Horrible CNA's

8mpg · Oct 27, 2011

I hope this doesnt come out wrong but I think you have a 'horrible' attitude towards your CNAs. You need to realize that it is ultimately YOUR responsibility to record the I/O of your patient and not the CNA. Why did you not dump the hat and record the urine in 8 hours? The CNAs are low paid for what they do and are not respected by many nurses which is a shame.

Just remember that ultimately this is YOUR job and that they HELP you....they are not there to do YOUR job. If you can see them as HELP, you will appreciate them more.

tojal1989 · Oct 29, 2011

Exactly, I am responsible for what they do. The CNAs on the floor are awesome and help alot, but the float CNA's don't do their job correctly. My manager said the first one I talked about had been reported a few times already so I know I have a point. It's frustrating that she put "BR" on output and didn't tell me anything. When adding up the totals I was looking for her to question it but she left without reporting to me.

noyesno, MSN, APRN, NP · Oct 29, 2011

To prevent this I/O problem in the future, check with the CNA at the beginning of the shift to make sure they know you need I/O's on the patient. If they don't comply after making this clear then you need to pull them aside and reemphasize the importance of I/O's. If they don't get it after the second chat, you need to up the chain of command or go the write up route.

Also, recording the I/O should be a joint effort between the CNA and nurse. Whoever finds the patient's pee/helps the patient to the bathroom should record the output.

The CNA's attitude towards you when you asked for her help is totally unacceptable. By not helping she is putting you in danger (you're going to hurt your back) and the patient (he/she might fall!). Find someone else to help because it sounds like you wouldn't get anywhere with her without making a big scene in front of the patient (not very professional). Pull her aside later and discuss. You might need to write her up.

Rathyen · Oct 29, 2011

My guess here is that you have never worked as a CNA. Prior to becoming an RN, I had done all kinds of work, including years of being a CNA. When I was a CNA, the best nurses I ever worked for were those that had at some point been in my position. If you do not respect your CNA's and if you treat them like they are beneath you, you will lose the legs you stand on. You need to be upfront about what you expect from them, but if you are condesending you will lose any respect they may have had for you. Oh, and you are perfectly capable of emptying a hat or urinal yourself. You should never ask your CNA to do anything you wouldn't be willing to do yourself.

NursesAreAngels2 · Oct 29, 2011

I can definetely see your frustration with the CNA with the attitude about helping transfer someone. I had an issue once with a CNA who got mad at me cause I asked her to change someone that was covered in feces because it was going to cut into her lunch break. Now mind you if I hadn't just removed someones bandages and was in the process of changing them I would have done it myself unfortunately I had someone with leaking wounds from the severe edema they had that I had to tend to first. I will say this though I have no problem ever helping my CNA's and I expect the same from them in return.

Freedom42 · Oct 29, 2011

My guess here is that you have never worked as a CNA. Prior to becoming an RN, I had done all kinds of work, including years of being a CNA. When I was a CNA, the best nurses I ever worked for were those that had at some point been in my position. If you do not respect your CNA's and if you treat them like they are beneath you, you will lose the legs you stand on. You need to be upfront about what you expect from them, but if you are condesending you will lose any respect they may have had for you. Oh, and you are perfectly capable of emptying a hat or urinal yourself. You should never ask your CNA to do anything you wouldn't be willing to do yourself.

I read nothing in the OP's post that suggests s/he thinks CNAs are beneath her or that she is unwilling to do what she asks of aides herself. What I read was that she expects professional conduct. I don't think a nurse has to have worked as a CNA -- or in any other capacity -- to expect that people will meet their job responsibilities.

tojal1989 · Oct 30, 2011

I know how it feels to be a CNA. I worked as an NSA which the title included everything a CNA must do plus a few nursing procedures under an RN's supervision (deep suction, foley insertion, etc)

As an NSA I made sure I did everything I was supposed to do and help out as much as possible. I saw how busy RNs were.

Now as an RN I expect other CNA's to do the same as a did, maybe that's the problem!!

DixieRedHead, ASN, RN · Oct 30, 2011

Your best bet is to handle this at the beginning of shift. Tell the nursing assistant that you need and expect a correct measurement of intake and out put.

And yes, if you see urine in a hat, be sure to empty it and record it.

If a patient needs care and you get any crap about "break time", just say, "the patient comes first" and then help the nursing assistant get the job done quickly. If you are otherwise occupied, just say "the patient comes first and I am tied up right now."

And as for "treating a CNA with respect", you do not owe respect to any coworker who is not respectable. Professionalism does not have a title, it's a responsibility of all involved in providing care.

I cannot see where a CNA is "helping" you do "your job" if they are not doing as instructed.

None of us decides what our assigned duties are. We all have job descriptions. Part of yours is to require certain things of nursing assistants and to take measures to that you get it.

Don't give the nursing assistants any crap, and don't take any.