do you check after your nursing assistants?

caliotter3 · Apr 7, 2009

I spot checked the residents and paid particular attention to the CNAs that I knew to be especially lazy. After two verbal warnings, I wrote them up. It was a difficult situation because in one of my facilities, sleeping on night shift was condoned and encouraged. The CNAs can't tend to the residents if they're too busy sleeping.

Straydandelion · Apr 7, 2009

i have worked with some very good cna's.. helpful and willing to help. it doesn't hurt to spot check, especially those you are unsure of.

for those

i've noticed that nursing assistants are not checking on their residents

... this is a sign that the residents definitely need to be checked.

pagandeva2000, LPN · Apr 7, 2009

What frustrates me is that since I was a CNA before, I KNOW that it is hard, back-breaking work and understand how they feel. I would love to help them more, but it takes away from the tasks that I am legally liable and responsible for. And, skin integrity is part of it, even though the CNA is actually doing the job.

I believe that I would start off by saying just that...I know it is hard, I will help where I can, but we each have a job description that has to be adhered to. Maybe encourage them to do teamwork, where they assist each other. I have always found that when I worked with another CNA as part of a team, we worked faster and better.

JumpingIn · Apr 7, 2009

Patient care is EVERYONE'S responsibility and TEAMWORK is key! We can't make blanket statements based on a few peoples short comings or frustrations for that matter. Everyone has encountered a particular coworker who seems to be lazy and out of breath for no apparent reason, whether it be a CNA or even an RN. I've worked with some RN's who, if they could get away with it, would delegate the med passing to someone else. I've also worked with some CNA's who would leave a patient wading in urine if they could get away with it. Point being, there are employees period, regardless of credentials, who are just plain LLAAZZYY (even some physicians)! Can I get an AMEN! :saint:

Everyone of US who knows their roles as health care professionals have no problem doing what we have to do and even helping others.

I must say that the folks I work with presently, are a die hard crew. RNs, Techs, CNAs alike all get elbow deep in poop and pee and whatever other body fluids daily.

GOD BLESS EVERYONE WHO DOES THEIR JOB WELL-- BLISTERED FEET AND ACHEY MUSCLES AND ALL! :bow:

Spritenurse1210, BSN, RN · Apr 7, 2009

In my facility we're required to pick a random 5 residents and check to see if the CNAs are doing thier rounds. I work 11-7 and have to do 5 skin assessments nightly, treatments, and med pass as well, not to mention if someone is gets sick or goes downhill. I usually do the spot check on the residents i have to do skin assessments done on, and then the rest as i go doing my med pass. kills two birds with one stone, keeps the CNAs on thier toes, and residents are taken care of. now i'm not going to claim to be supernurse, i'm far from it actually. I have found that if i can pair what i already have to do with following up behind my CNAs helpful, because that way everything gets done. also at my facility,laziness and insubbordination with the CNAs are the norm, and expected, so what can you do? I found that as long as I follow facilty protocol, I'm usually ok.

PrettyPrisonNurse31 · Apr 7, 2009

You have to kinda "BOLO" (be on the lookout) when it comes to CNA's. If they dont like you, they can set you up.

Weird Story...(I gotta million of em).....

There was Nurse Nasty Attitude. She was so rude to everyone, even me! So, her CNA's set her up. Now granted, this was a Nursing Home and we had about 30 patients each PLUS the 30 we split because one Nurse failed to show up...call the Board of Nursing!

Well that night, we were super busy. The CNA's did their rounds as usual and reported vital signs to both of us. All vital looks WNL. Within the next 2 hours, a CNA pulled me to the side and asked me to go check on one of the residents. When I walked into the room, I noticed that the poor man was diaphoretic and unresponsive. I immediately called a code (Yeah, in a Nursing Home at night..yikes). The guy was sent to the ER where he later died from a diabetic related coma. They told us that his Blood Sugar was 12 when he arrived. This poor man was not my patient, but I listened to my CNA who knew what was going on.

The next day we worked, they escorted the Nurse, 2 CNA's and a DON off the premises. It was rumored that the CNA's of the mean woman set her up so that she could get fired. They saw the signs and refused to report it to the Nurse. I understood her not being able to check all her patients as we were at 45 each. The DON refused to come help us, knowing this was against the law.

The only way they knew what happened, is because that CNA stood up and told me what was going on.

So moral of the story, check your CNA's work. I sure do. Even working in the Prison, I check my Medical Techs, I allow the attonomy, but its closely monitored. Even if it mean staying over 30 minutes. 30 minutes late sure sounds better than "Welcome to McDonalds may I take your order". No offense. :cry:

Batman24 · Apr 7, 2009

You shouldn't have to check 50 residents to make sure they are dry. If people aren't doing their jobs I would speak to them first and then next time it happens do a write up and get the ball rolling in writing. Management should back you. There's no way you can do all of your job and all of their job.

blondy2061h, MSN, RN · Apr 7, 2009

Absolutely. I am ultimately responsible for what they do.

I know which of our aids are good and which are kinda lazy and such, but if they ever get a wacky BP or something, I'll be back checking it myself.

I consider making sure my immobile/incontinent patients are clean to be part of my responsibility.

PrettyPrisonNurse31 · Apr 7, 2009

I agree Batman, we should not have to pick up and check up behind them. But I check them because there are some lazy ones. I have yet to hear about a facility complaining about CNA's causing decubes on patients. Its always "the Nurse should have..." or "the Nurse could have.." Its like in the end, it all falls back on us. Hate to say it.

:scrying:

jadey1 · Apr 7, 2009

Like someone before mentioned, you know which of your CNA's are really working and the ones that have time to take multiple smoke breaks and sit in the lobby, flipping channels, on 3rd shift. We ARE responsible for our CNAs' work. If there is skin breakdown, we're then, responsible for the hassel of the paperwork, involved in documenting and reporting the skin issue. That should be extra motive to keep a close watch on our aids.

Since I'm a floater, in our facility, and I work with ALL CNA's, I need to test my CNA's, to know their "M.O.'s." I pick random residents, stagger rooms, and time and date the briefs, in inconspicuous places. If the CNA does a round, I go back and check my times. If those residents are in the same position and their brief is wet, with my marking on it, I educate the CNA and make them change that resident. I, also, check that my CNA's have the creams available to them. I give report to my CNA's, after I get report, letting them know that certain residents have orders for special creams, and make them write it on their cheat sheets. If I have to remind a CNA to do something more than twice, and they're just not "getting it," I write them up.

That being said, I always end my report, to my CNA's with, if they need help, let me know, and I'd be more than willing to assist with turning, repositioning, and changing. I NEED my CNA's and I'm going to do anything in my power to help them, for the sake of OUR residents.

Some nurses, I work with, are complacent and feel that CNA's aren't on our level, therefore it's the CNA's job, and they're "above" it. That's completely untrue. Our CNA's are with our patients more. They know the patients, point out changes in behavior, mental status, skin issues, dysuria, dyspnea, dysphagia. Without CNA's, we'd be lost. Treat your CNA's well and they'll treat you well. As someone said in this thread, TEAMWORK IS KEY! Thank your CNA's at the end of your shift. Bring them in a treat, everyonce in a while. Spring for dinner, on occasion. TALK TO THEM! I avoid reprimanding my CNA's, at all costs, but sometimes, it's required that we put our foot down and take some initiative, because ultimately, the responsibility falls on us; their supervisors.

JumpingIn · Apr 7, 2009

I've only worked in hospitals. At the hospital I work in, there are a few people who definately don't belong there with regards to patient care (some are my peers and some aren't), but there's always someone checking behind everyone (atleast during day shift) and it seems that they will fire your behind in a :redbeathe. Also the CNA's and Techs don't actually work for the RN's. RN's have their clinical duties that are clearly defined as do the CNA's and Techs. The RN's are Techs are responsible for checking on all of there assigned patients every other hour (RN's evens & techs odds). Everyone does there own computerized documenting and issues of concern are then reported. But the RN's and CNA's/ Techs seem to be on a similar plain.

It's possible that employees are more relaxed during off shifts, but I've never worked any shift other than day shift, so I can't be sure. I am curious to hear from anyone who's worked in both a hospital and nursing home/ assisted living or who have seen differences in shifts. Bottom line is that the issues being spoken about are simply terrible!