How to enhance cohesive working and communication

[NYCRN6]

I am working on a task force team on my floor to enhance the communication between RN's and nurses aide's. I love my aide's and ai appreciate what they do but a lot of them do not do their job and they are lazy. I feel like we have to walk on eggshells around them when ultimately we as RN's hold all responsibility for patients. Even to ask to get a set of vitals is like asking them to run the boston marathon. So i made an entire list of tasks that they shoudl be doing every shift and i brougt it to my nursing managers attention. She loves it and wants me to be a part of a taskforce with another nurse who is more experienced on the floor. DO you guys have any ideas of how to help show the aide's OUR point of view?? (one idea was to have one PCA shadow an RN footstep by footstep an entire shift and explain what we are doing and what we have to think which takes a lot of energy but I think if the rigt person did it then it would be successful). ANy ideas or suggestions that i can bring to my floor? Thanks!!!!

New grad :)

[zuzi]

WRONG again, not to take one of CNA and see her how you work! THEY DON"T CARE about your work you can stay all day long as soon as for them is easy also! LOOOOOOL! NOP, the problem is not there. You need to go beetween them and see how them work and to be like them and fell like them and cry like them and worry like them and put your nice cozy hands in their hands, hands like men hands from so hard physical work and be able to look in their eyes when they cry and hug them and help them........ you could do it? As soon as you can't fell that you will never understand them!

And them will not fallow you!

Is not about power scale and hierachy is about compassion and soul related and is about TEAM!

Love you honey love your CNAs each moment and think at them to make their life as much happy and easy as your life is!

[NYCRN6]

Im not going to lie i have absolutly no idea what you just said; half of it wasn't even correct english. I do see it on their perspective, but the main problem is - is that a lot of them have resentment to those who have "disrespected them". Our goal here is to have RN's and PCA's work together as a team, enhance the communication, and also to understand BOTH roles.

[zuzi]

Im not going to lie i have absolutly no idea what you just said; half of it wasn't even correct english..

Yup honey you have right we don't have same communication paths....Hopefully one day you will understand, and you will be able to see the difference! Hugs you till then! Muaaaaaah! :heartbeat:heartbeat:heartbeat

[ilstu99]

What types of things aren't getting done? Do you really feel like it's a "laziness" issue, or possibly a lack of appreciation and/or knowledge?

I would guess that the odds are high that some of them feel the same way about the RN's....mostly because I'm close to a couple of our techs, and I hear that a LOT from them. The big three are: that the RN's treat them like servants, that the RN's don't complete some tasks because they act like they're "too good" to do them, and that the RN's spend time sitting around visiting while shooting the techs dirty looks for doing the same thing. Mostly, a "second class citizen" type of treatment.

One thing I discovered very early on was that even our "experienced" techs didn't understand a LOT of what we were asking them to do. Often, I hear things like, "Hey, I have to run to a delivery....would you please feed Baby A? He's been nippling 4 of 8, but still brady's some and needs some chin support. He gets the 14 he has left of enhanced in the volu-feed with a slow-flow, and then 28 of the Lipil 22. After 30 minutes, just gavage the rest over another 30. K? Thanks!!" Uhhh....what? So the tech asks another nurse for help and gets a put-down or an "I'll just do it." Guess what happens when the RN returns? Mhmmm...."Why didn't you do what I asked you to do!?!"

It's unreasonable to expect them to understand the RN terminology, or the "why" behind a lot of the things on their task list. It makes it hard to understand the importance, and most people aren't very good at accepting the, "because I said so" kind of direction.

Oh! We just talked about this one yesterday: That they feel like the RN's don't understand how it works for them. Say the unit is 30 beds. The RN's each have their patient assignment - say 4-5 patients. You have (for example) 2 techs, who have 30 patients and between 6-8 people giving them directions...plus their basic task lists. Their time management can be as difficult to get a handle on, and sometimes things may just have to go without getting done.

If it were me.....

I would seek out the most communicative/helpful 2 or 3 of the techs in your unit, and ask them to make a list of their responsibilities. Also, ask for a list of things they don't feel comfortable doing, and things they have been asked to do that they've never been trained on. Have a friendly chat about what they think of the things they're supposed to do, and ask them what they think of making a committee so there's more open communication in order to provide the best patient care possible (not to fix their laziness :)). Ask them who they think would make a good representative. IOW....involve them in the process and show them that their opinions are important.

AND....figure out how to show them that good work ethic is important and appreciated. Everyone enjoys a pat on the back. How can you say thank you when the job is done well?

[NYCRN6]

I agree with everything you said ilstu99.... i am takin these comments and bringing them to my nurse manager and the task force team to help! I love this website because it really gives me input on a lot of issues since i am new to nursing! thank you again

[AnnemRN]

I have an unusual problem with a cna I work with, she thinks she's a nurse already and questions everything I do. I've even had her tell me her recommendations for patient wound care if she thinks my recommendations are not appropriate. She has taken the prerequisites for the nursing program but, has not been accepted yet.

I have been an RN for many years and quite frankly am insulted by her behavior. I would like to have a good working relationship with her but, I feel she undermines my capabilities as often as she can. Does anyone have any ideas?

[BearyPrivate]

What about writing these lazy aides up:confused:. You know, the ones you say are lazy, you have to walk on eggshells around them, or the ones you say that feel like their asked to run a marathon if they are asked to do v/s's:banghead:. I think RNPerdiem has the right idea:bowingpur. In the facility I work at, they would be written up, if that didn't work we don't really have time to show the aides what it is our job consists of, that's why we have CNA's:uhoh3:. If they are lazy, no committee you can force them to be on is going to do the trick. If you invent a committee for RN's and Supervisors to be on to make an effort to help lazy aides try to be un-lazy, I'm afraid you are setting yourself up for heartache :nono:b/c if they are lazy I'm guessing the aides would take offense:madface:. Fire them and post their position. There are people who want to work I assure you.

[pebbles, BSN, RN]

Writing them up only works when/if the managers care and act on it..... *sigh*

[husker_rn, RN]

Maybe talk with them not in a confrontational manner but more like, we seem to be having problems getting blah, blah, blah done. I know you are very busy { bite your tongue } so do you have any suggestions on how to make this work. Often I've found that co-workers see problems and DO have solutions if asked. But....are reluctant to speak if they feel no one hears. Maybe no one heard them somewhere in the past. Just a thought.