CNA's and Fire Power

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Hello to fellow nurses who have been stung by the CNA wasp. After I got off a 3-11p shift on New Years Eve, I sat at the dining room table telling my boyfriend that I felt very uneasy about what occured at work that night and they have the power to get a nurse fired. When I got off the hall at 10:45 I discovered the vital signs sheet for my Medicare people were not where they are usually placed toward the end of the shift. When I discovered they weren't done, I asked the CNA if she could get them for me so I could do my charting and I really appreciate it. She told me I should have hand carried them to the end of the hall and given them to her personally even though they were in plain view sitting on the counter of the nurses station. All other employees pick them up and promptly proceed on to get the VS done. In the end I finally recieved them slapped on the counter with a rude smirk "there, is this what you want?" I told my boyfriend that me indicating that I couldn't get my charting done because she held me up is gonna come back on me or get me fired. Sure enough, this morning the DON gets me in her office and says she got reports that I made a stink and attituded up on the poor CNA and was told they have to LET ME GO. Folks who don't witness the balance we nurses have to keep with them and the tightrope we walk to keep our jobs. If CNA"S collaborate together to badmouth a nurse who simply needed what she needed to do her job if only they did theirs, and they succeeded. That is too much power lording over the licensed nurse. Has this happened to you or someone you know? People don't believe me that they can get you fired. :cry:

Hi, Our nurse aides's do not get the VS. The nurse is responsible for getting the VS at our facility.

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Specializes in VA-BC, CRNI.

There is more to this story.

The CNA was the excuse to fire you, not the reason.

Maybe she fired you because you waited until after your shift to check if your pt's VS were ok.

Tisk, Tisk.

I am sure you had to give some BP meds or something that would require VS...did you just get your own as you went along?

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Specializes in Hospice, LTC, Rehab, Home Health.

Some places the CNA's rule. During AM med pass in one LTC I found a pt totally drenched in urine and partially "brown rung". Although I will and often have changed pts. myself I don't do it during med pass. Asked the CNA assigned to the pt to change that pt next when finished with what she was doing. Next thing I know I overhear charge RN telling CNA "not to worry about it, some people just talk to others that way, not to quit they needed her!' Well, if they needed a CNA who leaves patients drenched in urine, they don't need me! Left that job before my 90 day orientation was up and never looked back!

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Specializes in med surg ltc psych.

Well to clarify on the VS canundrum, there is a sheet of specified only Medicare Part A folks that I needed the VS for and had them flagged on the sheet (there may have been 9 total out of 32) and in this facility we enter the charting/documentation at the end of the shift. It wasn't for dose alert reasons for BP or heart meds that I needed the VS for. It was for the plain fact that they weren't done at all and for Medicare charting only that did not allow for me to start entering info into the Medicare binder and I guess I couldn't believe it didn't get done. None of the other nurses address the VS sheet until the last hour or so of the shift so I was in compliance with my time frame for charting and asking for the VS. Yes I do get my own BP and pulse for cardio meds as I do the med pass because I don't trust the ficticious made up numbers CNA's give me on heart meds I give. I'm sure y'all have seen baselines and then see wacked out numbers that a CNA gives you and you have to retake and it's night and day. I saw an agency CNA get fired when I was a CNA for entering lunch and dinner diet % intake for peg tube feeders. I agree, there must have been some other hidden reason for this abrupt dismissal. It's sad because some of the employees were my former classmates and I've worked with all the other nurses on other areas of the floors and got along great. They liked me a lot. I loved that about this job and now it's...

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I had a similar experience at a small community hospital. The nursing assistants made various complaints against me because I would not do things the way they were used to doing them. I came from a large community andhad previously worked at various hospitals including a university hospital. I was used to the aides doing what I requested because I had a good reason for asking them to do it that way. Since I was ultimately responsible for the out come and was their immediate supervisor, my job was to tell them what to do. But at the small hospital, the aides resented authority and doing tasks because I said so. I always felt I listened to their point of view, but if I disagreed,then the decision was mine. I don't think a lot of aides understand the tremendous pressure a nurse is under sometimes. But then there are those speicalaides who will work with you and for you for the benefit of the patient. It is sometimes not apparent to aides why you are doing something.

I was also ultimately fired from this job, not because of incompetence but because I spoke out and tried to chang things.

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Specializes in med surg ltc psych.

Interesting chacomom that you said you were fired because you spoke out and tried to change things for the better. Now that I reflect back to three months ago, the new DON who actually originally hired me was a veteran 26 year charge nurse from a local large hospital. She wanted the change from hospital to SNF and related to me how much she liked her new position and better pay at the SNF. Three days after I got on the floor I found out they just fired her abruptly. Why?? I wondered. Heard it was because she "spoke out and tried to change things." After today, my mind reeled around the thought of doing another 2 yrs of school to get a bachelors degree in a NON nursing field that I would enjoy. Nursing is difficult enough, but to deal with egofied DONS and CNA's I don't know what to think or believe anymore. All that hell of nursing school and finally a license and I feel like they hire and fire the same as a Taco Bell franchise.

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Specializes in Geriatrics, WCC.

From listening to my staff, I have found that most CNA's just want some respect for the things that they do. Having been one myself back in the 70-80's, i totally understand. They would like it if the nurse would ask them to do things and not demand. They also have stated that a nurse will want something done ASAP when they are in the middle of something else. I have told them and the nurses that the CNA's need to let the nurses know that they can fulfill their requests just as soon as they are finished with whatever it is they are in the middle of. The whole thing oils down to communication. They need to talk to each other and use common courtesy. I hear a lot of please and thank-you.

For the most part, it works like a well oiled machine, but there is always a little rusty spot that needs a little more grease. I have monthly floor meetings with the staff. We have 3 floors and at change of shift in the afternoon, all the staff from that floor comes to that dining room to go over any issues. This includes dietary, housekeeping, etc. This is how they air any problems happening with each other and works quite well.

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Specializes in LTC, peds, rehab, psych.
:dzed: :dzed: :dzed: :dzed: :dzed:

Wow.

If you can be fired for that mere and singular incident - then woe betide the nurse that really makes a mistake. Or one that the CNA's get together and "vote off the island" :eek: --- seems like a bad situation either way.

;)

"vote off the island" is a phrase I've never heard used before for these circumstances but quite accurately describes what happened to a nurse I know. He was a nurse I had worked with on and off for a few years while we both worked agency. A very good knowledgeable nurse with the upmost respect for patients. We coincidentally ended up getting a job fulltime at the same longterm care facility on staff. Well he being hired caused another nurse who had worked the floor for quite some time and was not the best nurse, to be moved to another unit which also broke up a clique on that floor that included her and several cnas. Well the previous nurse was very unhappy and basically caused herself to be fired by acting unprofessionally due to her anger of being moved to another unit. The cnas in her clique were upset at her being fired and basically decided to take it out on the man who replaced her, and all went to the DON screaming patient abuse. You get enough CNAs to say the same thing about a nurse and admin is forced to believe it apparently because not only was he fired but they turned him in to state and he is now fighting for his license. Its downright frightening what CNAs can do if they want to get rid of a nurse.

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Specializes in VA-BC, CRNI.
Well to clarify on the VS canundrum, there is a sheet of specified only Medicare Part A folks that I needed the VS for and had them flagged on the sheet (there may have been 9 total out of 32) and in this facility we enter the charting/documentation at the end of the shift. It wasn't for dose alert reasons for BP or heart meds that I needed the VS for. It was for the plain fact that they weren't done at all and for Medicare charting only that did not allow for me to start entering info into the Medicare binder and I guess I couldn't believe it didn't get done. None of the other nurses address the VS sheet until the last hour or so of the shift so I was in compliance with my time frame for charting and asking for the VS. Yes I do get my own BP and pulse for cardio meds as I do the med pass because I don't trust the ficticious made up numbers CNA's give me on heart meds I give. I'm sure y'all have seen baselines and then see wacked out numbers that a CNA gives you and you have to retake and it's night and day. I saw an agency CNA get fired when I was a CNA for entering lunch and dinner diet % intake for peg tube feeders. I agree, there must have been some other hidden reason for this abrupt dismissal. It's sad because some of the employees were my former classmates and I've worked with all the other nurses on other areas of the floors and got along great. They liked me a lot. I loved that about this job and now it's...

Medicare does not require VS for charting. You missed the entire purpose of the Medicare requirements. Medicare requires by law a minimal set of standards, standards that many people forget or get lazy about. Mostly common sense things that you should be doing in the first place... Do you wash your hands after going to the bathroom only because you are made to?

They demand VS not so that you can write it down, they demand them so that they know you are assessing and monitoring your pts. They want them written down to verify that you did them. I am shocked that you would not look at or care about VS until after your shift...that is literally the first thing I look at after report. VS are not ONLY for charting and meds.

What would you have done or said if the VS tanked and one of your pts went bad? Handle the situation the last few minutes left in your shift or let the next shift handle it? You just spent 8-12 hrs with someone that may not have been doing so hot... You assess before...not after so that you can intervene promptly. If I was you CN or DON and I found out you were not checking the VS until the end of your shift and only for charting purposes I would have torn you up and down and written you up.

Just because everyone does something does not make it ok...you are a Nurse now, you do what is right and thats it.

Your statements are shocking to me and worry me. So what have you been counciled/written up for while there?

PS, documention/charting should always be done after, you say what you have done or what has happened, not what you will do. Never heard of a facility that predocuments.

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Specializes in VA-BC, CRNI.

I find it funny there are so many people claiming to be fired because of their CNAs...lol...everyone elses fault!

I am willing to bet money that the bulk of the terminations were because of

1. Incompetence or other larger issues known or unknown (CNA issue was the excuse for the canning)

2. Failure to lead...either you were a tyrant or failed to adequately supervise/educate...many times both.

3. Failed to present your case clearly and professionally...worst sin of them all.

Very rarely is a termination entirely a one sided "all their fault" situation, we like to believe that it is always "their fault" but I wonder what all the preceding events entitled.

For example the last 3 RN/LPN terminations I have witnessed or been a part of were for very minor stupid reasons BUT the terminations were justified do to either a long history of incompetence, poor performance, poor attendance. Think straw that broke the camels back.

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Specializes in Geriatrics, WCC.

That is why I always say to document, document, document. When I have terminated staff, i have a trail of paperwork to prove the reasons why.

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Specializes in Cardiac Telemetry, ED.

I've seen the damage a disgruntled CNA can do to a competent, professional nurse. While I agree that in some cases, a CNA's complaint can be the straw the broke the camel's back, I would also advise any nurse working in an environment where the CNAs rule the roost to keep your nose clean at all times and watch your back.

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