Incompetent nursing assistants

Nurses General Nursing

Published

Hi nurses.

Anyone else feel like many of the PCAs/CNAs/LNAs- whatever, do not have approriate training and competency for their job?? I did while I was working on a medical/tele floor for almost 3 years. Fortunately, I'm in the ICU now, and we do all of our VS and such. While on the med/tele floor, I encountered EVERY PATIENT had a RR of 18 or 20. I repeatedly told my manager about this; she addressed it in staff meetings a few times and sent out an email or 2, but it was never resolved. The problem continued. It annoyed me soo much because the interns/residents/attendings go by the patients vital signs. They are so important. One of the attendings actually said, "when the RR is different from 18-20, then I worry". I counted many pts that were in the 30s-40s and informed the PCAs about this; or vice versa, one patient had RR 10.

Another issue was one of the CNAs forgot to record the diastolic for my pts BP. I told her she forgot to write down the diastolic and she replied "what is that?" I explained it was the bottom number ( I guess that is all they know, about bottom or top number on blood pressure). I always thought they had much more training and understanding of what they were doing!!

I'm venting---but when it comes to patient care, safety- I can't stand the fabrication and laziness. It was absolutely ridiculous!:mad::mad:

Specializes in Medical/Telemetry. Now ICU.

I forgot to mention...many of our CHF patients, with signs up the wazoo about fluid restrictions and they still give the patient more. I also had numerous coversations with my manager about PCAs not reporting abnormal vital signs to the nurse as soon as it happens.

I've had BPs as high as 200 systolic that weren't reported to me right away, or 02 sats in the 80s when the pt was normally 97% on RA. The PCAs probably don't know why the pt is decompensating, but I'm sure they know those numbers aren't good. Anything out of the ordinary needs to be reported as soon as it happens.

Up Vote Up Vote ×
Specializes in Telemetry.

no motivation and lack of responsibility to our patients because in the end its always the rn's responsibility and the rn is the one who has to fix the problem. i see this happen all the time with bp, rr, especially I/Os because if i refill the water pitcher twice in the shift and tell the pct, i still see an intake of 200 for my shift even though the pitcher is 800! ugh this is frustrating.:uhoh3:

Up Vote Up Vote ×
Specializes in Long Term Care; Skilled Nursing.

I'm a new CNA. I believe CNAs get the proper training, but many don't care about their work. Also, some CNA programs don't teach blood pressure, because it's not a skill required for certain state tests. But, I had a friend who was in the hospital, and a CNA was checking her pulse and I noticed she was using her thumb (she didn't seem real competent), so, I'm sure she kept putting the pulse that was already in the computer +/- or just putting averages in. So, I think some CNAs are just lazy and only care about the paycheck they'll be getting.

Up Vote Up Vote ×
Specializes in Peds Medical Floor.
Bet you can't beat this -

I recently raised concerns about a CNA becuase she was taking over two hours to complete VS on 10 patients, and could never remember what the VS were, when I asked if any abnormal readings, so I ended up doing them all again myself.

She had been in post around 10 years, but I was new to the hospital, and I don't want problems on my watch, so . . . a quick email to our manager.

Turns out she cannot read or write.

She had somehow worked there all those years, and had been basically scribbling vague dots and lines on the charts, nobody ever said anything.

Since my email she has been moved to a LTC facility where VS is no longer part of her job.

O...M....G...Wonder what everyone thought/how they felt when they realized she had basically been faking it all this time?!

Up Vote Up Vote ×
Specializes in Medical/Telemetry. Now ICU.
I'm a new CNA. I believe CNAs get the proper training, but many don't care about their work. Also, some CNA programs don't teach blood pressure, because it's not a skill required for certain state tests. But, I had a friend who was in the hospital, and a CNA was checking her pulse and I noticed she was using her thumb (she didn't seem real competent), so, I'm sure she kept putting the pulse that was already in the computer +/- or just putting averages in. So, I think some CNAs are just lazy and only care about the paycheck they'll be getting.

Couldn't agree with you more!

Up Vote Up Vote ×
Specializes in Trauma Surgery, Nursing Management.
I'm a new CNA. I believe CNAs get the proper training, but many don't care about their work. Also, some CNA programs don't teach blood pressure, because it's not a skill required for certain state tests. But, I had a friend who was in the hospital, and a CNA was checking her pulse and I noticed she was using her thumb (she didn't seem real competent), so, I'm sure she kept putting the pulse that was already in the computer +/- or just putting averages in. So, I think some CNAs are just lazy and only care about the paycheck they'll be getting.

She was probably recording her OWN pulse!

Up Vote Up Vote ×
ibut if i want something important done, i do it myself.

that's just the way it is, and i'm not going to expend all this neg energy for nothing.

leslie

:yeah:To cut a long story short (in nursing).

Up Vote Up Vote ×

Hospitals, health care agencies and LTCs are more to blame than training at the original sites. Anytime you hire people for a servile job that pays very low wages without benefits, PTO or anything approaching adequate vacation hours and do not invest anymore training hours or career growth opportunities you are asking for poor job performance. Invest in your people and you will get good results. If you have a good aid you either have a future nurse or a saint, no one else would do that job for the current compensation.

Up Vote Up Vote ×
Specializes in LTC.

Just have to add, I am an LPN in LTC and the cena's do the vitals there for us. I put out the list of the vitals that needed to be done at the beginning of the shift. At the end of the shift I looked at the vitals and noticed I had put a patient on the list that wasn't even there (had gone out to hospital day before), and next to his name was a set of vitals! And naturally when I questioned all the cena's all denied doing it.

Now I would like to say I have worked with some really great Cena's and some bad ones. Same with nurses, I have worked with some wonderful ones, and not so wonderful. You will find that anywhere you go.

Up Vote Up Vote ×
Specializes in Home Health Aide.

I recently got my RMA and while doing my clinicals I was very diappointed to learn that in many physicians offices the MA's simply copy the last vitals from the patients charts to skip parts of the vitals or even worse just make up the vitals. One RMA that began her clinicals half way through mine was trained to divide the pulse by 4 to determine the respirations! I corrected her method and was so disappointed in the ma's that were working at the physicians off and that the ma who was in training went along with it. I have a few years caregiving experience (and now that I have some training I can't believe that I was doing some of the things in care giving with out any formal training. Like passing meds, bathing and lifting clients, wound care etc). I think it depends on the persons. CNA's are a dime a dozen, the pay isn't very high (min wage or a dollar or two above mw) and the training is quick dirty and cheap. I feel the same way about ma training though. I am going to start my prereqs for the BSN program in Aug so to me nursing means something other then the other kids I went to school with. Many of whome never go on to take their registry test or work in the medical field. It all depends on where someones motives come from and I think that people who work ina career that they are passionate about and really love to do then they will do a great job and give it their all. But unfortunatly many people think being a CNA is an easy job and a lazy one hence why you end up with lazy poorly educated and low worth ethics and morals in the work place. I am a confrontational type of person so if I see something being done that is not correct and accurate I speak up about it and if nothing is done then I keep speaking up and speaking up until something is done. This has cost me my job in the past but I thinkt hat it's more important to secure good care for your patients then earn a pay check.

Up Vote Up Vote ×
Specializes in Critical Care.

PCA's aren't the same thing as CNA's, and it is true that PCA's typically don't have enough training to be doing vitals. In my state you need at least 72 hours of class time to get a CNA, while there is no requirement for any class time to be a PCA; a hospital can spend 20 minutes showing them how to use a dynamap and call it good.

Up Vote Up Vote ×
Specializes in Cardiology, Oncology, Hospice,IV Therapy.
PCA's aren't the same thing as CNA's, and it is true that PCA's typically don't have enough training to be doing vitals. In my state you need at least 72 hours of class time to get a CNA, while there is no requirement for any class time to be a PCA; a hospital can spend 20 minutes showing them how to use a dynamap and call it good.

When I worked in the hospital, our PCAs not only did vitals but also drew blood, did EKGs, read monitors and transported pts on monitors, and a few were trained to pull sheaths after PTCA

Up Vote Up Vote ×
+ Add a Comment