I have been told that i need to stop doing the job of the CNA, and concentrate more on being a nurse,(RN). I feel that my job encompasses all, from CNA work, up to RN work. I love the hands on duties that the CNAs have. I love it when my patient feels comfortable with me, and can trust me, to take the best care i can of them. I dont know why i get reprimanded by my fellow nurses for this, but i feel that i can be a great nurse this way. There have been times when there was no CNA on my shift. So, do I not empty their foley, or help them to the BSC? Dont help them with their dinner, because that's a CNA duty? Does any one understand where I am coming from?
It's frustrating because in nursing school I feel like we've been trained more to be a CNA than a nurse. I understand that we have to know how to do these basic care tasks, but that should not be the essence of clinical. That's why it's hard to switch over in the real world of nursing. This last rotation we were told to delegate a bit to the CNA's on the floor because we were given more patients, but then when we told the CNA's we didn't necessarily have time to do everything, that we would help them when we could, they gave us attitude. The instructor ended up making us do all the work because she didn't want our school to look bad on this floor. Thus again, we didn't have time to focus on the RN aspects of clinical.
My school was the same. All bed baths and cna work for the most part. And 2 patients, very unrealistic.
Boy am i glad i found this topic!! I couldn't stand being told I did too much for my patients and that "my kind" of nursing isn't done anymore. I've been a RN for 35 years and a hospital trained nurse that can delagate with the best of them but it's so much easier when you are in a room and a patient needs something done to GET IT DONE! A total care patient given a bath can gve you a whole perspective on the care needed for that day. A bath takes such a short time (true all pain and scheduled meds come first). As hospital trained nurse we were taught how to plan our day and care. New nurses don't really get hands on training except to 2 pts at a time. I think that puts a graduate at a disadvantage.
you know I just overheard that kind of statement from 2 of my fellow co-workers (LPN nurses) last week and wondered if they were talking about me...
I am new at this extended care facility and just think that, as an RN, we need to know how to do the simple tasks (CNA) to working within our scope of practice, however when staffing cuts happen (low census etc..), when I heard a call light that has not been answered or an buddy alarm going off....I am going to answer and take care of the situation, so it is really tuff to not jump in when needed at that moment.
It sounds like you guys do way too much work for the CNA's. But I do know where you are coming from. When I first started work as an STNA, I would find people in old diapers (>12 hrs old), foley bags completely full, or fall risk patients with their alarms turned off or disconnected. I even found a lady (a huge fall risk) leaning forward in her wheelchair, face down in a plate full of food. The only thing that kept her from falling out of the wheelchair was the wheeled over-bed table. I reported one of them to my nurse, who then notified the DON. For the next couple of months, all of the nurses and nurse aides on that rotation tried really hard to get me in trouble. So, I know exactly where you are coming from. But you shouldn't have to do that much work.
If they have spoken to you about this, then this behavior is on their radar. You would do well to pay more attention to your RN duties, at least while in sight of your supervisors. You do not want to hear about this on your performance evaluation or your termination interview.
In reference to the posters who talked about how the CNA's just didn't understand that as an RN, you were doing RN work and not "sitting and talking on the phone all day" I have a suggestion. This really worked, as I was an aide and we had a high turnover of nurses. My favorite nurse really respected everyone. She called a meeting where she explained to all of the aides really nicely that when she delegated it wasn't that she thought that CNA work was beneath her or anything, just that she had other tasks that we all couldn't help her with.
It was seriousely a really helpful meeting. Everyone had a lot more mutual respect because of the talk. I know it can seem weird, but a lot of CNA's really don't know quite how much paperwork an RN has to do. this meeting was also successful because the RN lived up to what she stated in the meeting...she did still help out with CNA work whenever she could...but that came AFTER her RN duties.
I've never been accused of this but it is an ongoing problem that many (not all) of our CNAs resent being called by the nurse to do a task and we are accused of being lazy or acting superior.
I have no problem nor do most of my coworkers with doing bedpans, changing briefs, turning pt, refilling ice etc but who will hang my IV antibiotic, draw blood from the port, and call the doctor for a sleeping pill while I'm doing all of that.
No..they will simply call the nurse and say Rm 607 wants something for pain and sit down...when you go into the room they need a pain pill, plus juice and assistance to the bathroom.
However, do as your employer is telling you or make the effort. They usually never understand what is really going down on the floor.
As long as your specific duties as an RN aren't neglected, I don't see a problem with this. I'm surprised at how many people seem to think it is?
I have absolutely no difficulty delegating, and do so appropriately and regularly. At the same time, if I am in a room doing something else, I have no problem getting their I&O, or whatever. Our LPN's and CNA's can have twice the number of patients I do (and I know that's because their responsibilities differ), but they can have a bad shift just like I can, and if it's because their other patients that aren't also mine are taking up a lot of their time, I'll pitch in and help them with the patients on my assignment. I get a lot of positive feedback from the CNA's and LPN's I work with because of this, and they tell me they like to come in and see that they're working with me. Can't ask for much more than that. And no, it's never because they're being lazy and not pulling their weight. There are some days, though, that they have 12 patients and I have 6, and their other 6 may take up most of their time because of a variety of reasons. They can get horribly behind in their duties as much as an RN can.
I've never been even remotely reprimanded for being a team player, and I have been told in my evals that my patient care is thorough, etc (from an RN perspective), so that doesn't suffer for my helping out my teammates.
Specializes in Trauma Surgery, Nursing Management.
This battle is long and seems to never end. If you HELP with CNA duties (of course after the RN duties are complete), you get accused of doing too much for the CNAs. If you ask the CNAs to do something while you are completing tasks that only an RN can do, you get the "clucking tongue" sound first, then the eye rolling, then the dramatic sigh. I am not speaking for ALL CNAs, so don't throw me into the fire-filled pits of Styx. It can be a catch 22 sometimes. I really like the suggestion from the poster who described the meeting between the nurse and the CNAs where duties were explained. I think I will try that.
OP, I think I know where you are coming from. There is a certain bond of trust that develops between a nurse and patient that can be rewarding for both parties. I really enjoyed spending time with my patients after my duties were completed. Those times were few and far between. There is so much that you can do while giving a bath-you can do a lot of your assessments during this time.
It sounds like you guys do way too much work for the CNA's. But I do know where you are coming from. When I first started work as an STNA, I would find people in old diapers (>12 hrs old), foley bags completely full, or fall risk patients with their alarms turned off or disconnected. I even found a lady (a huge fall risk) leaning forward in her wheelchair, face down in a plate full of food. The only thing that kept her from falling out of the wheelchair was the wheeled over-bed table. I reported one of them to my nurse, who then notified the DON. For the next couple of months, all of the nurses and nurse aides on that rotation tried really hard to get me in trouble. So, I know exactly where you are coming from. But you shouldn't have to do that much work.
No one is saying we "have" to do this much work. Perhaps I want too. If I only have 4-5 pts and my tech has 12, doesn't it just make sense that my pts will receive better overall care if I chip in however whenever I can help out.
As a RN you need to do all the duties the CNAs can't do. You need to be able to prioritize and delegate. There are plenty of times I help with CNA duties and plenty of times we do a bath together. We do have teamwork and our CNAs and nurses are all wonderful. Everyone does their job because on my floor if you don't you will be out of work regardless of your title.
I do agree with those that pointed out that if this has been discussed with you it is on their radar. You need to put focus on your RN duties and be sure the CNAs are doing their delegated duties. If they aren't you need to start writing them up and get a paper trail in place. It is harder for management to ignore it when their is written documentation.
I also think it is important to point out that some CNAs hard as they try given their extreme workload just can't get to everything. That is much different than those who sit around and don't do their jobs because they are lazy and have a bee in their bonnet. Make sure to commend those working their heinies off. It will be so appreciated that you took the time to notice.
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I wouldn't disclose that information.....but I know I'm not the only one that complains of this. I know it's a general problem in a lot of schools.