Brand new Nurse in charge of Veteran CNAs

[beatrice1]

I am a new Grad starting in LTC. I keep thinking how akward it will be overseeing CNAs that have so much more experience than me. I have the utmost respect for CNAs, as they may not have as much "book Education" as RN's...However, they know their job and sometimes know more than the nurses. (as far as what I've seen during clinicals)

What are some of the experiences that you have had as a new Nurse, coming onboard and delegating, overseeing Vetran CNAs? just want to know what to expect.

Bea

[Lynx25, LPN]

It was a hard situation for me- not only was I brand new- most of the CNA's were much older than me.

I found for the most part, that I shouldn't have been worried. These people have been at their job much longer than me, and were a great asset in helping me get acclimated to MY job. However, there are certain people that will try and take advantage of you. If you don't feel comfortable bringing it up with them, go to your supervisor.

[xtxrn, ASN, RN]

I went from being the AGENCY CNA at the same facility I ended up in charge of....literally within a week's time. The CNAs were really good, which helped a LOT, and one in particular would politely let me know if I was being an idiot!! If there's a base of respect, it goes pretty well- if you can trust them to do their jobs, and ask their help with different resident's preferences, and help them when you can, it will be ok :)

[Hospice Nurse LPN, BSN, RN]

Treat the CNA's w/ respect and you'll be fine. Just don't let them walk all over you. I have seen some nurses get real bossy w/ the CNA's and it isn't pretty. A good CNA is your right arm. I'm blessed to work w/ 2 really awesome CNA's. Good luck @ the new job.

[Kristen75]

I am in the same boat that you are in. I agree with the don't let them walk on you, and some may try it. I am having that issue right now with two of my Medical Assistants. I wish you the best of luck.

[wishinguponastarLPN]

I was a CNA just 2 months ago and then became a brand new nurse. I let my CNA's know that I was in their spot just a short time ago, but also made my expectations knows. I chip in when I can (pass trays, take someone to the bathroom, ect.) And I try my best every night to Thank them for their hard work. I have had one incident where a CNA tried to take advantage of me and would take extra breaks for long times, disappear, not do check and changes except the last round and leave the floor without telling me. After a few days of this I said something to her and I got the eye roll. After another day I went to my supervisor and I wrote her up for it. At first I was very nervous but I explained to her that we have a very heavy resident load and in order for the shift to run effectively I need her there. At first she was really ticked off, but by the next shift she got herself together and it has been good ever since.

[NurseLoveJoy88, ASN, RN]

My best advice to you is to let them know you are not above assisting with ADL care.

Another habit I had to break is saying "my cnas". We don't own them. Just like docs don't refer to nurses as "My nurses"

We are a team.

[anotherone, BSN, RN]

Can be a total nightmare. Just remember you are the nurse and it is your job to delegate to make sure things are done. Not the cna's role to decide what needs to be done and by who. Don't get suckered into doing the job the cnas can do, while he/she gets break after break while you do your meds or assessments late. If they complain and whine so be it and talk to your manager. ( i often work with a really lazy group of cnas. some of them are awesome and very helpful, others are clowns, some are the lazy ones who sit around doing nothing until they get up to smoke.)

[applewhitern, BSN, RN]

NurseLoveJoy, thanks for pointing that out! I used to work with a unit secretary that always said "my nurses." Now I work with supervisors who say it! It is really irritating, esp. since I am much older than most of them.

[NRSKarenRN, BSN, RN]

moved to our geriatric nurses and ltc nursing forum

[goodneighbor]

Good veteran CNAs usually bond with their patients and know them very well. They also tend to know the "scuttlebut" in the facility. They are invaluable help in caring for your patients. But they can also be wily and so "efficient" that they tend to disappear for extended smoke time/break time! Veterans are usually the first ones to complain about a coworker CNA not doing her job. Be respectful of them but don't be afraid to ask for their help. If you want them to do a certain task, tell them in advance and they'll work it into their well-honed schedule. They are usually very compassionate with the patients. Try to develop an easy friendly tone with them. If you must counsel someone do it privately (they are usually intimidated by being called behind the nurses station). Preserve this area as your domain! Teach but don't delegate beyond scope of practice. Praise good care. Explain a little about disease processes so they know why it's important to (be clean, peri care, turn pts, feed carefully etc.) in the course of your side by side care. Find out what they need to do their job (more wipes? more pads?) and make sure they have it. You are in charge because you have more knowledge and are the clinical decision maker as far as medicine. They do quality of life on a more basic level. Oh, and explain you need the vitals and blood glucose first thing because you have to decide on medicines (they tend to think of it as just paperwork) and that you really need to know that your patients are voiding and having BMs because if they don't its a sign of sickness-its not "just for the chart"!

[tyvin, BSN, RN]

Well lets see ... after my family reported me missing and they found me strung up in the jungle wearing a hospital gown and diapers suspended by IV tubing and taped 4x4s with a Yonkers taped into my mouth I wrote the lot of them up. Let's face it; I was new, BSN (it was an issue due to I was the only one and they mocked me about it), older, and I wouldn't let them run me.

I was told that they would try to control me and run the place but I couldn't quite believe it until I actually experienced it. I tried, oh how I tried to be fair and do as much as possible to help them out. But it just wasn't good enough. Any time I was on the phone taking orders or charting they would walk by with snide loud comments like "There she is on the phone fooling around again" and other absolutely ridiculous things.

I tired to educate them about what it was that I did but they weren't ready to accept that I actually had responsibilities. It ended badly. The morale so low ... I found out that the last charge had only lasted 1 month; weeuuuwheee.

I know it's not like that at other places because I had worked in one LTC place previously. It wasn't exactly a kumbaya situation but we weren't trying to kill each other in the hallways either. This place was off the map completely; ahhhhh, the memories. :)