Do CNA's know what they are supposed to do or...

TiggerBelly · Jan 1, 2008

When I was hired I was given a checklist of things that I was responsible for during my shift. IMO it is not up to you to tell them what to do, it is the NM's responsibility. Part of my duties is to assist the nurse whenever they need help such as taking a patient to dialysis, assisting with turning a patient to do dressing changes etc, but also it goes both ways. If I need help changing someone and the other aides are busy at the moment, I will ask that patient's nurse to assist me. It really is all about teamwork.

Eirene, ASN, RN · Jan 1, 2008

they're banging "delegation" into our heads in nursing school.

on the floors, i typically ask the aides/techs if they'd prefer to do vs or accuchecks and i'd do the other. it's usually a win/win sitation.

but, i'm still in school; not real world yet. i'll probably do the same-- "nice delegation" until i got a feel for what the aides are to do.

good luck!

dani

*ac* · Jan 1, 2008

they're banging "delegation" into our heads in nursing school.
on the floors, i typically ask the aides/techs if they'd prefer to do vs or accuchecks and i'd do the other. it's usually a win/win sitation.
but, i'm still in school; not real world yet. i'll probably do the same-- "nice delegation" until i got a feel for what the aides are to do.
good luck!
dani

i got a lot of delegation in school, too, but what i learned was what tasks are allowed to be delegated. i'm asking about how this works in the real world.

Eirene, ASN, RN · Jan 1, 2008

i got a lot of delegation in school, too, but what i learned was what tasks are allowed to be delegated. i'm asking about how this works in the real world.

i'm sorry about that. :) i thought you were asking opinions.

you'll do great in the real world. let us know how it goes.

good luck,

dani

TexasPediRN · Jan 1, 2008

There are certain things that are expected of CNA's - vital signs, baths, etc.

However, I like when the CNAs meet with me each morning and we discuss what I need done, etc. This is when I can tell them that pt x has a 24 hour urine collection going, pt z needs assist with the bathroom, pt y doesnt have parents here and needs to be fed (then this gets split, aide does 8a/2p bottles and i'll do 11a/5p bottles). Things like that.

It never ever hurts to talk to your aide in the morning and make sure you are both on the same page.

Its taken me a while to get used to delegation, and I have a hard time delegating to older aides then I do the younger ones.

Good luck!

TiggerBelly · Jan 1, 2008

I got a lot of delegation in school, too, but what I learned was what tasks are allowed to be delegated. I'm asking about how this works in the real world.

Ok so you are asking for a real world scenario?

Let me give you an example

Part of my duties is to assist patients to the bathroom.

If Susie's patient calls the desk and asks for bathroom assistance and Susie answers the call light then Susie would page me asking me to go to room 123 for bathroom assistance.

So, therefore, Susie has now delegated the task of bathroom assistance to me being as how it is also part of my job description.

Is that what you were looking for?

Also we have report in the morning with the aides from the night crew telling us who has a foley, who needs to be fed, who needs total bathing care etc. This information is given to the aide when the patient comes onto the floor and she passes it on to the next aide, so on and so on.

*ac* · Jan 1, 2008

Susie answers the call light then Susie would page me asking me to go to room 123 for bathroom assistance.
.

So you don't say to yourself, Why can't Susie do it?

jjjoy, LPN · Jan 1, 2008

They told us "delegate" in school, too, as if by saying that they were teaching it. Kinda of like telling us to "prioritize" "use your nursing judgement" and "use your critical thinking skills." We told you thus we taught you. About as useful as a swim teacher telling his/her students "Swim!" "Kick your legs!" "Breathe!" without breaking it down step by step or even demonstrating what he/she was expecting from them. Ugh! And from what I hear from others, this seems common across nursing education. So they tell you that "you need to delegate"...

One problem is that different facilities follow different policies. So if you ask "what can the nursing assistant do?" the answer is "it depends." In some places, the role if very precise and, as one noted, more or less supervised by the nurse manager. An example would be that all NAs should get the morning vitals and report them to the nurse by 8am, make sure all patients have bathed and had linen changes by 11am, etc.

In other places, there is less clarity and each nurse and NA work out some kind of agreement or communication over how to get done what needs to be done... or they don't work out any kind of agreement and don't communicate well and each resents and dislikes working the other, feeling disrespected, under- or over-utilized, etc.

So what's with all the preaching about "delegating"? The point is that if your work arrangement is such that the task breakdown hasn't already been set by management, that you need to make sure that you aren't doing both the nurse's job AND the nursing assistant's job. That's it. As many things, it's easier said than done in many cases, what with personality clashes as well as when the delegatOR is less experienced than the delegatEE... which isn't a nice place to put newbies since how can anyone seriously expect them to be astute delegator's when they honestly barely even know their own job role? So you fumble through it at first. And then you finally figure it out and learn what and how to delegate to the nursing assistants.

On the bright side, I have heard of some schools that have their students work in teams similar to the nursing team, where in a couple of student act as the NAs and one acts as the nurse. The nurse, then, has several patients, more than she herself can expect to do all of the nursing care, and thus has to ensure that the NAs are on top of things while also having to do nursing assessments, med passes, and charting on all of the patients. It makes sense to me and I wish my school had done that. We only had exposure to two patients at at time and never learned how to juggle several patients or how to manage NAs.

Just thoughts! Good luck on your learning to delegate!

TiggerBelly · Jan 1, 2008

Yes sometimes I do ask myself that question, however I keep in mind that just because I see a nurse sitting in front of a computer, it doesn't mean that she isn't charting, waiting for the doc to call back that she has already paged twice, etc. Plus Susie may have answered the call light on her way to another patient's room to give meds, treatments, education etc. If it is part of my job and I am asked to do it, then by all means I will do it. Just as I help nurses, I ask them to help me when they can.

Virgo_RN, BSN, RN · Jan 1, 2008

is it up to the nurse to tell them?
I'm curious after reading some threads re: nurses/CNA's.
I'm starting my first job soon and was told by the nurses they had some issues with aids in the past but it had been resolved. The NM said, "You just have to know how to talk to them."
Now I'm a little worried about that. I don't like telling people what to do. I'm afraid I won't be good at it and I hope I don't have to do it. And as a student I often felt like the aids were some of my best teachers. (In other words, they knew more than I did in some cases.)

Both. The aides have a list of tasks and responsibilities to accomplish during their shift, but they are also there to assist the nurses by performing tasks delegated to them.

For instance, at my facility, the aides on day shift do baths, pass meal trays, pass ice water, do I&O, etc. But if a nurse needs something specific, that is also within their realm of responsibility.

KatieM123 · Jan 1, 2008

I was a PCA (patient care associate) on a med/surg floor in a pretty busy floor. Nurses were swamped but never seemed as unhappy as some on here say. There were generally 3 PCAs one for each "wing" and each wing generally had 2 nurses so each PCA had 2 nurses they worked with/for.

There was never any doubt about the things surely PCA only -- vitals whatever Q the patient was -- 4, 2, etc we ALWAYS did that and had specifics about what to report directly to the nurse and always wrote it down. We also did baths in day shift and all cleaning/diaper changes on other shifts. We emptied folies/drains and recorded amounts. And we aided as needed -- so I expected nurses to ask for help. Sometimes it was simple -- pass me bandages when I say so. Sometimes it was cool -- holding a hand while a PICC line was put in! A nurse would tell me if s/he smelled a full diaper or needed a bed pan or someone needed to walk or go to the bathroom. That was cool, it was my job. They weren't ordering me, my job was to do those things. And often if the nurse had a moment they would help me get the patient up and moving then I'd finish the walk or they'd assist even in a small way. Or I knew they were running for their lives and I'd gladly help out.

We had the one nurse who always said aids in his day got water and did this and that and blah blah an dhonestly we joked with him. He still deligated far more to us than any other nurse, but that was OK too -- he ALSO shared far more of his 20+ years of experience with us when he could.