CNA's Are Tired Of Laziness

[mlmckenzie]

I am a Certified Med Tech as well as a CNA. I perform all of the duties of a LPN with the exception of inserting/removing catheters. Nursing home LPN's for the most part have disappointed me as a nursing student. As a CNA I have worked 3 consecutive 16-hour shifts on a lockdown unit with 19 incontinent male, behavioral residents. The LPN did not change anyone, did not feed any of the 3 feeders, did not shower any of the 6 residents per day, did not perform vitals on the 9 patients... I did it all alone. She did nothing other than chart and pass medications once per shift, and sit at the nursing station cackling on her phone.

Well, according to the state of ARIZONA, these are ALL not only within a nurses scope of practice but their responsibility. A CNA is an ASSISTANT. He/She is to ASSIST the nurse with personal care, most nurses for some reason seem to think that these tasks are beneath them or not in their scope and responsibility.

With the current shortages, and even more post COVID, imagine no CNA or PCT... Think about that the next time you sit at the nurses station while your CNA works their butt off. Think about if the industry went back to pre CNA era and you had to do it ALL. Answer a light. Pass water. Change a brief. I'm done. I will not go back to facility for a bunch of ungrateful nurses who spent way too much money on fig scrubs and are afraid of a little poop. I will laugh hysterically as they go to social media crying about being understaffed. For the way most of them have abused CNA's and neglected patients, they deserve to work alone. My heart aches for the residents that are stuck with these entitled, lazy people.

[LuvNursing84, LPN]

You are right. Nurses need to help with the care of their residents. I work in a place where the aids aren't responsible for vitals . The nurses get their own vitals. I personally toilet, answer lights, get ice water, pass nourishments and snacks, and have gotten them fully dressed on many occasions. While it's not easy fitting all of the work in, some nurses who don't have attitudes or were aids themselves understand what it takes to run a unit the right way.  

You commented on my post.  Keep your head up you sound like you know what you're doing and will make a good nurse !

[nursel56]

16 hours ago, mlmckenzie said:

I am a Certified Med Tech as well as a CNA. I perform all of the duties of a LPN with the exception of inserting/removing catheters. Nursing home LPN's for the most part have disappointed me as a nursing student.As a CNA I have worked 3 consecutive 16 hr shifts on a lockdown unit with 19 incontinent male, behavioral residents.The LPN did not change anyone, did not feed any of the 3 feeders, did not shower any of the 6 residents per day, did not perform vitals on the 9 patients...I did it all alone.She did nothing other than chart and pass medications once per shift, and sit at the nursing station cackling on her phone.Well, according to the state of ARIZONA, these are ALL not only within a nurses scope of practice but their responsibility. A CNA is an ASSISTANT.He/She is to ASSIST the nurse with personal care, most nurses for some reason seem to think that these tasks are beneath them or not in their scope and responsibility.With the current shortages, and even more post covid, imagine no CNA or PCT...Think about that the next time you sit at the nurses station while your CNA works their butt off.Think about if the industry went back to pre CNA era and you had to do it ALL. Answer a light.Pass water.Change a brief. Im done.I will not go back to facility for a bunch of ungrateful nurses who spent way too much money on fig scrubs and are afraid of a little poop. I will laugh hysterically as they go to social media crying about being understaffed. For the way most of them have abused CNA's and neglected patients, they deserve to work alone. My heart aches for the residents that are stuck with these entitled, lazy people.

That sounds awful.  Hope you are able to find a new job! ?

 

[dawnmichele70, LPN]

Well, I was looking for help because I currently have a CNA that hates me and we had a big argument in a resident room.  After reading your post I understand a little better. 

I'm overwhelmed with passing meds, doing treatments, and charting on 52 residents.  I thought I always helped the CNAs out.  But this one that yelled at me pretty much said I was the whole reason she hates her life.  

What can I do to be a better nurse and help my CNAs, but still have time to do my own work?

[mlmckenzie]

Communication is key.Talk with your CNA's. Let them know that you see their hard work and appreciate them.Buy them lunch every now and then. Be vulnerable by being transparent letting them know your load is heavy as well and while you may not be physically exhausted the mental toll is just as serious. You guys need to work together to manage the time as a team.52 patients is UNSAFE for a nurse and the facility should be ashamed of themselves.Let your CNA's shadow a little bit over time, let them take a little peek so they can see how hard it is to NOT make a med error with this pt load.You guys will be fine because you are here trying to make the relationship better.

[dawnmichele70, LPN]

Thank you for your advice.  It seems like communication is the main problem we have.  I've told my coworkers that they have to let me know when they need my help. I have a CNA on the Alzheimer's unit and 2 CNAs for the remaining 34 residents on two separate halls.  It's so spread out... north and south halls, so we're having to run to opposite sides of the building.  

The administrator says we have to have a CNA on each hall at all times. So that leaves one on north and one on south hall.  Meanwhile they're doing the 2 assist and hoyers by themselves.  

One other question...how should I handle their complaints about day shift?  We come on at 6 pm.  They complain that days don't have anyone in bed and they have to get all the residents up in the morning.  Days are still finishing supper when we come in 

I think the night shift should pass ice, get vitals and do showers when they arrive.  But they just start putting people to bed.  HS snacks aren't being given and showers are being missed because they don't have time.

Sorry I'm just venting and any advice is appreciated.?

[mlmckenzie]

 Admin does not have a clue about what it takes to take care of people. They have grand and unrealistic expectations. In a facility, THERE MUST BE 2 staff members for Hoyers. So I would have my CNA's put the Hoyers to bed, together, I could care less what admin has to say about one leaving for a few moments to ensure safety measures are followed. If a resident falls from Hoyer or is injured while a CNA is operating alone, that same admin will not take any accountability and fire that CNA and interrogate you like the CIA. (they don't want the lawsuit and will throw anyone under the bus). OR you can let them know that you will put on the resident light when you come in to pass the medications to that resident, they run in and operate Hoyer. 2 must be present. You do not give your CNA's any direct order to perform an unsafe task, it can land you in a meeting with the state fighting for your own license that you worked so hard for. If possible, snacks should be placed on the cart and can be passed during med pass. Pudding, yogurt, ice cream, applesauce, keep it simple. It can be used as a bargaining tool for residents that try to refuse meds. Old people love soft sweets. Showers with one CNA are not an option and I would personally argue this with the admin. Admin stated that a CNA must be on the floor at all times, I would argue that means that said CNA can not shower residents because it takes her/him off the floor. I would have the CNA's perform bed baths, nail care, shave, linen changes. When residents and their families start to complain, the facility will get help. Concerning the unfairness of putting the residents down and getting them up. STOP. I would have the CNA's to put the residents to bed but they would not get anyone up in the morning, period. The facility allows this preferential treatment for the day shift because the day shift has to feed people, well, it is really because they want to keep up appearances that the residents are active. Meanwhile, there are cleaning crews, dining crews, maintenance, admin, more staff during the day. ANYONE can assist in getting a resident out of bed. ANY STAFF can standby as a Hoyer is operated. Nights do not have this support. I would leave every single one of them that I had to put to bed after dinner in bed. Ensure that they are all dry and comfortable but in bed. If the resident was dressed for bed but not in bed, I would have them dressed for the day but lying in bed. If they were not dressed for bed and not in bed, then they would not be dressed for the day and still in bed.  It is not your teams fault that the day shift is managing time poorly. They do this because they know that they don't have to put them to bed or get them up. They are essentially just serving people, not actually servicing the people. Talk with the day nurses and let them know that you find it unbalanced and it has a negative impact on resident care and quality of life. Be professional, be assertive, be fair to yourself and your aids. Advocate for your patients and your team even in the face of adversity. I would suggest that ALL the CNA's do Hoyer transfers in and out of bed at shift change. Because Days and Nights are both there, they should do this during rounds as to ensure that it doesn't fall on one shift and 2 are present for resident safety. If that means coming in a few minutes early or staying a few minutes late, well, it is what it is. To support this, the day shift should pass trays to the Hoyers first, or they will finish dinner in bed. Day shift should also shower all the Hoyer lifts as they are up anyway. If they have a problem with restructuring to ensure patient comfort and safety, take it to admin, where it will probably fall on deaf ears, but you document every single encounter. It is okay to vent, these are valid issues. We absorb so much negative energy we need to release it to make room for the crap that is to come.

[mlmckenzie]

My day: I get to work 30 minutes early and stop at the nurse's station, ask my nurse for my vital sheet, census sheet, Q15 paperwork(behavioral unit), and if I have a partner or not. Regardless, Im going to make the outgoing CNA walk the ENTIRE hall with me. It could be JESUS CHRIST, he WILL WALK THE HALL WITH ME before leaving. I check every single brief, every room for cleanliness. Some of the other aids hate me but I don't show up for friends. I don't care about what your kids did, what you will do this weekend, or chit-chat..please give me report, did Mr. Jones have a bm, did Mr. Smith eat at least 50 percent of all meals? How is Mr.Clark feeling since he got the booster yesterday. These are my concerns. They shaped up because I will check a brief and say then and there, Mr. Smith needs to be changed before you leave, Mr Jones needs his shirt changed, this room needs to be tidy before you leave...and I WILL REPORT TO THE NURSE, who will give write-ups. Now when I get there, everyone is dry and clean. My 2 Hoyers are already in their beds watching tv or reading. I perform vitals first, give the nurse the vital sheet, let her know we are going to the shower, then I take clothing into the shower for every resident that has a shower, I shower them ALL. I put on the shower alarm and turn it off to signal my nurse to come to perform a skin check..there are 19 residents and usually just me. I have 5-6 showers a day. It takes me about 2 hrs. After the showers, on 3-11p shift the drink cart comes around 400pm. The residents know to wait for me as I am in the shower room, they are trained well. LOL. I come out of the shower room and pass drinks while the nurse is finishing her med pass. Dinner comes at 430, Then I pass trays. Feed my 3 feeders, pick up trays. Now it is 530ish. Record their intake, chart a little, turn my bed bounds and Hoyer patients, change soiled briefs. 7pm I take the 2 smokers to smoke on our patio.715, I am in the kitchenette(on unit) making peanut butter and jelly sandwiches, gathering snacks, pouring juice, milk etc. 800pm I change briefs and assist residents to get into bed while pushing a little cart and passing snacks. 9pm to 930 lunch, if I am lucky. If not, I drink some coffee and keep it moving. 930 I gather the trash out of the unit as I have little bags of soiled briefs sitting right inside each door that I left while I was passing snacks.945/10pm they are all in the bed, I give the remaining paperwork to my nurse. 10 pm I check and change briefs, pushing my little cart, I pass ice, water, good night hugs, blow kisses, spray my body spray in their rooms to keep me near as they sleep(they love this), tell them I love them because they are Gods creation and to be nice while I am away. 11pm finish charting and give walking round report to oncoming aid. This is a behavioral unit with 19 male residents. There are fights, sometimes but usually I can calm them down. There is confusion, depression, and tears. I have cried in the bathroom, nurses station, and every crevice of the unit at some point. I feel their frustrations, sadness, loneliness, and depression. It is hard not to love these little old men. They teach healthcare workers about skills, medications, the human body, etc. but they should teach emotional strength because if you have a heart, it will break every day all day. Life is so unfair, the least the facility can do is staff no matter the cost of an agency. They deserve great care. With so many health care workers quitting, the facility should do everything they can to support the Nurses and Aids who show up. 

[Msmedic68w, MSN, RN]

Ahhh yes, I remember those days. I was a CNA a long time ago. But know this, this isn't just a problem for CNA's this is an issue for other nurses. I am on nightshift and the dayshift is useless, well...some of them are. Just lazy and unmotivated and pass off a lot of their work to nightshift because they think we just sit here and eat chips and watch Netflix all night....um, no. Anyways, it's a thing almost everywhere unfortunately. 

[Zippy83]

First off, I agree that CNAs are both overworked and under appreciated. I have always tried to show appreciation and respect  to EVERYONE on staff, CNAs, kitchen staff, secretaries, maintenance. Everyone is critical to providing care. I also sometimes get laughed at by staff nurses (I’m registry) for being “naive” because I let my CNA team know to call me if they need a two person assist etc, and I am not above any care, I will change diapers, feed etc. But I also have the responsibility and obligation to manage my time and get everything done, and in the past have fallen behind by NOT delegating some of these tasks to free myself up for others that cannot be done by the CNA.

As some others have mentioned here, there also is a tendency for everyone, because we are all burnt out, to feel that we are doing all the work and others aren’t, and sometimes it’s because we don’t know the exact ins and outs of others’ assignments. I am also night shift and day shift definitely often thinks they are busier and work more, but I used to do day shift and they don’t realize that night shift has left hands on deck AND you are fighting circadian rhythm, so it is just as hard, but in a different way. 

I would caution against phrases like “I perform all the duties of LPN except inserting/removing catheters”. That is the kind if statement that can rub people the wrong way, because it’s not entirely true, even if you can perform a lot of hands on tasks. The LPN is licensed and putting not just the job but license at risk every day. Even when you are passing meds as a med tech, you are taking on less risk than a nurse because if the nurse makes an error such as failing to notice an adverse reaction or checking placement of a gtube or giving the wrong amount if insulin etc, they had more education and training and were under license to administer correctly.

I cannot tell you the number of times a patient or CNA or family member thought I was “doing nothing” and tried to talk to me and thought I was rude for asking them to wait a few minutes, while I was actually doing something critical with the eMar that could cause a med error if I get confused or off track. I promise there are many things the LPN does, especially in prevention and planning, that non clinical staff, even those who are very experienced and great at their jobs, simply aren’t aware of because it is different training.
 

if the LPN you work with is really just on her phone and refusing to do basic patient care then she is a snob and/or burnt out, and I’m sorry that you are left holding the bag. It is so frustrating to have to do the heavy load when you truly care about the patients and just can’t do everything you know that they need. I commend you for hanging in there for the sake of the patients and I hope you are able to resolve this either through management or simply finding another place to work. 

 

 

[Kooky Korky, BSN, RN]

On 12/27/2021 at 10:35 AM, mlmckenzie said:

I am a Certified Med Tech as well as a CNA. I perform all of the duties of a LPN with the exception of inserting/removing catheters. Nursing home LPN's for the most part have disappointed me as a nursing student. As a CNA I have worked 3 consecutive 16-hour shifts on a lockdown unit with 19 incontinent male, behavioral residents. The LPN did not change anyone, did not feed any of the 3 feeders, did not shower any of the 6 residents per day, did not perform vitals on the 9 patients... I did it all alone. She did nothing other than chart and pass medications once per shift, and sit at the nursing station cackling on her phone.

Well, according to the state of ARIZONA, these are ALL not only within a nurses scope of practice but their responsibility. A CNA is an ASSISTANT. He/She is to ASSIST the nurse with personal care, most nurses for some reason seem to think that these tasks are beneath them or not in their scope and responsibility.

With the current shortages, and even more post COVID, imagine no CNA or PCT... Think about that the next time you sit at the nurses station while your CNA works their butt off. Think about if the industry went back to pre CNA era and you had to do it ALL. Answer a light. Pass water. Change a brief. I'm done. I will not go back to facility for a bunch of ungrateful nurses who spent way too much money on fig scrubs and are afraid of a little poop. I will laugh hysterically as they go to social media crying about being understaffed. For the way most of them have abused CNA's and neglected patients, they deserve to work alone. My heart aches for the residents that are stuck with these entitled, lazy people.

I hope you leave CNA work soon.

And if you become a nurse, maybe you will develop insight into how tough it can be to have an aide with a rotten attitude.

The cackling nurse - you should have asked her to help you.  But remember - things aren't always what they appear to be.

In the days before aides, we had a manageable number of patients.  And we did do it all. 

 

 

[Kooky Korky, BSN, RN]

On 12/29/2021 at 11:20 AM, mlmckenzie said:

My day: I get to work 30 minutes early and stop at the nurse's station, ask my nurse for my vital sheet, census sheet, Q15 paperwork(behavioral unit), and if I have a partner or not. Regardless, Im going to make the outgoing CNA walk the ENTIRE hall with me. It could be JESUS CHRIST, he WILL WALK THE HALL WITH ME before leaving. I check every single brief, every room for cleanliness. Some of the other aids hate me but I don't show up for friends. I don't care about what your kids did, what you will do this weekend, or chit-chat..please give me report, did Mr. Jones have a bm, did Mr. Smith eat at least 50 percent of all meals? How is Mr.Clark feeling since he got the booster yesterday. These are my concerns. They shaped up because I will check a brief and say then and there, Mr. Smith needs to be changed before you leave, Mr Jones needs his shirt changed, this room needs to be tidy before you leave...and I WILL REPORT TO THE NURSE, who will give write-ups. Now when I get there, everyone is dry and clean. My 2 Hoyers are already in their beds watching tv or reading. I perform vitals first, give the nurse the vital sheet, let her know we are going to the shower, then I take clothing into the shower for every resident that has a shower, I shower them ALL. I put on the shower alarm and turn it off to signal my nurse to come to perform a skin check..there are 19 residents and usually just me. I have 5-6 showers a day. It takes me about 2 hrs. After the showers, on 3-11p shift the drink cart comes around 400pm. The residents know to wait for me as I am in the shower room, they are trained well. LOL. I come out of the shower room and pass drinks while the nurse is finishing her med pass. Dinner comes at 430, Then I pass trays. Feed my 3 feeders, pick up trays. Now it is 530ish. Record their intake, chart a little, turn my bed bounds and Hoyer patients, change soiled briefs. 7pm I take the 2 smokers to smoke on our patio.715, I am in the kitchenette(on unit) making peanut butter and jelly sandwiches, gathering snacks, pouring juice, milk etc. 800pm I change briefs and assist residents to get into bed while pushing a little cart and passing snacks. 9pm to 930 lunch, if I am lucky. If not, I drink some coffee and keep it moving. 930 I gather the trash out of the unit as I have little bags of soiled briefs sitting right inside each door that I left while I was passing snacks.945/10pm they are all in the bed, I give the remaining paperwork to my nurse. 10 pm I check and change briefs, pushing my little cart, I pass ice, water, good night hugs, blow kisses, spray my body spray in their rooms to keep me near as they sleep(they love this), tell them I love them because they are Gods creation and to be nice while I am away. 11pm finish charting and give walking round report to oncoming aid. This is a behavioral unit with 19 male residents. There are fights, sometimes but usually I can calm them down. There is confusion, depression, and tears. I have cried in the bathroom, nurses station, and every crevice of the unit at some point. I feel their frustrations, sadness, loneliness, and depression. It is hard not to love these little old men. They teach healthcare workers about skills, medications, the human body, etc. but they should teach emotional strength because if you have a heart, it will break every day all day. Life is so unfair, the least the facility can do is staff no matter the cost of an agency. They deserve great care. With so many health care workers quitting, the facility should do everything they can to support the Nurses and Aids who show up. 

Aides like you are, sadly, few and far between.  Most that I have worked with don't seem to care anywhere near enough about their patients (BM's, appetites, and the like).

I do hope that you understand that things do sometimes happen that preclude having everyone clean and every room tidy.  That should not happen too often but they do once in a while.

You might want to stop donating 1/2 hour every day to your employer.  Or even an hour if you don't get your lunch break.