How do you do this, day in/day out?

[proudauntie415]

I am a new nurse working 3-11 on a unit where I generally have 30-60 residents depending on the night. Multiple tube feeders, diabetics, coumadins..you know the whole shabang. I have got my routine down and get through it on the nights I have 60 residents..and have perfected the nights I have 30. Stressful, overwhelming but it gets done...unless someone gets a skin tear or a fall...then goes out the window.

The biggest problem I have is aides. Some really great ones, but the few are making my nights horrible. I want shower sheets before 10:30 pm with abnormals, so I'm not stuck doing assessments and IR past when I should be leaving. Vitals by 8pm, and for god sake...TURN THOSE BEDFAST residents every 2 hours. The eye rolling, huffing, smart little comments......breaking me down.

I can take the crazy busy nights, things going to hell in a hand basket...I got the focus for that....but I can't keep up with aides that just don't want to do their job, or want to half a** it( excuse my language but no other way to put it). What makes it hard is that the other nurse has been on the floor for 3 years and basically has let the aides run the floor and acts like they are all "bff's". So I'm the new girl coming in expecting them to do their job, and I'm the big bad nurse.

Tonight, I spent more time answering call lights, turning residents, toileting, changing linens because of vomiting from the stomach bug....and I didn't get to pee at ALL, no break...but had to hear an aide tell me "im resting my feet" when I asked her to grab a snack for someone. And of course, I stayed 2 hours after shift to finish charting. Do you think a single aide was there that late? nope.

I'm emotionally wearing down.....then our DON's tell us to write them up...that these things need to change..aides should not be running the floors like they do. But so difficult writing up an aide, cause for the rest of night...they make it miserable because they all got each others back...so is it worth it dealing with 5 attitudes now? half a year in and I'm burnt out. And I worry about keep going to the DON's about it because I fear they would look down on me because I can't deal with the aides. They are great DON's though, have complimented on me on doing a such a great job and they are happy to have me at their facility.

How do I survive this? This the LPN field, LTC and since I don't have experience yet this is really my only option.

[ComeTogether, LPN]

I just want to chime in that if they're good at what they do let them know. Some people think we're a dime a dozen, but I think a good CNA can be hard to find and lord knows all I hear from my bosses is negativity while my nurses seem to genuinely love working with me. Makes me feel unappreciated. . Wah.

"No day but today"

[Lian]

Oh my. I am really hearing you on this issue. I am really over the attitudes of nursing aides. Top that off with the fact that they always run to management and complain that the supervisors are actually doing their job by checking on their work (and get believed) and work is becoming a nightmare. I know their work is hard. I started as an aide. But seriously, some aides and their attitudes towards supervising nurses are getting out of control. We are getting accused of bullying for just asking them to do things or asking if they have done a task yet. Don't need this! Just want to do my job and have others respect our residents enough to do the right thing by doing they are paid to do. End of shift rant over!

[CloudySue]

My favorite is when CNAs duck into a bathroom to complain about something on FACEBOOK! On an open account! With a timestamp!

[NurseGuyBri]

I was a DON that always reminds the LPN's and RN's to write up the staff when needed. I have changed that habit. It creates a negative atmosphere and is severely punitive. We are in the long process of change. People expect me as their new DON to change overnight, but it does take time.

Anyway, you have to sit down with your CNA's and tell them that they are valuable. Don't be all lip service, either- act like it, because it's TRUE. Your CNA's are your assistants, you must have a good relationship with them. Foster it. Explain to them that you are a team and you will continue to work on your shortcomings as well. Many CNA's feel worthless because they are at the bottom of the food chain. Well, they're not worthless, they are invaluable to us!!!

Once you work on your relationship, there will still be some that just don't follow the necessary rules/ policies. LET THEM KNOW YOU WILL FOLLOW UP. You're not out to "get" them or pick on them. Tell them you are checking on them. It's a culture change that is acceptable and progressive, and it will get better, I see it EVERY day. If they continue to have problems, at least attempt to help them improve or find out what the issue is. If they just won't or can't, THEN you start with verbal counseling first. Document that you talked to them and what about- use an In-service sheet, not a write up. That documents your discussion, because that's what it is now, not a write up, a discussion. Then, if they continue to have issues, you can proceed.

Do you know how I began to see this? From CNA's. I was one. I forgot where I came from. It will only get better when you get better as a professional. I'm still in the process of learning this and becoming better, I hope your DON can too.

[gabulldogs]

Not new at the supervising but new LPN (50). CNA/House sitter too and did 15 peeps for 7.55hr). I expect the same ethics from those at work too. I work nights 7p-7a. I go into 3-11 cna then 11-7 cna. So I'm dealing with usually 4 different ones in my 12 hour shift. Love my job and trying to continue on for degrees.

First I give respect where it's earned. So far been blessed 11-7. Good hearts, cause thats what it takes making as little as they do. Having problems with 3-11 CNAs. Using phone for personal use all the time and leaving the Alz. Unit by sitting in the TV Rm for usually 2 hours. Don't feel I would get too much help with ADM DON etc... Tried. New management right now, so the place is running poorly. We do run out of basics all the time (gloves,wipes,etc) The place is old and dirty. No healthy snacks to give in the pm (P&B, Bologni is what they usually leave and never enough). Just very frustrated, but the pay is good for LPN and the jobs are limited out here. HELP!!!!!!!!!