Am I expecting to much from my nurse??

colzanurse · Feb 22, 2011

Nurses where you work have 12 patients? And they have any kind of time to stand around and chat? The most I've ever had at one time was 8 for a whole shift and I was nonstop running room to room giving meds, documenting, doing wound care and loads of other tasks without even taking my lunch or sitting down. There was no time to chat about anything not work related. Typically I have had 6-7 patients and the Nurse Assistants would have 8-12. I always helped my aides when they needed me, and often they didn't have to ask. I knew who my heavy/needy patients were and I would offer to join the aides when they were going to see them or I would just show up when they were in those rooms. TEAMWORK is the only way to get the job done safely and right. Those patients are my responsibility as the RN and I want them to be comfortable and well cared for.

Flo., BSN, RN · Feb 22, 2011

I think this is a hard situation. Team work is soo important. It is hard to say that those nurses are not working hard when I can't see them. All I know is with 12 pts I would not be able to help the aide, I would be struggling to provide basic nursing care.

I work in the hospital on a ortho/ neurosugical floor. Your patients sounds alot like mine. On average I have 5 pts and the aides have 15-30. I try to help as much as I can but I know my aides are busting it. Those fresh post op pts can take 10-30 mins to get up to the bathroom!

GooeyRN, ADN, BSN, CNA, LPN, RN · Feb 23, 2011

It sounds like you need another aid on the floor that ONLY answers call lights and assists with transfers. (as in, NOT given an assignment) I bet everyone is equally busy and overwhelmed.

Whoever is with the patient should be asking them if they need anything before leaving the room. (nurse or aid) and taking them to the br or getting water if needed, outside of an emergency. Asking pt's if they need anything else before leaving cuts down on call bell use.

TickyRN · Feb 23, 2011

Did I read this right? the nurses have 12 pts too!!!

no wonder they dont bother to help because they are too busy. It seems like this five star hotel needs to hire more CNAs/tech . Also ask your co-workers how they manage to do jobs with such a heavy load.

And please while it seems like it would only take 10mins for the nurse to help you out, they may have a thousand other things to do and so therefore ignore you. Try to buddy up with your other CNAs so that they can help you out when you are busy with another pt.

Orange Tree · Feb 23, 2011

I think you may be expecting too much. Your nurses need assistants because they are too busy to do it all, not because they need more time to talk. For every task that can be delegated to you, there are many more tasks that the nurse must complete herself/himself.

I might "chat" while I'm in the nurses' station reviewing vitals and diagnostic results, paging doctors, doing chart checks/med recs, etc. It helps me keep my sanity. It might not look like I'm doing anything important, but I can't claim that I was "too busy" bringing patients coffee to notice Mrs. Smith's blood pressure was 220/100. I can't explain to Mr. Smith's surgeon that his STAT EKG didn't get done because I was busy making beds and didn't have a chance to check my charts until 4AM. "Oh, his critical potassium wasn't covered either? Well I didn't have a chance to look at labs because three people called and had to go to the bathroom."

I have to focus on the higher level tasks or they don't get done. There is no one to help me with them. Is it possible that you could make toileting a higher priority when you organize your day? Maybe patients could be approached and assisted before they all got desperate and called at the same time. Make the people who want coffee and ice wait. I know your job is hard and I appreciate everything you do, but please don't make the mistake of thinking that I have it easy. When I was a nursing student, I thought the nurses were lazy and the CNAs did all the real work. Now I know that's not the case.

Riseupandnurse · Feb 23, 2011

I'm sorry: I agree with Orange Tree. I thought the same thing when I was an aide but as a nurse I did not "help" the techs out very much, not because I was too good for it, or lazy or chatting. It's because I was drowning with things that absolutely HAD to be done at the time they were done (to be honest, often should have been done earlier than they were but I had no way of getting to them). Yes, the aides were running their butts off too, but on the other hand they got lunch and out on time whereas my fellow nurses and I never got off the floor for anything and almost always had to stay over for an hour or two or three of paperwork before we could get home. On a 12 hour shift that meant by the time we dragged home and got cleaned up we were lucky to get 6 hours sleep before it all started all over again. Poor staffing or too many expectations from administration means everyone is tense and it is hard not to look for the slightest bit of evidence that someone else is not working themselves to death like you are. Truth is, you ALL have just too darn many patients and too much to do. No wonder the patients are falling. That should be the real issue, but it also sounds as though your administration just doesn't want to hear about the root causes, probably because that would cost money.

whill08 · Feb 23, 2011

I would be curious to see how you feel after you graduate and begin working. I worked as an aide on an inpatient rehab floor in a hospital before I graduated nursing school. The nurses I worked with did help as much as they could, but I still worked my tail off. I promised myself that after I became an RN I would help my aides as much as possible. Guess what? Now that I'm a nurse I am able to really help my aides for maybe 30 minutes at the end of the shift. I am busy for 12 straight hours. Now if a patient asks for a glass of water or needs to use the restroom when an aide is busy I will certainly lend a hand. Just remember when those nurses are sitting at the desk more likely than not they are plenty busy. Good luck and keep up the good work!

anotherone, BSN, RN · Feb 23, 2011

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??? 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? Or, am I being unreasonable??

Yes, sometimes it is too much to ask.There is no advice. Most of the people I work with are running themselves ragged... I am a nurse and I answer as many call bells as I can even if the pt is not a pt assigned to me. But if I am doing something else than I often can't answer my own calls. I have my own assignment to do and it is a challenge. I have had aids yell at me because I didn't run fast enough to get a patient a cup of juice ! Meanwhile one of my pts is having "chest pressure" or a group of residents(mds) are running after me for dressing change supplies, someone's IV is beeping, someone else was just ordered blood and it's ready to be picked up etc..... so if I see a call bell I won't always run towards it unless I know that person is a huge fall risk and will get up on their own or something else I perceive to occur (told a pt to ring if a symptom occurs or gets worse). However I HATE when some nurses are busy and his/her's pts are ringing and the other nurses just sit around doing nothing.....

wishinguponastarLPN · Feb 23, 2011

Thank you all for your responses. I am going to try to not get as frustrated at work.

I know 12 patients is a lot for nurses as well. But if they are so busy then it doesn't make sense to spend 5 minutes looking for me to tell me so and so needs a cup of coffee, or so and so needs to go to the bathroom when they were just in that room and could of assisted with toileting, or grabbed a cup of coffee faster than locating me. Or even more frustrating is when a patients bed alarm is going off and the nurse is standing in the hallway at the med cart but doesn't blink an eye and you see the aide come running down the hallway to see what is going on! I had a nurse in clinical tell me once that she can do a CNA's job but only she can do her job. So I do get it and understand the pressures the nurses are under.

I'm sure this is a long time rant between aides and nurses, I just wish we had a little more support from the UM. :mad:

ChristineN, BSN, RN · Feb 23, 2011

Thank you all for your responses. I am going to try to not get as frustrated at work.
I know 12 patients is a lot for nurses as well. But if they are so busy then it doesn't make sense to spend 5 minutes looking for me to tell me so and so needs a cup of coffee, or so and so needs to go to the bathroom when they were just in that room and could of assisted with toileting, or grabbed a cup of coffee faster than locating me. Or even more frustrating is when a patients bed alarm is going off and the nurse is standing in the hallway at the med cart but doesn't blink an eye and you see the aide come running down the hallway to see what is going on! I had a nurse in clinical tell me once that she can do a CNA's job but only she can do her job. So I do get it and understand the pressures the nurses are under.
I'm sure this is a long time rant between aides and nurses, I just wish we had a little more support from the UM.

Ok, I'm sorry I hear the other nurses responding saying that the nurses are also busy with their 12 pts which I understand. However, if a bed alarm or bathroom alarm is going off, that is anyone and everyone's responsibility to answer. I love how where I work we have instilled a culture that when the bed alarm goes off any nurse/tech that is near runs to check it off. I don't care how busy you are, but unless you are down right in the middle of an emergency you have a responsibility to respond to the bed/bathroom alarms!

wishinguponastarLPN · Feb 24, 2011

I agree, but it is not that way where I work. I'm just at a loss of what to do about it. I really enjoy where I work, this is really the onlyissue that I have and hate for this to be the thing that causes me to go work somewhere else.

General E. Speaking, RN, RN · Feb 24, 2011

I agree that 12 patients for a nurse is a lot and I hope this has something to do with why they cannot help you. However, spending 10 minutes running around looking for you if they really could have taken care of it in 30 seconds shouldn't happen.

Like the other poster said, poor staffing is the root of your problem. I cannot believe that you cannot reach the goal of 5 days without a fall!

Do you have a Risk Management Dept? An ethics hotline?