why are cna's treated like they are stupid and replaceable?

LPN1974, LPN · Apr 8, 2005

I would REALLY like to know what LTC facility would even allow a NA to do these things......?
It doesn't matter if you have "previous nurses training"....if you are not a LPN or RN, you CANNOT do what you are describing.
What state are you in?
Personally, I read these posts about how nurses supposedly treat nurse aides like s**t, but in "the real world" that I inhabit, more often than not it is the nurse who gets abused.....it's a challenge to even get most nurse aides to do their jobs.
I have worked at several LTC facilities.
The last one, we had a man who would lie in his own excrement for hours, and the aides wouldn't clean him....
And no, I don't think I'm "too good" to "wipe butts", but when I'm doing a 2100 med pass, it's not easy to stop and do a COMPLETE bed change, including doing a bed bath, because they've laid in s**t for hours! Need I mention that the CNAs are doing rounds at the time? :angryfire
I always help them. I take people to the toilet when they need to go. To and from the dining room....helping the residents change clothes, do this or do that..if I am in their room and they need assitance, they get it from me...so don't even go there with the "nurses need to help", I've heard it too often.
We can do their job, but if we do their job and they never left a finger, who will pass meds? Who will do the assessments? As nurses, we have tasks that we MUST do.....and that we are responsible for.
That's why people are hired as "nurse aides"....because we need help. Unfortunately, all too often, we don't get it from the people who are being paid for that very thing.
And yes I do agree that CNAs are woefully underpaid. Their job is VITAL. What they are doing is truly important. Thank God for the good CNAs who understand that it isn't all about money. No that doesn't negate their legitimate complaint that they are underpaid; but that is no reason to not do their jobs. The true satisfaction comes from making a difference in the resident's lives, anyway, and yes that applies to us nurses, too..........

Well said.

However, SunStreak, they are starting to let CNAs do things that LPNs were once only allowed to do. There are several threads on here about that.

They are CMAs, Certified Med Techs, and other titles. They pass meds, put in foleys, give trach care, and no telling what else.

That's one reason why alot of facilites are trying to phase out LPNs and use only RNs and CNAs.

Alot of these duties are being delegated to the CNA level. For less money I might add.

There are several thread on here about it.

I worked in a LTC for awhile and had one NA that was going to do everything he could to force the nurses to work on the floor to help HIM with HIS work. It didn't happen.

It is NOT below me to wipe someone's butt, or feed someone, bathe someone, so don't ANYone go off on me.

I've been there, done that. I started out as NA.

I had the opportunity to go on to LPN school. I wanted to advance myself, and I'm glad I did.

I wish I had gone on to RN school later, but I didn't get that far.

But I will help anyone who asks me, if you need help transferring, lifting, assisting someone in anyway that I can.....

BUT I CANNOT DO YOUR JOB FOR YOU. I ALSO have a job, for which I am paid to do.

And I also agree the CNAs are tearfully, sadly underpaid. There isn't anything I can personally do about it, I would encourage anyone who could go on to school to do so, seek out any grants, assistance that you can find and go to school to raise your standard of living.

I would think that with the nursing shortage that we would start to see some grants for educational assistance coming out of the government somewhere.

I know that anyone with any kind of disability can get assistance. I have a co-worker with a severe hearng loss, and she had all of her LPN schooling, everything paid for. Including they bought her a hi-tech hearing disabled stethescope, costing 450.00. They bought her uniforms, books, shoes, even her pantyhose. And gave her money to live on and support her children while she went to school! She lived in govrnemnt housing and said money was tight, but they made it thru that year and now she's doing great.

So some help is out there if people are willing to search for it.

Sorry for rambling on and getting off the subject.

There I've said my piece for now.

Venting over.

Lanceman · Apr 8, 2005

CNA certainly don't get paid enough but there is no room on the payscale to pay them anymore than they get. If a CNA makes $10 an hour, a LPN makes $15, and a RN $20 an hour there is no room to give CNA more money without giving everyone a raise in the process. You can't have a CNA making what an LPN does, just as you can't have a LPN making the same as an RN. It just won't fly. In my experience any low paid worker is expendable, there is a larger younger labor pool of them and the technical center is spitting out a new class every month so technically the bodies are replaceable. It's just finding good ones and holding on to them that is important.

keep smiling · Apr 8, 2005

CNA's in Long Term Care- Where would we be without people like you? I have been a long term care nurse for over 25 years, prior to that I was a nursing assistant while I went to nursing school. Maybe that's the difference, I know from experience how hard your job is. You are right the patients/residents don't care about our titles we are all supposed to be there to lend a hand. I can tell you when I have conscientious CNA's my shift goes so much smoother. I get less complaints from resident, we have fewer falls and accidents and resident and staff morale is up. I wish there was something more I could do to support the CNA's where I work...every shift I thank them and tell them how much they are appreciated.

it seems to me that CNA's, esp. in long term care, get treated as if they don't know how to do anything, are overworked, unappreciated, and underpaid. This one nurse about drives me up the wall. You come to her with a patient related concern and she'll look at me like I'm busy you take care of it. No I cannot hang another feeding, do a dressing change, or insert a catheter though I've been taught how. ( previous nurses training). She walks like a waddling duck. A lady accidently slipped and I was taking her to the toilet. It was an accident and I wish I fell, I felt that bad. My partner was busy at the moment and this nurse was RIGHT there! I asked her if she would mind helping me stand this lady up, she goes oh I thought so, so was going to help you!!! This is the type of nurse that would actually make a mess in the process of giving a pt their meds and say gosh that's the aides job to clean it up. I never ever expect the nurse to do my job for me but if they are in the same room and can't even help their own patients, there is something wrong with that. She doesn't like lifting either, I wonder how she passed her physical for nursing school. No other aide in sight, asked her one day to help transfer someone( would have either injured myself badly or dropped him) nurse sitting on her butt and " oh I guess so" with a sigh! The nurses are suppose to help!!! maybe as a cna I am biased and only see one side of it. Other nurses assist at times but she thinks she is too good to do anything else, but now I'm in nursing school and once I get out I hope I don't ever treat my help this way. Maybe I'm expecting to be treated with respect because I work very hard to care for my patients in skilled care, but we are always short staffed, and the fact that I have a college degree in nursing/ general studies, while I'm not a nurse in the eyes of the law I am a caregiver that continually nurtures each and every one of my patients, in a way when a patient hollers for the nurse they don't decipher between me and the LPN or RN. we are all nurses to them providing patient care.

LPN2RN05 · Apr 8, 2005

Oh Lord!!

This was my gripe for so many years!! Having been a CNA for seven years I know excatly what you are talking about. Unfourtunatly, just as there are bad cna's and good cna's there are bad and good nurses too.

Bottom line we are a team...

I made a commitment to myself that I would never be a nurse like that..if someone needs help, then I help. Whether a call light has been going off forever I will answer it!

Truth be told though, when I was a CNA I did not realize all the paperwork that had to be done, or the thinking process that was involved doing most of that paper work. Now I know, the concentration that is involved..now I understand.

But even so...one person cant do everything and that includes a CNA..the CNA is a vital link in nursing!!

Love your CNA's people!!!!!

LPN1974, LPN · Apr 8, 2005

maybe I fail to see that the nurses are busy even when it looks like they're not.
i want to be a nurse but this is aweful. one lpn at our place regularly works at least 5-6 days a week and 4 or 5 sometimes are double shifts!
i wonder why so many nursing professionals get burnt out. !! i'm in lpn school now, looking for another job, or maybe just volunteer in a hospital.

You FAIL to see the nurses busy even when it looks like they are not??

And the nurses where you work are being called in 5-6 days a week and working doubles some of those days???

I am quite sure your nurses are NOT sitting on their a$$e$ if they are working overtime and doubles.

You said yourself you wonder why nurses get burned out. You just stated the reasons why yourself.

Just because they might sitting down at the computer or at a stack of charts does NOT mean they are not busy....there is a hell of a lot of charting to do on NH residents and it MUST be done or Medicare/medicaid won't pay, which means your salary won't get paid.

The med pass is no piece of cake. I worked on med pass from 7pm until 11;30 or 12 midnight. It's not just set up a tray and go down the hall within 30 minutes now, and hand out pills right and left. Med pass is different these days.

You set it up, administer it and chart it all at the same time now, which really makes about 3 times longer to do med pass than before. And if the nurse is helping you feed or do do rounds, and I'm not saying they shouldn't help, but who the heck do you think is gonna do her med pass? Not you....you don't have a nurses license. Who is going to help HER with the treatments? Not you. Who is going to help her with all that charting? Not you.

And it isn't the nurses fault that you have to work short.....

Neither is it really the DON's or administration......if there are no applications where are you gonna get the folks to do the job?

I worked a LTC myself, I know how it is.

The job I am in now, also has about same thing as a CNA..only they're called LSTs. We have a few every few months apply and come to work. The ones hired do not adequately replace the numbers who quit to go somewhere to further their education, or the ones who retire, or the ones who decide that this just ain't for them and work thru the orientation period and decide not to come back, or the ones who find something better. The new hires just do not keep up with the numbers leaving.

And the nurses are supposed to have 3 on duty everyday, but alot of times we work with just 2 nurses, to take of about 120 residents. I regularly give meds MANY days to approx 60-65 residents. I don't have time to help the aides.

I hope you are not going into LPN school thinking it's going to be easier than a CNAs job, because it isn't any easier. It's just a different job that's got a different set of headaches and much work to be done. Meds, tx's, IV care, charts, dr's to call, emergencies to take of when residents fall, and those horrible incident reports that take 30-45 minutes to fill out, neuro checks and vs every 15 minutes, etc, etc, etc.

And don't go off on me about this.

I've been there and done that....I started out as a nurses aide. I know where I came from and I will never forget it.

I will help anytime I'm asked, if you need help with a transfer, a lift, changing a bed, answering lights, but I cannot do your job for you, as I have a job to do also, and nobody to help me.

And I do know CNAs work hard and are a vital part of the team. I appreciate them.

But many many nights I went home after a 12 hr shift my feet hurting so bad.

Nurses have it hard, too.

Maxs · Apr 8, 2005

Hmm! Wow! I am not even at South Beach and I can feel the Heat :angryfire . When you have a problem, the professional thing to do is to find a solution to the problem. Now, you can write as good as shakespear, or some famous writer, but that will not be enough. LPN's Can dodge their flaming bottles at CNA's, then the CNA's can just swallow it and explode, or they can try to indicate the roots of the problem. Right now, all of you are biased in one way or another. You're solution will be to have more CNA's, and if the facility keeps saying "there are no applications." Well, you can confirm this by asking a qualifying candidate to apply for the position and see whether they get hired or not. There are many more ways I can tell you right now that are logical approaches that will get this argument standing up on it's own legs. However, until then you should think about solutions rather than fussing and fighting with each other. This problem is way above your decisions, the masters of the masters (corporate owners) make these decisions. So what you need is mandated laws to be passed and the laws should state the facilities that cannot meet this requirement will be shut down. If we want what is safe for the residents and the staff, then we must act like FDR and not use Herber Hoover's Hand's Approach. We have to manipulate and tweek the system until we reach the maximum. Do something. Like interview a resident whom before he/she was admitted what was shown and promised to him/her and etc and what they're receiving now.

Maxs

LPN1974, LPN · Apr 8, 2005

Hmm! Wow! I am not even at South Beach and I can feel the Heat :angryfire .
Maxs

MAX I"m not angry at anyone here....I'm angry at the NH I used to work at for the above reasons.

There was never enough help.

I couldn't do my job and work on the floor as an aide too.

I'm sure it's that way in other places, too.

I quit there, I don't work there anymore. It just got to be too much.

LPNs were expected to pass meds to about 50 people on the "hard" hall, which they stuck me over there, and would not make the other LPNs "float"....I had it most of the time. These were the Medicare patients.

Now the easy hall had the private paid residents which meant 1 person to a room, thus reducing the number of residents over there.

I was always busy. If an aide thought I looked like I wasn't busy, I was probably sitting at that confounded computer charting on the Medicare patients, then the hot rack, then the weeklys, then any others that come up.

It never ended, and sometimes nurses aides do not realize what all an LPN has to do.

Nurses have it hard, too, just like CNAs do in NHs, but I'm getting kinda tired of the LPNs always having to take the heat.

Purple Princess · Apr 9, 2005

i realize any profession has its stress and through doing clinicals and working along side nurses I've seen first hand what they go through. and we have a problem at our place with everyone wanting their break at the same time and not communicating this to their partner or the nurse. If there is two to a hall then one should tell the other hey I need a break, then I do work during that time I can do on my own and then when i go she'll do the same and when we're back together we finish the few clients that we couldn't do independently. this is how it should be. However, we have frequent call offs, not enough aides to begin with. We don't have drug testing so we ended up with at least 2 suspected you know! in six months alone we have gone through maybe 5 or 6 either quitting or fired. My point is instead of the facility putting their foot down and enforcing rules they just let it all slide.. ..

like i said i never expect the nurses to do my job, cause i certainly can't do theirs, but when it comes to employee safety i don't understand if you don't bug the nurse at all for anything else all night why they would just refuse to help you move someone so you don't end up hurting yourself as i did, or maybe the patient? i know as a nurse i will be busy but i hope i don't become heartless either. that was my main point all along.

LPN1974, LPN · Apr 9, 2005

i realize any profession has its stress and through doing clinicals and working along side nurses I've seen first hand what they go through. and we have a problem at our place with everyone wanting their break at the same time and not communicating this to their partner or the nurse. If there is two to a hall then one should tell the other hey I need a break, then I do work during that time I can do on my own and then when i go she'll do the same and when we're back together we finish the few clients that we couldn't do independently. this is how it should be. However, we have frequent call offs, not enough aides to begin with. We don't have drug testing so we ended up with at least 2 suspected you know! in six months alone we have gone through maybe 5 or 6 either quitting or fired. My point is instead of the facility putting their foot down and enforcing rules they just let it all slide.. ..
like i said i never expect the nurses to do my job, cause i certainly can't do theirs, but when it comes to employee safety i don't understand if you don't bug the nurse at all for anything else all night why they would just refuse to help you move someone so you don't end up hurting yourself as i did, or maybe the patient? i know as a nurse i will be busy but i hope i don't become heartless either. that was my main point all along.

I do understand where you are coming fom, too. I wouldn't refuse to help you turn or transfer someone, or help you clean someone up.

I know there are nurses who are heartless.

Your back hurts, I'm sure, just like mine and my feet do.

All I can tell ya, if it is a problem, talk to her, and if she doesn't help in a situation when you can't get any other help, then talk to someone above her.

You can't move someone by yourself, if it's a risk to the patient and you.

Town & Country · Apr 9, 2005

However, SunStreak, they are starting to let CNAs do things that LPNs were once only allowed to do. There are several threads on here about that.
They are CMAs, Certified Med Techs, and other titles. They pass meds, put in foleys, give trach care, and no telling what else.

I'd like to know what states this is legal in.

I've never seen or heard of a CNA being allowed to pass meds or put in Foleys, or do trach care.

To pass meds, a CNA must take a course to become a CMT (certified med tech), at least where I am from and where I've worked.

Where do you live where a CNA can do these things, legally?

No I'm not asking for personal info. Just which state....

NursesRmofun, ASN, RN · Apr 9, 2005

it seems to me that CNA's, esp. in long term care, get treated as if they don't know how to do anything, are overworked, unappreciated, and underpaid. This one nurse about drives me up the wall. You come to her with a patient related concern and she'll look at me like I'm busy you take care of it. No I cannot hang another feeding, do a dressing change, or insert a catheter though I've been taught how. ( previous nurses training). She walks like a waddling duck.......QUOTE]
I am assuming you are mostly just venting. It is hard to assess what you are saying without being a worker in your facility. Perhaps the nurses are that busy that they cannot help...they have their own things to do. Yes, they should clean up their own messes or ask you nicely to clean something up, if they made the mess. Neither nurses nor nurses aides get paid enough IMO. As someone said, it is not all about money. We can't generalize about people though...whether it be RN, LPN, or CNA. But we all have our own jobs to do. Lastly, CNA's are not nurses. It is illegal to represent yourself as a nurse if you are not. That is just a fact.
I appreciate hard working, good CNA/Techs....We can always use more of those!

LPN1974, LPN · Apr 10, 2005

I'd like to know what states this is legal in.
I've never seen or heard of a CNA being allowed to pass meds or put in Foleys, or do trach care.
To pass meds, a CNA must take a course to become a CMT (certified med tech), at least where I am from and where I've worked.
Where do you live where a CNA can do these things, legally?
No I'm not asking for personal info. Just which state....

I live In Arkansas, and they tried to get a bill passed to create Certified Med Techs, and they will be able to pass meds. PO meds, ear and eye gtts,

nasal sprays, administer some rectal meds, {like dulcalax supp I would imagine}.

The bill passed our Senate, and was to go to the House, but I have not been able to find out if it passed the House.

One of our fine and distinguished RNs on the Arkansas State Board of Nursing made this statement, "It doesn't take a rocket scientist to put pills in a cup and watch someone swallow them." I won't post her name. Obvioulsly she's in support of this bill, and it really shows ME how much she thinks of LPNs.

There were several articles in our state newspaper about it, but I haven't seen anything about whether or not it passed.

Check out these 2 links below, there are discussions about it. If the links don't work, search for Certified Medication Aides or Techs

and Medication Aides.

As far as putting foleys and doing trach care, I've seen conversations on this board by aides who say they do it.

Now I've never worked in a place where I have personally seen a CNA do foleys or trach care OR pass meds.

But apparently the professional lines that define our boundaries in nursing are becoming more and more blurred all the time.

It just seems very strange to me that on one hand they're hollering "nursing shortage" and LPNS and RNs are restricted to what they can and cannot do in

under their own licenses but on the OTHER hand states are creating Certified Medication Aides and allowing them to do things with very little training, that used to be done only by a nurse.

https://allnurses.com/forums/search.php?searchid=799149

https://allnurses.com/forums/showthread.php?threadid=96395