cna caught in the middle

[Destiny'skid]

I had a very strange thing happen to me at work last night, basically I got there and right away the charge nurse who is an rn called me in her office and gave me some instructions she wanted me to carry out that evening. It was simple stuff like walking someone and making sure certain people got their meal trays at certain times.

Now here's the thing, I come in as a support cna from 5 to 9. Another cna is on the floor from 2 to 10 and when I come in its just the three of us.

So my sort of question here is in cna training we were taught cna's do not report to other cna's nor do they delegate. We work as a team. This is kind of a unique situation as our only licensed nurse is also the charge nurse and needs to spend a lot of time in her office.

SO she really depends on us to do a lot of things (we stay in our scope of practice of course)

So i communicated with the other cna about what the nurse wanted and right away I could see she was not happy. She talked to the kitchen staff about the order of the meal trays (she had other plans then what I was told) and even went into a patients room with me to ask to the patient and family if it was ok if they waited on the walk so I could help her with other things. I understood that what she needed may be important and since the family was ok waiting Is tarted to do the other job, any way the rn came out and was not too happy I wasnt doing what she asked. I explained that the cna had asked me to do something else. She redirected me back to the room to do what she asked me to do earlier.

Well, the family member didn't want me to now because they thought I would get in trouble!!!

Did I miss something is this cna my supervisor since I am a support cna? if so that is fine I am quite happy following directions I just cnat follow two sets of opposing ones. If the cna is not my supervisor I must admit I really wish we would just split the floor when I come in instead of me helping her with everyone.(sometimes I am just waiting around for her and then have to stay later) But this is the way they do it here and who am question that?

[JDZ344]

RN outranks CNA.

[Natural510]

If you are given instructions by your charge nurse, those are what should be carried out. Explain to the other CNAs that you must do a, b & c before you help them out with their tasks for the evening. Likely what is happening is the other CNAs believe you are there to help "at will" with their assignments, while the RN believes the support role is to take on specific tasks she delegates, which then take the burden off the other assistants.

You should voice your concerns to your charge nurse, and ask for clarification of the expectations for your role. It sounds like there is miscommunication in your unit and not everyone (including yourself) understands your job description and expectations.

[jadelpn, LPN, EMT-B]

The charge RN specifically asked you to do these things. That means that in your time at the facility, these are your priorities. You do not nor should not discuss with, or get an apparent "ok" from the other CNAs, other than stating "I will be doing xyz this evening". "If this is an issue, then you need to discuss this with Charge RN, however, I will be speaking to the kitchen about the trays, and speaking with Mr so and so about his walk", They should do whatever it is that they do. You should call the kitchen and order the trays as you were delegated by the RN. You should go into the patient's room yourself and say "I will be back after supper for your walk". When, and only when all of what the charge RN tasked you to do should you then ask if there is anything you could do to help the other CNA's. You could, for instance, do HS care after ambulating the patient should the patient want to get ready for bed. When you take up the meal trays, you could take the residents to the bathroom, and do the same--quick washup and get them ready for bed. With all this being said, the charge nurse was perhaps annoyed. However, part of her responsibility is out of her office as well. If she says anything to you, which I am sure she will, I would say that it would be clearer to everyone involved if she were to speak to the other CNA's and advise them that you are being tasked specifically by the charge, and you are not to be tasked by them. And that you will advise them, and carry out any and all tasks that are given to you by the RN, and when you are through if time permits you will help them with anything else. Perhaps the other 2 CNA's could work as a team to accomplish tasks. But that is not your issue.

[Orange Tree]

The nurse's instructions should come first, but if there is a "charge" CNA, the nurse needs to notify that person of her plans, as well.