the cnas have taken over!!

Nurses General Nursing

Published

Help, I'm in a situation that I really don't know what to do. I'm a new lpn, about a year and a half. I consider myself a very good nurse and very professional and very fair. However, the facility I am currently employed has a real problem.You see, the cna's think they run the floor, and no one is doing a thing about it. They have blatantly told me that these were "their residents, and they can take care of them better than I can" I have complained to the don and nothing is done about it. The other two nurses that work the floor with me have been there for years, as have most of the aids, and they have been allowed to behave like this. The other 3-ll nurses have complained also but nothing is every done. The don, I'M told is afraid of getting involved because the aids belong the a union and the nurses don't. The aids are constantly involving themselves in nursing conversations I'm having regarding care. They easedrop on conversations with nurses and doctors and family members. I think they even go through charts when no one is around. I was even told by our infection control nurse to be careful, that the aids will "report" you in a second, just to see a nurse in trouble or get fired. I was even told that the cnas had to sign off on bolus feedings, just to prove that the residents were getting their feedings. I put my foot down with that one and was called to the don's office. I now have a fellow nurse sign for them. I have never been in a facility where the cna's were so empowered. It's really scary. I'm really thinking of going into home care. Have already contacted an agency. Would appreciate some feedback with this one, Thankss.

A similar situation happened at a facility I worked in as an 11-7 aide. The aides pretty much had the run of the place. The only nurse who stood up to them was the one that I worked with. In return she was threatened and all four of her tires were slashed right on the facility premises. She called the police, but they never found out who did it. Once the situation escalated to that point I knew I had better get out while the getting was good. I didn't even give notice.

Specializes in Corrections, Psych, Med-Surg.

I'd get out as soon as possible.

"I think they even go through charts when no one is around."

Oh my God...Call the president...

Relax on this particular one...

Why can't a CNA look through the chart?

I'm the nursing supervisor at a LTC facility. Before I started to work there, the CNAs weren't even allowed to use the phone in the nurses' station...Give me a break. Now some CNAs sit in on nursing report AND (are you sitting down?) look in the charts WHEN I'm around...

CNAs can have valuable input, and should be thanked for giving it (when appropriate)...

I have 150 patients in the facility...I can't assess each one every day...The LPNs and CNAs are my eyes and ears...

It's called teamwork!

Sean

I work as a CNA as well as go to school in an ADN program. I will alway's say that the CNA's should be respected and listened to. But as a CNA I need to realize that the LPN's and Rn's are better trained than me and they deserve my respect. They are in charge of the floor and while I will give my opinion they have the final say in most things. That is the way it should be. Do not loose your respect for CNA's becauser a few have over stepped their boundries. I too would leave and notify the state.

I can't believe that CNA's are allowed to look at pts charts. According to HIPPA, we are to ask ourselves "Is this something I need to look at in order to do my job?" Does the CNA HAVE to look at the chart in order to do their job? NO! However, the RN does. It's not called teamwork,...that's called being nosey!

Specializes in O.R., ED, M/S.

I think this is a exception more than the rule in most LTC. I agree with hogan4736 that your aides should be a part of patient care and any future care. The one thing that is disturbing is the fact the aides don't know and don't respect authority. I would leave also and check out other facilities in your area. I am sure the situation is different. I have no respect for your DON, no backbone. I don't care what they say, you are in charge! Your license is on the line. Chain of command, this is what the state will look at when there is a problem. Good luck and hang in there! Mike

Originally posted by Tory

I can't believe that CNA's are allowed to look at pts charts. According to HIPPA, we are to ask ourselves "Is this something I need to look at in order to do my job?" Does the CNA HAVE to look at the chart in order to do their job? NO! However, the RN does. It's not called teamwork,...that's called being nosey!

The above sentiment is likely the very reason for CNAs w/ attitudes...

I worked ER for 7 years before going to LTC...The ER techs not only looked at the charts (omigod, call the state :roll),

they were an integral part of the team (most ER techs have ZERO formal "ER tech" education; CNAs go to SCHOOL)...

How dare anyone suggest that a CNA not look at a chart or be involved in report...

God forbid a 15+ year CNA who has PAYED ATTENTION wants to know about a pt's history as it pertains to a patient's care.

To suggest that a CNA shouldn't look at a pt's chart, likely reflects an attitude of opression and control, and also definitely reflects great disrespect for CNAs as a whole. That sentiment disappoints and disgusts me (No, I was never a CNA)...

Pardon my (likely perceived by you) arrogance, but if not for the CNAs, many RNs (in charge of over 100 patients) would miss finite changes. I thank God for my (good) CNAs...

Am I advocating a CNA run the unit?

AHHH, NOOOO...

Do I value their input?

Yes!

Your idea of not letting CNAs look at charts, is not only elitist, but fundamentally wrong.

By your logic, you and I as the (charge) RN, should be disallowed at looking at the doctors' progress notes!

I don't need the MD progress note to give an enema, right?

Stop the caste system that some nurses have created.

And to cite HIPAA (another grammar mistake, you wrote "HIPPA," yet another all too common mistake by nurses) is LAME and WAAAAAAAAAAAY off base.

Oh, and so I can save a little face, recheck your apostrophe placement:

"I can't believe that CNA's are allowed" WRONG. doesn't belong

"to look at pts charts" WRONG. you omitted one.

Please someone back me on any of my many rants.

;)

:(

:cool:

You know something we all go around and around with this C.N.A issue and it never seems to be solved. Having been a C.N.A. myself I have a little more sympathy for their job and see things from both side.

The rift between the nursing assistant and the licensed nurse if born of both parties not understanding the other's job.

Neither one can care for residents in Long Term Care with out the other. Nursing assistants are not indentured servants who are there to serve at the pleasure of licensed nurses; they are there to care for the residents who live at the facility. Nursing assistants have the closest contact with the residents on a given unit and are expected to report changes in the resident's condition to licensed nurses. Good nursing assistants take ownership of their unit and their job and to a certain extent the residents they care for. There are many things a nursing assistant can tell a licensed nurse about a resident because they are there to see it. We often fail to listen to them and discount their opinions because they do not have the same level of education that licensed nurses do. This has always struck me as strange since the same observations coming from the resident's family would elicit a much different response.

Licensed nurses are all too often guilty of elitism when it comes to their relationship with nursing assistants. True the nursing assistant is the least educated and lowest paid of the staff caring for our elders but that is a function of how the health care industry is set up. Ask your self this question. Would you, with the amount of training that you have invested in your self, work for what nursing assistants are paid? I didn't think so. While each of us can do the job of a nursing assistant would we want to in addition to everything else we do to care for our residents? I didn't think so. So it is in the best interest of licensed nurses to work with nursing assistants instead of looking down our collective noses at them because they have less training and all to often come from a different socio-economic group that most licensed nurses come from.

On the other side, nursing assistants have to understand that licensed are responsible for the action of the nursing assistant and for the overall planning and implementation of care for every resident living on the units licensed cover. Much of what we do is governed by our nurse practice acts, standards of practice and State and Federal regulation. They cannot do our jobs and most know that but nursing assistants also know that we licensed nurses look down our noses at their job while preaching how important they are to the quality of life for each person we care for. Nursing assistants are not stupid and can see the disconnect.

I see nothing wrong with nursing assistants sitting on report. What is wrong with this opportunity for dialogue and coordination of the shift's work? As far as the resident's record is concerned HIPPA is clear about this and in servicing of the law and facility policy should have stressed what the nursing assistants responsibility is.

I have very little problems with the nursing assistants I work with; they know who I am and what my responsibilities on the unit are. When they are asked to do something I take the time to explain why. Most adults expect this. When they have something to report to me I take it seriously enough to listen to them and assess the situation. I then give them feed back of my assessment. Most adults expect that also. This is the same as I would do if a resident's family came to me with a problem. You know something the nursing assistants appreciate this.

And to clarify, this last weekend, 2 CNAs came to me during lunch tray pass. They were angry that a resident (w/ an open book pelvic fracture - external fixation, NEVER gets out of bed - 42 years old) wanted to get out of bed during the lunch tray pass. They came at me with: "He knows we're passing trays, he's just trying to be difficult"

I looked at them straight in the eyes, and said, " I'll help pass trays (likely something beneath many RNs), go get him up NOW!"

I bring this anecdote up, lest anyone think I believe CNAs should run the unit.

Their comment and outrage (at the resident) illustrates why CNAs should never run any unit.

That is not meant to offend, just to prove a point. CNAs don't know what they don't know.

As compared to MDs, RNs don't know what they don't know...

We are ALL valuable, and should all be allowed to look at the charts (CNAs, LPNs, RNs, PT, OT, Dietary)

Stop the madness and treat all (from the janitor to the CEO) with the EQUAL amount of respect and dignity that they deserve!

Sean

we_rn...

you get it!

'nuff said!

I started as a CNA.

I often worked with other CNAs who were downright hateful to both the residents and the nurses.

I saw CNAs who put a lot of work into figuring out ways to get out of doing their work.

I worked agency when I was a CNA, and facilities used to call my agency and ask for me by name. Why? Because I respected the nurses, worked hard, and knew my place!

The residents/pts were my number one priority, not figuring out how to take 20 smoke breaks a shift, hide from the nurse or sleep in a resident's room like I saw so many other CNAs doing.

As I said, I've been a CNA. Then an LPN, and am now an RN. Being an RN is by far the most difficult job of the three.

Great CNAs are the bedrock of any facility- they are precious gems.

The problem is they are far more rare.

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