CNAs running the building??!!

On 11/23/2021 at 3:10 PM, LuvNursing84 said:

This is a rant- 

Before I get anyone upset - I was a CNA for almost ten years before becoming a LPN.  What I'm noticing is it seems as if the majority of ltcs, the aides run things. I don't know about you all, but I don't remember it being this way before..

For example, how can someone not licensed tell a NURSE how to do their jobs? Or give an attitude when the charge nurse has to ask them to do ... you guessed it their jobs!

I think if you have a nurse who will answer lights, toilet, provide peri care right alongside the aides, the nursing assistants should have a little respect for the nurse.  It's been said many times..along with running the med pass, vitals, and treatments, the nurse is also thinking about a million things, charting, and making sure meds are reordered and available.

 

Does anyone else get soo tired of it?

CNA's don't know the job  of being a nurse. It is essentially hidden from them. They have no responsibility. This is a divide in LTC. You have responsibility, they don't. They report to  you, you don't report  to them. The major problem is staffing, many times there is only 1-2 aides working a hall, if that, and that's all you get, so the nurse is stuck with the  aides they have, good  or bad. Any problems that arise I send to administration.

Unfortunately that’s how it is and how it’s going to be in LTC/SNF’s. I was a CNA for 10 years and you’re right it never was like this from what I remember. Now I am an LVN.
 

That’s one of the reasons why I quit my FT job at a snf. I was tired of dealing with insubordinate CNA’s who wanted to boss you around or down right not listen to you. What’s worst was that the DSD didn’t do nothing, but claimed to talk to the CNA’s. I remember I had told a CNA to clean one of her pt’s who was soiled but she decided to go to her lunch break first. I wrote her up and got my DON and DSD involved but nothing happened: or this other time I did an abuse report and handed it over to the Admin, instead of suspending and investigating the CNA, he was being lenient towards her.  I remember she wanted to run the show by selecting her run, and when she didn’t get her way she went to go cry to the admin and the admin came rushing to me as to why she didn’t get what she wanted if she came to work 16hrs to help out.  So basically he sided with the aide. I quit after that. Not worth the money and stress.
 

I am now doing 1-1 care home health.  And I can say it is waay better. My stress level has gone down. I’m happier. 

I have absolutely noticed this and wondered when things change! Where I work there is Personal Care Aides, often not certified, and Certified Medication Technicians who take a 20 hr course on how to pass medication under delegation of a case managing RN. They are constantly stepping on toes, and yet make tons of mistakes and then management looks towards the LPNs as to why this isn't being supervised or something? When we are given limited authority as compared to before and these unlicensed staff are out of control with their egos. I was also a CNA/CMT for 5 years so I know the job. It's such a struggle, I'm also tired of it.

You all are so right..it makes us LPNs feel like we are pointless! I'm sorry I know I'm not able to tell the RNs what to do and what I'm not going to do. But for the sake of the residents I just try to brush off the egos but when I see a wrong I feel inclined to politely speak on it. 

Exactly, we listen to the RNs. The CNAs should have the same amount of respect and listen to LPNs as well. I also get tired of them having the idea that since an LPN isn't an RN they can treat them however type of way. I'm almost an RN (May'22) and cant wait to get out of the LTC environment and hope the hospital ones are better, sigh...

path0gems that's great! You'll have to post on the NCLEX RN !

While there is never an excuse to be insubordinate, let me say that I AM a CNA/CMT and I know the job of an LPN. A big part of the issue is the attitude of some nurses.Example: You said if they have a nurse that will help they should give respect....WELL, excuse me nurse but these are YOUR PATIENTS not mine, remember I don't have any responsibilities.These are your vitals, your skin checks, your standards of care.The problem is, is that some nurses continue to think that personal care is the job of the CNA ONLY. When in fact it is YOUR license on the line, these tasks are within your scope and ultimately your responsibility too, this is why a nurse must be staffed in facility.A CNA is an assistant/aid.Someone to HELP the nurse with personal care.Great that you help someone that is helping you with your patients ADL's.As for a CNA being disrespectful, mouthy, refusing that aid should be written up and or terminated.It is bad nurses that created these types of CNA's that have become burned out and have a bad attitude. When the mass of LPN's start to act as a team, LTC will change for the better.I never fight with the nurse...although I have had lazy ones, one that ate all day, one that would tell us he is going to sleep and not to wake him unless someone was coding and then had us make a bed and he went to sleep..EVERY night, disappearing ones,a couple being intimate in the supply closet almost every shift.I just do what I gotta do because all the darn fighting negatively impacts patient care.I cant make grown people do right so I control what I can, me.I do as much as I can, make no excuses, love my LTC old people, I bring them food...cupcakes, ice cream, mcdonalds, and sugar free treats for my diabetics..It is a little something from the outside and what I can do to try to make them smile.I have been wet from showering residents...looks like we both showered...pooped on, projectile vomit...had to wear 2 facility gowns one in front one in back while my scrubs were in laundry, I couldnt go home at that moment, my pissy old person was sick I was the only aid on the floor the nurse...nope she wouldve just melted away.We do what we must for our residents, often we are the family. 

As I said I was a CNA for 10+ years before becoming an LPN. If some nurses don't realize the patients are theirs, they are wrong. Please read the post again..

I read it correctly the first time. I was just advising of my experiences and opinion. A CNA shouldn't give "respect" to a nurse for that nurse doing what is in their scope. A CNA should give respect to a nurse because the nurse is their superior, no matter the letters after their name. I understand exactly what you are saying. In today's climate, more and more responsibilities are put on the nurse and there are so many nurses that refuse to perform personal care, so if an aid gets a nurse who is willing to perform personal care, be thankful. But this entire thought process is what is wrong with the LTC industry. It is a team effort even though some tasks seem that they can't be shared, they can. Passing meds, while the CNA can not, the CNA can support the nurse with resistant patients by encouraging them to comply. Ensuring that they are not agitated before med pass etc. Making sure that the Nurse has ice, water, cups, spoons, med cups, empty trash, applesauce, pudding on cart. It is the little things that go a long way. If you can't pass meds at least you can contribute this way is what I tell my fellow CNA's. Perform vitals as soon as shift starts, this helps with parameters for blood pressures, Blood glucose etc. so the nurse is not blindsided at med pass. If we want to be a great team, we all have to be a great teammate, and try to empathize with each other. You know what it is like because you have been a CNA, these make the best nurses in my experiences.

I completely agree mlmckenzie . I think at this point LTC needs a total revamp of what's going on in these buildings. It's terrible that residents have to wait or not be cares for properly because some CNAs and nurses don't want to go out of their way to work hard. I understand it's not easy because we all get too many residents to take care of but if we want to be treated as professionals we have to have the high standards in our work ethic. 

Maybe I'm still green as an LPN. I graduated just as covid was taking hold in Spring 2020..not the easiest times for sure!

mlmckenzie said:

While there is never an excuse to be insubordinate, let me say that I AM a CNA/CMT and I know the job of an LPN. A big part of the issue is the attitude of some nurses.Example: You said if they have a nurse that will help they should give respect....WELL, excuse me nurse but these are YOUR PATIENTS not mine, remember I don't have any responsibilities.These are your vitals, your skin checks, your standards of care.The problem is, is that some nurses continue to think that personal care is the job of the CNA ONLY. When in fact it is YOUR license on the line, these tasks are within your scope and ultimately your responsibility too, this is why a nurse must be staffed in facility.A CNA is an assistant/aid.Someone to HELP the nurse with personal care.Great that you help someone that is helping you with your patients ADL's.As for a CNA being disrespectful, mouthy, refusing that aid should be written up and or terminated.It is bad nurses that created these types of CNA's that have become burned out and have a bad attitude. When the mass of LPN's start to act as a team, LTC will change for the better.I never fight with the nurse...although I have had lazy ones, one that ate all day, one that would tell us he is going to sleep and not to wake him unless someone was coding and then had us make a bed and he went to sleep..EVERY night, disappearing ones,a couple being intimate in the supply closet almost every shift.I just do what I gotta do because all the darn fighting negatively impacts patient care.I cant make grown people do right so I control what I can, me.I do as much as I can, make no excuses, love my LTC old people, I bring them food...cupcakes, ice cream, mcdonalds, and sugar free treats for my diabetics..It is a little something from the outside and what I can do to try to make them smile.I have been wet from showering residents...looks like we both showered...pooped on, projectile vomit...had to wear 2 facility gowns one in front one in back while my scrubs were in laundry, I couldnt go home at that moment, my pissy old person was sick I was the only aid on the floor the nurse...nope she wouldve just melted away.We do what we must for our residents, often we are the family. 

MacKenzie.  I am an LPN just getting home from night shift.  I think you stated you know what it means to be an LPN.  With all do respect that's impossible. I am a nurse that does my job and helps my 1 CNA at night so I do personal care right along with her. I have also been spat on, pooped on, sworn at, called names. You name it.  Then I get to do my job also, pass meds, dressing changes, vitals, assessments, chart checks, documenting orders, filing, checking labs, glucometer checks, crash cart checks, flushing and sometimes changing Foley catheters, weights if the CNA is to busy and then my charting and notes, which is why I get out late every morning.  I know it happens but don't understand how nurses sleep all night and get away with it.  Please look up your job description.  You are working under the nurses license but also have certain duties YOU are responsible for and the nurse can then delegate within your scope of practice.  Also, the residents are OUR residents not just mine.  You keep doing your best, your residents count on you, and I will continue to do my best also