aides that put your job on the line

[erezebet]

I had an aide blurt out in front of another patient and his family that I had just given a drug that a patient was allergic to. Horrified, I felt stupid and looked in the chart to verify this. It was untrue.

Later I asked this aide "who told you he was allergic to that med?" "Oh, no one" she replied, "he was confused last time he took it."

This patient was always confused. And she wanted to know why I was so pissed off at her. She should know better having graduated from nursing school (she is an aid because she can't pass boards)

[J Nurse Supporter]

Originally posted by nsyrRN:

I think that the problem may lie in that people are so short handed that they are working outside the scope of their practice.

I think you are close when you define the problem, but don't really hit the nail on the head. The problem is that you continually accept to work so short handed and continue to accept taking on more and more patients. Who do you think is going to say no the nurses can't take on any more patients it would be unsafe? Management? They are the ones who put you in that spot in the first place. Nurses have to start deciding what is safe and what isn't. It's your license. And nurses have to start doing this together.

I am continually baffled by the fact that nurses work in the conditions that they do and get paid what they do. Tell me what other field there is where there is a continuous shortage of workers that require significant training and a license to practice and yet overall their wages don't go up? It's a supply and demand thing only the nurses don't demand anything.

When are the 2 million nurses in America going to unite and be the force they should be?

[njdawn]

Let me say, the 2 Million nurses in this country should come together may 5,2001 in their state capitol and march!

I also worked as an aide on the midnight shift. We had from 2-4 aides taking care of 67 clients. And 2 LPN's passing meds all night. Let me say, that was 6 yrs ago. And when it was me and another aide with 67 people, it was a nightmare! I knew that if anything went wrong, the nurses would take the blame and had respect for them. But it also made me mad that the 2 LPN's sat on their butt and watched tv until it was time to pass meds. And when the movie "It's a wonderful Life" came on around christmas, and they sat and ate M&M's all night, suggested I watch some tv too, that was irritating. If they helped out, maybe we all could relax a little. Now as an RN, I remember this and hope to never act like that or be disrespectful.Although I won't hesitate to write someone up for disrespect or getting paid for not doing their job. I agree we are all understaffed and need to help each other out. Education is the only way i know besides incentive programs for jobs well done or exceeding their duty.

[bluesgirl]

Well said Country-----

Especially the engineer metaphor

I am an excellent caregiver--top of my class.

Don't ever live or feel safe in the house that I built.--I too started out as a buttwiper--nurses call them code brown's and I'm still wiping those butts--I can't even imagine the low calliber of nurses you must work with.----I never once gave out Meds. as a tech, and thought nursing was easy........

I'm a good nurse---was and am an excellent caregiver--the difference? Come back at me after your next pathopharm course-----don't insult me again, don't ever tell me how easy it is to give meds.

Sorry---buttwiper-- you named yourself---I personally apologize to all techs with a brain in their heads,=== Buttwipe adjust==turn off my dopamine drip one more time!!!!!!!!!!!! do you even know how much diff. it makes when we are adjusting coumadin 2 , 4 , 6, 8.Not even going into the heparin thing.

It's so easy??

Again, I do apologize to every great tech who said to me--- he looks funny--he's not acting right====call me slow, call me thorough---I really can't encourage you to pursue nursing as a career-I think everbody else was being polite---let's suggest mortician--not the greeter--the embalmer--that's the career for you.

Please spare me--and the rest of us===you don't aide or tech

nur

Originally posted by rncountry:

I cannot help but wonder why we expect CNAs to have a level of professionalism that nurses do. They go through a quick course that emphasizes only the basic needs of the patient without training that lends itself to teaching how to behave professionally. Often, at least in my experience, this is the first job they have held that demands any type of accountability. What type of rewards are there for those that do behave responsibly? More of a load, to pick up for those that are not being effective in their position, while little if anything happens to those that are unable to do the job right. Why? Because any body is better than no body, at least that is the way administrators believe. Then we wonder why some aides have attitude? The vast majority of CNAs I have worked with are good people, some are better at what they do than others, though I have worked with nurses that I could say the same thing about. In any case if the CNA is given respect as a member of the team, you will most always, have someone you will want to work with. When orienting new nurses I would put it this way. The aide is to you, what you are to the physician. The physician in the LTC enviroment relys heavily on the nursing staff to be the eyes and ears of the physician who usually only sees the patient every 60 days, though some come in more frequently than that. The nurse is heavily involved in passing meds on 30, 40 or more patients, as well as the tx and charting, therefore the nurse must rely on the aide to report anything unusual. If an aide tells you something about your patient then go look, do an assessment. Do not ignore what is told to you. How would you feel if the physician ignored you when you just offered what you felt was important information. Take the time to round and know your patients beyond what meds they are on. If you have an aide who you feel is inappropriate than take a minute to do some education. Not a chewing out session. Explain how they could have handled that situation better, why it should have been handled in a different way, what your expectations are in the future and how you can help them achieve that goal. Nor would I ever ask an aide to do something I myself was not willing to do. Buttwiper, I am sorry that you feel the anger that you do, however if you label yourself as a buttwiper and nothing more than how to you expect to earn the respect you feel you deserve? Yes, you are capable of giving someone medications, anyone is, however when you do it in a health care setting you must be prepared to take the responsiblity that comes with giving that medication, and have the knowledge of what you gave, why you gave it, what is it expected to do, does it interact with anything else, is it an appropriate medication for your patient? There is much more to it than watching the patient swallow them. As a CNA, you are an intergal part of the health care system as it stands, I fully expect for that to continue, it is unfortunate if you have been treated badly, but if you are taking on duties that open yourself or the nurse to liabilities than you should be reprimanded. In Michigan a couple years ago a CNA gave a patient an enema while the patient was sitting on the toilet, the nurse felt she did not have the time to do it and instructed the CNA to. The patient ended up with a perforated bowel and died. BOTH the nurse and the CNA was charged with negligent homicide. I do not know whether they actually ended up in jail as it dropped out of the news, but I am sure that both lost their careers, as well as the financial issues that would go with having to hire an attorney. With more education that CNA would have known to never give an enema to the patient while on the toilet, she should also have felt comfortable in saying that was out of the realm of her practice and declined to do what she was told. So understand that if you do procedures outside of what you are certified to do you may harm a patient and you may find yourself in a great deal of trouble. Many CNAs are more intimately familiar with a patient and their feelings and it is imperative for the nurse to listen to the CNA, those that do not do a disservice to the patient. I often feel that nursing homes will never change unless the CNAs are given the opportunity of better education. The system sucks for them as much as it does for nurses. I also believe that the CNA that is not suited for the job should be asked to move on. Am I special Buttwiper because I am an RN? No, but I do have a knowledge that you have not yet gained, and for you to state that you could do what I do is wrong. But then I would not ask an engineer to start an IV or adjust an IV either. That engineer has a specific set of knowledge that is not nursing knowledge, you have a set of knowledge about your patients that your nurse may not, but your knowledge is not enough to do what the nurse does either. To believe so hinders your working relationship with all of your coworkers. If you want to act like a nurse than put forth the effort it requires to be a nurse.

[HazeK]

Originally posted by J Nurse Supporter:

I think you are close when you define the problem, but don't really hit the nail on the head. The problem is that you continually accept to work so short handed and continue to accept taking on more and more patients. Who do you think is going to say no the nurses can't take on any more patients it would be unsafe? Management? They are the ones who put you in that spot in the first place. Nurses have to start deciding what is safe and what isn't. It's your license. And nurses have to start doing this together.

I am continually baffled by the fact that nurses work in the conditions that they do and get paid what they do. Tell me what other field there is where there is a continuous shortage of workers that require significant training and a license to practice and yet overall their wages don't go up? It's a supply and demand thing only the nurses don't demand anything.

When are the 2 million nurses in America going to unite and be the force they should be?

*** Good for you! You've hit it right on the head! ....but hopefully, NOW is the time

for the 2 million nurses in America to unite! Please, as a nurse-supporter, go to the Million Nurse March Discussion.....read the notes......and pass along your viewpoints as a "civilian!"

------------------

[leslie :-D]

lesliee-

I agree with you completely re: lack of work ethic. Although I work with some very competent cna's, I also work with some beauts. And even though our DON says to write them up, this gets us nowhere because it is sorely acknowledged the shortage of cna's so they virtually run the facility where I work. Short of blatant pt. abuse or neglect, they get away with too much b.s. And since our administration won't stand behind the nurses in our expectations for adequate care and professionalism, some of us have resorted to referring complaints from family members to our DON....we will NOT take the responsibility for substandard care, especially where we have talked to these particular individuals til they're blue in the face about what to report and the dos and don't's of caring for pts. Now, we are anticipating our annual state survey, and look forward to it. As far as my nsg. responsibilities go, I've documented all educational inservices with my cna's as well as any undesirable (and desirable) outcomes.

[rncountry]

You may have seen it in other postings or read it in news section somewhere, but an administrator of LTC was recently arrested for the poor care that was being given in his facility as it had been brought to his attention many times by family member. I say ALL RIGHT! Maybe just maybe this will give some administrators pause when they want to give responsiblity to the nurse without the tools to do the job. Not to mention letting CNAs run a facility. Does happen. Worked in one that had horrid, and I mean horrid survey. Started out as ADON, then DON and my job was to fix the problems. I fired over half of the CNA staff, because they were unwilling to comply with what was necessay to do appropriate patient care, many were openly insubordinate. Had one make a paper hatchet and hang it on my door. I didn't fire people just cause I could, I fired those that were unwilling to do their job, and unwilling to be supervised. I was able to replace those that were terminated because as word got out what we were trying to accomplish I had CNAs from other homes apply because they wanted to be part of the changes that were taking place. The resurvey went well, 7 cites, 3 of those in nursing with the lowest being a level B. Did I do that by myself, hell no, I had great staff that wanted to be able to provide what needed to be provided, even when we didn't have the best resources to do so. But it also was necessary to stand up to CNAs that had been in this facility for years and did not see anything wrong with what was being done, after all, thats the way they had done it for years. They felt they could run that facility better than anyone, and they had been allowed to do so. The kicker to this story is that we got a new administrator, I was told I was too harsh. Not two days later he was treatening to physically harm a CNA to his face in my presence. Now this CNA had not done anything that was patient care related. The admin. had a thing about BR doors being left open. Didn't look good, and this poor guy was leaving those doors open and royally pissed off the admin. Does this make sense? I left two weeks after this incident. It was time to go. The next survey had so many deficits that substandard quality of care was given to the facility. Yep, admin. should be fully responsible for what happens in their facilities, and if harm results to patients than let the admin. be held accountable, while were at it I think corp. should too.

[bluesgirl]

Originally posted by Birdie:

This is my first time to see the site & I hope I offend no one with my comments. I have been a CNA for 26 years in a small rural hospital. I find myself agree with both sides of the issue. When I first started as an aide we were allowed to adjust IV flowrates, we were often sent to the ER to see patients with the doctor and at that time had responsiblities that were overwhelming. Since that time many changes have occurred, but I feel the one thing that has changed for the worst is the lack of teamwork between the aide & the RN. The aide does see more of the patient because the RN is buried in paperwork (not by their choice). Therefore the RN must trust & rely on the aide to report accurately any oddities that the aide notices with the patient. But the aide must also remember she is there to assist the RN, not make her job more demanding than it already is. With teamwork the combination can make for the best care given to a patient. I hope I have not been confusing, I find it hard to put in to words something I feel so strongly about.

Dear Birdie--

Will you come work with me???????

Most of the technicians/nurses aides I have worked with are excellent --have had trouble with young techs with major attitudes, overworked- yes-- but clueless --I too worked as a tech first--and can only appreciate and be eternally grateful to a tech with a teamwork attitude---then---there are the ones working till they get through school-and only miss the opportunity to learn every day they are at work---experience--the best teacher---is the one the ones with attitude are the most clueless about. Kudos to you birdie--

[teapot]

Nothing inflames me more than when aides start crying about nurses making more money than them and they can do our job.I hear it all the time. I've had aide's say, "I could start that IV or insert that foley catheter." Just because they have seen you do it a hundred times. Any moderately intelligent person can be trained to start IV's or foley's. They just don't get the point that you need the background knowledge that goes with the task.Most of these nurse-want-to-be's aren't able to

cut nursing school and pass the tests and they are just jealous. I hope butt wiper gets out of the medical field, because she is a bitter person and should not be inflicking her bitterness and negativity around her coworkers and the sick. I work with many CNA's that care about their patients and have respect for the nurses. We work together in harmony and help each other, but one's like butt wiper make everyone miserable.

[longforseaair]

I'm sorry that Buttwiper is so upset. I worked as an aide myself, and passed meds before I became an RN. There is no way anyone can understand what it takes to be a nurse until they are in those shoes. Sure it looks easy to hang a bag of fluid on a pole and push buttons. Imagine what it is like for a professional baseball player to play an entire season and never strike out, never miss a catch, and never let a runner score. It's impossible. Yet that is what is required to be a nurse. And we don't get paid the millions of bucks, either. My assistants are hired to assist, and some do a good job, and some are awful. Some are blatantly rude, telling me what I should be doing and how badly I'm doing it, and they don't know what they are talking about. The assistant who gives me the worst time, is the one who flunked out of nursing school. She actually refuses to do things I ask her to do. I asked her to give an enema, which is in her job description, and I would have done it myself, but the patient was on-call for a procedure and I had to so other things that an assistant cannot do. She refused to do the enema, stating that she had to give a bath and take her break. She agreed to give the enema, if she could take only a ten minute break immediately afterward, promising to be back in time for the return. She was gone twenty minutes, and I informed her of such. She nastily replied that she had only been gone 15 minutes, which was her legal break. Then she complained to everyone at the nurses's station about how awful and demanding I am. The other nurses gave me a warning about it. I often find myself doing the assistants work and mine, and getting myself behind on nsg responsibilities because the aides don't help. If I tick an aide off and they quit, management and co-workers will be mad at me. Our aides are really babied, and if a nurse has a favorite one, she babies them and cross-trains them and lets them do additional tasks that are probably out of the scope of their legal job description. If I had the choice, I would choose to work without assistants, if we could have a lower patient to nurse ratio and have the assistants' pay tacked on to ours. Don't get me wrong, I remember what it's like to be an assistant. Now I understand how it feels when an RN is asked to fill in for an assistant for a shift. They always said, "Thank you, same pay less responsibility." I don't think many assistants go home and can't sleep, because of all the near-misses they saw all shift. Or grieve because they didn't give a shower, or turn the patient exactly every 2 hours, or take the BP in the wrong arm, etc.

[nursebabs]

I am a first semester nursing student and I have to disagree with buttwiper--knowing what medication to give is not enough! In class we have already learned the six rights (medication, dosage, person, route, time, and documentation). There is a lot of information to know just to be an LPN. I don't claim to know everything, but am willing to learn. Just because the job looks easy, doesn't necessarily mean it is. Nursing is a job with a lot of responsibilities. I don't mean to offend anyone, but if buttwiper dislikes her job so much then maybe she should do something different.

[johnboy]

Congratulations Butt Wiper! You have shown all the classic traits of a true hospital CEO/director of nursing.

You must IMMEDIATELY leave your position, and apply for any of several "management in training" positions at ANY hospital in the US. How refreshing it is to know that there are a few intelligent individuals out there who realize that nursing school means nothing, and that the TRULY uneducated are the best to be molded into management personnel.

With your brilliant thinking that "passing pills" doesn't require any messy knowledge, we believe that you have the potential to increase year-end bonuses for all the management team by double-digits! Utilizing CNAs as "pill passers" (hey, let's REALLY be funny and call them, oh, "medical technicians") the cost savings will be absolutely ENORMOUS (in terms of saved registered nurse-hours of course). Perhaps that administrative Xmas party FINALLY can be held on Maui...BUT ONLY WITH YOUR HELP!

PLEASE do us all a favor and quit that disgusting patient care job, and RUN right into the nearest CEOs office, and make your uncanny skills known. Exercise that muscle in your head instead of even THINKING about being in the vicinity of those diseased husks lying in the beds!

[Mona]

Hey Butt Wiper,

Where are you??????