To all the wonderful CNAs out there, thank you for being the fantastic assistants you are. You are greatly appreciated for everything you do. You help to keep things running smoothly and by performing what seem like menial tasks, you free the nurses you work with up to handle more pressing issues. Reporting important information is extremely important and for those of you who do this I thank you. Although I may consider myself a competent and worthy nurse, I am not super-human and do not have eyes in the back of my head, so I count on you to give me insight to what's going on in many situations. B/Ps outside parameters, febrile temps, broken skin, and the multitude of other things you might discover while providing care. I can not possibly express the gratitude I truly have for your contributions to the health and well being of our patients. Thank you!
That said, for future reference, please try to refrain from telling me how to do my job. When you come to me to report a patient is in pain, great! I got it. I'll do what I can. When a patient is having an episode of increased confusion, again, I'll try to do everything possible to help that pt. But, just because I don't jump and run to a pt who says he is in pain does not mean I haven't done anything or don't plan to. There may be circumstances you are not aware of, circumstances that I am not at liberty to discuss with you, or feel I have to explain. Its not your call. Its mine. Just because a pt is causing you to get behind in your other duties, having to put them back into bed because he/she is crawling out, or screaming out for what seems like no reason, does not mean I am going to sedate or chemically restrain that pt. so you can move on to other things. It is my call. It is my decision. It is also illegal to chemically restrain a pt without express orders from the doctor. Also, many medications ordered for decreasing anxiety and agitation in dementia patients don't work. Often they have a paradoxical effect. That is the opposite effect of the one they're supposed to have. Rather than calming the pt, the medication might make their anxiety/agitation worsen. Not that I need to explain, but perhaps explaining may give you a better picture. Many times talking to the pt, getting their attention and re-directing them proves more helpful than meds anyway. Toilet or change him/her, give him a snack, sit down and just talk to her. So, you get five minutes behind. You can easily catch up. However, coming to me every few minutes to tell me (not ask), to "do something" isn't helping at all. :loveya:
It did not occur to me that what I said might be construed as demeaning. I really do appreciate CNAs, I was one for 10years before returning to school for my LPN and know how difficult a job it is. And, when time permits, I take pts to the bathroom, clean them up, sit down and just talk with them if they are confused and trying to get out of bed. I will also keep a pt at my side to monitor while at the desk or keep in eye-view of my med cart while passing meds. And even though I may lose a small amount of my time needed for other things (more pressing issues; like a bloody nose), it often saves me the aggravation of filling out endless incident reports on falls and injuries.
I have worked with many more great CNAs than bad ones and in my experiences it isn't the "good" CNAs who come to me and hound me about a resident. I'm not talking about the CNA who reports something then later maybe coming to find out if I've taken care of it. Or, telling me that mr. soandso is still complaining. I'm talking about the CNA who comes at me like they are the "nurse police". "Did you do that"? "Did you take care of that"? That CNA is the one who usually doesn't want to do their job. Who's looking for a way not to deal with a problem, but rather push it off on the nurse. That same CNA will shirk their responsibilities off on other CNAs, asking for help with a pt (and its usually the one they asked for help that does the job), then hiding out or making excuses not to help the other CNAs on the floor.
When a new CNA comes to the floor, I do my best to place them with a CNA who knows their job inside and out. So they can learn how to do their job well. When he/she comes to me with questions I answer them. I certainly would not leave a CNA to handle a bloody nose no matter how experienced they are. Because that's my job, not theirs.
Well, LilPeon, it seems like maybe you are just coming across a little more abrasive than you meant to. Perhaps you should reconsider your previous communication with the CNAs in question and try to resolve things.
I guess I'm blessed to work with FANTASTIC CNA's. They do "their jobs" (much as I hate the term) and more. For patients that frequently need attention (toileting every 30 minutes, crawling out of bed, etc) I try as much as I'm able to take turns, so my CNA (and I don't mean "my" in a derogatory way....we do team nursing on my floor, so any LPN or CNA is teamed up with an RN, or else an RN has an assignment alone, so by "my" I mean my CNA teammate) isn't the one that has to be going in there every time they ring or set off their alarm. Granted, things will certainly come up that ONLY I can take care of, leaving my CNA to have to deal with said difficult patient, but I have no problem going in to redirect someone if my CNA did it the last 5 times.
It's all about teamwork, and there are just as many lazy/misguided/bossy/whatever RN's as there are CNA's. That's my belief, anyhow.
Sorry for sounding abrasive, they tell me here in the south its because i'm a yankee (there's a stereotype!) actually got called onto the carpet for the way i talk. told i should probably add the phrase "bless its heart" to my vocabulary by my NM and people here would forgive me anything i said. Now that's condescending! i can't help it, i am what i am. people either love me or hate me, there's no happy medium with me. but, i believe i do my job well, i choose to keep my education on a higher level than required by my license, participating in workshops, going to classes, taking online CEUs not required of me. i also hold high standards of care for my residents. i provide care to my residents just as i would my own mother whom i love dearly, and expect everyone around me to do the same. i get peeved with nurses as well as nurse assistants who provide substandard care and i do take my concerns to my manager. but as with many facilities and organizations, one person making a complaint does not always make a difference. without the support of other staff members action is usually minimal. if i were to make repeated complaints, even though i know the complaint is genuine, then i become labeled "a troublemaker". so i don't do that.
Specializes in Community Health, Med-Surg, Home Health.
Basically, I think that the OP was venting. It may have sounded abrasive, but I have encountered both sides of the fence. There are some people in other positions than nursing (not always CNAs, either...it can be a non-nursing manager, for example) that are quick to demand something from a nurse without knowing the rationale of why.
Just this week I had to take time to explain my position to many. I work in the OB/GYN clinic as an LPN. As an LPN, I do not triage. Calls are transferred to my room that I am not qualified to handle, walk ins that really need an RN assessment and small nuances such as administering Rhogam has to be given to an RN because it is a blood product. The manager, CNAs and health educators have brought patients to me with these issues and they thought I was rude even though I nicely stated that this case should be given to an RN initially. One person said "Well, you ARE a nurse, aren't you?" in a very confrontational manner. I told them that while I fully comprehend what is going on with the patient, I cannot make an independent decision and if I took the chance and made the wrong decision, it could be determental to the patient; and maybe even waste their time. There are 7 RNs in the clinic, 2 LPNs. It got to the point this afternoon that I had to gather these people together to explain in one setting why.
We do need to take the time to explain to members of our team a bit on what is happening on our ends, but I can admit also that sometimes, there are those that are just trying to flex their muscles and then say that we are incompetent because we didn't act in a way that are satisfactory to their eyes.
:redbeathe "Basically, I think that the OP was venting. It may have sounded abrasive,..."
I have to agree with the previous post. I read the original posting a few times to see if it was mean. It just kept coming across as venting.
LilPeonNo1, from your postings it is obvious you are an EXCELLENT nurse:redbeathe You truly care about your patients. With that being said, remember you can't make others care to the degree that you do.
As many have said before me, there are good and bad in all professions. When things get stressful sometimes it only takes one person and a tone of voice to push one over the edge.
Sorry for sounding abrasive, they tell me here in the south its because i'm a yankee (there's a stereotype!) actually got called onto the carpet for the way i talk. told i should probably add the phrase "bless its heart" to my vocabulary by my NM and people here would forgive me anything i said. Now that's condescending! i can't help it, i am what i am. people either love me or hate me, there's no happy medium with me. but, i believe i do my job well, i choose to keep my education on a higher level than required by my license, participating in workshops, going to classes, taking online CEUs not required of me. i also hold high standards of care for my residents. i provide care to my residents just as i would my own mother whom i love dearly, and expect everyone around me to do the same. i get peeved with nurses as well as nurse assistants who provide substandard care and i do take my concerns to my manager. but as with many facilities and organizations, one person making a complaint does not always make a difference. without the support of other staff members action is usually minimal. if i were to make repeated complaints, even though i know the complaint is genuine, then i become labeled "a troublemaker". so i don't do that.
Most of your original post was fine. CNA's are there to support you, and to free you up to do other things. That's just the way it is, and there's nothing wrong with that. But it was your tone, and some of the things you said that revealed a big part of your problem: your communication with your CNA's. You aren't sure of what their training is, and you have apparently not talked to them about the things that bother you. I come from the south, and moved to California. I never really liked the "bless his/her heart" thing either, but I bet you can find a better way to communicate with CNA's. A few minutes here and there to let them in on what you are thinking and doing will probably go a long way. They want to know what's going on, where to contribute, and what to look for. Be thankful for that. They are obviously concerned about the patients, which is good right? So if you aren't sure how to talk to someone in a critical but constructive way, take a page out of the coach's handbook and say two positive things and then one negative. That's how you'll get the most work done to improve your one negative. You sound like you take your job very seriously, which is great. You should. But you have to get along with your peers, too. If the management doesn't support a good work ethic, I'd be quietly looking elsewhere for employment.
Specializes in Community Health, Med-Surg, Home Health.
Who is to say that the OP speaks to the CNAs in an abrasive, derogatory manner? I was not present to see what actually happened, but she may not have. When we vent when the culprits are not around, of course, we may sound more abrasive to our peers because we can release what we really want to say without offending anyone. Most of us do this all the time. For example, when I speak to my supervisor on an issue that she has angered me about, I don't sound like this, nor do I sound like this when I speak about the same issue to my co-workers because some like to run back and spread rumors for brownie points. But, when I get home and speak to my friends, I just may sound abrasive, because it is safer and yeah, I was probably very, very angry or annoyed. There are proper settings to express our frustrations away from those who we feel initiated the thoughts.
I am just saying to give the OP a break. Speaking for myself...I don't know what she said to the CNAs. But, her feelings, I can understand.
LilPeonNo1
38 Posts
It did not occur to me that what I said might be construed as demeaning. I really do appreciate CNAs, I was one for 10years before returning to school for my LPN and know how difficult a job it is. And, when time permits, I take pts to the bathroom, clean them up, sit down and just talk with them if they are confused and trying to get out of bed. I will also keep a pt at my side to monitor while at the desk or keep in eye-view of my med cart while passing meds. And even though I may lose a small amount of my time needed for other things (more pressing issues; like a bloody nose), it often saves me the aggravation of filling out endless incident reports on falls and injuries.
I have worked with many more great CNAs than bad ones and in my experiences it isn't the "good" CNAs who come to me and hound me about a resident. I'm not talking about the CNA who reports something then later maybe coming to find out if I've taken care of it. Or, telling me that mr. soandso is still complaining. I'm talking about the CNA who comes at me like they are the "nurse police". "Did you do that"? "Did you take care of that"? That CNA is the one who usually doesn't want to do their job. Who's looking for a way not to deal with a problem, but rather push it off on the nurse. That same CNA will shirk their responsibilities off on other CNAs, asking for help with a pt (and its usually the one they asked for help that does the job), then hiding out or making excuses not to help the other CNAs on the floor.
When a new CNA comes to the floor, I do my best to place them with a CNA who knows their job inside and out. So they can learn how to do their job well. When he/she comes to me with questions I answer them. I certainly would not leave a CNA to handle a bloody nose no matter how experienced they are. Because that's my job, not theirs.