CNAs sleeping on the job... What can I do as a new nurse?

Nurses New Nurse

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So...

I've work at this facility for two years as a CNA and I just recently (one month ago) passed my NCLEX

and transitioned into the role of RN. So I've known the bad habits of my co-workers for years, but now it's under my watch/license. These aids feel so comfortable they pull their chairs yup in front of the nursing station and just conk out.

Everyone who works 11-7 knows. Most of these CNAs have been working here for over ten years We have no overnight supervisor... And as a CNA I just worked and grumbled about it with other CNAs. But with my nursing license on the line...

I feel like I'm in such an awkward space. Has anyone been in this position? Any suggestions? My DON is pretty gruff, I don't know how or if I should approach her.

Any thoughts our guidance would be appreciated.

I mentioned an incident like this to a supervisor , once. I was ordered to put it in writing. Then , I was 100% THROWN UNDER A BUS. Long story but suffice to say it was an environment where the slackers were lauded and ethical workers were taken for granted / never promoted. Other nurses had their cars keyed , and false accusations made against another who reported sleeping staff members.

I no longer work there and I do NOT miss it. Oh, and yes " management " knew and most things were common knowledge. But " nothing was ever done ". I gave up and made the change by taking myself out of the sick equation

Just wake them up when you need them.

Most of the CNA I've seen sleep have two jobs and are old in age. Pull them to the side and tell them to start drinking coffee.

Specializes in Psychiatry, Community, Nurse Manager, hospice.

On the sub topic of CNAs working under your license, they do work under our license, but that doesn't mean that every single thing they do is under our license.

The things you direct them to do are under your license. And there are things they can't do unless it is under your direction.

For example in psych, a tech restrains a patient only under the direction of the RN. If you have techs who are restraining patients willy nilly, you'd better take care of that because that is happening under your license.

If you direct a cna to feed a patient who is npo, that would be under your license. You are responsible for stuff like that.

Your license doesn't hold you responsible for cna work ethic. But it is an issue that concerns you.

Specializes in Varied.

I truly believe that because of your rise to RN you're going to face many hardships with this issue. Ultimately, I would consider finding employment elsewhere if the DON doesn't supoort you.

Also, reporting the issue may lead you no where even if the DON addresses it.

On the sub topic of CNAs working under your license, they do work under our license, but that doesn't mean that every single thing they do is under our license.

The things you direct them to do are under your license. And there are things they can't do unless it is under your direction.

For example in psych, a tech restrains a patient only under the direction of the RN. If you have techs who are restraining patients willy nilly, you'd better take care of that because that is happening under your license.

If you direct a cna to feed a patient who is npo, that would be under your license. You are responsible for stuff like that.

Your license doesn't hold you responsible for cna work ethic. But it is an issue that concerns you.

If I delegate a task outside CNA scope of practice, we will both be held accountable, true.

If I delegate a task, or it is simply part of the CNAs job, and they do something outside of their scope, training, or facility policy, I do not believe I will be held accountable. If a CNA uses scalding water to wash a PT, this is not "under my license", unless I told them to.

We have a CNA who will sometimes, on my instructions, open the roller clamp on IV tubing to administer a bolus. I am at the computer, he just started an IV, I have scanned the fluid, and I can see it is being opened. If this was an error, and the PT goes into CHF, then of course I am responsible. I will be responsible for what I did, which was to delegate the wrong task. OTOH, if he goes into a room on his own and administers a bolus, this is not "under my license".

For those nurse who fear for the actions of others, and how it will affect your license, I recommend you go to your BON discipline page online. Search for an instance in which an RN was disciplined for the actions of a CNA.

A constructive idea for the OP:

Talk to people.

There is a middle ground between writing somebody up and ignoring a problem.

You could:

A- Tell the CNAs that you are in an awkward position. You feel that now you are in a supervisory position, you have certain obligations, and want to do your job faithfully and maintain a good working relationship, but are not sure how.

B- talk to a supervisor. Ask for advice on how a new nurse should handle this situation. Ask what they would do.

Also- you know the culture of the organization. Think through the possible outcomes, and think about how that will affect your work life.

Maybe this has been a festering problem and other CNAs will appreciate that somebody got fired or disciplined, and they no longer have to carry the load of those sleepers.

Or, will you be resented, and get less support?

None of us work there- you do. Run through some possible scenarios in your mind, or on paper, and weigh the pros and cons of various outcomes. Risk/benefit ratio.

Given your description of the work culture, I suspect the risk outweighs the benfit, but only you can know.

Specializes in Pediatrics, Pediatric Float, PICU, NICU.
I truly believe that because of your rise to RN you're going to face many hardships with this issue. Ultimately, I would consider finding employment elsewhere if the DON doesn't supoort you.

Also, reporting the issue may lead you no where even if the DON addresses it.

I'm not sold on the idea that the hardships the OP will face are because of their "rise" in status to an RN, but rather the fact that they were always complacent and therefore an enabler of the sleeping when they were a CNA and now suddenly want to act like it's new and a big deal.

In my opinion if you want to change it, you need to start first by talking to those CNAs that are sleeping. Just be honest that when you were a CNA it didn't really effect you but now it does and you don't want them to get in trouble. They'll either listen or they won't, but at least you'll know the first thing you did is try to reason with them. I wouldn't feel a single ounce of guilt reporting them or writing them up after I talked to them directly myself first and established my expectations.

Specializes in ED, Cardiac-step down, tele, med surg.

If I were that concerned, I'd ask them if they were okay because I had seen them asleep. I would tell them I'm worried about patient care or if they had a medical issue going on. I would never go behind someones back and write them up before speaking to them. This person is part of your team and deserves a chance to improve. Also, CNAs are not working under your license so unless you are incorectly deligating then you shouldn't have a problem.

Specializes in SNF, Home Health & Hospice, L&D, Peds.

That is not true. CNA's do work under the license of the nurse in charge. Just as we work under our supervisors licenses.

Specializes in Work Comp CM 3 yrs & Cardiac PCU 27 yrs.

When I worked night shift, not only CNA's but RN's slept on the job. Administration new about it, other Team Mates new about it, and NOTHING was ever done! Best Wishes!

When I worked 11 - 7, you were permitted to nap ON YOUR BREAK (because it was YOUR break,) but after your break you were to be up and working. Perhaps approach it as "Break time is over, this needs to get done now." But I agree, since you worked with them, it's likely to be a difficult situation.....

Specializes in Complex pedi to LTC/SA & now a manager.
That is not true. CNA's do work under the license of the nurse in charge. Just as we work under our supervisors licenses.

Absolutely positively false. You work under your own license. Period. The only way you or your supervisors license is in jeopardy is if they inappropriately delegate a task out of the practice scope

I am kinda shocked there was so much feedback, but I thank everyone for their responses. I did go to

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