CNA's on your floor?

JessaAustralia · Oct 11, 2010

I have to say, if you work in hospital and you have someone to do the showers and linen change for you that's great!. That just doesn't happen here in Australia, though CNAs are starting to come in slowly.

I do feel your anger though, I work in a nursing home and my carers (not quite a cna) are sometimes very lazy. In the mornings they start out great. I do get complaints from residents that they wanted to get up an hour ago, but when they have 12 residents between two it's damn hard work. It's when I go into a residents room and they say I've been waiting for someone to answer my bell for ages and now I'm soaked, my chair is soaked, etc etc. NOT HAPPY. The carers are no where to be found and I can not hoist this lady on my own. I don't get to carry a pager for call bells, so if I'm busy doing wounds or notes I have no idea these people need anything. It's very frustrating, and where I work it's basically if the carers didn't do it oh well. They can't really afford to fire staff as they just can't get enough carers. :confused:

enchantmentdis, BSN, RN · Oct 11, 2010

Finally--someone is brave enough to post on something that has irked me for years! Most CNAs don't help the RN/LVNs especially when they are extremely busy--that is when you are let down. I have done so much CNA work my whole RN career that i was certain my title should be changed to nursing assistant's assistant--NAA. Hospice nursing is wonderful because i don't do the work for the HHA and the HHA is never there when i am present--thank God! I can actually be an RN. I have very little tolerance for foley emptying, bed pan giving, vital signs taking-- if i wanted to do this i would have stayed an aide and never become an RN or i would work for a hospital like Kaiser, horrible place, that only uses the aides as sitters and makes the RN do everything. That is not to say that if a patient has a BM that i will call for the cna, i will gladly clean the patient alone if it is physically feasable. And it is wonderful if the patient lets me know they are ready for the commode--i'd rather do it myself. And i prefer to take my own vitals if pt's condition changes because i will actually take it in both arms. Every CNA i've worked with had to be told to check the bp twice and looked at me like i was nuts when i asked for orthostatics. They know exactly what they are doing. They do not want to work, yet will interrupt you during report or disagree with you in front of a physician to report something insignificant. Once i complained to the nurse manager that the cna sat around in the nursing station taking up space, perusing charts, eating, and generally not doing her work and the manager said "she makes so much less money than you do". She'd better, because she doesn't do anything. CNAs love to see me run around, drowning in work, and being harrassed by physicians, patients, and family members. They are like children and are very jealous of RNs yet don't want to go back to school. Oh, boo hoo.

enchantmentdis, BSN, RN · Oct 11, 2010

I'm so tired of busting my butt and then passing by the common area for the staff and seeing them on the ******* internet when I'm busting my rump doing my job and they are just hanging out waiting til 7 when they could be doing something productive. It's frustrating.... I'm over it.

Is this a common problem? Suggestions? Pllleeassee.

They are like children, have no license, no responsibility, their pay is like an allowance that they don't deserve because they didn't clean their room or do what momma RN/LVN told them to do. They gloat because you --the RN, are responsible if the CNA makes a mistake. I would report the internet use and other insubordinate activity and have several other licensed staff sign the report and put it in the manager's box. Also you won't have this problem if you work in outpatient preop, endoscopy, school nursing. I've been doing this &^%$#@ for 15 years--people don't change. Just take the easiest nursing job you can get.

steelydanfan · Oct 11, 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.

"So I ask them to keep a list"... As a manager, your job is to get YOUR butt out on YOUR floor and manage YOUR employees. It is NOT my job to monitor the people YOU hired! And it is NOT about being the bad guy, it is TOTALLY about the fact that I do not have the time to do YOUR job. I get at least 2 dictums every week about some new task I am now responsible for. Hell, now I have to clean the rooms before the housekeeping staff will deign to come in to clean them.

If I tell you a CNA is not up to snuff, I will present you with at least 3 instances of troublesome behavior. At that point I expect action, not platitudes and requests for ME to make a case.

it does not take a whole lot of time to follow an aide and ascertain whether or not they have turned a pt. every 2 hours. Nor to shadow an aide and see how they respond to a direct request from an RN. You will soon see who gets up and who is always "busy" in the break room. You get paid for managing this unit, BE THERE, DO IT. Instead of going to meetings.

steelydanfan · Oct 11, 2010

I have to say, if you work in hospital and you have someone to do the showers and linen change for you that's great!. That just doesn't happen here in Australia, though CNAs are starting to come in slowly.
I do feel your anger though, I work in a nursing home and my carers (not quite a cna) are sometimes very lazy. In the mornings they start out great. I do get complaints from residents that they wanted to get up an hour ago, but when they have 12 residents between two it's damn hard work. It's when I go into a residents room and they say I've been waiting for someone to answer my bell for ages and now I'm soaked, my chair is soaked, etc etc. NOT HAPPY. The carers are no where to be found and I can not hoist this lady on my own. I don't get to carry a pager for call bells, so if I'm busy doing wounds or notes I have no idea these people need anything. It's very frustrating, and where I work it's basically if the carers didn't do it oh well. They can't really afford to fire staff as they just can't get enough carers.

12 residents betweeen 2! My aides are responsible for 8-16 acutely ill patients at at time. And as far as when they get up, well, someone will be first and someone has to be last. Hire a private nurse if you want to be coddled. Ages and ages are minutes except to the person having to wait through them.

JessaAustralia · Oct 11, 2010

Though a lot of acutely unwell people can still walk and shower themselves. When you have 2 people to 12 residents that aren't self caring at anything. It becomes a much harder job.

I say give credit where credit is due, these men and women that are carers/CNAs are working damn hard and not getting very well paid. If it wasn't for them, a lot of these places wouldn't run.

I know I've been told by my own friend that I should be a nurse that helps the carers and that nurses sit around and talk and have it easy. Well sometimes I wish I had the extra time to help! I wish my job wasn't all paper work and making phone calls to doctors. It isn't always what it seems from the outside looking in. Not all my carers are lazy all the time, and I'm sure is the same for your CNAs. Maybe they need to be thanked as well sometimes and feel important as they are not just CNAs, they should be treated as a important part of the team. A CNA that has brought you information about a patient weather it is trivial or not should be listened to. That is your JOB! They should be telling you when something is noticed but not emergency, so it does not get to that stage.

RNs and LPNs should be educating their CNAs as a role of a nurse is always to be a educator. Take the step up and ask them to do something if it isn't getting done instead of running to the DON. You will get a lot more respect and help from them treating them as team members instead of dirt under your shoe.

I'm also wondering why you don't always know if your patients have gotten showers today? You should know what's going on being the RN and since uneducated staff are being used to make sure obs and showers are done.

I wouldn't want to be working under most of you, you should never treat someone on your team like they are under you. Treat them as your equal, it shouldn't matter how much education you have. Seriously disappointing that nurses behave that way.

pers · Oct 11, 2010

I wouldn't want to be working under most of you, you should never treat someone on your team like they are under you. Treat them as your equal, it shouldn't matter how much education you have. Seriously disappointing that nurses behave that way.

I agree that CNAs should be an important part of the team. However, if you're in the unfortunate position to be part of a "team" where the aides aren't doing their job and you are expected to pick up the slack it's not really a team. Management tells you that as the RN it is up to you to delegate to the CNA but when the CNA doesn't do the job your only option is generally reporting/writing them up. From there, it's up to management to deal with the issue but when they don't take care of it (for whatever reason) the job still has to be done, and it falls on the nurse to do it. It's not up to me to fire (or hire) a CNA, I am expected to get the job (meaning total care of the patients) done with the staff I'm given.

A CNA who does their job (and I'm talking about just actually doing the job requirements, nothing extra) is a great asset to a unit while those who go above and beyond are worth their weight in gold. The ones who think they are too good to actually do the job they were hired to do? They aren't just useless in terms of getting the job done, they actually create more work for everyone else! Personally, I don't want, much less need, people like that on my team. They count towards our staffing and I'd much rather have fewer patients and do total care than be staffed with more patients and end up doing total care anyway because the CNA is always on break or hiding out somewhere.

hecallsmeDuchess · Oct 12, 2010

Ahhhhh, that original post could have been made by me! I swear, that it pains me to see what aides on my floor do. I feel like I have to beg them to do things (we were told in orientation not to beg them but to request that they do things, hmm). I don't understand why morning vitals are not done or ice pitchers not filled, baths not done. I have to get report, pull meds, and try to run around doing every other thing in between. Some days I never sit down once because I'm usually running about doing my job and theirs, which I wouldn't mind if I had all the time in the world.

The most surprising thing that happened one day was a CNA told me one morning to come get her in the break room if I needed her, I swear my jaw hit the floor. Morning vitals hadn't even been done for goodness sake! I think it's even more painful because I've walked in those very shoes and I never waited for anyone to tell me what to do. It's frustrating especially since I still have to go back on the rare occasion when things are done and make sure everything was done in such a way that my newly minted nursing license won't get snatched away. I could vent all day but what good would that do me? :nurse:

kcochrane · Oct 13, 2010

In the majority of the cases, the CNAs/Techs know exactly what needs to be done. Why then do I need to tell them or remind them? No one tells me what I need to do, I just do it. We are a team and we are all adults. So if you want to be treated like an adult, act like one. The CNA/Tech job is important and needs to be done. We can't work without them.

The other end of this is that those CNAs/Techs that actually do their job usually end up getting burnt out because they try to take of the slack of the those that don't.

It really comes down to whether or not your really care about your patients/residents. If not, you need to find another job.

Chixie · Oct 13, 2010

I have worked with some of the best CNA/HCA's and they have made my shift lovely including one lovey who on hearing the doctors do their rounds, took the cloth and towel out of my hand and pushed me out of the cubicle so that i could participate in the round. On another ward ive also worked with the laziest,rudest and downright meanest HCA's ever. The highlight of working with the lazy ones include, sneaking off once an hour for smoking breaks because they were friends with the ward manager. Yet when i asked to go for morning break i was told not until the washes are done. The washes that were left were doubles and i had everything set up for the wash and was trying to round up a HCA to assist me with them.