it seems to me that CNA's, esp. in long term care, get treated as if they don't know how to do anything, are overworked, unappreciated, and underpaid. This one nurse about drives me up the wall. You come to her with a patient related concern and she'll look at me like I'm busy you take care of it. No I cannot hang another feeding, do a dressing change, or insert a catheter though I've been taught how. ( previous nurses training). She walks like a waddling duck. A lady accidently slipped and I was taking her to the toilet. It was an accident and I wish I fell, I felt that bad. My partner was busy at the moment and this nurse was RIGHT there! I asked her if she would mind helping me stand this lady up, she goes oh I thought so, so was going to help you!!! This is the type of nurse that would actually make a mess in the process of giving a pt their meds and say gosh that's the aides job to clean it up. I never ever expect the nurse to do my job for me but if they are in the same room and can't even help their own patients, there is something wrong with that. She doesn't like lifting either, I wonder how she passed her physical for nursing school. No other aide in sight, asked her one day to help transfer someone( would have either injured myself badly or dropped him) nurse sitting on her butt and " oh I guess so" with a sigh! The nurses are suppose to help!!! maybe as a cna I am biased and only see one side of it. Other nurses assist at times but she thinks she is too good to do anything else, but now I'm in nursing school and once I get out I hope I don't ever treat my help this way. Maybe I'm expecting to be treated with respect because I work very hard to care for my patients in skilled care, but we are always short staffed, and the fact that I have a college degree in nursing/ general studies, while I'm not a nurse in the eyes of the law I am a caregiver that continually nurtures each and every one of my patients, in a way when a patient hollers for the nurse they don't decipher between me and the LPN or RN. we are all nurses to them providing patient care.
I was a nurse aide for 12 years before going to school and have been an LPN for 2 years now. I always thought the LPN had it so easy till I actually became one. I remember 1 nurse in particular who I thought was the same way (lazy, didn't want to help out, and seemed to have a bad attitude towards the NA). Then when I became an LPN and of course stayed at the same facility guess who trained me. It was then that I realized how mentally draining her job was, how even though NA's have a physically demanding job (and yes stressful too) the nurse has the responsibilty of the entire floor. Which entails dealing with the dr., families, residents, staff disputes, lab, pharmacy, RN manager, incident reports, med pass, treatments, tube feedings, endless mountains of required paperwork, charting, etc.. that comes with that little bit of more money. I may not leave at the end of the night physically tired, but I am mentally exhausted. Then I spend the ride home trying to rememnber if I did this or that, and if I didn't how much trouble is that going to be. So then I get home and call back to work to find out if I did remember to do everything. That same nurse who I dispised became my best friend. She was the one nurse who knew all the ins and outs and knew how to dot the i and cross the t's. Many a night I called her at home and she always knew the answer to the problem, and who to call what to do. And while training me I realized that she NEVER took a break (lunch or otherwise) came in just a little bit early and left only after everything was taken care of. You never know till you walk in someone else's shoes. Yes there will always be the bad with the good. But NA's can never realize the burden of our job, and the responsibilty, until you actually do it. I always thought I would be the nurse to help the NA's out. (feed, toilet and help out) but at the end of the shift they've had all their breaks and are leaving on time. I've not had one break and am staying over to finish up my job so that I don't get in trouble. You get good nurses with the bad just as you get good NA' in the mix also. Just try to realize that even though that LPN acts like she doesn't want to help out, maybe there is more of a reason.
I completely agree with you!!! I was a nursing assistant for 2.5 years in a hospital while in nursing school, & remember how exhausted I always was at the end of the day. Now that I'm a RN I realize that nurses have totally different responsibilities to attend to, that I never even knew until I became an RN. I remember what it was like as a NA, & always treat the NAs I work with with respect & try to help them out when I can. However,on the hospital unit I work at now (which I like a lot) three of the aides have told me (I'm a new RN & have only been there for 3 weeks) that while they are happy that I help them out when they need it, that many of the other nurses do not help them at all. They told me how many of the nurses will be sitting down chit-chatting & don't help the aides out with their busy assignments. I didn't say much to this because I am new & don't want to bad mouth anyone, whether or not I agree with this. Actually the truth is I am so busy learning how to be a new nurse stil that I just do my job & help others out when needed & try not to gossip & get involved with all of that. But here is the other thing: the other nurses ALSO complain in front of me how the aides don't do this or don't do that. So now I don't know who is telling the truth! I feel very torn cuz I was an aide for over 2 years but now I'm a nurse. I can see how both the aides & us nurses have demanding jobs to do & honestly I think the problem is in communication & in not being able to put yourself in the other person's shoes (at least on my unit! ) It's pretty sad that everyone is frustrated with each other. How would all of you handle this as a new nurse? I just listen to what people tell me & don't comment on it, cuz I don't want to take sides. I am not sure I want to get involved in this cuz I'm not directly involved in any of the complaints, but on the other hand my unit is supposed to be following a team nursing model with 1 RN, 1 LPN & 1 aide working together for every 8-10 patients. Some team though, if everyone is complaining about the others! Has this happened to anyone before? What should I do? Thanks!
However,on the hospital unit I work at now (which I like a lot) three of the aides have told me (I'm a new RN & have only been there for 3 weeks) that while they are happy that I help them out when they need it, that many of the other nurses do not help them at all. They told me how many of the nurses will be sitting down chit-chatting & don't help the aides out with their busy assignments. I didn't say much to this because I am new & don't want to bad mouth anyone, whether or not I agree with this. Actually the truth is I am so busy learning how to be a new nurse stil that I just do my job & help others out when needed & try not to gossip & get involved with all of that. But here is the other thing: the other nurses ALSO complain in front of me how the aides don't do this or don't do that. So now I don't know who is telling the truth!
-Christine
True where I work also. I think the problem is that we all have TOO much to do, and not quite enough time to do it the way we'd like.
I know many nurses in my facility will sit while a light beeps without checking it out. I know which of my aides will answer when they aren't busy and the ones who never answer a light. I help both because the one's who work hard may be in the middle of something messy, time consuming or are teaming up to help with a difficult patient. I also answer the lights on the ones who are always MIA cuz it is the pts who suffer. I had an aide today who is always out smoking. Dietary came and asked a question about a resident and told me that the aide had put this pt on the toilet 1/2 hour earlier and was supposed to come back and tell her if he was going out for lunch. Pt was still on toilet. I paged cna but he didn't respond and then I went out and told him that he needed to get back in and take the poor guy off the toilet. I also wrote him up for leaving him so long. I seldom do this because my aides are mostly good but this is a repeat performance for him. It is the ones like him that people think are the norm but they aren't. That is just a bunch of bullpucky. You guys are great.
I think the CNA problem is clearly a misunderstanding at the management level on what makes people tick. I remember once mentioning to the scheduler at a LTC that I was frustrated that I could not give quality care because of the high pt/assistant ratio. She replied that if she assigned less pt for each assistant, the other CNAs would just sit around more. I thought this was screwy logic. I say, give the assistant a reasonable work load and REQUIRE performance.
If management really wants to make money, they need to provide excellent pt care, and put a stopper in the CNA turnover. The treadmill of working your butt off to give barely adequate care, being berated, and doing it all for slightly more than minimum wage, is a recipe for pt neglect and abuse. I do not blame the nurses in LTC for this; they are under enormous stress for less than optimal wages.
But I have been in enough LTC facilities to know that there is a prevailing prison mentality..
If you want to motivate people, some time, money, and effort need to go into educating, supervising, and rewarding. If we treat our assistants as if they are cheap, replaceable and uneducable, we will get what we expect!
I am on a major rant here. I have seen so many times management doing exactly what would demotivate people. They constantly shoot themselves in the foot.....
I think the CNA problem is clearly a misunderstanding at the management level on what makes people tick. I remember once mentioning to the scheduler at a LTC that I was frustrated that I could not give quality care because of the high pt/assistant ratio. She replied that if she assigned less pt for each assistant, the other CNAs would just sit around more. I thought this was screwy logic. I say, give the assistant a reasonable work load and REQUIRE performance.
That LTC scheduler obviously has a very low opinion of CNAs. And I agree about requiring quality in exchange for a lower patient/CNA ratio. When I worked in the nursing homes we didn't have time to comb people's hair and make them look nice--it was rush, rush, rush, just get them changed, dressed and get them to the dining room so we can hurry up and get them all fed. In assisted living the pace is slower so we have more time to do a thorough job. It's a good thing too: We just lost the budget for an activities director in the Alzheimer wing so we caregivers are expected to do all the acitivities with the residents--and the guy in charge of the Activities Department makes sure that we're following the schedule. It's just as well. I don't like sitting around with nothing to do for very long. :rotfl:
Specializes in psych both adult and kids, cardiac.
I am sorry that you are being treated that way. It is unfair to you as well as your patients. When I was working in acute care, my CNAs and techs were worth everything to me, the patients and the floor. You are our eyes and ears. I worked a cardiac step down unit and alot of times my aides alerted me a patient was looking a little odd and darn if they didn't sometimes catch our patients before they had a downturn. They worked so hard, I had 8 patients but sometimes due to staffing levels at our hospital they had 14 or more. It was unfair and unsafe for them and the patients there.
In your case, I would report her to the DON because the fall was a patient safety issue and she needed to assess the pt's condition. If she is the DON it sounds harsh but if this a habit of hers I would go higher but cover yourself and it sounds like to me you would be a fine asset at any place you decided to work. I am sorry that you and your patients there are being treated that way. Because we are all there to take care of the patient.
Yes we need RNs like you and I know I worked as an AIDE while in school. Its the hardest job in many ways... Hang in there you will be a great nurse and it sounds like she is just in a word.. LAZY.....
take care...
it seems to me that CNA's, esp. in long term care, get treated as if they don't know how to do anything, are overworked, unappreciated, and underpaid. This one nurse about drives me up the wall. You come to her with a patient related concern and she'll look at me like I'm busy you take care of it. No I cannot hang another feeding, do a dressing change, or insert a catheter though I've been taught how. ( previous nurses training). She walks like a waddling duck. A lady accidently slipped and I was taking her to the toilet. It was an accident and I wish I fell, I felt that bad. My partner was busy at the moment and this nurse was RIGHT there! I asked her if she would mind helping me stand this lady up, she goes oh I thought so, so was going to help you!!! This is the type of nurse that would actually make a mess in the process of giving a pt their meds and say gosh that's the aides job to clean it up. I never ever expect the nurse to do my job for me but if they are in the same room and can't even help their own patients, there is something wrong with that. She doesn't like lifting either, I wonder how she passed her physical for nursing school. No other aide in sight, asked her one day to help transfer someone( would have either injured myself badly or dropped him) nurse sitting on her butt and " oh I guess so" with a sigh! The nurses are suppose to help!!! maybe as a cna I am biased and only see one side of it. Other nurses assist at times but she thinks she is too good to do anything else, but now I'm in nursing school and once I get out I hope I don't ever treat my help this way. Maybe I'm expecting to be treated with respect because I work very hard to care for my patients in skilled care, but we are always short staffed, and the fact that I have a college degree in nursing/ general studies, while I'm not a nurse in the eyes of the law I am a caregiver that continually nurtures each and every one of my patients, in a way when a patient hollers for the nurse they don't decipher between me and the LPN or RN. we are all nurses to them providing patient care.
We had a nurse refuse to help a CNA because she was "too busy" and didn't have time. The head honcho was told about it and needless to say she didn't work there too long after that and was put on the "do not rehire" list.
It might be true that we all have a lot to do but be very careful how you phrase your refusal. You might want to say "I will help you as soon as I can" or "I will find someone to help you". If it is an emergency, as was the case in this scenario, you should drop what you are doing unless you yourself are in the middle of an emergency.
About management de-motivating the nursing assistants: when I started at my last LTC (SNF) there was a young girl (late 20's) who helped train me. She was wonderful! I remember her enthusiastically making sure we all had our percentages of mealtime intake recorded, she wrote down every one in the dining hall. She was kind to the patients, meticulous in their care.....she could do with ease what I could only do running and sweating:) She loved doing her job, and she did it well. The DON had promised her she would have a position in the new wing, with a permanent assignment, and she deserved it. Well, some disgruntled nurses said, no way. The just pulled her from pillar to post. {Some of the girls did not even get the pay they were promised.} By the time I left and the place was closed down, this girl was talking about 'why bother? I could get a job at a fast food..."
I thought she would be a good prospect for nursing school, but I am afraid they sunk her ship.
Specializes in med/surg, telemetry, IV therapy, mgmt.
I remember what it was like as a NA, & always treat the NAs I work with with respect & try to help them out when I can. . .They told me how many of the nurses will be sitting down chit-chatting & don't help the aides out with their busy assignments. . . I . . .try not to gossip & get involved with all of that. . .I can see how both the aides & us nurses have demanding jobs to do & honestly I think the problem is in communication & in not being able to put yourself in the other person's shoes (at least on my unit! ) It's pretty sad that everyone is frustrated with each other. How would all of you handle this as a new nurse? I just listen to what people tell me & don't comment on it, cuz I don't want to take sides. I am not sure I want to get involved in this . . . Christine
I know you are sympathetic to the aides, but you will have to eventually realize that you are also their direct supervisor. You owe that to your employer. Nursing procedures are so much easier than supervising people. When you were in nursing school, your clinical education pretty much focused on learning procedures and the management of patient. Although you might have had some exposure to leadership and supervision skills, you most assuredly had very little or no actual experience of putting them into practice. The skills needed to supervise are learned much the way you learned to start an IV or insert a foley catheter--by doing them again and again. The difference is, however, that you have no nursing instructor to stand by your side to guide you. This is where your education and ability to seek out resources comes into play. School doesn't teach you everything you need to know. But, it does teach you how to work out your problems. You will need this ability throughout your career as you face learning new skills. This is why you get a formal education. Anyone can pick up a book and read it. The question is, which book.
As a charge nurse, you do have a supervision responsibility over both the patients and the CNAs. The frustration of your aides comes from their powerlessness over their situation. Your frustration also comes from your powerlessness over the situation. However, you have one big advantage that they do not: legitimate authority and knowledge of supervision techniques. Your frustration comes from not knowing how to use the power you have. And, you are very vulnerable at this point in your career because you are a new graduate and still learning--you don't want these people to see you fall on your face. That is so understandable and normal. News flash: you will make all kinds of little errors all throughout your life so you have to make peace with that fact. You can supervise and still be a nice person. You can be friendly, but you cannot call yourself their friend at the same time. This is a very hard thing for many new graduates who were once CNAs themselves. For now, I think you should do as you have been . . .stay out of the conversations. Participating in them sends a clear message that you consent to them.
I also want to point out to you that if these people are criticizing the other nurses in front of you, chances are they are also saying things about you to others. That's the way gossipers work. If you are not a gossiper, you won't understand that it works that way. Believe me, they are watching you very carefully and trying to make an assessment of who you are and what they can expect of you. They watch your reactions to things that happen very closely. They already know that you are not stopping them from gossiping about your co-workers. You are no longer on an equal footing with the CNAs and as an RN you will never be again. Believe me, they recognize that. Painful as it is going to be for you, you are eventually going to have to establish that you are in charge and you are not going to tolerate certain kinds of behaviors. You have that right as the RN in charge. This is what you went to school for. You earned this privilege. What I think you are scared of is mis-using your authority.
Talk this situation over with your DON or the nurse who oriented you. If you had a good relationship with one of your old instructors, call her and discuss what is happening. Have someone help you work out plan of action. Like any nursing intervention, supervision of employees is not much different. It just requires different techniques.
You have been provided with an excellent opportunity to develop your leadership skills. Don't waste this opportunity. PM me if you would like some ideas. Hang in there. Your education is only beginning!
I know you are sympathetic to the aides, but you will have to eventually realize that you are also their direct supervisor. You owe that to your employer. Nursing procedures are so much easier than supervising people. When you were in nursing school, your clinical education pretty much focused on learning procedures and the management of patient. Although you might have had some exposure to leadership and supervision skills, you most assuredly had very little or no actual experience of putting them into practice. The skills needed to supervise are learned much the way you learned to start an IV or insert a foley catheter--by doing them again and again. The difference is, however, that you have no nursing instructor to stand by your side to guide you. This is where your education and ability to seek out resources comes into play. School doesn't teach you everything you need to know. But, it does teach you how to work out your problems. You will need this ability throughout your career as you face learning new skills. This is why you get a formal education. Anyone can pick up a book and read it. The question is, which book.
As a charge nurse, you do have a supervision responsibility over both the patients and the CNAs. The frustration of your aides comes from their powerlessness over their situation. Your frustration also comes from your powerlessness over the situation. However, you have one big advantage that they do not: legitimate authority and knowledge of supervision techniques. Your frustration comes from not knowing how to use the power you have. And, you are very vulnerable at this point in your career because you are a new graduate and still learning--you don't want these people to see you fall on your face. That is so understandable and normal. News flash: you will make all kinds of little errors all throughout your life so you have to make peace with that fact. You can supervise and still be a nice person. You can be friendly, but you cannot call yourself their friend at the same time. This is a very hard thing for many new graduates who were once CNAs themselves. For now, I think you should do as you have been . . .stay out of the conversations. Participating in them sends a clear message that you consent to them.
I also want to point out to you that if these people are criticizing the other nurses in front of you, chances are they are also saying things about you to others. That's the way gossipers work. If you are not a gossiper, you won't understand that it works that way. Believe me, they are watching you very carefully and trying to make an assessment of who you are and what they can expect of you. They watch your reactions to things that happen very closely. They already know that you are not stopping them from gossiping about your co-workers. You are no longer on an equal footing with the CNAs and as an RN you will never be again. Believe me, they recognize that. Painful as it is going to be for you, you are eventually going to have to establish that you are in charge and you are not going to tolerate certain kinds of behaviors. You have that right as the RN in charge. This is what you went to school for. You earned this privilege. What I think you are scared of is mis-using your authority.
Talk this situation over with your DON or the nurse who oriented you. If you had a good relationship with one of your old instructors, call her and discuss what is happening. Have someone help you work out plan of action. Like any nursing intervention, supervision of employees is not much different. It just requires different techniques.
You have been provided with an excellent opportunity to develop your leadership skills. Don't waste this opportunity. PM me if you would like some ideas. Hang in there. Your education is only beginning!
Wow! Thank you so much for putting in the time to fully respond to my question I posted here. I really appreciate it. I almost want to print out your words & use it for motivation for me to delegate & supervise. :) I think that after 3 weeks of being an RN, that is the hardest/strangest part for me:delegating. Today I did delegate a couple of tasks to a CNA when I was super busy-so that is a good start, right? :)
Question for you: what would you do if CNAs or if nurses were gossiping to you about other nurses/CNAs? I do not participate in any of the gossip. I am usually just standing somewhere charting outside of a patient's room or something when the CNAs wander up to me & tell me that some of the other nurses are lazy. I certainly do not say anything to them-I just listen. They know I'm not going to agree with them out loud. I guess if they gossip about me I really don't care because I know I'm doing the best job I can & don't care if others don't see that (but I do try to help others if they need the help & I'm not running around like nuts with my own crazy assignment). My question is this: would you come out & say to them "Please don't gossip around me." ? I honestly think they're telling me things cuz they're frustrated & need to vent. Anyhow, lately i've been so busy taking care of 3 patients on my own that I don't have time to stand around & listen to anyone's chit-chats anyways. :)
I think I do get more comfortable with delegating with each shift I'm at work. The more familiar I am with what I'm doing (& the busier I get) the more I notice I delegate to others-so that's good! :) Thanks for your advice & if you have any more for me or other new grads in general-please share!
I'm sorry you have to work in an environment like this. I also work in a LTC facility. I have worked with wonderful cnas, that I would do every thing in my power to keep happy(and working with me) :) , and others that should seek employment in a different field!! (If you know what I mean). But I have seen some nurses abuse their cna. I answer lights, put residents on and off toliets, and bedpans. Baths, dressing... I've also got them up out of bed, esp when they are confused and are most likely to fall before the CNA can get to them. I will help anyone , but I will never "DO" someone's job for them. I think all nurses should have to work as a CNA then they would appreciate the Aides better. (I have worked as an Aide) It is a VERY DEMANDING JOB! to say the least. Not all nurses are like that. PLEASE don't judge every nurse poorly because of one idiot. :uhoh21: I appreciate the CNAs. THey are the backbone of my facility. LTC could not survive without them!
(If you know what I mean). But I have seen some nurses abuse their cna. I answer lights, put residents on and off toliets, and bedpans. Baths, dressing... I've also got them up out of bed, esp when they are confused and are most likely to fall before the CNA can get to them. I will help anyone , but I will never "DO" someone's job for them. I think all nurses should have to work as a CNA then they would appreciate the Aides better. (I have worked as an Aide) It is a VERY DEMANDING JOB! to say the least. Not all nurses are like that. PLEASE don't judge every nurse poorly because of one idiot. :uhoh21: I appreciate the CNAs. THey are the backbone of my facility. LTC could not survive without them!
christvs, DNP, RN, NP
1,019 Posts
I completely agree with you!!! I was a nursing assistant for 2.5 years in a hospital while in nursing school, & remember how exhausted I always was at the end of the day. Now that I'm a RN I realize that nurses have totally different responsibilities to attend to, that I never even knew until I became an RN. I remember what it was like as a NA, & always treat the NAs I work with with respect & try to help them out when I can. However,on the hospital unit I work at now (which I like a lot) three of the aides have told me (I'm a new RN & have only been there for 3 weeks) that while they are happy that I help them out when they need it, that many of the other nurses do not help them at all. They told me how many of the nurses will be sitting down chit-chatting & don't help the aides out with their busy assignments. I didn't say much to this because I am new & don't want to bad mouth anyone, whether or not I agree with this. Actually the truth is I am so busy learning how to be a new nurse stil that I just do my job & help others out when needed & try not to gossip & get involved with all of that. But here is the other thing: the other nurses ALSO complain in front of me how the aides don't do this or don't do that. So now I don't know who is telling the truth! I feel very torn cuz I was an aide for over 2 years but now I'm a nurse. I can see how both the aides & us nurses have demanding jobs to do & honestly I think the problem is in communication & in not being able to put yourself in the other person's shoes (at least on my unit! ) It's pretty sad that everyone is frustrated with each other. How would all of you handle this as a new nurse? I just listen to what people tell me & don't comment on it, cuz I don't want to take sides. I am not sure I want to get involved in this cuz I'm not directly involved in any of the complaints, but on the other hand my unit is supposed to be following a team nursing model with 1 RN, 1 LPN & 1 aide working together for every 8-10 patients. Some team though, if everyone is complaining about the others! Has this happened to anyone before? What should I do? Thanks!
-Christine