How to help my CNAs

KareBear0609 · Jun 12, 2011

Probably the first nurse I've come across who is willing to lend a helping hand to the CNA's. THANK YOU!

Laying people down, etc. - I would leave to the CNA's. Unless you seriously have a good 15-20 minutes to potty them, take off their bottom half (we lay our residents down with nothing on the bottom half to "air out"), and get them in bed.

Some of the things that bother me with the nurses are work with are: they will be giving a resident medicine and realize there is no water in there water cup in their room... so - they will come and find me (even if I am 10 rooms away) and ask me to give them some water. That drives me crazy. So, that is something you could do (if you don't already). Also, we are to have all of our garbages emptied by the end of our shift (a pair of gloves in the garbage = write up). The nurses leave all their tubing from the tube feeds in the garbage can after I have put that person to bed, cleaned the room, and emptied the garbage. This also drives me crazy. So, you could make sure you get your garbage out if the CNA has already been in the room and cleaned it out. Another thing that bothers me is if the nurses are charting at the desk and they see a resident trying to get up. I will be in the middle of walking with someone with a gait belt and they will scream at me that someone is trying to get up. This also drives me crazy.

So, basically - it is the little things. If someone wants their hair brushed - just do it, it will take longer to find someone to do it. If someone wants the necklace in their purse put around their neck - just do it. Hopefully this helps.

Mrs. SnowStormRN, RN · Jun 12, 2011

Wow! Filling oxygen was something we (the nurses) did at the facility I use to work (LTC) years ago. It is very simple. Are you talking about replacing O2 tanks (which is slightly more difficult) we had the old tanks that you had to roll and use a tool to open up the O2. As for the O2 attached to the wall you usually can just add sterile water to the fill line, anyone can do this and it only takes a minute or so. You will have to get to know your patients. I know how busy it is in LTC, but if someone has to use the restroom offer a bedpan, if youre not sure if the person can get up or not (which, as the nurse, is something you will need to know about the patient) plus it may be unsafe to assist this person alone especially if youre not familiar with their strengths and weaknesses. Just imagine holding your urine/stool until someone answers the callbell, maybe everyone is occupied. If you put your patient on the bedpan and youre running behind, you can tell your aid "Ms. so and so is on the bedpan, could you take her off when she's done? " (and make sure you give the patient the callbell. Communication and teamwork makes for a great work enviroment, but you cannot do everything. Just keep asking for help like youre doing, much luck to you!!!

SneakySnake · Jun 12, 2011

Thank you for the replies! I am doing the little things....can you move my remote closer.....can you pick that up off the floor for me.....can you get me some water. I do, do all of those things unless there is some emergent situation and I just can not.

Maybe I just need to ask the CNAs who requires minimal assist for toileting (I could get them on the potty, make sure they have the call light and tell the aid they are there?) and make a point to help those if I am able?

I just hate telling the resident to wait while I try to find an aid to do something I should be able to do (time permitting) while the resident waits.

The residents have portable oxygen tanks that are filled from a large tank. It looks like there is some kind of port and you push the portable tank onto the big tank?

NotFlo · Jun 12, 2011

Thank you for the replies! I am doing the little things....can you move my remote closer.....can you pick that up off the floor for me.....can you get me some water. I do, do all of those things unless there is some emergent situation and I just can not.
Maybe I just need to ask the CNAs who requires minimal assist for toileting (I could get them on the potty, make sure they have the call light and tell the aid they are there?) and make a point to help those if I am able?
I just hate telling the resident to wait while I try to find an aid to do something I should be able to do (time permitting) while the resident waits.
The residents have portable oxygen tanks that are filled from a large tank. It looks like there is some kind of port and you push the portable tank onto the big tank?

There should be a CNA assignment sheet or list that has every patient and their basic info, like how they transfer, how much assist for ADLs, if they are alarmed/fall risks, if they are in thickened liquids, etc. I know in my state the CNAs are required to have this list on them at all times while working. When I'm on a new floor I always take one of these lists for myself and then I know who is a hoyer, who transfers with assist of two, who is continent, etc. Comes in very handy.

One place I worked at had this information in a CNA cardex at the nurses desk. Another had this in a holder right at the foot of the patient's bed. Whatever the case, fine out if your facility had something like this and get yourself a copy/know where to find it.

As far as the O2 goes, we have two types. One type is the "liquid" portables you are describing. Our fill tanks are located downstairs and outside in a special shed. Honestly, there is no way I can run down there during my med pass to fill tanks. It is incredibly easy...you're right, you just line up the holes on the bottom of the portable with the bumps on the big tank, lift a lever and push it down and it fills within a few minutes.

However, at my facility maintainence brings filled tanks up twice daily, once in the AM around 8 and once in the afternoon before they go home around 4. This usually prevents people from running out and special trips having to be made. If maintainence wont do this at your facility perhaps one CNA needs to be assigned with filling all the tanks in the morning. It is crazy doing them one at a time as you go room to room.

Ruthiegal · Jun 12, 2011

Ask them to show you, they will love to teach you, let them know that they are valued as your eyes and ears to the residents as they are with them most of the time and that you want to know more about what they do and how they do it so you can pitch in when you have time. I have had wonderful CNA's who loved to show "the nurse" what they did and how and many who were so helpful when I was new to a unit. Showing me where things were and telling me about the residents... They are some of the hardest working people I know... being a CNA is one of the toughest jobs I know of.... Now go Ask!

Good Luck!

Anna Flaxis, BSN, RN · Jun 12, 2011

When I was a CNA in LTC, our facility had each resident's care plan posted on the inside of their closet door. In this way, any staff member could easily refer to the care plan. If you know where to find the residents' care plans, you can simply check and see if they are a stand-by assist, one-person, two person, etc. and if they are a SBA or assist x1, you can go ahead and potty them yourself, for example. The only consideration would be if you have the time. I know that for myself, the fifteen plus minutes it takes to potty the average LOL, get her tucked back in, all her pillows adjusted to her satisfaction, etc., is fifteen plus minutes I don't have.

LPN_mn · Jun 12, 2011

All of our residents have cork boards in their rooms above the bed. Recently we put little cards up on their boards. We drew stick people or put a P for Pal, H for Hoyer. Now when I go into a room I know if I can help that person or if I need to go get help. My CNA's know that I will help whenever I am available and they have no problem asking me to help with a lift. If I have the time and not on my way to do something important I will stop and help. When you have a few extra minutes and you see an aid going into a room ask them if you can go with them and help. They will appreciate the extra hands and after a while they will see that you really want to be a helping hand and they will appriciate the help that you can give.

bigboi · Jun 12, 2011

At my hospital, we have a rounding system. The aid and the nurses both take turns on alternating hours to check on the patient e.g potty, pain, pocessions, water and repositioning. Offcourse some of the nurses were not too crazy about the idea initially but they've accepted it. This is a way for the aids and the nurses to work together and fulfill the pts needs. This system really makes both the nurses and the aids job easier. I read above that nurses don't help with the most mundane things like getting H2O for pills? Damn! I fill so sorry for you guys who work in a such a degrading nursing culture. The nurses at my hospital are relatively self sufficient. Hell, some of the best nursing at my hospital will help you a bath! The next time I hear one of my fellow cnas complain about a nurse no helping with a bath, I'd be sure to educate them on how bad it could get.

Forever Sunshine, ASN, RN · Jun 12, 2011

l I have been on the job a few weeks and except for the exceptions (admissions, deaths, transfers, indecent reports) I am getting to know my job well. My med passes are within the allotted time frames I am getting my charting and assessments done too.
So, now that I am getting more efficient at my job (if nothing out of the ordinary happens) I would love to be able to help the aids but I am not sure how. For example I give a women all her medication and she says she needs to go potty (or lay down) I tell her to put on her light and I will go find someone to help. I do this because I don't know if this person needs a lift, or a 2 person assist, or what.....I just don't know:o. I also don't know how the aids decide when to get people up or lay them down. I don't want to put someone in bed who is supposed to be up or vice-versa. As you all can probably tell I went straight through with my schooling and never worked as a CNA.
I want to help but I feel lost. I think I should have had an orientation day with the CNAs before I started my nursing orientation! Any suggestions?
Another example "nurse I need my oxygen filled"
Me "ok I would love to help let me find someone for you"
ARRGH I hate not being able to do simple things! I actually asked my nurse I was orienting with to show me how to fill the oxygen and she told me "oh the aids do that". No wonder some of the CNAs think all we nurses know how to do is push pills.....I am feeling the same about myself just about now:uhoh3:

I went straight to LPN. I was never a CNA. So basically the CNA duties I learned on the job. I will toilet 1 assists or help a CNA with a 2 assist or someone who needs a lift machine. I will not use a lift machine on my own. I help feed at dinner. But there are some things that you have to leave to the CNAs and I have mentioned this in several other posts.. you have to draw the line. You can't do their job for them all the time. They can't do yours.

As you learn your residents you figure out how they transfer. This should also be found in the careplan.

Oxygen tanks.. the nurses do. There are a couple of CNAs who know how to hook up a tank. I'll let them do it but make sure the oxygen is set on the correct settings.

CharmedJ7 · Jun 12, 2011

I find this entire thread amazing. Maybe this is just a difference in LTC vs. hospital, or maybe it's just my hospital, but I am shocked that:

a) The techs actually DO generally get all those little things done and

b) That the nurse wouldn't know the basic mobility and diet of a patient they had. For us that's part of our assessment, because it figures into things like risk for skin breakdown, risk for atelectasis and/or pneumonia, risk for aspiration, ileus, etc.

Now, I do feel there are some things the techs are just better at like making the bed perfectly and cleaning up a pt quickly and thoroughly and *sometimes* getting the patients out of bed. I would love it if our techs would answer the call bells and help patients to the toilet and get them water and all of that! Sometimes they do, but I would say 80% of the time we're on our own. Our techs generally bathe the patients (which I might help with if the patient is large or very sick or the tech is running very late), take some vital signs, check blood glucose, and sometimes clean up or help a patient to the bathroom. But the first call for a lot of those things is to the nurse.

INparrothead · Jun 12, 2011

Just start small and the aides will let you know if you screw up. And remember, the more you help the aides the more they help you. But don't be surprised if you get dirty looks from some of the other nurses that don't want to get their hands dirty.