I work among two CNAs who are in their 40s/50s. According to them, they have been CNAs for 20+ years. I frequently hear them gossiping and talking down about certain nurses (especially new ADN grads). I've heard such comments along the lines of, "anyone can get a two year degree, I'm 20+ years older than her, I could do her job with one hand, etc." Basically, these two think that because they are older that they are wiser than some of us on the floor. I'm not a new grad, but I am a young nurse, younger than these two women. To me, their comments are insulting- but, nothing has ever been directed towards me/said to my face, so I try and ignore them. Has anyone ever experienced this before- older CNAs who think they know everything and are real ignorant about it? If so, have you done anything about it?
What is this "working under my license" nonsense? If I inappropriately delegate, of course I would be held liable. But if the CNA, who was given an appropriate task, and then kills the patient, that's not on me.
I may have thrown out that "my License "stuff inappropriately. I mean working under my direction.
If I direct, I must make sure it's done. Either way, I am responsible for what they provide to my patients. The only time I was called for a deposition , the CNA did not apply the pressure relieving mattress I had asked her to do.Did not follow up, it was in the last 1/2 hour of the shift. As the licensed professional... I was the one that had to answer in the deposition.
"Well, bless your hearts, thank goodness we have you all teaching these new kids a thing or two, no?!" (nudge, nudge, wink, wink)
With all due respect, unless this is an issue that the CNA's decline to help or take direction from the newer nurses (at which point it needs to be brought up with the charge nurse) I would not be quick to get involved in the gossip. However, I would be mindful and try and help the newer nurses as much as possible. Even if it is a "are you doing ok" pass in the hall.
Good CNA's are worth their weight in gold. I get that it is an often thankless job. (like a number of jobs, CNA or not) They have and do figure a million different ways to make a patient comfortable. There's a boatload of tricks of the trade they employ to make that happen. They are eyes and ears, and can bring to the attention of the care nurse changes in condition. However, many can not imagine doing all this and the nursing part too. (at least I couldn't when I was a CNA). Interestingly, there are nurses every day who do exactly that and don't have CNA's.
Throw a couple of newbie CNA's on these 2---"you just bought yourself precepting!!" THAT outta be interesting......
The CNA is NOT "working under the RN's license." CNAs do not work "under nurses' licenses." CNAs are responsible for working under their own scope of practice. Accepting delegation from a licensed nurse does not constitute working under the nurse's license.
That said, the RN who delegates tasks to anLPN or CNA is responsible for knowing that the person to whom the task is delegated is qualified and able to do it, and the RNis responsible for following up to see that it was done as delegated. However, if it is not done or is done contrary to CNA scope of practice, it is on the CNA, not the RN.
There is however, a difference. An LPN holds a license that they are responsible for. When an RN delegates, it IS the responsibility of an LPN to work under their own license, and not an RN's license. We have our own licenses.
However, when any nurse RN or LPN delegates to a UAP (and CNA are CERTIFIED, not LICENSED) then in most states and facilities (not legal advice per TOS, just musings) then the outcome of the delegation needs to be monitored by the nurse who did the delegating. Yes, CNA's need to know their scope and stay within it. The nurse needs to delegate appropriately. However, the CNA chooses not to carry out a delegation and it is the nurse who answers to this.
I am a new grad ADN nurse, who is also middle aged (44), and also worked as a CNA on the unit I currently work on (ED) for three years prior to becoming an RN. I think anyone who thinks getting a 2-year ADN is easy has never tried it. I do think that CNAs have no idea what a nurse actually does behind the scenes. That was one of the biggest transition areas I had to get used to. I was a rock star as an aide. When I first started orientation I went in with all the confidence in the world, maybe even thinking I could do the job with one hand By the end of the first week, I was like a deer in the headlights. I've found that most negative/derogatory comments stem from jealousy. Maybe encourage those aides to go to nursing school. It's never too late. I had a woman in my class who is 10 years older than me!
Because I don't want to start an entire thread for my particular rant, I'm just going to do it here. On one floor I work on, the first shift CNAs are just horrible! I practically kiss the feet of the second shift CNAs when they come on because they are so much better. When I go to other floors, the CNAs are constantly saying to me, "Why are you doing that? I got this. Go!"
On the floor with the horrible first shift CNAs, they do what they want when they want. If you try to delegate something to them they walk away blabbering about all the reasons they can't do it. They never turn patients on time, so the nurses do it. Nurses do the 1:1 feeds. Nurses get the patients up to the chair. Nurses discharge patients via wheelchair to the lobby. Their meal entries are complete lies because I'm the one that removes my patients' trays, so I enter accurate PO intake percentages, usually right next to their fudged entries on the flow sheet. I put in my skin interventions in real time, like turning, and I can see that they are lying about the turns. Frequent patients to our facility have said to me and my fellow nurses, "Do you have nursing helpers? Nurses do everything on this floor." They never answer call lights. I despise these lazy, lying CNAs that management knows about, but does nothing.
Because I don't want to start an entire thread for my particular rant, I'm just going to do it here. On one floor I work on, the first shift CNAs are just horrible! I practically kiss the feet of the second shift CNAs when they come on because they are so much better. When I go to other floors, the CNAs are constantly saying to me, "Why are you doing that? I got this. Go!"
On the floor with the horrible first shift CNAs, they do what they want when they want. If you try to delegate something to them they walk away blabbering about all the reasons they can't do it. They never turn patients on time, so the nurses do it. Nurses do the 1:1 feeds. Nurses get the patients up to the chair. Nurses discharge patients via wheelchair to the lobby. Their meal entries are complete lies because I'm the one that removes my patients' trays, so I enter accurate PO intake percentages, usually right next to their fudged entries on the flow sheet. I put in my skin interventions in real time, like turning, and I can see that they are lying about the turns. Frequent patients to our facility have said to me and my fellow nurses, "Do you have nursing helpers? Nurses do everything on this floor." They never answer call lights. I despise these lazy, lying CNAs that management knows about, but does nothing.
Rant over.
Let it out- put it in the burn book.
Also think about telling the CNAs that they are refusing to do work and let them know your documenting incident reports and taking the issue to management. It's a patient safety issue plus your work is going to suffer because your doing their job and your own! Don't put up with this!
Because I don't want to start an entire thread for my particular rant, I'm just going to do it here. On one floor I work on, the first shift CNAs are just horrible! I practically kiss the feet of the second shift CNAs when they come on because they are so much better. When I go to other floors, the CNAs are constantly saying to me, "Why are you doing that? I got this. Go!"
On the floor with the horrible first shift CNAs, they do what they want when they want. If you try to delegate something to them they walk away blabbering about all the reasons they can't do it. They never turn patients on time, so the nurses do it. Nurses do the 1:1 feeds. Nurses get the patients up to the chair. Nurses discharge patients via wheelchair to the lobby. Their meal entries are complete lies because I'm the one that removes my patients' trays, so I enter accurate PO intake percentages, usually right next to their fudged entries on the flow sheet. I put in my skin interventions in real time, like turning, and I can see that they are lying about the turns. Frequent patients to our facility have said to me and my fellow nurses, "Do you have nursing helpers? Nurses do everything on this floor." They never answer call lights. I despise these lazy, lying CNAs that management knows about, but does nothing.
Rant over.
They can get fired for falsifying documentation. Shouldn't be too hard to prove it seems.
I'm a young nurse and fortunately most of the aides respect me. There is one who I know doesn't but she has a lot of other problems so I let it slide a little.
the entire tone of your post is degrading... They haven't talked about you (yet) so perhaps you're treating them with the respect they deserve? How are the other new nurses treating them? Like they're better than them because they have the degree?
some of my CNAs have a TON of experience and I learn a crap-ton from them. I appreciate the knowledge they bring to me and the job and they point out things I'd have likely missed d/t my inexperience. Redefine how you think about them, maybe you'll end up learning from them.
On the other hand, I had a CNA last night refuse to do an ordered blood sugar. That's an issue.
CNAs are either a gift from God or a curse from hell of ignorance and arrogance.
How they treat the residents should tell you everything that you need to know about their character.
They can gossip, talk trash, but if they do it about you when you are within earshot yell I heard that ! If they think its so easy to get an ADN say then you should. Don't be ugly but don't take any crap. Eventually they will get sick of you being sassy right back. Good luck.
I notice sometimes the attitudes are due to being envious, and sometimes they're due to working with newbie nurses who do things like put a brief on upside down. *shrugs* It just depends on the context and on the aides personality. It can be VERY thank-less indeed. We get nurses who bark orders at us and refuse to help (even when they can, and I do know the difference), and we get nurses who value our experience and knowledge. If the aides in question are good at what they do, I would let it go. If they've been around 20+ years, they may just want to feel like their experience is appreciated.
The clinical site I'm at this quarter has 2 that are like this. One even said to the RN in front of one of my peers, "Don't tell me what it is this patient needs - I've been doing this for 35 years and I sure as hell know better than you!" Sheesh whatever okay. That same day, when I was feeding my patient, one of them was complaining to the other while they were making the bed next to my patient that "the student in room such and such hasn't fed her patient yet OMG" because the other one was mentioning how there weren't enough volunteers on the floor to help with breakfast. (Sorry, but that's not what we're there for -- especially when this is our first quarter starting IVs and learning how to give IV meds pt feeding is definitely not a priority concern for us!) I wonder sometimes if they are resentful because they are doing what they consider the actual patient care v the RNs and LVNs who are responsible for medications and ensuring patient readiness for procedures and such (oh, and also doing some "actual" care, too!). It's this warped perspective that breeds these bad attitudes with the CNAs and there is always one that insists on stoking the others to have this messed up way to look at things, too. Yeah, I get it, patient care is hard but it's the delegation and teamwork that makes this situation work for the patient and provides optimal care, too. I guess it just teaches me to be careful in making sure my gratitude is expressed to my CNAs for doing their jobs. Whatever I dunno /end rant.
By the end of the first week, I was like a deer in the headlights. I've found that most negative/derogatory comments stem from jealousy. Maybe encourage those aides to go to nursing school. It's never too late. I had a woman in my class who is 10 years older than me!
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Sheesh whatever okay. That same day, when I was feeding my patient, one of them was complaining to the other while they were making the bed next to my patient that "the student in room such and such hasn't fed her patient yet OMG" because the other one was mentioning how there weren't enough volunteers on the floor to help with breakfast. (Sorry, but that's not what we're there for -- especially when this is our first quarter starting IVs and learning how to give IV meds pt feeding is definitely not a priority concern for us!) I wonder sometimes if they are resentful because they are doing what they consider the actual patient care v the RNs and LVNs who are responsible for medications and ensuring patient readiness for procedures and such (oh, and also doing some "actual" care, too!). It's this warped perspective that breeds these bad attitudes with the CNAs and there is always one that insists on stoking the others to have this messed up way to look at things, too. Yeah, I get it, patient care is hard but it's the delegation and teamwork that makes this situation work for the patient and provides optimal care, too. I guess it just teaches me to be careful in making sure my gratitude is expressed to my CNAs for doing their jobs. Whatever I dunno /end rant.
Been there,done that, ASN, RN
7,241 Posts
I may have thrown out that "my License "stuff inappropriately. I mean working under my direction.
If I direct, I must make sure it's done. Either way, I am responsible for what they provide to my patients. The only time I was called for a deposition , the CNA did not apply the pressure relieving mattress I had asked her to do.Did not follow up, it was in the last 1/2 hour of the shift. As the licensed professional... I was the one that had to answer in the deposition.