I'm writing up the CNA at my LTC facility

Nurses General Nursing

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I told this CNA last Nov. that vital signs are due by 12 midnight. She has been doing them for me by 12 midnight ever since. I recently learned that she is not doing it for the other nurse and I am furious!!! The other nurse seems to be afraid of this CNA so I am going to write her up for the other nurse. It's a power trip the CNA wants to show that other nurse that she will do the vital signs whenever she damn well pleases. Enough is enough. I am worried that this CNA is going to drive away this other nurse who happens to be one of the nicest and most wonderful nurses I have ever worked with. No wonder this facility is always looking for night nurses. :angryfire

Thanks all for your great advice. Oops it looks like I may have accidently gotten 2 different threads started on this same subject. Yes I think I will urge the other nurse to write up the CNA and I will offer to back her up or confront the CNA with her. Or yes maybe we can write her up together. I will leave it up to the other nurse whatever she decides. No we don't have a union here. My nurse friend is the main night shift nurse in charge. I am the charge nurse on that unit only on her days off. Yes the CNA is taking advantage of the other nurse. It makes me furious because this particular nurse has been so very helpful and wonderful to me. I want to do something for her too. I am worried that this wonderful nurse will get fed up and quit because of this CNA.

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Thanks all for your great advice. Oops it looks like I may have accidently gotten 2 different threads started on this same subject. Yes I think I will urge the other nurse to write up the CNA and I will offer to back her up or confront the CNA with her. Or yes maybe we can write her up together. I will leave it up to the other nurse whatever she decides. No we don't have a union here. My nurse friend is the main night shift nurse in charge. I am the charge nurse on that unit only on her days off. Yes the CNA is taking advantage of the other nurse. It makes me furious because this particular nurse has been so very helpful and wonderful to me. I want to do something for her too. I am worried that this wonderful nurse will get fed up and quit because of this CNA.

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I work in LTC and I know the way I run the unit when "i'm on duty" is a little different than the way the other nurses run it when they are on duty...

I would say that vitals by midnight is a good idea that way the patient can get the most uninterupted sleep possible. Also it is good for the nurse to be able to get some of the charting out of the way and to know if anything is going on with a patient early in the shift! I prefer for any shift I'm working to get vitals as soon as possible because if something is going on I want to be able to get the patient the care they need as soon as possible!

Maybe if you do talk to the CNA you could explain the rationale for early vitals and make it more of a learining experience as maybe they think it's more of a power trip for the nurse?

I would say if the other nurse talked to you and asked you to intervene I would still probably encourage them to try to take care of it themselves if they could but if they had a hard time doing it then I'd probably talk to the CNA for the nurse. Just keep in mind that maybe the other nurse is telling you one thing but not telling the CNA the same thing?

I am not a big advocate of Write-Up's! To me the only time to use it is if you have a really bad employee who needs not to be taking care of patients and you need a paper trail to get rid of them! I've been fortunate I guess because for the most part most of the CNA's I've worked with have done a pretty good job!

I can count on one hand how many times I've had to write anyone up.

It's not that I won't do a write-up but it's got to be something pretty severe to get me to that point and that is probably going to be working with a person who truly does not care about the patient and needs to be outta there!

As I said I guess I am pretty fortunate because I work with many wonderful people who do care!

I've found that a more effective way for me to work with the Nursing Assistants is to talk to them and work with them especially when there's a problem... We start out our day with a brief report of what's new then work together as much as possible the rest of the day. Things just seem to go better when we have a caring attitude for all the people we come in contact with regardless of if it's a patient, visitor or coworker and a good attitude can become contagious and make just for a better work place for us and better patient care!

Try talking before writing...

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I work in LTC and I know the way I run the unit when "i'm on duty" is a little different than the way the other nurses run it when they are on duty...

I would say that vitals by midnight is a good idea that way the patient can get the most uninterupted sleep possible. Also it is good for the nurse to be able to get some of the charting out of the way and to know if anything is going on with a patient early in the shift! I prefer for any shift I'm working to get vitals as soon as possible because if something is going on I want to be able to get the patient the care they need as soon as possible!

Maybe if you do talk to the CNA you could explain the rationale for early vitals and make it more of a learining experience as maybe they think it's more of a power trip for the nurse?

I would say if the other nurse talked to you and asked you to intervene I would still probably encourage them to try to take care of it themselves if they could but if they had a hard time doing it then I'd probably talk to the CNA for the nurse. Just keep in mind that maybe the other nurse is telling you one thing but not telling the CNA the same thing?

I am not a big advocate of Write-Up's! To me the only time to use it is if you have a really bad employee who needs not to be taking care of patients and you need a paper trail to get rid of them! I've been fortunate I guess because for the most part most of the CNA's I've worked with have done a pretty good job!

I can count on one hand how many times I've had to write anyone up.

It's not that I won't do a write-up but it's got to be something pretty severe to get me to that point and that is probably going to be working with a person who truly does not care about the patient and needs to be outta there!

As I said I guess I am pretty fortunate because I work with many wonderful people who do care!

I've found that a more effective way for me to work with the Nursing Assistants is to talk to them and work with them especially when there's a problem... We start out our day with a brief report of what's new then work together as much as possible the rest of the day. Things just seem to go better when we have a caring attitude for all the people we come in contact with regardless of if it's a patient, visitor or coworker and a good attitude can become contagious and make just for a better work place for us and better patient care!

Try talking before writing...

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Is the CNA not getting vitals by midnite just to cause trouble, or is there just a misunderstanding? maybe you like your vitals to be done by midnite, but unless you come out directly and tell her that ALL vitals for ALL patients need to be done by midnite (or if this is the facility policy perhaps) you cannot expect her to be a mindreader. It is not uncommon that different nurses have different ways of doing things and will ask different things of an aide.

also, what is the number of patients the CNA is expected to get vitals on? is this difficult for her because she is busy doing other CNA duties? remember that CNA means certified nursing ASSISTANT- they ASSIST the nurse. In the end it is ultimately the nurses responsibility to have vitals for their patients. Delegation is a great thing, but so is helping. If the aide is having a problem getting all of them done by herself and there is a nurse present, why can't the nurse help? is the nurse that much more busy than a CNA at that time of night? Somehow I doubt it.

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Is the CNA not getting vitals by midnite just to cause trouble, or is there just a misunderstanding? maybe you like your vitals to be done by midnite, but unless you come out directly and tell her that ALL vitals for ALL patients need to be done by midnite (or if this is the facility policy perhaps) you cannot expect her to be a mindreader. It is not uncommon that different nurses have different ways of doing things and will ask different things of an aide.

also, what is the number of patients the CNA is expected to get vitals on? is this difficult for her because she is busy doing other CNA duties? remember that CNA means certified nursing ASSISTANT- they ASSIST the nurse. In the end it is ultimately the nurses responsibility to have vitals for their patients. Delegation is a great thing, but so is helping. If the aide is having a problem getting all of them done by herself and there is a nurse present, why can't the nurse help? is the nurse that much more busy than a CNA at that time of night? Somehow I doubt it.

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It kind of seems to me that you see the RN as your colleague and the CNA as the outsider. Even though the CNA is not on your level educationally...you do need her. So maybe you need to start treating her as a member of the team instead of the outsider. I say confront her in a non-confrontational way with the other nurse. You get more flies with honey than vinegar. If you write her up she will do her job grudgingly and she will always hold it against you. And hey, you never know you just may need that lowly CNA to scratch your back someday.

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It kind of seems to me that you see the RN as your colleague and the CNA as the outsider. Even though the CNA is not on your level educationally...you do need her. So maybe you need to start treating her as a member of the team instead of the outsider. I say confront her in a non-confrontational way with the other nurse. You get more flies with honey than vinegar. If you write her up she will do her job grudgingly and she will always hold it against you. And hey, you never know you just may need that lowly CNA to scratch your back someday.

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Well, I gotta put in my 2 cents worth, too.

When and if I get in the nursing home, and somebody comes in and wakes my a$$ up at midnight to take v/s on me, they're gonna get their a$$ chewed out. I'm not a good sleeper anyway, and when I can catch some of it, I want it.

When I worked in LTC, I made my aides get the v/s by 9pm on the ones that it was possible to do that, like the ones who did not have to be turned and checked q2hr.

That's ridiculous to be waking folks up at midnight for v/s.

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Well, I gotta put in my 2 cents worth, too.

When and if I get in the nursing home, and somebody comes in and wakes my a$$ up at midnight to take v/s on me, they're gonna get their a$$ chewed out. I'm not a good sleeper anyway, and when I can catch some of it, I want it.

When I worked in LTC, I made my aides get the v/s by 9pm on the ones that it was possible to do that, like the ones who did not have to be turned and checked q2hr.

That's ridiculous to be waking folks up at midnight for v/s.

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I think the nurse involved should be the one to take care of it. Your not doing her any favor by doing it for her.

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I think the nurse involved should be the one to take care of it. Your not doing her any favor by doing it for her.

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