Are we overworking the CNA's or are we lacking teamwork?

abbaking · Jul 14, 2011

I think the easy answer would be for the CNAs to tell the charge RN if the pts primary is unavailable. Having the RNS check vitals is taking away a major job responsibility of the CNAs and unnecessarily contributing to the RNs work load.
On another note all CNA activities are not equal. Prioritization must be used, I always tell my CNAs to ask me if they are having trouble deciding what is the most important task.
I love my CNAs and I do think they are overworked and underpaid, just like the nursing staff. We all have less than ideal pt ratios

I believe that RN's should do the initial set of vital signs with their assessment - we are doing the whole 9 yards anyway so why not just do the vitals and get that out of the way - not to mention its part of the assessment of the patient.

I disagree with you about all CNA duties being equal - they have different degree's of needs and prioritization but they all are equal. I say this because of years of CNA experience in acute med/surg. Vitals, bathroom needs, feedings, call lights, etc are all equal in the sense that they all need attention at the same time. Thats why if hospitals would stop being so cheap and actually hire more CNA's work could actually get done.

pat8585 · Jul 14, 2011

I believe that CNA's ARE overworked. And my 2 :twocents: is that if MEN were primarily CNA's the wages would

be A LOT higher! It is also my opinion that CNA's are NOT appreciated from the higher up's.

Been there done that!

fuzzywuzzy, CNA · Jul 14, 2011

And my 2 is that if MEN were primarily CNA's the wages would
be A LOT higher!

Agreed! We do hard physical labor with a high risk of injury, just like a lot of traditional man jobs, yet because it's caregiving stuff, it's "woman's work" and therefore not considered valuable. It's too bad men didn't do it from the start. I think they should at least require an associate's degree to be a CNA so that we could make more money but then they'd have to increase the pay for nurses too and everyone would actually get paid what they're worth, and we can't have that!

CBsMommy · Jul 14, 2011

Unfortunately on my floor recently we've been running with one tech for 25 pts on a somewhat regular basis. And we have a few nurses who still act like we're full staffed.
To make up for it, I try to do as much care as is possible on my patients, including vitals and blood draws and cleaning up the pts who I can by myself. While the "queen of England" types have time to sit on the internet b/c they have hogged the tech and therefore have free time. I've started to get nasty with some of them..."I'm done with the vitals machine. It's your turn for it." I've also gone to our direct management about the lack of teamwork from those individuals b/c I know most of the techs won't b/c they don't want to rock the boat. But our floor is known throughout the hospital for its teamwork, and I'm not going to stand idly by while a couple of newcomers jack things up.
The easy answer to the vitals dilemma...make the nurses get their own. That way they'll know immediately if they're not WNL, and the CNA won't be wasting time hunting people down.

We are running into this too, on our floor. One CNA (read: Me) to 25 patients with 4-5 RNs on the floor. That equals too much drama for the entire team!!!

Most of the RNs that I work with are wonderful!!! If they have a med that they are giving and need to have a set of vitals before giving that med (BP meds, Dig, whatever) they will just tell me, "Hey, I grabbed a set of vitals in room ***, so you can cross that off your list".

Our call lights ring directly to my phone so I can answer them from wherever I am at the moment (which is kind of nice unless I'm placing an IV, foley or NG).

It's nice that we carry phones too so if I get a weird vital sign or there is something going on with the patient, I can call the RN's phone without having to look for them or sometimes I don't want to leave the patient. If the RN doesn't pick up, I will call the charge nurse.

Otherwise, I do try and answer each and every call light. It doesn't always work out especially at the beginning and ends of shifts but I really do try.

Because I work nights, the RNs and I will sometimes try to do cares at the same time so we will time it. For instance, the RN will tell me, "I have a med in room *** to give at 0300. Do you want to come in there with me and we can check them and reposition"? That way we only have to wake the patient once.

Bottom line, it's best to work as a team. I will always remember this when I become an RN in a few months and will always have an appreciation of my CNAs since I've been there and done that! Thanks for this thread, OP!

Erie77 · Jul 15, 2011

My one comment is ...Of course 20 patients to one aide is expecting too much. Why do you think God doesn't give us 20 kids each; namely He knows it would be expecting too much. We, as a society, make negative comments about Oxtomom, yet we expect Nurses and Nurses Aides to take care of sick or injured people at 15-20 a piece? Get real Powers that be. But I have always believed what goes around comes around and those in power will have to some time deal with the crappy health care system they have helped produce. :lol2:

iwanna · Jul 15, 2011

I can remember while working as an LPN, the charge RN let me run around like crazy while she sat and read a book. Also, another charge nurse reused to help an aide in need. She needed help in giving a bath to a difficult patient. The RN said that is why I have RN after my name, and I don't give baths. OTOH, at a new job in a nursing home, the NA would get mad, if I didn't answer call lights during my med pass. Previously, I was helping the NA, but got called on helping them, as they could not pass my meds. And, being new, I agreed that I was still way too slow to be able to help them. It is not that I did not want to or felt above it. However, the NA looked at me as being lazy. Really, it is all about teamwork. And, when I was not busy with tasks that NA could not do, I would help them with anything. I think everyone should answer call lights, but sometimes you are doing a task that others do not have the scope to do.(and understood that at times, the RN had priority with her work than to be able to assist me in the moment) I believe that most places are grossly understaffed. Some places have nurses with attitudes that their initials entitle them to not do anything beneath them. Some places have great teamwork, and they all appreciate each other. Really it is all about treating others as you would want to be treated and treating the patients as they are our own immediate family. It is great when everyone is all on the same page, and it is about the patient care.

sounappreciated · Jan 19, 2012

Being a former CNA I understand the back-breaking hard work that the assistive staff preform on a daily basis. I am lucky to work with fantastic CNA's but I have noticed some alarming trends both on the floor and during staff meetings.
Sometimes there is only 1 CNA for the 20-bed tele/med/surg unit. Our CNA staff do vital signs, assist with bathroom needs, admissions, transfers, feeding patients and other important duties. Some of my co-workers seem to take advantage of this and request the CNA to monitor the surgical drains output (JP's, Hemovac). BIG NO NO! That is a nursing responsibility and In my opinion it is not something the CNA staff should be responsible for. Its a great learning experience to observe the RN and ask questions but its not something that I feel the CNA staff should preform.
The CNA's have told me that when its terribly busy during the start of shift and the RN's can't be found to tell them about abnormal vitals, the CNA gets reprimanded for with-holding information. This is a big issue on our unit but I side with the CNA's. Look at it from their perspective - they have 20 patients vital signs to do (with outdated equipment mind you). Call lights are going off left and right (which the unit clerk pretends is not going off - god forbid she actually have to answer it). Patient need help to the bathroom. Patients are dirty and need to be cleaned up. Post op patients are arriving on the unit and need assistance into bed and routine post op care. Patients need to be fed and some patients need to be transfered for tests. AND ITS ALL EQUAL. That would put anyone behind in their duties. The argument is always communication and teamwork - but depending on who your working with as a CNA, an RN can mean either a Registered Nurse or Real Nutcase.
My manager told the CNA's that if vital signs are abnormal and the RN can't be found, the CNA's are to stop what they are doing and document on the computer in real time the vital signs. I saw one of the CNA's doing just that the other day and the charge nurse told him to get off the computer and work and answer call lights. Thankfully this guy has balls and told the charge to do it herself - your still a nurse here and being a charge nurse doesn't mean your the queen of england - LOVE THAT GUY! I feel for the CNA staff tremendously. I will do my vital signs and help them out whenever I can
What do you guys think?
Is this crazy or is it just me?

this is true and such a shame the nurses and administrators of the hospitals and ltc facilities treat cnas' with so much disrespect. they are people who make you feel real small some of the nurses of today are so stuck on themselves 6 month mandatory ltc cna work should be required before obtaining there license as a vn,pn or rn. so when they advance to the next level of nursing they would have a better appreciation for the cnas' that do help them

sounappreciated · Jan 19, 2012

I can remember while working as an LPN, the charge RN let me run around like crazy while she sat and read a book. Also, another charge nurse reused to help an aide in need. She needed help in giving a bath to a difficult patient. The RN said that is why I have RN after my name, and I don't give baths. OTOH, at a new job in a nursing home, the NA would get mad, if I didn't answer call lights during my med pass. Previously, I was helping the NA, but got called on helping them, as they could not pass my meds. And, being new, I agreed that I was still way too slow to be able to help them. It is not that I did not want to or felt above it. However, the NA looked at me as being lazy. Really, it is all about teamwork. And, when I was not busy with tasks that NA could not do, I would help them with anything. I think everyone should answer call lights, but sometimes you are doing a task that others do not have the scope to do.(and understood that at times, the RN had priority with her work than to be able to assist me in the moment) I believe that most places are grossly understaffed. Some places have nurses with attitudes that their initials entitle them to not do anything beneath them. Some places have great teamwork, and they all appreciate each other. Really it is all about treating others as you would want to be treated and treating the patients as they are our own immediate family. It is great when everyone is all on the same page, and it is about the patient care.[/quote/]
appreciate and support your cnas' nobody is going to school for cna anymore so get use to doing patient care. it's nursing! multi tasking it's feasible cnas' do it all the the time..

sounappreciated · Jan 19, 2012

yes rn should do there own vital signs. you have 4 or 5 patients max the lvn or pn passes the meds. rn are hanging piggybacks and giving narcotics when and as needed. so doing your own vitals is feasible. remember you have 5 max patients and in ltc you sit and do nothing just come to work with your coach bags and magazines and give orders to the little people Cnas' some of your for the whole 12 hours in ltc dont do leave the nurses station except to go to the restroom.

sounappreciated · Jan 19, 2012

to many Chiefs and not enough indians!

sounappreciated · Jan 19, 2012

dont go move forward cnas are phasing out so the rn needs to get use to doing patient care the younger generation are in school to become lvn,pn or better they are not going to school for cna nobody wants to be treated like crap and paid slave wages anymore. patient care is nursing..

tokidoki7, ASN, RN · Jan 19, 2012

When I was a nursing assistant, I got the impression that no one cared about nursing assistants. I got paid $10/hr, and I remember having to take care of 17 patients and taking nearly an hour or more to bathe people, get vital signs and accuchecks. Patients having watery bowel movements every 10 minutes because they were on Lactulose. Nurses spending 20 minutes in a patient's room, then leaving and asking "Can you put so-and-so on the bed pan?" even though they were just in there. I can go on and on, but most of the nurses didn't help, except for the ones who worked night shift. The good ones recognized the lack of teamwork and left.

I'm an RN now and we don't have a nursing assistant most of the time. We get a lot of post op and stroke patients and they all want to use the bathroom and get into bed at the same time. Whenever there is a nursing assistant around, I never ask them to do what I can do for myself.