Does your ICU have CNA's?

[Rose44]

In my ICU we have lost two full time CNA's and I have just found out they are not replacing them. We are a very large ICU with high acuity patients. Administration is telling me that most ICU's don't have CNA's anymore. I find that hard to believe and was curious to hear if this is true. If you could also let me know what state you work in this will help me identify id this is a national problem.

[Ruby Vee, BSN]

18 bed CTICU in a 1000 bed teaching hospital with 7 ICUs. We have 2-4 CNAs per shift, and I don't know what we'd do without them.

[calivianya, BSN, RN]

We didn't have any at all at my first job, not even someone to answer the phone. It sucked having the rooms closest to the station because you got stuck on secretary duty in addition to having two ICU patients.

At my current job, we have ones that answer the phone and occasionally call central supply for us, call housekeeping to get rooms clean, etc., but none of them ever help us with patient care. One was showing me her new ring the other day and I said something like, "That looks like it would rip a glove, I'd be afraid of getting poop in it," and she replied that she doesn't really deal with that and she and I had really different jobs. I resented the crud out of it because I worked my butt off as a CNA and it's frustrating that the ones I work with mostly have a desk job.

The CNAs here are very upset because they just took a pay cut; I can't bring myself to feel sorry for them because they don't do much. I see them spending most of the night shopping on eBay... that must be nice. I don't see how they are of much use in the ICU.

[delphine22]

Job 1: 22 bed MICU, 1 CNA days or nights, they do fingersticks, empty trash and help with turns and baths. We do our own temps, empty foleys, and answer phones at night when there's no secretary. If our tech is off or sick there is no replacement for her.

Job 2: 25 bed general ICU, no CNA ever. Full-time secretary at night who prints monitor strips (but doesn't really watch). Two RNs are assigned to each 2-hour block as a turn team.

[Greenclip]

I work MICU/SICU of a large (1000+ beds) teaching hospital with multiple ICUs. No ICU has more than 16 beds. All routinely have one CNA attached to each. They help with turns (we have a turn team, each RN and CNA is expected to sign up for at least one slot) so that patients are turned every 2 hours. They also get all the blood sugars. They do the baths, although the RN has ultimate responsibilty for that. We often do them together especially for a heavy patient...aka most of the time. Taking temps q 2h and emptying Foleys is no longer part of their task list, although they will do it if asked. They also feed patients who need help or supervision with meals. They help to settle in new patients and can witness the "undress and assess" that we do for every new patient or transfer. They can also help to break down a room when a patient leaves, especially if we have campers waiting in the ED to come upstairs.

The best ones are very proactive, will fly through the baths, you check the computer and see that the blood sugar was taken 20 minutes ago, you look in and see that your patient with up orders is in the chair eating lunch. Others have to be asked or reminded about everything and roll their eyes when you have a DKA who needs hourly blood sugars.

We also have a unit secretary but they do not work 12 hour shifts, and on the weekends the secretaries often float over a couple of ICUs. Everyone and anyone is expected to answer phones if they ring more than a couple of times.

I would love to have two techs, especially on the 16 bed units. I think 1:8 staffing is ideal for them. I'd love it if they got temps and Foleys for us as well as blood sugars.

I look at, "What can I and only I do?" That is what I have to focus on. I have no problem getting AC/HS blood sugars, taking temps, and giving baths, but in a crunch those things have to fall away and be delegated.

[ashleigh_0804]

What's a CNA?!? Haha, JK. Well, I work on a 28 bed neuro/med-surg ICU. We have one CNA whi works 36 hours a week, and I usually never see her when I work. When I do see her, she's taking temps and blood sugars. That's cool and all, but I can do that myself. All I ever want is somebody to help me turning patients and cleaning them. Heck, I'll gladly take the "dirty" side and do all the cleaning and wiping. I just physically not strong enough to do it all on my own. My manager can't figure out why we keep getting dinged for pressure ulcers. I DO turn my patients every two hours, more even. But it's impossible to completely get them all the way off their side by yourself. I shove the pillows under, I use the turn assist...but nothing beats a pair of hands to really help you do it. My fellow nurses would help, if they weren't so swamped theirselves.

[guest769224]

My fellow nurses would help, if they weren't so swamped theirselves.

It only takes 30 seconds to turn, they can't be that swamped. Ask the charge nurse to help. Don't ruin your back by doing it alone.

[Larry3373]

We had CNAs on day shift, but recently they were taken away due to budget.

[whofan, ADN, BSN, RN]

1-2 CNAs on day shift only. Night shift has none. 69 bed unit.

[Ruby Vee, BSN]

It only takes 30 seconds to turn, they can't be that swamped. Ask the charge nurse to help. Don't ruin your back by doing it alone.

Thirty seconds to turn? I must've been doing it wrong all these years! Taking the pillow out, boosting the patient, turning on the opposite side, repositioning the four pillows and ensuring that the patient is comfortable takes a whole lot more than thirty seconds!

[Brittnurnberg]

I work in La Porte, Indiana and we do have CNA's working in our ICU. I am a CNA and I work in our IMCU. We can get floated there when we are needed.

[Bluebolt]

I've worked in three different ICU's, only one had a specially trained CNA to assist the RN's. The job was a dual secretary/tech job and I think it worked perfect. They did blood sugar checks, stocked linens, helped roll patients, all the ADL things that just create overwhelming busy work for the RN. I miss their help when I work a busy ICU that has none.

[econ2nursing]

I work in a 12 bed CCU and we usually have a CNA scheduled, but rarely get to use them. They are usually pulled to sit with 1:1's somewhere else in the hospital. Our CNA's take temps, empty foleys, answer call lights, turns, and do baths. It is very challenging to manage without an assistant and we have all been told the same thing... Most ICUs and CCUs don't have nursing assistants.