How do I deal with "needy" nurses

LDAthleteNurse, BSN, RN · Jan 15, 2016

"Sorry, I can't do it right now. I am busy." Or "I will take care of it when my break is over."

ProgressiveActivist, BSN, RN · Jan 15, 2016

Stop referring to professional nurses as needy for asking you to fufill your job duties.

You were hired to do non skilled nursing tasks.

Its ridiculous that you are offended about being asked to change a finger sensor.

Leave the cell phone in your locker.

Be proactive with meeting your patients needs for comfort, fluids and help with adls.

Arrange for another cna to cover your patients when you take your meal break.

allnurses Guide · Jan 15, 2016

So to put it into perspective I am a current nursing student and current nursing assistant. I have noticed that there are a few nurses on my floor that will ask me to do any and every little thing. My second week I was pulled off of my 30 minute break, twice to assist in cleaning up patients. I quickly learned to eat off of the unit. Another nurse asked me to fetch a new o2 sensor for his patient because he "couldn't possibly have the time to do it" even though the supply closet is right door. Mind you he had no problem taking a break to eat pizza after he already took a smoke break and a meal break. Then we have another nurse who has literally had me paged while I was doing patient care, leave that room to see what is needed, only to find out her patient needs a warm blanket or some other simple task. It is frustrating to no end because in all cases these nurses could have done these tasks themselves instead of either interupting my current list of patient care tasks or interrupting my entitled 30 minute lunch. How do I learn to say no? Now please keep in mind the majority of nurses I work with are great! It's just the few bad eggs that seriously make me want to walk off the unit.

Ok first off I totally feel your pain. As a nurse in an LTC we are constantly told to clock out for breaks and lunches (both CNAs and Nurses) and to continue working charting etc.... This I absolutely refuse to do and have let both my DON and administrator know this. Once I let them know in a calm professional manner they have never brought up the subject again. That being said I am a very hands on nurse who values teamwork and fairness in the workplace. While I have seen many nurses call an aid off their break to attend to some minor chore - I don't do that. If I am in a room and the resident/patient needs a change I do it. It's a great chance to perform a skin assessment. One day when I was just starting we had a patient arrive with an exploding colostomy bag. The aid who was to take the patient started to do the clean-up and was quite surprised when I came in with a basin of warm soapy water and a stack of towels. I had to assess the colostomy anyway so no skin off my nose. Unless it is an emergency don't let anyone take you off your break unless it's your administrator and if you do clock back in as missed breaks are to be legally paid at time and a half.

Most of the nurses in my facility will help a CNA out when they can - but there are a few who are rude and obnoxious to ancillary staff. I had one who we hired who didn't last long who would whistle loudly and call the CNAs "Hey You" I pointed out that they had names.

That being said the CNA needs to understand that a nurses job is a lot more complex than it may seem from the outside looking in. I won't assume you are lazy if you afford me the same courtesy.

Hppy

Horseshoe, BSN, RN · Jan 15, 2016

When you interrupted patient care to answer a page that turned out to be completely non-emergent, you set an expectation that you are easy to manipulate. The patient for whom you were caring deserved better. It may seem difficult to say no, but you are going to have to learn. You don't say no because you are busy checking Facebook on your phone, but you say no when you are currently involved in another legitimate task. Just as nurses have to prioritize their care and the demands made upon them, so do you.

I know it's hard for certain personalities to set limits, but this is one of the most important skills you will learn, no matter your profession or where you lie along the power hierarchy.

RNperdiem, RN · Jan 15, 2016

Some units are busy places with lots of total care patients.

A nurse cannot do it all and depends a lot on the CNA; the workload is big. When I was a new med-surg nurse, I discovered quickly that the CNA can make or break your day.

I do understand the need to protect your breaks. Do you have another CNA to cover you when you are off the floor? When asked if you can help clean the patient, either say "could you ask X, she is covering my patients right now" or say that you have 5 minutes left and if the nurse wants to gather some washcloths, you will meet them there in 5 minutes.

Here.I.Stand, BSN, RN · Jan 15, 2016

You just have to get in the habit of saying "I'm on break now, but if you haven't found help by the time my break, I can help then." Ignore pages during pt care; that pt should not be made to feel s/he is not your priority for that time of receiving said care. Or else say when contacted on your device "I am assisting another pt at the moment" -- if it is appropriate to answer, of course; while stocking the pt's supply drawer is one thing, assisting her on the toilet is another. Definitely ignore calls while in the BR with pt (but do call or find thr RN asap.)

As far as the tasky things they ask for...honestly it's probably better to not waste headspace on it. I did once say something to an RN (during my 5 yrs as a CNA) when we were the only ones on the floor, we had 3 call lights going off, and she literally had her feet up on a chair and was working on her cross stitch. But I felt that was a safety issue -- we worked on a subacute ortho rehab floor, and nearly everyone needed help with toileting. I was afraid someone would in desperation try to self transfer and get hurt.

But asking you to do things that are in your job description...eh, maybe it would make more sense for him to do it himself (it does happen), but why spend energy worrying about it?

But again, it is perfectly fine to set boundaries around your well being and around pt care. If that smoke+pizza+meal taking nurse is asking for a sat probe but you are 4/5 through your shift and no break yet? If you are off the clock? If you are in the act of pt care? It's okay to tell someone it will have to wait.

And then, remember how it feels. The other day, our CNA was swamped as the only one in a nearly full ICU. I had one pt who was very sick but not particularly unstable. The most I spent time on was 1) pulmonary hygiene and labs (was in ARDS) and 2) keeping her sedated -- she was on a paralytic and her BIS numbers kept popping into the high 60s, indicating that she may have been aware. And then of course, turning and oral care, and answering questions from the family. Would it have been reasonable to ask the CNA to get me a new sat probe, just because I could? No, I don't think so.

OTOH, sometimes I'll delegate things while sitting down. If that's the case, I'm either charting or waiting for a return call from an MD.

Xlorgguss · Jan 16, 2016

Stop referring to professional nurses as needy for asking you to fufill your job duties.
You were hired to do non skilled nursing tasks.
Its ridiculous that you are offended about being asked to change a finger sensor.
Leave the cell phone in your locker.
Be proactive with meeting your patients needs for comfort, fluids and help with adls.
Arrange for another cna to cover your patients when you take your meal break.

Ok first off I don't have my cell phone. I use it on my break as is expected of me. I have been the only aide for 20 patients. I do an awesome job at anticipating patient needs and getting my tasks done. I have no problem being delegated tasks. My problem is with being asked to do something while I am in an important part of patient care. Out of 20 patients say 17 of the 20 need full assistance with their ADLs or at least partial. Take out time for doing blood sugar checks three times a shift, take time for changing beds, take time for taking vital signs three times a shift, take time for changing patients, take time for charting, take time for re-stocking, take time for any other multitude of tasks. I do not have time for a nurse who is taking a 40 minute extra break and a smoking break when they should be assisting in their patients care. And I have been asked to do duties outside of my scope simply because I am a nursing student. Many nurses have complimented me on how great I am with patients. Other clinical staff have done the same. I was simply asking advice on how to deal with SOME nurses who try to take advantage of me. If they don't have time to complete what is expected of them then their should talk to our manager.

Xlorgguss · Jan 16, 2016

Some units are busy places with lots of total care patients.
A nurse cannot do it all and depends a lot on the CNA; the workload is big. When I was a new med-surg nurse, I discovered quickly that the CNA can make or break your day.
I do understand the need to protect your breaks. Do you have another CNA to cover you when you are off the floor? When asked if you can help clean the patient, either say "could you ask X, she is covering my patients right now" or say that you have 5 minutes left and if the nurse wants to gather some washcloths, you will meet them there in 5 minutes.

Thank you. The aides are the ones that make and break the unit. I guess I will quickly learn to play politics. This unit has a bad reputation as it is, and it doesn't come from the work of the aides.

Pangea Reunited, ASN, RN · Jan 16, 2016

My problem is with being asked to do something while I am in an important part of patient care.

Well, that's going to get a LOT worse after you graduate and start working as a nurse. :roflmao: Just wait and see...

Karou · Jan 16, 2016

There are nurses will will run a PCT ragged. I especially notice it when the PCT is assigned to both my patients and the "needy" nurses.

There are nurses who will call a PCT to empty a urinal, get ice water, fluff blankets, ect... Even though they know the PCT is elbow deep cleaning a total care incontinent patient. I have seen nurses do this. These same nurses are needy to the charge nurse and their hallway partners also.

Be aware that while the nurse can do everything in your job description, you cannot do everything in theirs. Often a nurse will appear to not be very busy, but in fact be doing something important (ex. looking up medications, on the phone with doctors/families, ect). We have to constantly prioritize and be aware of the bigger picture. Many things we do are time sensitive (medications, labs, ect) as well. I'm sure you already know that, I just want to explain it for anyone else reading.

Be firm when you are on lunch. "Sorry, I am taking my lunch break. I will be back in (insert minutes). If something emergent comes up let me know."

When they call and you're in another patients room say, "I am in a room right now, would you like me to leave to do this now? I am not finished with this patient yet."

There certainly are times when the RN will need you to do something quickly, even though you have other tasks you need to do. So by asking if they want you to do X or Y, you'll be communicating more clearly and the most urgent/priority task can be done first.

You sound like a hard worker, and a good PCT to work with.

Xlorgguss · Jan 16, 2016

There are nurses will will run a PCT ragged. I especially notice it when the PCT is assigned to both my patients and the "needy" nurses.
There are nurses who will call a PCT to empty a urinal, get ice water, fluff blankets, ect... Even though they know the PCT is elbow deep cleaning a total care incontinent patient. I have seen nurses do this. These same nurses are needy to the charge nurse and their hallway partners also.
Be aware that while the nurse can do everything in your job description, you cannot do everything in theirs. Often a nurse will appear to not be very busy, but in fact be doing something important (ex. looking up medications, on the phone with doctors/families, ect). We have to constantly prioritize and be aware of the bigger picture. Many things we do are time sensitive (medications, labs, ect) as well. I'm sure you already know that, I just want to explain it for anyone else reading.
Be firm when you are on lunch. "Sorry, I am taking my lunch break. I will be back in (insert minutes). If something emergent comes up let me know."
When they call and you're in another patients room say, "I am in a room right now, would you like me to leave to do this now? I am not finished with this patient yet."
There certainly are times when the RN will need you to do something quickly, even though you have other tasks you need to do. So by asking if they want you to do X or Y, you'll be communicating more clearly and the most urgent/priority task can be done first.
You sound like a hard worker, and a good PCT to work with.

Thank you! What you describe is exactly how it is. And before anyone is quick to defend some of these nurses, I am aware of when they are doing work and when they are shopping on Amazon and eating a pudding cup. I am well aware that nurses have a difficult time getting everything done. There are plenty of nurses that are awesome and I love working with. The frustration happens when the aids are expected to answer each and every call light essentially within a minute or so. I get so bogged down with tasks and hate to be told that "my patient wants her bed bath now" when I have already offered it twice and have now taken on responsibility elsewhere. In addition there is no way for me to contact the nurses or vis versa from the patients rooms. Aids don't phone's and our nurses are notoriously bad for not using them