On a very busy morning where I'm trying to control a patient's surgical pain to discharges and family and patient education I was confronted by a nurse tech. This is how the conversation went:
it was 11:35am. Me: " I know you are having your lunch at 12. Would you make ms. m's bed. She just sat in the chair but she will soon be called to dialysis in her bed so she will go need to go back to her bed soon."
reply from nursing attendant in front of the patient:" I will make her bed when I get to it. I don't appreciate you telling me how to do my job. I don't like the way you talked to me"
she had just created added unnecessary stress that morning.
she complained about me to my nurse manager who didn't agree or disagree but she listened. I had to tell her what transpired between us though brief. now I have a meeting this week with the nursing attendant and the nurse manager to discuss what happened?
to be honest I didn't even know anything bad happened? All I did was delegate a task.
I understand saying please and thank you. If the N.A. do tasks without my asking we wouldn't have had this encounter. What I dont understand is we all do what we need to for the patient. The N.A. is not doing me any favors. Im barely sitting down.. and if I dont say please make her bed im suddenly the bad nurse and she has to talk back to me in front of the patient?
I want the shift supervisor to call me up every hour and ask if I would "Please record the VS from my patients is it wouldn't be too much trouble". Maybe pharmacy can call me whenever a med is due and tell me "how much they appriciate it if I would pass the ordered meds on my patients".
I am so tired of being told I have to be all sugar and spice to the non-licenced support staff because apparently they are doing me a great favor by doing any work at all, and I should be thankful they don't write me up for disrupting thier day with all that noisy patient care I'm doing. I'm not saying I want to be nasty and rude to the NAs and techs I work with, I'm just tired of the attitude that I should be grateful for any scap of work they manage to put out. It seems they are the worker of last resort- if all the nurses are frantic, and no one has had a break but the NA, and somone may die if something isn't done- then maybe, if I ask real nice, they will get up and help out for a few minutes- but the want an extra break, and to clock out earily without loss of pay, and they don't have to do any of thier regular assigned duties because they answered one call light, or helped keep an eye on a confused patient for 10 minutes until I could get back to the bedside. When I was a NA I worked my hiney off because I recognized I wasn't in charge. I was there to "assist" the "nurse" like the title says. I worked with a good group of nurses who didn't dump on me if they could help it, but it they were watching the Tele monitors and chatting about thier weekend, they were using thier training to monitor and assess the patients. If I was sitting at the desk and chatting about my weekend, I was wasting time. I didn't have the education and licence to sit at the desk and plan my patients needs for the next few hours.
I don't think you did or said anything wrong, and I ran the world, you could fire the NA for being "insubordinate" and "disrespectful". These are the words I keep hearing thrown at nursng staff when they try to make a suggestion to better meet the needs of the patients.
No matter the situation, the NA was definitely wrong to speak that way in front of the patient.
Was this in front of the same patient you were discussing? If possible it's better to avoid discussing one patient in front of another at all.
I usually preface directions like that with"are you able to..." because I know full well that the NAs are busy too, and I don't know what else they have on their lists. I always prefer an NA tell me honestly that they don't really have time, rather than skip it or put it off until later. Then I can make the choice of how urgent it is--if I need to do it myself or find another NA to help out.
I've had one or two similar run-ins with NAs who simply don't know as much as they think they do (regarding prioritization in particular) and I know that sometimes the nurse acts appropriately and the CNA doesn't. (I posted an experience like that to AN once upon a time and felt belittled by the responses--I wasn't even asking if I did right or wrong, because the CNA was wrong and was disciplined; I was asking for advice on teaching the CNAs about priority.) So I try to give posters the benefit of the doubt. Just try not to get defensive in the meeting; even if the NA is being unfair, it doesn't look good.
I could understand her being ticked off if she was busy while you weren't doing anything..... but sounds like you were incredibly busy doing your job and patient care. I don't think you were out of place at all.
Well, being a nurse means everything in the world is your fault. And to top it off, your peers and administrators agree. Maybe you should bring coffee and donots and flowers in every morning for the CNAs so they will feel appreciated. It doesn't matter that you feel unappreciated. Maybe if every single nurse in he world went on strike on the same day maybe we would get some appreciation.
If you have a strong leader who says "you are in the role of a CNA." (and it is a nursing assistant, not a nurse assistant, that leads one to believe they are a nurse who happens to be assisting). "As a CNA, you are to be delegated by a nurse tasks within your scope. That includes bedmaking. Going forward, the goal would be for you to observe and participate in tasks that you see need to be done, such as patient's beds are made in a timely fashion, answering call bells, doing vital signs, and other various tasks as indicated by the nurse" "If you are unable or unwilling to complete these tasks as directed, then perhaps this is not the job for you."
Okay. Just straight-shooting when I say, some people (in all job descriptions) have attitudes and don't want to do their jobs and play games. I find some CNA's will allow the nurses to do as much of *their* work as possible under the guise of they are ALL of our patients and nurses can toilet someone OR make their bed as well as a CNA, yadda, yadda. So, then you do have to request that they do their job...sad as that is. And, unfortunately,...if you write her up, she may retaliate and report you...maybe even for something you didn't even do.
If you have a strong leader who says "you are in the role of a CNA." (and it is a nursing assistant, not a nurse assistant, that leads one to believe they are a nurse who happens to be assisting). "As a CNA, you are to be delegated by a nurse tasks within your scope. That includes bedmaking. Going forward, the goal would be for you to observe and participate in tasks that you see need to be done, such as patient's beds are made in a timely fashion, answering call bells, doing vital signs, and other various tasks as indicated by the nurse" "If you are unable or unwilling to complete these tasks as directed, then perhaps this is not the job for you."
That would be a perfect Nurse Manager, if she could just spell it our truthfully like that!
I do feel for the OP, because I think they were probably really pressed for time. Hopefully when the OP goes to the meeting they will be very objective. I was a NA for four years before becoming a nurse and there would be other NAs who would simply refuse to do something if the tone was off. I realize that it goes on both sides, sometimes the RN is not respectful of the NA, and sometime the NA is not respectful of the nursing duties or the time constraints placed on nurses
Good Luck, I hope you are able to get to a happy median
suanna
1,549 Posts
I want the shift supervisor to call me up every hour and ask if I would "Please record the VS from my patients is it wouldn't be too much trouble". Maybe pharmacy can call me whenever a med is due and tell me "how much they appriciate it if I would pass the ordered meds on my patients".
I am so tired of being told I have to be all sugar and spice to the non-licenced support staff because apparently they are doing me a great favor by doing any work at all, and I should be thankful they don't write me up for disrupting thier day with all that noisy patient care I'm doing. I'm not saying I want to be nasty and rude to the NAs and techs I work with, I'm just tired of the attitude that I should be grateful for any scap of work they manage to put out. It seems they are the worker of last resort- if all the nurses are frantic, and no one has had a break but the NA, and somone may die if something isn't done- then maybe, if I ask real nice, they will get up and help out for a few minutes- but the want an extra break, and to clock out earily without loss of pay, and they don't have to do any of thier regular assigned duties because they answered one call light, or helped keep an eye on a confused patient for 10 minutes until I could get back to the bedside. When I was a NA I worked my hiney off because I recognized I wasn't in charge. I was there to "assist" the "nurse" like the title says. I worked with a good group of nurses who didn't dump on me if they could help it, but it they were watching the Tele monitors and chatting about thier weekend, they were using thier training to monitor and assess the patients. If I was sitting at the desk and chatting about my weekend, I was wasting time. I didn't have the education and licence to sit at the desk and plan my patients needs for the next few hours.
I don't think you did or said anything wrong, and I ran the world, you could fire the NA for being "insubordinate" and "disrespectful". These are the words I keep hearing thrown at nursng staff when they try to make a suggestion to better meet the needs of the patients.