CNAs no longer doing vitals on our floor

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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.

Did we work on the same unit?? ;)

LOL, perhaps we did! Or, could it possibly be that there is more than one PCU in the world with a leadership vacuum?

Anyway, back to the OP. I think if the CNAs are solid in performing the core aspects of the job for which they were hired, then it's not a big deal to get your own vitals. But, if this is just another in a laundry list of things the CNAs aren't doing, thereby contributing to poor teamwork and poor morale, then that stinks and I'm sorry that's happening on your unit.

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Specializes in Pulmonary, Transplant, Travel RN.
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.

"Now at night, they will only be taking patients to the bathroom and changing patients........"

Your aids do twice as much as ours if they do that much. Our aids have been playing the same game for years, no one is going to redirect them.

They claim they are too busy with answering call lights to do vitals and glucose checks. So that got dumped on the nurses. So, they pass water while we: assess, pass meds, do vitals, do glucose checks and answer call lights/the phone.

Yep, you read it right. Go back and read it again if you must. But....I haven't even told you the best part: We get done sooner.

Then, once all the routine vitals and glucose checks are done, we give them a list of "extras" that need done. These are the people who need their vitals/glucose rechecked for w/e reason (someone had high BP and was given a med, a low glucose and the patient was given food etc etc). They do this list then move on to stocking gowns for ISO rooms. Once they are stocking gowns, for the rest of the night you can pretty much count on them not answering a single call light or anything else. They are too busy.

I've been trying to push the idea of just going with a primary care approach and being done with having these aids around at all. Most agree with me.

Want to know what the manager said to me when I mentioned it to her?

"Do you really want to have to do everything?"

She then walked away annoyed with me after seeing me roll my eyes. I never knew eye rolling could be an involuntary movement but there I was doing it................

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I live in Australia. Here nurses do:

- all respiratory treatments including managing ventilators in ICU (no such thing as respiratory techs)

- all vital signs inc BSLs

- assist patients with elimination and hygeine

- make beds

- turn patients

- everything else a nurse does (meds, IVs, catheters, dressings etc)

Where I work we have PCA's but their scope is limited to passing meals, assisting with turning patients and transporting them to theatre and back etc (with a nurse escort)

We usually have 4/5 patients during the day (5 always at the private hospital I work at)

I can't imagine having someone else doing the things that take up a good portion of my shift! I'm not sure whether I'd like it or not..

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TheCommuter, thank you for your post, it was very useful. I'm researching CNA work because I think that is the line of work I would like to get into, so I'm reading everything I can about it. Your article about the tasks commonly performed by CNAs was so very helpful.

I do have a couple of questions that I'm hoping someone could answer.

1. What happens if a CNA comes across a person that they know, I mean, wouldn't that be awkward ummm sort of speak?

How would one handle a situation like that?

2. This next question is because I'm curious about it, not that I have a problem with doing it. ( I think )

Are CNAs expected to prepare a deceased/expired patient for the morgue to pick up?

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In Australia we do everything for our patients, I can't believe in an acute setting you let someone take vital signs for you! Who is responsible when things go wrong?

I am in the UK. I am an assistant. I am PERSONALLY responsible if I fail to report abnormal vitals to a nurse.

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"Now at night, they will only be taking patients to the bathroom and changing patients........"

Your aids do twice as much as ours if they do that much. Our aids have been playing the same game for years, no one is going to redirect them.

They claim they are too busy with answering call lights to do vitals and glucose checks. So that got dumped on the nurses. So, they pass water while we: assess, pass meds, do vitals, do glucose checks and answer call lights/the phone.

Yep, you read it right. Go back and read it again if you must. But....I haven't even told you the best part: We get done sooner.

Then, once all the routine vitals and glucose checks are done, we give them a list of "extras" that need done. These are the people who need their vitals/glucose rechecked for w/e reason (someone had high BP and was given a med, a low glucose and the patient was given food etc etc). They do this list then move on to stocking gowns for ISO rooms. Once they are stocking gowns, for the rest of the night you can pretty much count on them not answering a single call light or anything else. They are too busy.

I've been trying to push the idea of just going with a primary care approach and being done with having these aids around at all. Most agree with me.

Want to know what the manager said to me when I mentioned it to her?

"Do you really want to have to do everything?"

She then walked away annoyed with me after seeing me roll my eyes. I never knew eye rolling could be an involuntary movement but there I was doing it................

I can't believe that you have to do all of that, yourself. What is the point of having aides at all?

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TheCommuter, thank you for your post, it was very useful. I'm researching CNA work because I think that is the line of work I would like to get into, so I'm reading everything I can about it. Your article about the tasks commonly performed by CNAs was so very helpful.

I do have a couple of questions that I'm hoping someone could answer.

1. What happens if a CNA comes across a person that they know, I mean, wouldn't that be awkward ummm sort of speak?

How would one handle a situation like that?

2. This next question is because I'm curious about it, not that I have a problem with doing it. ( I think )

Are CNAs expected to prepare a deceased/expired patient for the morgue to pick up?

1. You just ask to switch assignments with someone.

2. Yes, but it's honestly not that bad.

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I have to say, as a nursing student working as a tech, that I am frightened by *some* other techs behaviors. Guessing respirations and temps...disconnecting IV lines and throwing them on the floor, not cleaning them at all and reconnecting, for the sake of not having to unsnap a gown, taking away call bells because they were being used too much....I could go on and on for days about it. I had a moment last week when asking another tech why someone was on airborne precautions and the response I got whispered in my ear like a secret was 'they have hepatitis.' I knew at that point it wasn't even worth my breath to argue. All of this, to me shows a huge lack of education on their part, laziness too, but mostly they just don't know why these things are appalling.

Anyways all of that rambling was just for me to back my opinion that I think RNs taking their own vitals seems positive. Isn't that the first thing we are taught? It truly takes a little bit of skill to get a good set of vitals, cuff position and selection are something I see that is incorrect more often than not, the simple question have you had a drink in 30 minutes...nope never asked, I see 96* temps posted all the time, no way our unit is full of 96* patients, that's probably statistically impossible lol...since nurses are reporting these numbers to DRs who are rx meds based upon them, and nurses using them as part of an assessment that you are legally liable for....its scary...

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Anyways all of that rambling was just for me to back my opinion that I think RNs taking their own vitals seems positive. Isn't that the first thing we are taught? It truly takes a little bit of skill to get a good set of vitals, cuff position and selection are something I see that is incorrect more often than not, the simple question have you had a drink in 30 minutes...nope never asked, I see 96* temps posted all the time, no way our unit is full of 96* patients, that's probably statistically impossible lol...since nurses are reporting these numbers to DRs who are rx meds based upon them, and nurses using them as part of an assessment that you are legally liable for....its scary...

It is indeed scary. Makes me sick that people fake it, or that they are too stupid to know why faking it is dangerous for the pt and can kill them. If there are vitals that need reporting to the MD/PA-C, I recheck them. If i anticipate a problem with a pt, I will be getting his/her vital signs because I do not trust 75% of the aides to do it correctly. THe ones I do trust are either in nursing school or have been doing the job for a while and have a great work ethic.

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Specializes in Med-surge, hospice, LTC, tele, rehab.
The CNA's don't do vitals where I work so you are running around doing vitals, then the patient needs the bathroom and you are doing that, ending up late on your meds. All the while the CNA is sitting at the end of the hall on the internet doing nothing unless the call lights go off, which they don't since you are there doing their job for them already! So you are busy, running around doing your nursing job and their job and they get to sit back and relax on the internet. Oh you can "ask" them to help, beg and maybe they will do one or two vitals or they will make an excuse or say they will and then 30 minutes later they still haven't with another excuse. But you will have to help them turn and clean the patients, but they can't do your job! It is totally ridiculous!

You walk into isolation rooms and find no thermometers, no pulsoxes, sometimes no BP machine! Nothing is stocked and the BP equipment doesn't work because it wasn't plugged in for hours by the previous shift. Same with computers not plugged in. No thermometer probes because stocking is too much work for the CNA's. Don't ever put the paper in the machines to print out the vitals so you have to write on your hand! All the while they are sitting around, gossiping, reading magazines or on their I-pad! You're lucky if they actually pass out water sometimes!

I think this policy of CNA's not doing vitals only makes them lazy and disengaged! They act offended and put upon if you want them to help out with the vitals which we are supposed to feel free to ask but then you get the attitude that it is not their job! I wish management would wake up and realize this policy promotes disengaged CNA's who do the bare minimum! If we had computers and dash BP machines in every room like ICU has it would at least make it easier on us nurses. Instead we have to drag both machines with us from room to room. The CNA's show no initiative they will tell you so and so wants to see his nurse and you are in with another patient. It turns out something simple the CNA could have done themselves but why ask when you can pass the work off. And don't expect them to take the initiative and get the vitals while the patient is awake and waiting for you though you are busy elsewhere! This really steams me! The sad thing is some of our float CNA's are much more hardworking and will help and take the iniative. One time the regular CNA's complained to the supervisor because a float was doing the vitals, making them look bad. Can you believe that! So many will sit at the end of the hall to get as far away from everyone as possible, but the agency CNA will sit right outside the door of a confused patient, ready to keep him safe. Why can't our own staff have half the initiative? Then they wonder why the fall rate is so high!

Sometimes I think I might as well be working by myself! But given the many total patient care patients and the many morbidly obese patients that would make things even more unsafe increasing the chance of back/neck injuries! We literally need all the help, hands we can get to turn and move these patients safely!

You could be talking about my job. This is the exact behavior from the nursing assistants on my unit. Where I work, a good hardworking CNA is few and far between. When we actually have them, they are much appreciated.

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I work as a PCA on a med-surg unit, and that seems nuts to me!

I can do the following:

Take vital signs and collect I/Os, daily weights

Collect blood sugar levels

Insert and d/c a foley catheter

Administer an enema

Perform bladder scans

Help patients with ADLs

Help discharge and admit pts from and to the hospital

And...so much more.

But I am only paid 9.68/hr. I should be paid more for what they expect me to do.

YIKES! As a PCT you can insert and d/c a foley cath? REALLY? And administer enemas? I thought that these procedures were done by nurses and not PCT's. As in my state, we need a doctor's order to do any of this. Is this exclusive to your facility? Especially the insertion of foley caths, there are so many rules regarding this procedure, as a PCT I am not sure I would be comfortable with these procedures, as the outcome is not always what is intended, and there is some risk to the patient involved.

I think that just because one is "allowed" to do stuff, depending on the nurse, doesn't mean PCT's should. For me, I like to get the first set of vitals as part of my assessment. Along with blood sugars, as if I have to medicate a patient for a high, or intervene for a low blood sugar, that needs to be done pretty quickly, and would be priority for a patient. If I asked a PCT to insert or dc a foley, or give and emema, they would look at me like I have 3 heads!! And as a former CNA these were not things we learned in CNA class. As a nurse, if the patient for instance ended up with a UTI or worse, foleys are ultimately my responsibility. And in some facilities, a hospital acquired UTI means that the stay is unpaid--by at least Medicare. In any event--back on topic--PCT's and CNA's who feel like they are being taken advantage of, I am curious. What is it that you believe your role should be? How is it that you would like your day to be arranged? Should there be more CNA's/PCT's and team up? I am always curious about the "lazy nurse/lazy CNA" debate. What is it that you need/want? If you all came up with a specific plan, take it to your manager and try to advocate for a change. I do get why a PCT/CNA would be uncomfortable with vital sign taking, especially with acute care patients, needing to find the primary nurse to report any abnormals, not because CNA's/PCT's lack critical thinking skills, but because depending on the outcome, interventions needs to occur that only a nurse can do.

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I didn't read all of the posts ahead of mine, do I'm not sure if someone else said this. I used to work as an aide and the hospital where I worked didn't allow us to do vitals (but we could do POC and phlebotomy, figure that out) because they said vitals are an assessment and only nurses can assess.

Just another side of it. I'm not sure what I think about your situation though. I do believe that pressing a button on an automatic Bp cuff is really not that hard. If you only use manual bp's (which another hospital I worked at did) than aides should not be doing that.

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