking about changing briefs, just merely walking the patient into the toilet! Many many many times I have begged for more help from my nurses but this gets me nowhere. I'm not asking the nurses to do my job, but is it to much for me to ask to take that patient a cup of coffee when you are headed in to hand out meds to this patient anyway???:uhoh3: I have made comments to the DON about nurses not helping, but everyone just turns the other cheek. Me, along with all the other aides, are running ourselves ragged to keep up. Any advise?:confused: Or, am I being unreasonable??

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Sounds like a long day. If this is really the way it is........I would say it is an unrealistic expectation to expect anyone to care for 12 people alone. I am of the belief it is everyone's responsibility to answer call lights.......that's just how I roll. NO one is too high or to low on the totem pole to answer call lights....it's everyones responsibility to assist the patient to meet their needs.

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Specializes in LTC.

It all depends on how many patients the nurses have. If you have the unreasonable number of 12, I can only imagine that the nurses have a hard to manage load as well.

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Specializes in Rehab, LTC.

The nurses have the same number of patients.

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Wow, that sounds pretty rough! Are the nurses also running around as much as you are? I'm sure they have a lot to do in the morning before lunch too, prep patients for surgery, admissions, assessments, charting, med pass. It can get pretty hectic for them as well.

With that said, I think it is pretty ridiculous that they can't bring the patient ice water/coffee or whatever or even help toilet a patient on their way in to the room.

It is everyone's job to help answer call lights, not just the aides. I think it is ridiculous when a patient asks for a nurse to do something "that can be done by the aide", for example get them ice water, and the nurse spends 10 minutes looking for the aide to let them know; all they had to do is get it themselves and it would have taken 1 minute!

I help my aide clean all my complete care patients at night; but then agian, day shift is a whole nother beast compared to nights. I get my patients whatever they ask for when they want it; the aides sometimes get so busy. The only time I don't help right away is if I am super swamped with my own tasks or have something else that is a much higher priority to go check on.

Maybe the nurses you work with are extremely busy...or extremely lazy.

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The nurses have the same number of patients.

Yikes. It seems like they are extremely busy themselves!

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Specializes in Pediatrics.

I agree with the above post, that it is everyones job to answers the call lights, but if you have 12 patients how many do the nurses have?

I work in a SNF and the aides have 9-12 residents with a lot of hoyers and they are heavy assingments, however the nurses have 30 patients to take care of. Before I became a nurse and was a CNA, I thought too the nurses should help out more, but as nurses there is so much you have to do.

I would look into your states BON to see if what the staffing ratios are, and start asking for more aides on the floor. Bring it up as a saftey issue. If there were more aides on the floor then there may be less falls.

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Specializes in Rehab, LTC.
Wow, that sounds pretty rough! Are the nurses also running around as much as you are? I'm sure they have a lot to do in the morning before lunch too, prep patients for surgery, admissions, assessments, charting, med pass. It can get pretty hectic for them as well.

With that said, I think it is pretty ridiculous that they can't bring the patient ice water/coffee or whatever or even help toilet a patient on their way in to the room.

It is everyone's job to help answer call lights, not just the aides. I think it is ridiculous when a patient asks for a nurse to do something "that can be done by the aide", for example get them ice water, and the nurse spends 10 minutes looking for the aide to let them know; all they had to do is get it themselves and it would have taken 1 minute!

I help my aide clean all my complete care patients at night; but then agian, day shift is a whole nother beast compared to nights. I get my patients whatever they ask for when they want it; the aides sometimes get so busy. The only time I don't help right away is if I am super swamped with my own tasks or have something else that is a much higher priority to go check on.

Maybe the nurses you work with are extremely busy...or extremely lazy.

We don't prep for surgery, the patients we get have already have surgery and they now require rehab to recover from the surgery. I also forgot to mention admissions and discharges in my list of duties! lol. As well as charting.

As a nursing student about to graduate I completely understand that nurses have a lot to do such as treatments, orders, med pass, ect. But as you mentioned I really feel that the nurses are taking advantage of the CNA's. I work in an excellent facility, 5 star for sure! And the aides truely work their tails off, all shifts. The nurses work hard too, but you always see nurses sitting or standing around talking before you see aides doing it at our place. If I don't have any support from the UM, do I just have to suck it up??

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No, It is not too much to ask. We are all in this together, or are supposed to be anyway. I don't know the answer to how to get people to help. It isn't any wonder why people get so burned out.

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Where do YOU work? 5-star? I thought I was at a n excellent place as well..until I worked there for awhile....substandard care and people showing up just to get paid. Whatever happened to this "caring" profession....Caring?

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We don't prep for surgery, the patients we get have already have surgery and they now require rehab to recover from the surgery. I also forgot to mention admissions and discharges in my list of duties! lol. As well as charting.

As a nursing student about to graduate I completely understand that nurses have a lot to do such as treatments, orders, med pass, ect. But as you mentioned I really feel that the nurses are taking advantage of the CNA's. I work in an excellent facility, 5 star for sure! And the aides truely work their tails off, all shifts. The nurses work hard too, but you always see nurses sitting or standing around talking before you see aides doing it at our place. If I don't have any support from the UM, do I just have to suck it up??

The nurses should have no excuse not to help, especially if they are sitting/standing around and talking amongst each other.

You said you spoke to your UM, is there anyone else you can speak with, a higher up perhaps? 12 patients sounds like a pretty unsafe number to me in the first place, and the number of falls that occur at your facility (not being able to go 5 days without a fall) seems pretty unsafe as well, at least where I work a fall is pretty rare; however we don't nearly have as many patients per nurse as you all do. You all definitely need more help!

And when you do see a nurse who is just standing around, try to work up the courage to ask for help; you definitely should not be afraid of asking; even if it isn't unit culture. You got to do what you got to do to keep the patients safe and that is everyone's responsibility. If the nurse really wasn't doing anything, it would be pretty horrible if she denied helping you.

We would be nowhere without our aides! It isn't about who is helping who it is about doing everything you can for your patients.

Teamwork rules :)

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the bottom line is, your expectations are a moot point, if policy isn't changed and/or enforced.

duties and expectations will have to be clearly delineated, in order to get all on the same page.

and unless the don is willing to hire more aides, change policy, or support you, it seems there is little that can be done.

the workload sounds unrealistic, but without knowing exactly what the nurses are doing/not doing, i cannot accurately comment if your expectations are too much.

leslie

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