Flip side of the CNA coin or HELP!

[rebel_red]

Hey ya'll:cool:

I need some advice. For over a decade I worked in LTC's and retirement communities as Activities Director, Social Service Designee and Programs Director. I hold a Bachelor's in Social Work. (I thought some background might be useful.)

At the age of 39 I decided that it wasn't enough and looked for a new career were I could put my current abilities to use, and develop new skills. Voila! Nursing.

I accepted a position as a CNA (still training) in a local facility. I wanted to make sure I was capable of giving direct care, and develop a high level of proficiency, for the patients, myself and the day when/if I would be supervising others as an LPN/RN. (I am going to train for LPN first, as we have limited (1) nursing program in my area.)

I have great supervisors who take the time to explain procedures, answer all my questions about meds, psychosocial issues and any other area of knowledge that pops up. They will also get in and get dirty with code browns, toileting, etc.

My issue is my coworkers. I work the 11-7 shift. We have a patient load that varies from 12-20 dependent upon how many aides are present.

My first rounds with 12 residents usually take me about an hour and a half. First I do my vitals and make sure all are dry, clean and comfortable. Than I take up our housekeeping tasks. (ice water passed, trash removed from the room, clean trash bags, straightening the room if need be, and trust me sometimes those rooms look like a hurricane passed through.) And of course throughout this I answer call lights. If the resident's haven't been properly seen to on 3-11 first rounds can take me two and a half to three hours.

Also we usually don't get our shift assignments until after our nurses give each other report, so say about 11:30. In the interim if the call lights go off, I answer them, only myself and one other CNA will do this. (The others have verbalized they aren't doing someone else's work.)

During the downtime between rounds (12, 3 and 5am) most of the aides sleep. I can't do this. (for the obvious ethical reasons) I understand most of them have other jobs, or young families. In their defense (!) they do get up for call lights.

Also the aides gossip alot about each other. I hate this and ignore it. There is one who has been a CNA for 14 years who denigrates everyone. She only speaks to make others appear bad and herself good. She had the temerity to write our schedule the other night when the report was taking time. (Granted it was a good schedule!) Needless to say she and I are like oil and water. She has belittled me 2x in front of residents. I have addressed this with my supervisor.

My problem is this: The supervisors (an LPN and an RN) are pleased with the work. My co-workers are madder than hornets. They believe I am doing all this to make them look bad. How do I handle this? So far I have ignored them. Yet I am getting tired of the gossip that finds its way back to me, the offhanded comments, etc. (example: They were ridiculing me for making a resident cream of wheat at 2:30 am and sitting and chatting with her while she ate, they perceive her as difficult. Fortunately I only had 10 residents that night and was able to take time with this one.)

I am really sick and tired of the gossip, the backstabbing and the just get in and get done attitude, when we really do have the luxury to take time with the residents in this particular facility.

Thanks for all your help.

Tres

Almost forgot:imbar I posted this after reading cargal's thread on management skills. Great thread.

[traumaRUs, MSN, APRN]

Gosh Tres - After reaading your story - I can't tell you how happy I am that you're going into nursing. Have you considered hospital skilled nursing facility??? You will (sadly) find a more professional atmosphere.

When I was an LPN and worked LTC while in school for RN (I needed the flexibility) - I too found most CNAs unprofessional. I was always right in the thick of things too: no sleeping on the clock, checking up on residents constantly myself and makiing sure the work was getting done. I wasn't anyone's favorite by any means. But...I could sleep at night knowing I did the absolute best I could do.

Historically, CNA pay is low, responsibilities many and not so nice and the climate of most LTC isn't professional. That leads to huge employee turnaround, continued low pay and sometimes continued poor care for patients.

Consider a hospital. I shudder to think what LTC will look like when I get older. I'm working very hard to ensure that I can go to private-pay nursing home if needed.

I'm not CNA-bashing either. I have worked with some excellent CNAs and I tell them so. I enjoy the teaching aspect of working with CNAs and challenge them to continue their education.

[ShortFuse_LPN, LPN]

I agree that low pay for CNAs is a major factor in some of the attitudes toward their jobs. However, I have been lucky enough to work with some of the best CNAs ever. And have learned a lot from them. My advice would be to continue giving the quality (high) of care that you have been giving and not listen to the negative things being said. I know that is easier said than done at times. Keep your head up and be proud knowing that you are making these residents feel better and that you can rest easy after your shift knowing you did your best!! :D

[LoisJean]

Here it is rebel:

What you are experiencing now is something that you will be experiencing for the rest of your career-should you go into nursing...how you deal with it is what is important. Their actions are wrong. These aides are spit in the face of decency. They are a 'certain type' of patient care personnel who could give a rip less about how their acts of comission and omission affect the fiber of people who are not like them...patients and co-workers alike. They have the ability to leave the caring worker exhausted, burdened, angry, sad, confused and negatively anticipating the next work day. They leave the patient with a sense that he is nothing more than a piece of flesh and bone to be handled as infrequently as possible. They are not there for the money. They are not there for the patient. So who are they there for: they are there for you...they want to eat you alive. They are not interested in working WITH you, they are interested in the opposite because they know it BOTHERS you. They are there because they know they have power over you just by the fact that you take their crap in silence. Tell them to shut up when they gossip; when they ridicule you tell them to shove it... Perhaps because you are still 'in training' you feel you cannot express your distaste for these people...perhaps you don't feel comfortable telling your supervisors that some of your co-workers are as useless as tits on a boar- just in case said supervisors don't know it- but I'll bet they do.

What will you do when you get that nursing degree and these types of people act in the same way against you and other employes who you supervise? What will you do when you find out your patients are being treated with less than respect, attention and good care? Believe me, there is no on-unit behavior modification system that will change these people...they need power and they will see to it someone gives it to them. You gotta get tough...now seems to be a good time to practice.

I was a nursing assistant for 10 years......god, I can't believe how grossly malformed that once noble position has become.

You're going to be a great nurse--take this opportunity to learn how to be tough.

Peace,

Lois Jean

[rebel_red]

Tough?? LoisJean! Heck Confrontation is a subspecialty of mine! I just don't see where this particular group of people is worth the time. Yet, if things continue as they are, we will be having a row on the unit, that will end up with my verbally ripping their still beating hearts from their bodies. (Social workers are really good at that.) I just prefer not to raise my blood pressure. So if ignoring them doesn't work......ya'll will be sure to hear the fireworks.........

Fortunately, I don't feel negatively about work. (Ask me again in a few months.)

TraumaRus: I would enjoy working in a hospital, unfortunately our local hospital is referred to as "Burn'em Dead", a play on the hospitals name. Both my Mom and my Grandmother have been patients in that facility. Ummmm they lost my Grandmother's body......(My family has a wierd sense of humor we found this amusing as my grandmother has always been a gypsy and a traveller.) The entire time of my mother's stay I was there being a noisy, annoying, unrelenting family member because they refused to listen to her. She finally signed herself out AMA. In short the hospital is worse than the LTC. (And I even haven't told the story of how a doctor threatened to have security remove me from ER.)

Bottom Line: Thank YOU! TraumasRus, Belinda and LoisJean for your advice and expertise. A few motley folks aren't going to scare me away from a job I really love. :)

Tres

[traumaRUs, MSN, APRN]

Good - you keep on!!!

[ricquet]

hi

you are god sent even though you are only a CNA but you are upholding the profession. please don't let others make you stop. soon they will be following too.i am a BSN student.

[tonicareer]

Your fellow CNAs are sleeping on the job? They should be reprimanded and fired if it continues. Hey I would sneak in a camera or video camera and get proof of this. You need to get proof that is why they are bad mouthing you. They know you have work ethics and want to get rid of you.

[rebel_red]

We had a resident who was alert, oriented x4 on our subacute wing, there primarily for rehab. Anyhow she was a smoker. So one night she rings and asks if I'll take her outside for a cigarette. I say yes, we get bundled up and go outside. Anyhow she notices that our replacement LPN is asleep in front of the tv as are the nursing assistants. She reports this to our DON. Nada zip zilch zero. I hear about it the next morning from another alert and oriented resident (resident number 1's smoking buddy). All I can think is well everyone knows it occurs, no action is taken, ergo it is the accepted norm. Not right but then again the world is not a perfect place.

Tres

[RN auditor]

It is very frustrating to watch people like you describe continue to treat others the way they do and suffer no consequences. I worked in a LTC facility as the staff nurse with CNAs doing exactly as you described. I became the squeaky wheel with the management to no avail. Finally I saw my opportunity when the state surveyors walked in and requested an "interview" with some of the staff. The abusive CNA was "dismissed" less than 30 minutes later. Do whatever you have to do to protect the residents and continue being the squeaky wheel if you have to.

[jschut, BSN, RN]

I feel so fortunate to work with the wonderful bunch of ladies who are the CNA's at my facility. They work together and handle themselves and the residents very professionally.

Yes, there are some rough ones, and a bit of gossiping, but for the most part, they are a great bunch of gals!

PS I have run into CNA's like the ones you describe though....

[cargal]

Hi Rebel,

Welcome to the healthcare profession. I have been dealing with things like this since I got my degree in the late 90''s. You are very wise to start with being an aide. You are seeing some behavior that spans all healthcare staffing-from gossiping and backstabbing to sleeping on the job.

see https://allnurses.com/forums/showthread.php?s=&threadid=19079&highlight=why+do+nurses+eat+their+young. You sound like you can handle yourself just fine. Go for it.

It sounds as though this facility is particularly bad. Sleeping on the job is grounds for instant dismissal. These workers have been getting away with this for a long time it seems. As far as the gossip, it is pervasive isn't it. If you just don't do it, they will get the idea sooner or later.

Don't give up. I will be ecstatic to work beside you as an RN, LPN someday, and today as an aide.

I wish I were more articulate, but I am tired this am. BTW, I finally see the light, I have started Tues with Hospice. The people exude kindness and professionalism. I took me 5 years to find this job.

Hang in there and keep up the good work. Good aides go to heaven!

Blessings,