do you feel like the CNA's run the floor?

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I am a new nurse of about 2 years and work on an acute med-surg geriatric floor. It is an 18 bed unit and we work with 3 RN's and 2 CNA's. THough this ratio seems fair, myself and the other nurses constantly feel like we are doing everyones work. When we do ask for extra help from the aides, it is usually accompanied by an attitude or a smart remark. The nurses on my floor feel as though it is unfair that we have to sacrifice our nursing time with our patients to do aide work. (We do perform these duties anyway, but can not do both jobs for the whole shift). The aides seem to do oly the minimum to get by per their job description. Has anyone else encountered this issue?:angryfire

PS: When this issue was brought to attention to administration, we were told that they cant change anybodys personalities and do the best we can.:uhoh21:

Specializes in Nursing assistant.

Maybe an inservice (yeah, Im stuck on that!) on what actually are the roles of each employee. Sometimes I think there is just some plain misconceptions, admittedly on the CNA side (been there, done that).

Sometimes I think the aides just don't know all the responsibilities you all have.

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i also think that frequent inservices to pump up and treat aides as professionals: that is, lift the expectations, but equip them to succeed.

:yeahthat: that is an awesome idea!!! i find them to possess a lot of experience. not just as aides but as they are as individuals. most of the ones i know are very experienced in life ~ far more than me. so i'm more than sure they can handle the information they get from the inservices.

that is such a great idea. at the hospital i work for, they mostly hire rn's and rpn's. there's a lot of injuries there. at the nursing home i work at, i work mostly with psw's and i'm the rn. we recently had a mandatory inservice about lifts and transfers. no recorded injuries since. they held us responsible for the information they provided. and we were paid. i think everyone took it seriously ~ me included. and no injuries. the psw's i work with are very mature and act very professional. sure we get the odd one who "knows it all" and is "going to be a nurse someday".

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On my floor, a nurse will search 5 minutes for a tech to tell them pt X needs a coke, when she could have gotten it in less than 1 minute.

I have NEVER seen this, in all the places I've worked.

Not one time.

The last place I worked, I couldn't even get the CNA to HELP pull a patient up in the bed - I had to find another RN.

It's a **** shame what they get by with.....

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Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.
I have NEVER seen this, in all the places I've worked.

Not one time.

Boy i did, from one particular person on the floor i used to work on night shift. She would pass the water fountain 2 times looking for me, carrying the pitcher for me to fill. It would take her longer to find me to hand the pitcher to than to just fill it up herself.

She would have 5 pts, and i was the one float aide for a floor of 35.

She would also insist that i change someoen by myself, nevermind that pt. is pushing 300 lbs. and is total care. Hey her solution to that was to page the house orderly for help, and wait another 30 min for him to get there while that pt. layed in poop that much longer.

Had she not been doing crossword puzzles during this time, i wouldn't have been so ticked.

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Boy i did, from one particular person on the floor i used to work on night shift. She would pass the water fountain 2 times looking for me, carrying the pitcher for me to fill. It would take her longer to find me to hand the pitcher to than to just fill it up herself.

She would have 5 pts, and i was the one float aide for a floor of 35.

She would also insist that i change someoen by myself, nevermind that pt. is pushing 300 lbs. and is total care. Hey her solution to that was to page the house orderly for help, and wait another 30 min for him to get there while that pt. layed in poop that much longer.

Had she not been doing crossword puzzles during this time, i wouldn't have been so ticked.

:angryfire I can relate from my CNA days.

Ok, OK. I know that this thread is about CNA's running the floor but I have add one experience from being on the CNA side of it as well.

I worked as a CNA in a nursing home and the med nurse kept asking me to change the clothes of a resident who kept spilling his Ensure on himself.

(Being a fairly new CNA, it took me a while to catch on to this.)

Every day I'd get this guy up for dinner, dress him, and put him in his geri-chair. This was no easy task. He was a total care, non-weight bearing with dementia and got very combative no matter how gentle and slowly you approached him when it came time to change clothes.

It never failed for 4 days. As soon as I put this guy in the dining room and went to get another resident up for dinner, this nurse would call me to take him back to his room, clean him up from spilled Ensure, put on fresh new clothes, and put him back in the geri-chair again.

One day I saw how it was happening. She was in such a rush to get her med pass done, that she would give him a full glass of Ensure (with his meds in it to boot) and then walk away to the next resident and leave this guy alone to hold the cup and drink it.

Did I mention he had severe Parkinsons as well?

Well, of course he's going to spill it all over himself!!

When I voiced my concern to her, she dismissed me and said that she "didn't have time" to "play around" meaning to stay with the resident to finish drinking his meds.

I even offered for her to come get me before she gave it to him and that I'd stay with him so that he didn't spill it all over himself - again.

She said she "didn't have time" to stop her med pass to come get me.

When he finally spilled it again and she called me to clean it up for the 5th time, I finally told her that today it was me who "didn't have time" and that she'd have to do it herself.

I'd finally had it and called the house supervisor and told her what this nurse had been doing.

It never happened again.

I know that it wasn't right to say that to her, but I just wanted her to see first hand how difficult it was to keep changing this total care combative man over and over just because she didn't want to stay with him to drink his meds.

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Specializes in Nursing assistant.
:angryfire I can relate from my CNA days.

Ok, OK. I know that this thread is about CNA's running the floor but I have add one experience from being on the CNA side of it as well.

I worked as a CNA in a nursing home and the med nurse kept asking me to change the clothes of a resident who kept spilling his Ensure on himself.

(Being a fairly new CNA, it took me a while to catch on to this.)

Every day I'd get this guy up for dinner, dress him, and put him in his geri-chair. This was no easy task. He was a total care, non-weight bearing with dementia and got very combative no matter how gentle and slowly you approached him when it came time to change clothes.

It never failed for 4 days. As soon as I put this guy in the dining room and went to get another resident up for dinner, this nurse would call me to take him back to his room, clean him up from spilled Ensure, put on fresh new clothes, and put him back in the geri-chair again.

One day I saw how it was happening. She was in such a rush to get her med pass done, that she would give him a full glass of Ensure (with his meds in it to boot) and then walk away to the next resident and leave this guy alone to hold the cup and drink it.

Did I mention he had severe Parkinsons as well?

Well, of course he's going to spill it all over himself!!

When I voiced my concern to her, she dismissed me and said that she "didn't have time" to "play around" meaning to stay with the resident to finish drinking his meds.

I even offered for her to come get me before she gave it to him and that I'd stay with him so that he didn't spill it all over himself - again.

She said she "didn't have time" to stop her med pass to come get me.

When he finally spilled it again and she called me to clean it up for the 5th time, I finally told her that today it was me who "didn't have time" and that she'd have to do it herself.

I'd finally had it and called the house supervisor and told her what this nurse had been doing.

It never happened again.

I know that it wasn't right to say that to her, but I just wanted her to see first hand how difficult it was to keep changing this total care combative man over and over just because she didn't want to stay with him to drink his meds.

Oh dont get me started! What really upset me was finding pills on the floor, or in the bedsheets, or on their jammies....not in the tummy!

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Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.
Oh dont get me started! What really upset me was finding pills on the floor, or in the bedsheets, or on their jammies....not in the tummy!

I remember several times at the NH, finding pills in the chairs, floor, beds, taking them to the nurse, and one in particular shrugging and saying "So what do you want me to do about it."

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Specializes in Nursing assistant.

Are nurses supposed to watch the pt take the meds? I would find the med cup on the side table, still full.

But LTCs can be real zany crazy places!

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Are nurses supposed to watch the pt take the meds? I would find the med cup on the side table, still full.

But LTCs can be real zany crazy places!

The textbook answer is yes, they are supposed to watch.

But it's not always that easy in the real world.

A year later, as an LPN, I worked the same unit and did the same med pass as the nurse I was referring to above.

I thought of that nurse every time I gave meds to that combative resident with Parkinsons. The only thing I did differently is that I only filled his cup

Later I floated to units that had more alert/oriented residents. They constantly requested that I leave their meds at the bedside table or dinner table and that they would take them when they were ready.

Just like I was taught in school, I would then take the meds back to the cart with me and asked the resident to let me know when they were ready to take their meds and I would come back and bring it to them.

You wouldn't believe the reactions I got from the residents:

"Are you new here? The other nurses never had a problem with it, so what's your problem?" Or:

"I can't believe you're going to stand over me to make sure I take my pills like I'm some child."

I even got reported twice for refusing to leave meds unattended and guess what? Management sided with the residents telling me to do what they say.

Of course, had the state been there, they would have played dumb and claimed to never have told me to leave meds unattended in the dining room and on bedside tables.

On a side note about aides finding pills, I realize what you and Marie are saying. But I did find that the aides could get a little dramatic about finding pills at times.

Some of the aides most notorious for leaving their patients in dirty diapers and hiding out most of their shift, would go crazy over finding pills on floors or elsewhere.

"I can't believe these nurses leave pills on the floor and the residents aren't getting their meds."

As if they really care about the residents or something. I'd have to shake my head and walk away.

Here the reality:

One nurse is passing pills for 30-60+ residents on a unit, and 98% of them need meds of some sort on every med pass.

Pills get thrown, dropped, and spit out for a variety of reasons every day on every med pass.

Any nurse who claims that they can find every single pill that gets thrown, spit out, or dropped under linen carts, beds, tables, etc. is full of baloney.

It happens.

Sorry to get off topic, aren't we supposed to be discussing CNA's running the floor? I guess I'm not doing that right now.

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Here the reality:

One nurse is passing pills for 30-60+ residents on a unit, and 98% of them need meds of some sort on every med pass.

Pills get thrown, dropped, and spit out for a variety of reasons every day on every med pass.

Any nurse who claims that they can find every single pill that gets thrown, spit out, or dropped under linen carts, beds, tables, etc. is full of baloney.

It happens.

Yes, it happens amd some patients are really good at hiding pills in their cheeks and spitting them out after you leave.

No matter how much you give them to drink or pudding or whatever, some can hide pills.

And some patients won't open their mouth for you to see, and I would never stick my fingers in there to see if they had swallowed all of it.

So sometimes you just have to hope for the best.

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Chadash,

I think that inservices are a great idea!!!!!!!! Techs do need MORE education in certain areas of our job:>)

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Specializes in Nursing assistant.
The textbook answer is yes, they are supposed to watch.

But it's not always that easy in the real world.

A year later, as an LPN, I worked the same unit and did the same med pass as the nurse I was referring to above.

I thought of that nurse every time I gave meds to that combative resident with Parkinsons. The only thing I did differently is that I only filled his cup

Later I floated to units that had more alert/oriented residents. They constantly requested that I leave their meds at the bedside table or dinner table and that they would take them when they were ready.

Just like I was taught in school, I would then take the meds back to the cart with me and asked the resident to let me know when they were ready to take their meds and I would come back and bring it to them.

You wouldn't believe the reactions I got from the residents:

"Are you new here? The other nurses never had a problem with it, so what's your problem?" Or:

"I can't believe you're going to stand over me to make sure I take my pills like I'm some child."

I even got reported twice for refusing to leave meds unattended and guess what? Management sided with the residents telling me to do what they say.

Of course, had the state been there, they would have played dumb and claimed to never have told me to leave meds unattended in the dining room and on bedside tables.

On a side note about aides finding pills, I realize what you and Marie are saying. But I did find that the aides could get a little dramatic about finding pills at times.

Some of the aides most notorious for leaving their patients in dirty diapers and hiding out most of their shift, would go crazy over finding pills on floors or elsewhere.

"I can't believe these nurses leave pills on the floor and the residents aren't getting their meds."

As if they really care about the residents or something. I'd have to shake my head and walk away.

Here the reality:

One nurse is passing pills for 30-60+ residents on a unit, and 98% of them need meds of some sort on every med pass.

Pills get thrown, dropped, and spit out for a variety of reasons every day on every med pass.

Any nurse who claims that they can find every single pill that gets thrown, spit out, or dropped under linen carts, beds, tables, etc. is full of baloney.

It happens.

Sorry to get off topic, aren't we supposed to be discussing CNA's running the floor? I guess I'm not doing that right now.

Sounds like it is hard to do.

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