Handling CNAs

Columnist · Mar 24, 2007

I think you handled it pretty well. You explained your assignment/responsibilities, and you even offered to help her change the bed. It's too bad that an employee, such as the charge nurse, didn't explain your responsibilities to the rest of the staff....CNA's included. Even still, you would have those who expect to be able to tell you what to do.

HeartsOpenWide, RN · Mar 24, 2007

I'm currently doing my last semester preceptorship and I have been experiencing some difficulty with CNAs expecting me do give total patient care. This is not part of my rotation this semester. I am actually supposed to delegate to the CNAs but I don't feel comfortable doing so because I am not actually employed by the hospital (plus I'm chicken!).
How should I handle bossy CNAs without being rude or looking like I'm shirking?
Here's an exchange yesterday:
CNA: Is bed 18 your patient?
ME: Yes.
CNA: She needs to have her bed changed.
ME: I'm sorry. I'm doing a last-semester preceptorship. I have 4 patients today. I'm giving all the meds and doing all the charting. I really don't have time.
CNA: She needs to have her bed changed. {Tries to hand me the bed linens.}
ME: I can help you change her bed, or, if you are really busy and unable to do it, I will change the bed. But it's not part of my assignment this semester and I have other things to do.
CNA: {Rolls her eyes and walks away.}
Did I handle this correctly? What could I have done better?

You could have nicely told her that in fact it is your job to delegate jobs and that SHE needs to go change the sheets. Period.

firstyearstudent · Mar 24, 2007

Thanks. I think my problem is that I wanted her to go away loving me and it didn't happen (heh heh). I think I am going to be really challenged in dealing with others forcefully because I really want people to like me. I need to accept that that is not always going to happen.

cuddlebug · Apr 7, 2007

With 4 patients you must be soooo busy. I remember what it was like during preceptorship. If your too busy than delegate it. You are focusing on time management, leadership, charting, skills. Take charge. Its what you have to do. It might help if in the begining of the shift approach the CNA for your area and tell them....Hi______. My name is ........I'm a 4th semester nursing student at bla bla college. I have rooms __-___ I'm taking 4 patients so I will be delegating their direct care to you today......smile. say "Thank you" (CNA's name). If it doesn't work than you might have to be more direct like heartsopenwide explained it. You will survive. :bugeyes:

It's ok to say no.

Its ok to say no.

Its ok to say no. :smiley_ab

Kim O'Therapy, BSN, RN · Apr 7, 2007

Thanks. I think my problem is that I wanted her to go away loving me and it didn't happen (heh heh). I think I am going to be really challenged in dealing with others forcefully because I really want people to like me. I need to accept that that is not always going to happen.

I'm learning this lesson too, but not just with CNAs.

Crux1024 · Oct 29, 2007

I'm currently doing my last semester preceptorship and I have been experiencing some difficulty with CNAs expecting me do give total patient care. This is not part of my rotation this semester. I am actually supposed to delegate to the CNAs but I don't feel comfortable doing so because I am not actually employed by the hospital (plus I'm chicken!).
How should I handle bossy CNAs without being rude or looking like I'm shirking?
Here's an exchange yesterday:
CNA: Is bed 18 your patient?
ME: Yes.
CNA: She needs to have her bed changed.
ME: I'm sorry. I'm doing a last-semester preceptorship. I have 4 patients today. I'm giving all the meds and doing all the charting. I really don't have time.
CNA: She needs to have her bed changed. {Tries to hand me the bed linens.}
ME: I can help you change her bed, or, if you are really busy and unable to do it, I will change the bed. But it's not part of my assignment this semester and I have other things to do.
CNA: {Rolls her eyes and walks away.}
Did I handle this correctly? What could I have done better?

I think you handled it very well..I wonder why she tried to hand the sheets over after you already told her no??? :)

Luckily, I havent had this problem yet..

NursingAgainstdaOdds · Oct 30, 2007

CNAs/HAs are in a difficult position w/ regard to nursing students. I have noticed a lot of friction this semester between the HAs I am working with and the nursing students assigned to some of their patients. Notably, they feel that what was "supposed to be done" isn't completed. Being fresh out of nursing school myself, and having worked as an aide while in school, I have a thorough understanding of both perspectives. The best thing you can do is communicate clearly with the nurses and aides you are working with, in terms of what you are expected to do that day.

You are in a difficult position, because the HAs may not understand the work you need to complete. To them, you're "just a student" and (in my experience) they are frequently thinking "all they have to do is X, why is it SO HARD to do Y as well?!?". It's not your fault, it's not their fault. In the modern American healthcare system everyone's overworked, and when an opportunity for a little relief doesn't pan-out, it's frustrating. I know, and you know, you have to get into all the teeny tiny details of the patient's medical record and assessment in order to complete those care plans and answer the questions your instructor has.

Do what you are expected to do, make your role as clear as you can, help when you are able, and hope for the best.

I, too, have had difficulty in the past because I really just want everyone to LIKE me. Fact is, that won't be the case now and it won't be the case later, often just due to the stresses of working in a system which places nearly all of its burdens squarely on the shoulders of those working face-to-face with patients. Frequently, we turn to one another for someone to blame.

DusktilDawn · Oct 30, 2007

I'm currently doing my last semester preceptorship and I have been experiencing some difficulty with CNAs expecting me do give total patient care. This is not part of my rotation this semester. I am actually supposed to delegate to the CNAs but I don't feel comfortable doing so because I am not actually employed by the hospital (plus I'm chicken!).
How should I handle bossy CNAs without being rude or looking like I'm shirking?
Here's an exchange yesterday:
CNA: Is bed 18 your patient?
ME: Yes.
CNA: She needs to have her bed changed.
ME: I'm sorry. I'm doing a last-semester preceptorship. I have 4 patients today. I'm giving all the meds and doing all the charting. I really don't have time.
CNA: She needs to have her bed changed. {Tries to hand me the bed linens.}
ME: I can help you change her bed, or, if you are really busy and unable to do it, I will change the bed. But it's not part of my assignment this semester and I have other things to do.
CNA: {Rolls her eyes and walks away.}
Did I handle this correctly? What could I have done better?

I don't think you handled it incorrectly, unfortunately what you were saying was not what the CNA wanted to hear. You were talking to a CNA that felt that since that patient was assigned a student, the student should have to do it. The position of a student nurse during clinicals is not always the greatest, something like being between a rock and a hard place.