Help with hopeless horrible nurse's aides

[xmaxiex]

What to do when stuck with a few bad nurses aide's ?

I have reported and written up . I am getting no back up from my DON ? What's a nurse to do . Any advice would be helpful . I find myself running like a madwoman , toileting people , answering call bells because my aides have disappeared , or are hiding in pt's rooms on their cell phones ? Ughhhh so frustrated .

[UM Review RN, ASN, RN]

There's been times that I've stopped what I'm doing to help the nurse give treatments when I could've said "sorry, thats not my job".

I am all for teamwork. That's how our busy unit functions. I help our techs, they help us, and the patients benefit.

However, please look over your employee job description. I'm sure that if a nurse needs you to help position a patient for a treatment or assist with the patient while the nurse does the treatment, it IS part of your job, and refusing will only get you in trouble for insubordination.

[tmiller027]

I am all for teamwork. That's how our busy unit functions. I help our techs, they help us, and the patients benefit.

However, please look over your employee job description. I'm sure that if a nurse needs you to help position a patient for a treatment or assist with the patient while the nurse does the treatment, it IS part of your job, and refusing will only get you in trouble for insubordination.

Well, since I've yet to be insubortinate to a nurse, I guess thats not really an issue. And when a nurse hands me a tube of cream off the med-cart and tells me to put it on someone's bottom, I'm pretty sure that is not my job, since its considered medication. Same with turning oxygen off and on. CNAs are technically not supposed to do it, but I do it a lot because nurses ask me to when they're busy. Same with "burping" an ostomy bag.

Some aides, no matter who the nurse is will declare that they are not doing it, and the nurse doesn't have much choice, because its not really something our facility wants the nurse to be delegating. If I know the nurse is busy and she wants me to do it, and I know how to do it, I don't have a problem with it, job description or not. Thats the teamwork I'm talking about.

Also, at our facility, it IS in the nurses job description to assist with a transfer or spotting with a lift for an aide if the aide needs help. One nurse actually got in trouble for telling an aide that "I don't do aidework". When we're shorthanded, the DON will come down and help get people dressed in the morning. I"m pretty sure THAT is not in her job description, but she does it anyway, that again is teamwork.

[tmiller027]

I am all for teamwork. That's how our busy unit functions. I help our techs, they help us, and the patients benefit.

However, please look over your employee job description. I'm sure that if a nurse needs you to help position a patient for a treatment or assist with the patient while the nurse does the treatment, it IS part of your job, and refusing will only get you in trouble for insubordination.

Well, since I've yet to be insubortinate to a nurse, I guess thats not really an issue. And when a nurse hands me a tube of cream off the med-cart and tells me to put it on someone's bottom, I'm pretty sure that is not my job, since its considered medication. Same with turning oxygen off and on. CNAs are technically not supposed to do it, but I do it a lot because nurses ask me to when they're busy. Same with "burping" an ostomy bag.

Some aides, no matter who the nurse is will declare that they are not doing it, and the nurse doesn't have much choice, because its not really something our facility wants the nurse to be delegating. If I know the nurse is busy and she wants me to do it, and I know how to do it, I don't have a problem with it, job description or not. Thats the teamwork I'm talking about.

Also, at our facility, it IS in the nurses job description to assist with a transfer or spotting with a lift for an aide if the aide needs help. One nurse actually got in trouble for telling an aide that "I don't do aidework". When we're shorthanded, the DON will come down and help get people dressed in the morning. I"m pretty sure THAT is not in her job description, but she does it anyway, that again is teamwork.

[UM Review RN, ASN, RN]

when a nurse hands me a tube of cream off the med-cart and tells me to put it on someone's bottom, I'm pretty sure that is not my job, since its considered medication. Same with turning oxygen off and on. CNAs are technically not supposed to do it, but I do it a lot because nurses ask me to when they're busy. Same with "burping" an ostomy bag.

Yes, in those cases, you certainly have the right to refuse because the nurse should not be asking you to do those things. I just didn't want CNAs to get the idea that they had no responsibility to help the nurse.

The point is--the nurse can do the aide's job. But the aide cannot do the nurse's job. I could help you with a transfer, but you could not help me push Lasix on a patient who's suddenly gone into CHF, or call the doc for the med.

In general my patients aren't in jeopardy if I don't answer a call bell in 3 minutes. But if I don't assess my patients and get them treated fast, the patient in respiratory distress might have a bad outcome. Or if I'm late getting that BP med to a patient, she could suddenly go into a dangerous arrhythmia.

There are priorities in nursing, and this is one of the reasons that CNAs are delegated the less-than-critical tasks. Many nurses really prefer not to use CNAs at all, because of this resentment over the fact that many of the nurse's tasks are "invisible"--that is, it doesn't look like we're "doing anything" when we're assessing someone's voice quality or watching them swallow or guaging how labored their breathing is.

Yet it's very important to the patient.

Many CNAs really have a hard time with this, and don't really "get it" until they've become nurses themselves.

I still have a bad back from being a CNA, but that doesn't stop me from properly positioning patients or cleaning them up if they need it while I assess them.

No facility should be so desperate that a "warm body" is sufficient to care for patients.

[UM Review RN, ASN, RN]

when a nurse hands me a tube of cream off the med-cart and tells me to put it on someone's bottom, I'm pretty sure that is not my job, since its considered medication. Same with turning oxygen off and on. CNAs are technically not supposed to do it, but I do it a lot because nurses ask me to when they're busy. Same with "burping" an ostomy bag.

Yes, in those cases, you certainly have the right to refuse because the nurse should not be asking you to do those things. I just didn't want CNAs to get the idea that they had no responsibility to help the nurse.

The point is--the nurse can do the aide's job. But the aide cannot do the nurse's job. I could help you with a transfer, but you could not help me push Lasix on a patient who's suddenly gone into CHF, or call the doc for the med.

In general my patients aren't in jeopardy if I don't answer a call bell in 3 minutes. But if I don't assess my patients and get them treated fast, the patient in respiratory distress might have a bad outcome. Or if I'm late getting that BP med to a patient, she could suddenly go into a dangerous arrhythmia.

There are priorities in nursing, and this is one of the reasons that CNAs are delegated the less-than-critical tasks. Many nurses really prefer not to use CNAs at all, because of this resentment over the fact that many of the nurse's tasks are "invisible"--that is, it doesn't look like we're "doing anything" when we're assessing someone's voice quality or watching them swallow or guaging how labored their breathing is.

Yet it's very important to the patient.

Many CNAs really have a hard time with this, and don't really "get it" until they've become nurses themselves.

I still have a bad back from being a CNA, but that doesn't stop me from properly positioning patients or cleaning them up if they need it while I assess them.

No facility should be so desperate that a "warm body" is sufficient to care for patients.

[shay]

Tmiller, you're exactly right. :) I frequently find that those who are of the "that's not my job" mentality are usually the first to scream when there's "not enough help" yet the last to offer a helping hand to anyone else.

Truly sad. Scope of practice issues aside, helping eachother, even with those "mundane" and "dirty" jobs, is what makes the difference between a nice place to work and a not-so-nice place to work, IMO.

[shay]

Tmiller, you're exactly right. :) I frequently find that those who are of the "that's not my job" mentality are usually the first to scream when there's "not enough help" yet the last to offer a helping hand to anyone else.

Truly sad. Scope of practice issues aside, helping eachother, even with those "mundane" and "dirty" jobs, is what makes the difference between a nice place to work and a not-so-nice place to work, IMO.

[tmiller027]

Yes, in those cases, you certainly have the right to refuse because the nurse should not be asking you to do those things. I just didn't want CNAs to get the idea that they had no responsibility to help the nurse.

The point is--the nurse can do the aide's job. But the aide cannot do the nurse's job. I could help you with a transfer, but you could not help me push Lasix on a patient who's suddenly gone into CHF, or call the doc for the med.

In general my patients aren't in jeopardy if I don't answer a call bell in 3 minutes. But if I don't assess my patients and get them treated fast, the patient in respiratory distress might have a bad outcome. Or if I'm late getting that BP med to a patient, she could suddenly go into a dangerous arrhythmia.

There are priorities in nursing, and this is one of the reasons that CNAs are delegated the less-than-critical tasks. Many nurses really prefer not to use CNAs at all, because of this resentment over the fact that many of the nurse's tasks are "invisible"--that is, it doesn't look like we're "doing anything" when we're assessing someone's voice quality or watching them swallow or guaging how labored their breathing is.

Yet it's very important to the patient.

Many CNAs really have a hard time with this, and don't really "get it" until they've become nurses themselves.

I still have a bad back from being a CNA, but that doesn't stop me from properly positioning patients or cleaning them up if they need it while I assess them.

No facility should be so desperate that a "warm body" is sufficient to care for patients.

In that case, I agree with you. I understand that nurses can only do certain things, and I would never expect a nurse to DO my job. There's been times when nurses try to help too much and actually get in the way LOL...Where the problem comes in is when one of us aides is running from call light to call light, trying to get people toileted and in bed as fast as we can, and the nurse wants to bark into one of the rooms "You need to start answering these lights!"

Well, what does she think we've been doing? Thats the one thing that drives me nuts...

On the other hand, I've had other CNAs refuse to help. Like when I'm on the heavy unit with a new aide, and we're way behind, I'll ask another CNA from a lighter unit to help (someone who I may have helped several times myself) only to get "Nope, my work is done, I"m outta here." So it goes for all of us to try and work together.

[tmiller027]

Yes, in those cases, you certainly have the right to refuse because the nurse should not be asking you to do those things. I just didn't want CNAs to get the idea that they had no responsibility to help the nurse.

The point is--the nurse can do the aide's job. But the aide cannot do the nurse's job. I could help you with a transfer, but you could not help me push Lasix on a patient who's suddenly gone into CHF, or call the doc for the med.

In general my patients aren't in jeopardy if I don't answer a call bell in 3 minutes. But if I don't assess my patients and get them treated fast, the patient in respiratory distress might have a bad outcome. Or if I'm late getting that BP med to a patient, she could suddenly go into a dangerous arrhythmia.

There are priorities in nursing, and this is one of the reasons that CNAs are delegated the less-than-critical tasks. Many nurses really prefer not to use CNAs at all, because of this resentment over the fact that many of the nurse's tasks are "invisible"--that is, it doesn't look like we're "doing anything" when we're assessing someone's voice quality or watching them swallow or guaging how labored their breathing is.

Yet it's very important to the patient.

Many CNAs really have a hard time with this, and don't really "get it" until they've become nurses themselves.

I still have a bad back from being a CNA, but that doesn't stop me from properly positioning patients or cleaning them up if they need it while I assess them.

No facility should be so desperate that a "warm body" is sufficient to care for patients.

In that case, I agree with you. I understand that nurses can only do certain things, and I would never expect a nurse to DO my job. There's been times when nurses try to help too much and actually get in the way LOL...Where the problem comes in is when one of us aides is running from call light to call light, trying to get people toileted and in bed as fast as we can, and the nurse wants to bark into one of the rooms "You need to start answering these lights!"

Well, what does she think we've been doing? Thats the one thing that drives me nuts...

On the other hand, I've had other CNAs refuse to help. Like when I'm on the heavy unit with a new aide, and we're way behind, I'll ask another CNA from a lighter unit to help (someone who I may have helped several times myself) only to get "Nope, my work is done, I"m outta here." So it goes for all of us to try and work together.

[tmiller027]

Tmiller, you're exactly right. :) I frequently find that those who are of the "that's not my job" mentality are usually the first to scream when there's "not enough help" yet the last to offer a helping hand to anyone else.

Truly sad. Scope of practice issues aside, helping eachother, even with those "mundane" and "dirty" jobs, is what makes the difference between a nice place to work and a not-so-nice place to work, IMO.

And even we have the "not my job" people, and quite a few of them, though they often don't last long, because they tend to get ostracized by the rest of us lol

[tmiller027]

Tmiller, you're exactly right. :) I frequently find that those who are of the "that's not my job" mentality are usually the first to scream when there's "not enough help" yet the last to offer a helping hand to anyone else.

Truly sad. Scope of practice issues aside, helping eachother, even with those "mundane" and "dirty" jobs, is what makes the difference between a nice place to work and a not-so-nice place to work, IMO.

And even we have the "not my job" people, and quite a few of them, though they often don't last long, because they tend to get ostracized by the rest of us lol

[lovingtheunloved, ASN, RN]

After this whole thread, I gotta say, my coworkers totally rock! The concept of not working as a team blows my mind. I think of the unit I work on (behavioral dementa unit) and can only imagine the chaos we'd have if everyone only did "their job" As a CNA, the way I see it is this: I'm assigned certain residents. But they are all "mine." If a call light goes off and it's not my room, I march my happy a$$ down the hall and answer it. The other aides I work with are the same way. We work together in the best interest of the resident. And as a preceptor, my first statement to a new orientee is "We work together on this unit. If that is a problem, please request another one."