CNA's on your floor?

TransplantRN3 · Oct 10, 2010

Checklists sound like a good idea if the CNA's seem to need reminders. Be thankful you have CNAs.. our floor does not. We have one tech for all of our patients.

Nurse_Hagatha · Oct 10, 2010

Check lists do not seem to matter in my experience. If a person is lazy, has a poor work ethic, and generally does not give a rip, all of the checklists in the world are not going to make a difference. I feel your pain though! I cherish my good CNA's who work hard, truly care about patients, and do not see my asking them to do something for a patient as being bossy or lazy. A CNA can make or break a shift some days, and there have been days I have gone into the bathroom just to cry from being so overwhelmed and having NO help whatsoever. I have always been the type of person who wants everyone to like me, but nursing has changed that. Now I don't care so much, as long as my patients are getting good care.

nurse121 · Oct 10, 2010

Is there any accountability for your aides at your hospital. Our don't seem to have any they are sitting down charting while call light are ringing or worse texting on their phones.

I agree lazy aid is going to be a lazy aide, but I also think that we have to give them instruction and expectations. A possible solution another nurse and I were talking about at work (has not been implemented) having a pre-made sheet of duties listed for each patient that the nurse fills out after report and gives to the aide with the expected care for the day.

this would eliminated the excuse they did know what we wanted done. I don't know what to do if they do not do these things then. I too want to get along with my coworkers, but why should I have to work hard while they are playing on their phones.

RNNITEOWL · Oct 10, 2010

Regarding beds/baths:If you have N.A. for both AM/PM-odds done 1 shift/evens the other and the N.A. has to sign the flowsheet, marking whether it was done or not..if not, pt refused,family will do etc. then the primary nurse is to be made aware & co-sign. And yes a checklist,expectation list, whatever you choose to call it, is a great idea. That in itself will requre some accountability. And yes, there are lazy CNA's just as there are lazy nurses...So, let them know you appreciate and respect them..be willing to work with them. If your problem continues then your nurse manager should definetly address the situation with them.

netglow, ASN, RN · Oct 10, 2010

Now I am admitting this might not be wise for what ever reason (I cannot think of).

But I remember reading a post on AN, I think where the OP was upset at CNAs lying about having done things like baths/sheet changes, etc. One commenter suggested to take a Sharpie pen of some color and mark the disposable bed pad/brief, or buy those "dots" circle shaped stickers and hide one or two on the underside of a bottom sheet or bottom corner of a gown, etc. This dated/timed as a way to check to see if the "Of course I bathed and changed the patient... I did a complete full bath last night" is true or not.

Sounds sneaky.... it is.

missdixie023 · Oct 10, 2010

I am a CNA & nursing student. I can't believe that you would actually have to make a checklist for your NA's but it sounds like it's a must in your situation. I work in gyn-onc and on my floor these things are just expected. I start at the beginning of my shift going to each room offering a bath and changing bed linens. We do vitals every 4 hrs on our patients, so while we're in each room getting vitals we do all of our I&O's, blood sugars, etc. Our nurses expect that these things will be charted every 4 hours and if they aren't, they WILL hunt us down Without the "routine" we have, I can see how things might get chaotic. We also have good communication between our aides and our nurses. They know we stay busy so they don't mind helping us out when we're swamped and vice versa.

roser13, ASN, RN · Oct 10, 2010

List or no list.....in my experience nothing will work unless and until management takes an active role in the process.

Once this lazy atmosphere has been allowed to settle into the unit, it likely will not be fixed without a major come-to-Jesus moment for the guilty ones. And sometimes it will not even change then.....sometimes there must be a major turnover in staff to remedy the situation. So again, management must be involved.

kayern · Oct 10, 2010

There are a few things here that need to be addressed.

First as the licensed professional you are accountable for ALL tasks delegated to the CNS regardless of how simple they may be. So it is up to you to follow up on ALL tasks, yes even bed baths that you

delegate.

Secondly, as other posters have state............lazy is lazy and nothing will change that. As a manager, nurses will come to me and say "she/he never does...." Generalized statements are not actionable, so I ask them to keep a list, i.e., on 10/10 AM care not rendered on Pts. XYZ, on 10/10 foley's were not emptied and recorded for XYZ. You get what I'm say. Yes, it does take some work on the part of the nurses, but then I can refer to the medical records and have the proof needed to start that oh so familiar paper trail.

Lastly, I find most nurses will make the blanket statements but are not willing to do that little record keeping because they want the managers to be the big bad one, not them. An as I understand that we are paid a reasonable wage to come to work to work, some just don't get it. We're all at work for one reason...........the patient. The lazy ones, if it doesn't come from within them, no write-ups, coaching, etc will help them get it.

AtomicWoman · Oct 10, 2010

I work in acute rehab and I must say our CNAs generally bust their butts. The ones who don't are soon dispatched. CNAs come in in the morning knowing what their assigned tasks are and they get right to work. That said, our unit manager stresses that we RNs are the CNAs' immediate supervisors. If we have a complaint about a CNA, we must first try to address it by asking the CNA to do a specific task or checking whether routine tasks were done and then speaking with the CNA. Once the CNA has refused to do something or just ignores it despite our attempts to get the task done, only then are we supposed to go to the manager -- with dates, times, facts handy.

OttawaRPN · Oct 10, 2010

We don't have CNAs in my neck of the woods... in hospitals we call them orderlies and in LTC they are personal support workers (PSWs) or HCAs.

I work with some phenomenal orderlies but also with some pathetically irresponsible ones. My theory is that until the day comes when this line of health care workers are regulated, the (overall) attitude and work ethic is unlikely to change.

himilayaneyes · Oct 10, 2010

If a CNA is lazy, even a checklist won't help. CNAs know to clean the patient, change the sheets, empty the foleys, etc. If someone has poor work ethic it isn't going to change b/c of a checklist. Those particular cnas will have to be reprimanded by management, incident reports filed....it's a tough job market right now so I'd think these pcas would be doing everything they could to make sure they keep their jobs. I'd bring it up to my boss to bring up at the next staff meeting definitely b/c if you have to do your job and the cnas job...they might as well fire all the pcas and pay the nurses more. However, some cnas may not be bathing some patients b/c they're busy bathing other patients/answering call lights/feeding someone/stuck in a code brown...so offer to help when you can..but as far as being on the internet all the time...not acceptable.