Having problems with NA's and PCT's

bigmona · Jul 25, 2006

yep. I am a new grad and the techs think that because I am orienting with a preceptor, between the two of us, I have "plenty" of time to do THEIR job as well as my own. I am a hard worker and will definitely bathe, do vitals, fingersticks, toilet or whatever else my patient needs. But I have had the problem of asking a CNA to do something for me and getting the evil eye. I let it roll off my back, because I do not let it become my problem just because they have an attitude. I know when I have the time to do something and when I don't and if I need help I will ask for it.

If the CNA is making up vitals, that *needs* to be reported to his/her supervisor or your NM. That can potentially be very dangerous. Also if you don't want to deal directly with talking to the techs about their "laziness" then perhaps your NM can help you out with that as well. Good luck.

Anagray, BSN · Jul 27, 2006

I believe you have the right wright up the techs and if you don;t know where the documentation forms are, please find out. Tell your supervisor immediately and talk to your techs. It is a part of our job - I hate it too, but I am not going to allow ANYONE to compromise my patient's health and to have my lisence revoked for something I did not do. If a patient has a problem because of a tech making up vitals it is a huge liability for the whole hospital. If your nurse manager does not see that as a problem, her/his boss will.

I am sorry for what you have to deal with, but sometimes noone does anything until a person like you stands up.

good luck.

meownsmile, BSN, RN · Jul 29, 2006

If these folks are adults, why mollycoddle them? Give them their tasks for the shift at the beginning in report. Have a midshift meeting and give them some more if they are done and if things arent done WRITE EM UP!!! I have no patience for people sitting around while im running my behind off. If im up running they better be too. Ill find things for them to do.

heather1999 · Jul 30, 2006

Thank you everyone who posted. Night before last, I had the stay problem and my NM was the other nurse on my team. She says she's written up techs 3 or 4 different times and it seems nothing is done about it. And a tech did it to me AGAIN...my patient was on FOUR different BP meds (so vitals were VERY important to me) and I find my tech charting some vitals, but I suspected they hadn't been taken. I even asked my patient if she had had her BP taken at 6 am and my patient, told me "no, no one had taken her BP since last night", yet there in the chart was a BP (and HR) with an 0600 time marked by it. And while I'm angry about it, my patient's safety is my primary concern, so I took vitals myself (and my tech saw me doing it, too). But I didn't say anything except to my NM. I've got to do something about this situation, but what? I must learn to assert myself, not for myself so much, but for my patients. I'm their advocate; I'm their voice...I want them to get the best care possible, but I can't do it all by myself.

Does anyone know of a good book about asserting one's self?

EricJRN, MSN, RN · Jul 30, 2006

Next time a situation like that occurs, you might approach it like this. Tell the tech, 'I'm confused. The patient says she doesn't remember anyone taking her BP this morning.' You're not really being accusatory, but it might give the tech some incentive to behave for a while.

ItalianRN, BSN, RN · Jul 31, 2006

I am a new grad also. I've only been working as an RN for a few months. I wonder if there is a correlation between new nurses & PCT's not doing their jobs. Do you think they feel they can get away with it more with us?? It seems that way from the posts I read. I was having a problem with one & I kept biting my tongue about it. I'm new at this hospital & didn't want to make any waves or enemies. Yesterday was the last straw. I ended up reporting her to my manager & they are investigating her now to see if this is a common occurence with her. She doesn't do anything all day. She's pretty much AWOL all day. They she had the nerve to mouth off to me at change of shift last night in front of family members. I didn't say a word. I was off today but spoke to my manager & she will handle it from this point. When I return to work, if she is assigned to work with my patients again, I will have to stay on top of her & I will. I don't want to do it, but she obviously needs the constant supervision. I really stinks because I haven't had a problem with anyone else & since I'm new, I don't want people to hate me. I just couldn't ignore it anymore especially because my patients' care was affected & the way she snapped at me in front of family members. I just couldn't let that go.

widi96 · Aug 9, 2006

Okay - here is the perspective from a tech (May 07 BSN Grad). We have a few new grad nurses who seem to think . . . I'm an RN now and don't have to do any of the 'grunt' work. We have been told by our manager that "A RN can do anything a Tech can do". We also have a couple of new grads who openly stated that taking a patient to their room (from the ER to their room on the floor) was "a tech's job". :angryfire (Yes it is in our job description but I don't remember the nurses losing the ability to push a bed upon receiving their diploma)

Now . . a little background. I work in a Level II ER (27 beds) with an average of over 100 patients a day. Between 12pm-12am there is two to three techs depending on what day it is. In addition to assisting the patients, the techs have other responsibilities such as stocking, verifying machines are still at their appropriate settings, etc.

90% of our nurses work extremely hard and I (and most of the other techs) would bust our butts to help these nurses. Now, the issues tend to come when the ER is extremely to moderately slow. There are some nurses that will only have one patient and page the tech to print their paperwork and take the patient to the floor, no matter if the tech was busy with stocking or another patient, etc. This past week I was the only tech on at 2am with five nurses (normal staffing). We had two patients, one that was being admitted and one that had just came in and was critical. I was in the room with the critical patient assisting two of the nurses - getting the patient on the monitor, getting an EKG, assisting in placing a foley, etc. One of the two nurses that was sitting at the desk (the fifth nurse was in Triage) repeatedly paged me to take the only other patient in the ER up. Two nurses for one patient who was NOT remotely critical - and they kept paging the tech. She backed off when the charge nurse stuck her head out of our critical patients room and told the other nurse that I was not coming. (her call).

The point is there are certain nurses who think it is not in their job description to take patients to their room, clean them up, empty a bed pan / foley, etc. Now unfortunately in this situation it has been mainly the new grads who have this state of mind. If you are sitting there socializing - you have the time to properly take care of your patient.

Now, on the other side. The tech that is falsifying legal documents by charting vitals that were never done should be fired and have their certification jerked, if not more. If the nurses are running around extremely busy and the techs are sitting and there are things the techs are capable of doing (there are the occassions when most of what needs done must be done by an RN i.e. passing meds) - but if it is something that they are capable of doing - they should be up and doing it.

Now, another unfortunate trait that some of our new grads (and unfortunately several of the older nurses) is stating what needs done. Now techs are not nurses personal assistants, but even if they were . . .

1. Asking (not stating) what needs does goes a really long way

(Could you get an EKG in Rm 3? vs I need an EKG in Rm 3.)

2. Three words that can help get you ANYTHING!

Please

Thank You

natsfanrn · Aug 9, 2006

Now techs are not nurses personal assistants, but even if they were . . .
1. Asking (not stating) what needs does goes a really long way
(Could you get an EKG in Rm 3? vs I need an EKG in Rm 3.)
2. Three words that can help get you ANYTHING!
Please
Thank You

Sorry, but if I need an EKG in Rm 3, I'm going to tell my tech that I need an EKG in Rm 3. This is delegating. If the tech is in the middle of a situation that takes priority, fine, she can tell me that and I'll certainly understand if she can't get to it right away. But until the day comes that the doctors start asking me if I can do something, instead of ordering something, I feel like it's certainly within my job description to assertively delegate a task.

Now mind you, I always include a "please" and a "thank you" ... and I get along great with my aides/techs.

cardiacRN2006, ADN, RN · Aug 9, 2006

Okay - here is the perspective from a tech (May 07 BSN Grad). We have a few new grad nurses who seem to think . . . I'm an RN now and don't have to do any of the 'grunt' work. We have been told by our manager that "A RN can do anything a Tech can do". We also have a couple of new grads who openly stated that taking a patient to their room (from the ER to their room on the floor) was "a tech's job". :angryfire (Yes it is in our job description but I don't remember the nurses losing the ability to push a bed upon receiving their diploma)
Now . . a little background. I work in a Level II ER (27 beds) with an average of over 100 patients a day. Between 12pm-12am there is two to three techs depending on what day it is. In addition to assisting the patients, the techs have other responsibilities such as stocking, verifying machines are still at their appropriate settings, etc.
90% of our nurses work extremely hard and I (and most of the other techs) would bust our butts to help these nurses. Now, the issues tend to come when the ER is extremely to moderately slow. There are some nurses that will only have one patient and page the tech to print their paperwork and take the patient to the floor, no matter if the tech was busy with stocking or another patient, etc. This past week I was the only tech on at 2am with five nurses (normal staffing). We had two patients, one that was being admitted and one that had just came in and was critical. I was in the room with the critical patient assisting two of the nurses - getting the patient on the monitor, getting an EKG, assisting in placing a foley, etc. One of the two nurses that was sitting at the desk (the fifth nurse was in Triage) repeatedly paged me to take the only other patient in the ER up. Two nurses for one patient who was NOT remotely critical - and they kept paging the tech. She backed off when the charge nurse stuck her head out of our critical patients room and told the other nurse that I was not coming. (her call).
The point is there are certain nurses who think it is not in their job description to take patients to their room, clean them up, empty a bed pan / foley, etc. Now unfortunately in this situation it has been mainly the new grads who have this state of mind. If you are sitting there socializing - you have the time to properly take care of your patient.
Now, on the other side. The tech that is falsifying legal documents by charting vitals that were never done should be fired and have their certification jerked, if not more. If the nurses are running around extremely busy and the techs are sitting and there are things the techs are capable of doing (there are the occassions when most of what needs done must be done by an RN i.e. passing meds) - but if it is something that they are capable of doing - they should be up and doing it.
Now, another unfortunate trait that some of our new grads (and unfortunately several of the older nurses) is stating what needs done. Now techs are not nurses personal assistants, but even if they were . . .
1. Asking (not stating) what needs does goes a really long way
(Could you get an EKG in Rm 3? vs I need an EKG in Rm 3.)
2. Three words that can help get you ANYTHING!
Please
Thank You

I honestly can't wait until you are a nurse. I was a tech for 10 years in a very busy ICU where we were allowed to do lots of skills (phlebotomy, foleys, ACTs, dressing changes). I thought a lot of the things that you do. Why can't the nurse help me with this, now that she's a nurse she doesn't want to do grunt work... I can tell you now from experience that being a tech was a walk in the park compared to nursing. I honestly laugh at myself for ever thinking it was even remotely comparable to nursing.

When you see a nurse, and it looks like she is doing nothing, please keep in mind that you don't know or understand what she is doing. You won't until you actually get out there as a nurse and feel that awesome responsibility. You don't get that in nursing school, and you don't get that as a tech. I do agree with you that a little courtesy goes a long way. Techs don't like to get orders barked at them.

BTW, congrats of being a tech, because that experience in invaluable to your future in nursing. As a result, I have no problems working in an all RN ICU, with no tech support. When the day comes that I work with techs, any help that they provide for the patient will be great!

Humbled_Nurse · Aug 9, 2006

If those tech's are truly writing down "made up" vital signs then they should be fired ASAP. If they won't even take the time to take vital signs then that tells me that their work ethic sucks and they shouldn't be given the privelage to work with patients. I don't have much tolerance for laziness and poor work ethic. I don't care if you scrub toilets or you are the CEO of a hospital you should give it your all.

Of course I do agree that mutual respect goes a long way. Like I said whether you scrub toilets or you are the CEO everyone deserves respect.

I would keep a close eye on these tech's and document what you see and don't see them do.

I'm like you in that I lack assertiveness skills. I want everyone to like me, but as you get more experience and confidence in your nursing abilities your assertiveness skills should improve. I have been fortunate that I haven't had to be very assertive with my co-workers throughout my nursing career because generally everyone does their job.

Good luck!

widi96 · Aug 10, 2006

Okay - Natsfan - if you can not ask - it just means you are a rude person. Nurse or not. If you want someone to do something - asking them and using the words please and thank you are just plain descency and good manners. Asking, using Please and Thank you still fall under the category of delegating.

Also, Ms. CardiacRN - You don't seem to understand the point I'm trying to make. We have a majority of nurses that work their butts off and I know they are hard working and would do anything to try to help them. Those that are frustrating are two of our new grads and one who was a fairly new hire. Now with all of your vast cardiac knowledge - you want to tell me that me doing the EKG, assisting with starting a IV, starting the foley, getting them on the monitor is less important than taking a patient up while the nurse who is responsible for the patient and the other nurse who had no patients sit at the desk - eating chips and dip and talking about their dating lives. Yes, I know the majority of the nurses are always busy and doing things I am not even yet aware of, but unless having an active sex life to openly discuss is a critical piece of nursing that I was unaware of, that was not what these two were doing. Oh, and they were both written up later in the evening by the charge nurse for this type of behavior when she had asked for help. Now, since you think "I don't know or understand what she is doing." Please explain to me how the sex and dating discussion is a credit to the nursing profession.