Have you ever had CNA's/MA's who dont want to work?

grimmy, RN · Jul 23, 2005

we have pcts that work in the or, and most are quite good, but there are a few slackers. we have tried to eliminate all the "hiding" places (i never knew there were so many!). the real problem, of course, is that they know they have administration by the short hairs. if you think there's a nursing shortage, there is a tremendous ulp (unlicensed personnel) shortage. i was a pct in nursing school, too. the wages are crap, the work is often literally crap, and typically labor-intensive. some don't get benefits. i worked very hard as a pct, and when i first started as one, the other pcts hated me because i did work hard. they grew to like me because i never asked anyone to do my job, and i never tried to tell anyone how to do their job. they also knew that my time there was limited as i was to graduate nursing school the next year. while i was there, one of the pcts was fired for fabricating vitals! he just never did them. the thought still makes my hair stand on end. you're hardly alone. i wish i could come up with some better ideas for you, but without administrative support and/or you coming up with a real legal liability for the pcts not doing their job, you are doing all that you can right now.

grinnurse, RN · Jul 23, 2005

As a new nurse, I have been blessed with the 2 CNAs that are our regulars. They work their tail ends off every shift as much as the nurses do and then I have one in particular, that if the nurses are trying to chart, she makes sure that we have the time to do it and takes it upon herself to go see what they need if the call lights are going off!!! They are both awesome and are consistently awesome at that. The night shift CNA though is a different story!! When we come on, our two are always having to reload the carts with towels, etc and empty the dirty laundry hampers cause the ones on nights won't yet when they come on they are ready to go.

I reward my CNAs for their hard work!! Yeah, it's their job to all this, but when I know I don't have to wonder if my pts are being taken care by top notch individuals the entire time that I am there, you betcha I am doins nice things for them in appreciation for a job well done!!

Sorry that you are having the problems that you are having. W/O support from management though, all you can do is keep doing what you are doing unfortunately.

PhoenixGirl · Jul 23, 2005

I am in nursing school and recently started working pool in LTC/rehab as a cna. I have been very surprised at the things I've seen. Some CNA's are *awesome* and some are just complete jerks. The other day during dinner a woman was soaked through her pants with urine, she seemed pretty incoherent and didn't say anything. When I told the CNA that was supposed to be taking care of her, she didn't do a darn thing. The girl was talking to me later about how she wants to do prereqs and become a nurse. I am just floored. She doesn't seem to want to take care of a patient and she wants to become a nurse. I think what some people see is the $$$ and they don't care that these are PEOPLE and it could easily be them getting neglected.

Rebecca

SharonH, RN · Jul 23, 2005

As someone else pointed out, the work of a CNA is hard "crap" work for unjustifiably low pay. I don't know if there is a great solution to the CNA problem. Like most low-skilled workers, they are treated as disposable and thus many of them do not feel a lot of loyalty to the job. I worked as an NT during college and not only was the work hard, but the nurses were mean and condescending and I was treated like a 2nd class citizen by pretty much everyone. Were it not for the fact that I knew that the work was temporary and I was doing it for the exposure, I could not have been motivated to do the job well. That's the sad truth. I know that doesn't help your problem and I know that there are CNAs and NTs who do a fantastic job, but I'm just offering a different perspective. Good luck.

allamericangirl · Jul 23, 2005

Have you ever had ancillary staff who doesnt like to do the basics of their job? That is the boat I am in. I am a traveler and don't usually get involved in staffing issues but the MA's at the hospital I am contracted at really take the cake. I work nights and I am lucky if they round on patients twice during an 8 hour shift! I think I have just about tried everything, from asking nicely to offering to help them to giving them a list of tasks to do on their shift. I have also discussed the issues with the manager of the floor but that was a waste of breath. I wrote them up a few times but that didnt really do the trick either. Now I am just riding their buts every two hours- reminding them of the time/duties etc. (I feel like an oversized cukoo clock when i have to stop taking care of my 9 patients and charge nurse duties to tell them it is 2 am and time to do 2 o'clock rounds and then have to stop every 5 minutes over the next 1/2 hour or so to keep on them till they finally get up) I know there are awesome MA's/CNA's out there, and I was once one myself so I feel like I can understand how hard their job can be but this hospital's aides are the worst I have seen across in the Mid-West, South and East coast. Hopefully everyone else out there is having better luck than I am...

There are 720 total minutes in a 12-hour shift. Last night I completed my fifteenth day working as a PCT. This includes the days I was in training. I work 1900 to 0730 hrs. This is my 1st job working as a CNA. I work 3 - 12s, back to back. This is my 1st experience as a CNA. :smackingf

I am the only Tech on our floor at night. I am in Med-Surgery and Barriatrics. We have 22 PT beds. I had 19 Pts, divided among 4 nurses at 5, 5, 5, & 4 Pts.

I do 3 sets of VS and 2 sets of IOs per Pt. and 9 additional sets of VS (4/ 3/ and 2) ... on Post Ops. Last night, I had 3 Post Ops, and 1 new Pt, in my total of 19 Pts. I took a total of 106 sets of VS and IOs! If everything goes perfectly, and I take no breaks or lunch, I have a total of 6.8 minutes per Pt, per visit. If Pts are away from their beds, in the bathroom, need help going to the bathroom, need, water, juice, ice, changed, moved up, etc, which they do...Its my job. I also chart 5 times, empty Ngs, all Pt drains, do Blood Sugars, and Foleys. There is a minimum of 2 Techs on the day shift and 5 RNs. I am new and working hard on my speed. I admit I am slow, but I don't stop. Last night the 1st time my butt saw the bottom of a chair was at 11:30 pm. The next time was 3 am. Two 10 minute breaks...and I certainly am not lazy ... but the linen carts did not get filled and the cleaning did not get done, and the laundry hampers did not get emptied for the day sift. I wanted to but there wasn't time. The nurses, though, had time to sit around and discuss their vacations, families, boyfriends, off and on for at least 1 ½ hours. Night before last I had the same Pt load but different Nurses, who helped me, and I got out on time. Maybe some of you just don't understand all of your Techs duties. I am determined to get it all done and have time for 3 - 15 minute breaks and a lunch break too, but it will be a while longer, I'm afraid! god, I'm tired!

The biggest problem I'm having is getting trough my first set of VS during visiting hours! Climbing over visitors and running down stray Pts. My next biggest problem is getting the Dynamap to quit sputtering and dragging out the blood pressure readings! Sometimes it takes so long! Definitely need help with the Dynamap! :banghead:

tridil2000, MSN, RN · Jul 23, 2005

There are 720 total minutes in a 12-hour shift. Last night I completed my fifteenth day working as a PCT. This includes the days I was in training. I work 1900 to 0730 hrs. This is my 1st job working as a CNA. I work 3 - 12s, back to back. This is my 1st experience as a CNA. :smackingf
I am the only Tech on our floor at night. I am in Med-Surgery and Barriatrics. We have 22 PT beds. I had 19 Pts, divided among 4 nurses at 5, 5, 5, & 4 Pts.
I do 3 sets of VS and 2 sets of IOs per Pt. and 9 additional sets of VS (4/ 3/ and 2) ... on Post Ops. Last night, I had 3 Post Ops, and 1 new Pt, in my total of 19 Pts. I took a total of 106 sets of VS and IOs! If everything goes perfectly, and I take no breaks or lunch, I have a total of 6.8 minutes per Pt, per visit. If Pts are away from their beds, in the bathroom, need help going to the bathroom, need, water, juice, ice, changed, moved up, etc, which they do...Its my job. I also chart 5 times, empty Ngs, all Pt drains, do Blood Sugars, and Foleys. There is a minimum of 2 Techs on the day shift and 5 RNs. I am new and working hard on my speed. I admit I am slow, but I don't stop. Last night the 1st time my butt saw the bottom of a chair was at 11:30 pm. The next time was 3 am. Two 10 minute breaks...and I certainly am not lazy ... but the linen carts did not get filled and the cleaning did not get done, and the laundry hampers did not get emptied for the day sift. I wanted to but there wasn't time. The nurses, though, had time to sit around and discuss their vacations, families, boyfriends, off and on for at least 1 ½ hours. Night before last I had the same Pt load but different Nurses, who helped me, and I got out on time. Maybe some of you just don't understand all of your Techs duties. I am determined to get it all done and have time for 3 - 15 minute breaks and a lunch break too, but it will be a while longer, I'm afraid! god, I'm tired!
The biggest problem I'm having is getting trough my first set of VS during visiting hours! Climbing over visitors and running down stray Pts. My next biggest problem is getting the Dynamap to quit sputtering and dragging out the blood pressure readings! Sometimes it takes so long! Definitely need help with the Dynamap!

you sound like you are a great cna! i'd love to work with you. pls do try to take a break though, bc if you continue like this, no one will ever expect you to stop. set the standard now... you give 100%, but you want those 30 minutes unless some serious unforseen event occurs.

you deserve 30 minutes to eat/rest!

i also think the 'lazy cna' problem stems from lack of appreciation. you know how some schmuck drs think we 'should' do everything for them...that they're just soooo helpless (eye roll)... well i think we tend to have the same affect on cnas.

thank them for their work, speak to them like collegues and share pt info with them and your clinical concerns. you'll see a difference!

mstigerlily · Jul 23, 2005

Oh YESSSSSS! We have fantastic dedicated CNAs and I thank God every time I see their names on the boards. Then there are the lazy slackers where I cringe when I see their names on the board. It makes the difference between me having a good night and a bad night.

With the bad ones, I've found them: sleeping, watching TV in an empty room, surfing the internet, chatting, going out to their CAR in the parking lot to have a smoke, chatting in FRONT of the linen room for nearly an hour when I had to ASK THEM TO STEP ASIDE so *I* could get the linen to clean up after patients, which is their freaking job!!!

Nothing more annoying than to have a patient who needs an IV push, or early discharge teaching, or to have foley put in or have a primary line converted to a saline lock and have to do such mundane tasks as change a baby's diaper, get a pt up to change her pad or bring pitchers of ice water because the CNA is doing one of the above.

ALSO - some of them don't chart correctly. C'mon, all pts don't always have a RR of 18 every 4 hrs. And I've seen them empty a 1000cc foley bag and nothing was charted at 7am and I see them clocking out.

Melissa

Or I've

Have you ever had ancillary staff who doesnt like to do the basics of their job? That is the boat I am in. I am a traveler and don't usually get involved in staffing issues but the MA's at the hospital I am contracted at really take the cake. I work nights and I am lucky if they round on patients twice during an 8 hour shift! I think I have just about tried everything, from asking nicely to offering to help them to giving them a list of tasks to do on their shift. I have also discussed the issues with the manager of the floor but that was a waste of breath. I wrote them up a few times but that didnt really do the trick either. Now I am just riding their buts every two hours- reminding them of the time/duties etc. (I feel like an oversized cukoo clock when i have to stop taking care of my 9 patients and charge nurse duties to tell them it is 2 am and time to do 2 o'clock rounds and then have to stop every 5 minutes over the next 1/2 hour or so to keep on them till they finally get up) I know there are awesome MA's/CNA's out there, and I was once one myself so I feel like I can understand how hard their job can be but this hospital's aides are the worst I have seen across in the Mid-West, South and East coast. Hopefully everyone else out there is having better luck than I am...

wa-rn · Jul 24, 2005

so far I have been so unimpressed with these CNA’s...I used to say of the nurses that wouldn’t help lazy & condescending, but guess what, I didn’t go to nursing school to do other people’s jobs, I have my work to do, and the CNA’s have theirs to do, why the hell should I do it for you if you are just sitting on your ass doing nothing…I am all about helping but CNA, that A stands for assistant, so assist and get off my back…

mom2michael, MSN, RN, NP · Jul 24, 2005

I work as a Student Assistant (which is really a NT) PRN for the summer on a Med/Surg floor. I have anywhere from 6-13 patients working day shift. I took the job for the exposure to the patients, nursing care, etc.... I hate every single second I'm there. The job is horrible, the pay is horrible and you work your ever loving butt off for 12.5 hours straight only to get yelled at for not doing something (and I get yelled at by everyone from the housekeeper to the DON). There is no TEAMwork there and it's sad. I see the staff turnover there and I now know why....The regular techs hate me because I'm PRN and I'm also a student. They do horrible things to me like hide the vital machine, refuse to help me turn and change a large patient, refuse to help me answer my call lights "because that's not their room". I very rarely get a lunch....I sit in the break room and get screamed at by the U/S that my call lights are going off. Because there is no TEAMwork, I have to stop what I'm doing (lunch) and go and answer my lights. I usually find at least one other tech standing at the nurses station when I leave the break room. I complained, it got me no where but more hateful attitudes. I keep sticking it out though... I have just 2 more shifts and I'm done there because school is starting....

Now for my regular job (the one I work 24/hours a week at) I work as an ER tech with some seriously awesome people. There is no "thats your job" it's everyones job from the time the patient comes in to the time that they leave to take care of them. We help each other out with every single thing. Things are deamed "my job" are done by every single person there. This gives me hope that not all jobs are like my PRN job :) I think that's the key though to a good tech in any department....if they don't feel like they are part of the team, they don't care about their job.

exodusgo, BSN · Jul 24, 2005

I think the irony of my situation is that usually the CNA's I come across tend to think of me as their favorite nurse since I am always willing to pitch in with the duties and don't mind putting a patient on the bedpan or cleaning one up or answering a call light etc. I always do my own vitals and I&O's so their usually isn't a reason for them to get an attitude. They are really only responsible for turning and checking for incontinence on my patients at 2am and 4 am since I turn and check mine at the start of my shift during my assessment and turn and check them at the end of my shift. The sad part is that the floor I work on is mainly housed with patients with stage 3-4 breakdown so turns are more than just a job duty- these patients really need to be rotated. But usually what happens is that I have to stop charting and sorting out meds/MAR's and go and make my turns after it becomes obvious that they aren't planning on doing them. They try to skip rounds all together by starting one set late after taking a 1 1/2 hour lunch break then telling me that they just finished rounds so it can't be time to start them again. I asked the other nurses and they all agree that they dont have good aides, "but that's just the way they are". (Well, I am sure that inspirational message just sinks right in with the aides- talk about enabling poor behavior.) Needless to say, I am looking forward to this contract being done...

DusktilDawn · Jul 25, 2005

I currently work on a unit where there are numerous issues between the CNAs and the RNs. The CNAs seem to believe that their job is to only do VS, chemsticks, I&Os, and lab draws, they perform these tasks as quickly as possible so they can goof off and hide. :sofahider As far as they are concerned all aspects of patient care that do not fall under those categories is our job (ie: changing patients, turning & positioning, providing water, ambulating, etc).

I don't understand why they feel it is okay to sit at the desk surfing the net, taking personal calls on their cellphones, reading, etc, while the RNs are running ragged. They believe that despite the fact they are not doing anything (at least anything work related) that they have the right to refuse to help. If I hear "That's not my patient" from another sitting CNA, I may go balistic!! :lol_hitti I am frustrated by this nonsense and I no longer accept this excuse from them.

Respect is another issue. I have never seen such disrespect from CNAs towards the RNs as I do on this unit. The RNs are far more curteous towards the CNAs than the other way around. We are EXPECTED to gush thanks for the least little thing they do, despite the fact that it is THEIR job, excuse me, I don't hear thanks from them when I assist them.

I would fall over in shock if a CNA ever asked me "Do you help with anything?" This does not happen EVER.

When I first started on this unit if a patient uttered the word "nurse" in a sentence to a CNA, they would pivot so fast out of the room to inform me that my patient needed a "nurse". I quickly learned to ask them what the patient needed a nurse for after one to many times of the patient requesting something that the CNA could easily have done. Some of the other RNs followed my suit which caused the CNAs to c/o to the NM about the RNs asking what the patient wanted when the patient wanted a "nurse". The NM wasn't very sympathic towards the CNAs in regard to this complaint.

Team work is another concept that the CNAs don't seem to understand. I have yet to see 2 CNAs helping each other change or turn & position a patient. Thankfully, almost all of the RNs I work with help each other out, if they didn't I would have quit a long time ago.

There is also the excuses of "I didn't know" or "You didn't tell me". If a patient was incontent on admission and has remained incontinent throughout their stay, do you NEED me to tell you to change them!!! :angryfire :angryfire :angryfire There is no reason for them not to take the initiative to do some things without direction. I wasn't hired to be their babysitter.

The RNs are unwilling to write up the CNAs for fear that situation could get worse (can't get too much worse). We have a NM who is willing to deal with the problem CNAs if proper documentation on incidents was provided.

I did discuss these and other issues with my NM. She introduced me to her "boss". One decision made was to have an outside mediator to come in and discuss the issues between the CNAs and RNs both separately and then collectively as a group. I do feel that the CNAs do not understand what the RNs responsibilities and duties are and vice versa. Having the CNAs shadowing the RNs is also being considered. The RNs also need to realize that they are enabling CNAs behavior by not doing anything (ie: writing up incidents when it is appropriate). I'm hoping that providing outside mediation will be the first step in changing the work situation.

PS: to all the hardworking CNAs reading my post, my frustration is not directed towards you. I wish that our CNAs had you work ethic. If you are working with RNs that don't appreciate you, I'd love to have you here. I have had CNAs floated from other areas that were AWESOME to work with and have begged them to consider working here.