CNAs no longer doing vitals on our floor

Published

I work on a med/surg floor where I guess some CNAs complained that nurses abuse them and our manager has now made it where the RNs will be doing all vitals on top of everything else. Is this normal for other hospitals? I understand that everyone is busy, but CNAs used to be able to do so much more. Now at night, they will only be taking patients to the bathroom and changing patients, which the RNs do as well.

I know I'm obviously a tad biased, but it strikes me all this could be resolved with a return to team nursing. The RN would do the assessments, monitor the labs, call the doc, stuff like that. The LPN would do all the vitals, meds, glucoscans, dressings, stuff like that. The CNA would be delegated only direct care duties. Clearly the RN would be assingned a few more pts, but think how much more time he'd have with all the "tasky" stuff delegated away. Just a thought...

Up Vote Up Vote ×
Specializes in Nursing Education, CVICU, Float Pool.
\

No, my issue is not with techs providing incorrect vitals. My issue has mostly been that the CNAs I have observed did not know the normal ranges. If I am going to doubt if they can let me know when something is abnormal, then I might as well check it on my own. But again, I am only speaking from MY experiences. I have not worked in hospitals where all charting is electronic. If all your information is at the tip of your fingers, all you have to do is log into a computer at bedside, then I can find what I need and interpret it on my own, if I am concerned at all. However, where I worked, paper charts are still the thing. Sometimes, vitals are only put in at the end of the shift.

BTW, even if they arent supposed to, I have been in hectic rounds where one of our CNAs, who was a nursing student, went and took our vitals and BG. And we were fine with that, because we knew what he knew, and trusted that he could tell us if anything was abnormal.

Besides, all of this is not a matter of trust. It is a matter of interpretation. Trust would imply that I know they can do it, but dont. For instance, they know the BG of 250 is abnormal, but dont feel like chasing me down to let me know. My problem, with the CNAs I have worked with, is that sometimes I dont know if THEY know what the normal values are.

I can understand your plight. Not trying to "toot my own horn" but many times the nurses I work with say they like it best when they have a CNA that is a nursing student because they feel we will report anything abnormal more faithfully. They are right to an extent. I've noticed that done of my CNA coworker may report something more slowly than I would or won't report done stuff that I would. That being said. There are awesome CNAs that effectively report and they are not nursing students, so I think it can be dependent on the person, like you said earlier.

Up Vote Up Vote ×

CNAs on my unit do not do vitals either. it has been that way since I began, so I guess that's why I don't think much of it. Plus they're helpful in a lot of other ways such that it doesn't seem unfair. We get vitals when we do our assessments which makes it a little more convenient.

Up Vote Up Vote ×
Specializes in Med-Surg, Neuro, Respiratory.

At the M/S floor where I work the nurses obtain their own vitals. It's usually done with the physical assessments and as needed (before BP meds, changes in condition, etc.). I don't mind doing this, because at least I know the vitals will get done and then I don't have to follow up with someone else when I need that info. It also helps me to see what kind of trends a patient is following and better help me to assess the patient. Just my opinion though.

Up Vote Up Vote ×
Specializes in Acute Care, Rehab, Palliative.

Where I work aides do not do vitals.Taking a patient's vitals is considered an assessment and should be done by a nurse.

Up Vote Up Vote ×

I have worked in a variety of hospitals. I begin my assessment with the basic information of vital signs taken by the assistant.

If it is required that I have to obtain that data on my own... it will mean time spent gathering the data, instead of time acting on it.

The RN 's responsibility is to observe, judge and act.

This a no brainer, present me with the data.. for example the BP is 80/40.. and then I can assess the problem and correct it.

In a perfect world, while nurses are in report, assistants obtain (correct) vital signs . Then we can hit the floor running .. in the right direction.

Up Vote Up Vote ×
Where I work aides do not do vitals.Taking a patient's vitals is considered an assessment and should be done by a nurse.

Same here Lori.

Our NAs all have to take a course before being hired. But most won't touch an ostomy and will get a nurse of any grade to do it for them. Like another poster said, they have time to check their phones and find a nurse to assist them with ADLs but the good ones are few and far between. Locally our biggest complaint is the poor spoken English.

I felt the LPN crack a while back was outline but then it came from a Quebecoise. We know that Quebec has the lowest nursing wages in the nation, and from what I've read here, Georgia isn't the greatest state to work in either.

Up Vote Up Vote ×
I worked on a busy PCU floor, and this happened there as well. In addition to no longer doing vitals, the CNAs were pushing for the nurses to assist with passing meal trays and take turns with repositioning and toileting. That was right before I got out.

I worked on this floor as a CNA prior to becoming a nurse, and though it was busy, the patient to CNA ratio was very doable. We had mostly walkie-talkies, and for those heavier patients, you could buddy up.

I think the culture on the floor was such that the CNAs didn't realize how busy the nurses really were, and there was a divide among the nurses about what the CNAs should and shouldn't help with, where nurses who asked for more assistance than others were labeled as "needy" or "lazy", and the nurses who just did everything themselves and let the CNAs pick and choose what they would do were the "good" nurses. There was no unity, the CNAs got mixed messages about what was expected of them, and the NM was totally ineffective.

Did we work on the same unit?? ;)

Up Vote Up Vote ×

My personal philosophy is that I do everything I can by myself. This includes vitals, fingersticks, answering call bells, bed pans...I only have 1-2 patients now, but even when I was on a busy gen-med floor I would offer to help the CNAs with bed baths if I was able. That way if I'm truly stuck or one of my larger patients is in diarrhea up to his ears, I can count on them to help a sister out ;)

I think that not allowing the CNAs to take vitals is the wrong approach to solving the problem. I think everyone would be a lot happier if the environment and their attitudes to one another changed. Maybe instead of "all CNAs take all the vitals" or "all nurses take all the vitals" it could be that the CNAs take vitals in the morning while the nurses get report and then if the nurse asks because she's caught up doing something else? Or if the CNAs talked to each nurse and they established the patient needs and role expectations at the beginning of every shift? Just throwing ideas out!

Up Vote Up Vote ×
Specializes in Med-Surg.

Was that meant as some crack about the skill of Quebec nurses? Because Ill have you know that for one, I passed the NCLEX like all of you, so my education must be adequate at the very least. And for another, if I can work with the constant shortstaffing, low pay, inadequate equipment, and all the rest, I think I can handle pretty much anything. Now, if you really were making a joke about healthcare in general in Quebec and Georgia, then Ill agree for Qc, it sucks. As far as Georgia, other than the CNAs not needing much education or training, I cant really judge anything about nursing here.

Up Vote Up Vote ×
Specializes in Med/surg, Quality & Risk.
Maybe I'm a bit of an optimist but if you want your techs to accurately take vitals and help on the floor than instead of doing it yourself a little reinforcement of your expectations would help. Show them how to properly take vitals. Explain what you expect of them as a part of the team. it just seems that taking on the extra yourself adds to your load and builds resentment amongst the department.

Oh but then it looks like you're "too good" to take vitals or do toileting!!! When in reality you have things to do that you cannot delegate to a CNA. A coworker went to one of our patient care techs once and said "The lady in 425's bedside commode is almost overflowing, I need you to go see her please." and when she left the tech said, "I love a nurse who's too good to dump toilets." Meanwhile the nurse had meds in her hand for another patient! I mean really? I'd love to have the CNA pass meds but oh yeah THEY'RE NOT ALLOWED. That doesn't mean I'm too good to dump toilets; it means I don't have enough time to do this!

Up Vote Up Vote ×
Specializes in Acute Care, Rehab, Palliative.
Same here Lori.

Our NAs all have to take a course before being hired. But most won't touch an ostomy and will get a nurse of any grade to do it for them. Like another poster said, they have time to check their phones and find a nurse to assist them with ADLs but the good ones are few and far between. Locally our biggest complaint is the poor spoken English.

I felt the LPN crack a while back was outline but then it came from a Quebecoise. We know that Quebec has the lowest nursing wages in the nation, and from what I've read here, Georgia isn't the greatest state to work in either.

Oh I didn't mean they were refusing to do them. They would do them but management says it's a nursing duty as they view it is an assessment.Our aides are terrific for the most part.Phones aren't allowed on the floor so that's not a problem. We do help with ADLs willingly.Our aides are called Personal Support Workers and their program is 8 months long( full time).

Up Vote Up Vote ×
+ Join the Discussion