Disrespectful Nurse aids

[holdensjane]

I am a new grad RN that started in October. Overall people on the floor have been supportive. But I'm having trouble with some of the assistants. I work on an oncology floor so weights and I/O are important. alot of the times they will chart numbers that are way off and when I ask them to do it again they will give me attitude. I always say please and thank you. Well just three of the assistants there are like that. They're all regulars on the floor and have been there many years and are many years older than I am. I'm only 22 and look like i'm 16. Today one of my patients have been having high BP for several days so I gave a bp med and at nine and asked if the PCA would check it again in an hour. Nine is around the time she gets the vs in the chart and reports to me a higher than normal bp. anyway, she says "well I just took it right now...." with attitude. then in the afternoon comes around and comes up to me and tells my patient's bp is 135/87, then she says she got confused between patients and its actually 178/90, and then after another second she says "no wait, rm 09 its 157/75". I say okay not thinking anything and casually just asked her to record it in the chart. She was standing right there next to it and chatting with someone next to her. The next thing I notice she's going into another room to take another bp and says to me "oh no, i got the wrong patient again, 09's bp is 135/87". This time I was thinking "okay which is it" but i didn't say that I just say "okay can you just record that in the chart please" and she says "YES I WILL LATER, I am taking vs right now, I cannot do that". Ok so i figure she's busy so i say "well could you just read me off the vs and I'll record them just so I have something to work with", then she got irritated and said okay and left to continue her vs. and nothing happen. So i got frustrated and took the dang bp myself. The reason I wanted her to write it down was because I knew she was confused so I figure if she writes it down, I will be getting the right BP since she'll have to decide which BP it was and it will be official for me. Oh yeah and earlier in the morning she was emptying out stool and asked me to come see it (i was in the room) she had already flushed it at the time but there was still some red tinted fluid left. I asked her if there was urine mixed it and she said that there was not because the urine was dark but normal. Well I didn't see the urine so I was trying to assess the situation her dark but normal can mean something different that me right? so I asked her again "so there was no red in the urine at all?" and she said "OF COURSE NOT" to me in front of the patient. Like I had just asked her a stupid question, I just wanted to know if maybe the urine spilled over to the stool. anyway, she proceded to say "maybe you want to get an order from the dr. to check blood because let me tell her the smell of the poop and the color I think is blood, it does not smell normal". she said that to me and the patient. Of course I'm just starting out but I was also a PCA before I starting working as a nurse there and sometimes would float to that unit. The patient said she had tomato soup last night. Then the PCA just said "well I'm just telling you". I personally didn't think it was that big of a deal because tomatoe soup sounds reasonable an answer but I figure i'm a new grad and was willing to hear what the pca had to say, but I just felt really disrespected. when I was a pca I NEVER acted that way. I went and told my preceptor the situation (just with the patient, not the pca) and she said that it was probably the tomatoe soup too. I feel like i shouldn't bring this stuff up as a new grad cause I don't want to get black listed. Somtimes I'd rather just suck it up and do things myself. I don't get this from many of the other PCAjust the older ones who have been on that floor for many years. a big part of me is saying just to suck it up, what would you do if you were in my situation? btw, the three assistants that do this are also big gossipers. i keep thinking maybe its something I'm doing, but I always say please and thank you I just feel like they get annoyed when I ask them to do something. when i was a pca i always her how pcas are lazy but i never understood because I always tried to do what the nurses told me. and now more and more i'll hear from nurses that pca are unreliable and will find an excuse to keep from doing something.

[juicyjake]

That's just what happens when places are understaffed. The aides are overworked and so are you. You need their help, but they are already overloaded, and have probably been mistreated by about 75 percent of the nurse that they are HELPING.

I have some absolutely outrageous stories about lazy lazy lazy/ignorant nurses.

Let me go into just one.

the CHARGE nurse on our floor was up at the desk. The desk is right next to "room X".

In room X is a little old lady with sundowners and a bed alarm and a severe fall precaution. I'm in the break room halfway down the hall eating my "lunch" and sitting down for the first time in 7 hours.

So...The bed alarm goes off, and what does the CHARGE nurse do? She walks her butt right past room X and down the hall to tell me that her alarm is going off. I was in disbelief. I had already heard the alarm and was running out the door to meet her halfway.

"Room X's bed alarm is going off." she says.

My jaw just dropped to the floor.

This poor old lady could have been on the floor with a broken hip that could have possibly ended her life, but GOD forbid this nurse would step in there to intervene because that is MY job as a care tech.

It's ashame that we have to be at such a battle with each other (RN's and PCT's) because we are supposed to be on a TEAM.

I have even had nurses call me from the room and ask me to come get a set of vitals on that patient. DID YOU FORGET HOW TO TAKE A _______'IN BLOOD PRESSURE?

phweew...I feel a little better.

My point being that tech's/aides have been mistreated by so many RN's that every time someone asks them to do something, they feel like they're being pushed around/taken advantage of/unappreciated.

We have a computer in every room at my hospital and we chart the vitals as we go.

Maybe you could pull the tech aside and tell her that all of her hard work is being wasted if you can't see the vital signs that she has taken when you need them. Tell her that you appreciate her help, but maybe you could both modify the system when you work as a team, so you're both happy.

Good luck!

[NurseKatSteeZ]

You know what, I think they just feel like they CAN do this to you because of your age and because you are a new nurse. I, myself, get this from some of my CNA's. I feel like I'm not assertive enough, or that I'm too nice. But they really do walk all over me, and I need to do something about it. I try, but I'm just too passive. I'm 24, and have been an LVN for a year now. I always feel like they don't take me seriously. I always catch them lying to me, or tryin to get away with things. I always tell them things in a nice way, but the things I tell them seem to go into one ear and out the other. Finally, my DON gave me a little lecture about being THEE charge nurse. She told me I really need to toughen up my game, and if needed, write the aids up or simply clock them out and tell them to take their attitude somewhere else. Hope everything works out well!!!

[Virgo_RN, BSN, RN]

When I was an aide I had no clue how busy the nurses were. I always got my breaks, and I had time to drink water and pee. As a nurse, I am lucky to get a ten minute break in an entire eight hour shift, and I often find myself having to make a conscious choice to either pass meds on time or eat. I don't even have time to pee. Tonight, I chose to eat. My blood sugar was so low I was about to strangle someone. As a result, all of my eight o clock meds were passed late. The aides have NO CLUE. Yes, they are busy, but I can honestly say that as a nurse, I am five times busier than when I was an aide, because not only am I doing nursing tasks that are not delegatable to unlicensed personnel, but I am also doing "aide work"; tasks that can be delegated, but there is no CNA in sight to delegate to (often because they are on their dinner break while I am rapidly becoming hypoglycemic). I am getting a thicker skin with each and every shift, and where I used to be insecure about asking aides to do things, I am no longer that way. The fact is, I need their help, and I express my appreciation at every opportunity. I thank them for their help both at the time they do it, and at the end of the shift. I truly believe a good CNA is worth their weight in gold. However, I will not tolerate a CNA being rude to me just for being asked to do their job. I will report such behavior in a heartbeat.

[mr.ahp]

Why is it always the Doctor, Pharmacist,nursing assistants, medical assistants and lab that are always wrong? Maybe some of you should get the hint.

[FireStarterRN, BSN, RN]

mr.ahp said:

Why is it always the Doctor, Pharmacist,nursing assistants, medical assistants and lab that are always wrong? Maybe some of you should get the hint.

What are you talking about?

[mr.ahp]

I am talking about the way some nurses think they are god's gift to health-care and are above every other profession.

[FireStarterRN, BSN, RN]

mr.ahp said:

I am talking about the way some nurses think they are god's gift to health-care and are above every other profession.

That's a rather inflammatory thing to say.

[jmking]

mr.ahp said:

I am talking about the way some nurses think they are god's gift to health-care and are above every other profession.

As I can recall, not only nurses are known for this behavior. Docs, nursing assistant, MA's, and other health professioals exhibit this behavior too.

[abooker]

Nervous laughter ... aren't we drifting off topic here? I'm a former Patient Care Technician and not RN yet, but I'm trying.

On the path to my RN I've encountered the following:

An Elsevier online learning module stating "RN" stands for "Real Nurse"

A discovery that in the CIHAHL online nursing database and in our textbook (Cherry & Jacob) the nursing assistants are identified as "Unlicensed Assistive Personnel"

Nurses as leaders; "Professional nurses must serve as role models for all health care professionals, caregivers, and administrators ... " RNs are not differentiated from LPN/LVNs in the USA by our ability to hang blood and push IV medications, but by our advanced level of professionalism, our superior critical thinking skills, and the three E's ... Effective, Efficient, Equitable. (I'm supposed to change those E words into action verbs, but nevermind).

The quest for prestige - is it a larger issue in the nursing model than in the medical model (Docs) and in the technical model (nursing assistants)? I haven't researched MAs.

Of course there are individual doctors, UAPs, MAs, and other professionals who behave as though they believe they are a "gift to health-care and are above every other profession."

Of course there are nurses who will spend 20 minutes looking for a CNA to avoid having to put a patient on a bedpan.

Of course there are bullies in health care, just as there are bullies in every other profession on the planet. Some people are jerks.

Sounds like the OP has become a target for bullying by the people she is responsible for supervising, and I hope she is documenting and I hope she is willing to persue disciplinary action if patient care isn't being done properly.

mr.ahp's statement DOES seem inflammatory, but some nurses ARE jerks. Also, some CNAs are jerks. Is it possible to discuss issues on a case-by-case basis, rather than generalizing and stereotyping and doing the "How DARE you" thing, maybe? :)

[Natkat, BSN, MSN, RN]

happyloser said:

It really pisses me off when RN's talk about us being jealous because we "couldnt pass Nursing School" not all of us want or went to nursing school. Im going through nursing school right now and I will never be a lazy RN because my patients need me. *sigh* Please guys just help our ur NA cause we're swamped and tired and the smell of stool gets to our head.

I'm sorry you took this so personally. I think everyone made it clear that not all NAs are like that, but the ones who are can make life hell.

It is a reality that there are aids who do resent it when a co-worker goes on to nursing school and they can't. It's not just because they can't do it intellectually - it could also be financial. Either way, they resent it and they take it out on the nurse.

[swee2000]

happyloser said:

Everyone loves bashing the NA's because its so easy to do. but we do so much and get such little recognition. There are days when I have 15+ patients and I change everyone, pass out water, do my glucose testing, draw blood, organize the rooms. and RN's still want more. Today I had 28 patients and I still had RN's asking me for glucose results when I have 28 patients to take care of. I find it extremely unsensitive and disrespectful for them to not ask but demand I do that for them. RN's need to understand that yes they have to chart and pass meds but they must help the nurses assistant because we're not there to chat and gossip but to take care of patients. It really pisses me off when RN's talk about us being jealous because we "couldnt pass Nursing School" not all of us want or went to nursing school. Im going through nursing school right now and I will never be a lazy RN because my patients need me. *sigh* Please guys just help our ur NA cause we're swamped and tired and the smell of stool gets to our head.

Before I put my two-cents in, &/or before anyones' feathers get ruffled, let me be clear by stating that I know the above comments or my own below DO NOT apply to every single RN or CNA in this country or in this world.

Now for starters, I agree with most(if not all) of the above post. There is alot of truth to what was said.

Secondly, speaking from a former CNA and now a nurse's point-of-view, I don't think the "animosity" from CNAs towards RNs has ANYTHING to do with jealousy, either for intellectual or financial reasons. Rather, I think it is an RN's way of justifying the "animosity" in their own mind vs actually dealing with the problems head-on. That isn't to say jealousy doesn't exist. I just think it's pretty presumptuous and arrogant for one to assume it's the root of the problem.

Third, I work with many wonderful CNAs who have never had any desire to be a nurse. I also work with many wonderful CNAs who, at one point in time, had the desire but for whatever reason, chose not to/could not fulfill them. Is it wrong for one to choose being a CNA as their career? No!!! Is it wrong for one to enjoy being a CNA? No!!!! Is it wrong for one to enjoy the work a CNA does? No!!! Is it wrong for nurses to look/come down on CNAs because they're not on the same level of the totem pole? Yes!!!!! Personally, I enjoyed every day I worked as one and, if it weren't for my own educational goals & aspirations, would still be doing so. Yes the work is hard, strenuous(in all aspects), exhausting, etc, etc...the list could go on and on. So is nursing. But it is also very rewarding and allows one to develop closer, more intimate relationships with patients. So does nursing. The difference is that CNAs do not have a clue, other than thru observation, what it's like to walk in the shoes of an RN or what other "behind the scenes" tasks an RN is responsible for getting done. And the only way they'll actually get a full understanding is if they graduate from a nursing school & pass NCLEX. On the other hand, nurses, especially those who worked as CNAs at one time, have some understanding but may "forget" what it was like in that role or that the work is not easy. In turn, this may lead to conflicts between nurses & CNAs or it may lead to the CNAs feeling unappreciated, unrecognized, or taken advantage of.

Now here's something that bugs me and I read about so often on here. In the case of CNAs that do their work and without being told to or what exactly it is, a common frustration seems to be this scenario: "why couldn't the RN do xxxx for the patient, and thus the CNA, when the RN was just in the same patient's room doing _______________ and knowing very well that the CNA and RN are both really busy with their individual tasks." Using this in a specific example that also came from another poster, why does an RN feel justified in spending 20 minutes chasing down a CNA to take a patient to the bathroom/put them on a bedpan/clean up an incontinent patient vs just doing the task themselves? Especially when the RN just finished doing a dressing change or med pass, for example, in this same patient's room and knew before walking out the door that the patient had to go. I mean, seriously, come on! I know this doesn't occur everywhere, but after reading many posts on here, it sure seems to occur more often than not.

[squeakykitty]

kaeky said:

I Today one of my patients have been having high BP for several days so I gave a bp med and at nine and asked if the PCA would check it again in an hour. Nine is around the time she gets the vs in the chart and reports to me a higher than normal bp. anyway, she says "well I just took it right now...." with attitude. then in the afternoon comes around and comes up to me and tells my patient's bp is 135/87, then she says she got confused between patients and its actually 178/90, and then after another second she says "no wait, rm 09 its 157/75". I say okay not thinking anything and casually just asked her to record it in the chart. She was standing right there next to it and chatting with someone next to her. The next thing I notice she's going into another room to take another bp and says to me "oh no, i got the wrong patient again, 09's bp is 135/87". This time I was thinking "okay which is it" but i didn't say that I just say "okay can you just record that in the chart please" and she says "YES I WILL LATER, I am taking vs right now, I cannot do that". Ok so i figure she's busy so i say "well could you just read me off the vs and I'll record them just so I have something to work with", then she got irritated and said okay and left to continue her vs. and nothing happen. So i got frustrated and took the dang bp myself. The reason I wanted her to write it down was because I knew she was confused so I figure if she writes it down, I will be getting the right BP since she'll have to decide which BP it was and it will be official for me.

It sounds like there is a BIG problem here with how accurate the vital signs are. They probably should have been retaken, because of the aide not remembering whose VS is whose. Does she write them down when she takes them? Is she taking them? And her attitude is insubordinate and needs to be dealt with either verbal or write up.