I can do your job, you can't do mine.

[crobson221]

Hello,

I've been a CNA for 8 years. I've been recognized and awarded for outstanding patient care 6 times. I don't say this to boast, I just say it to establish the fact that I am a good aide. So when I ask a nurse for help, it's not because I'm a slacker, it's because I'm desperate.

My facility, like many others, is chronically short staffed. This past four months, we have experienced the worst staffing crisis I have ever seen in my entire time as a nurse aide. The current ratio on the evening shift, on average, is 26 total assist residents per aide. Several nights a week, I take both halls for several hours before I get another staff member with me. This means answering lights and toileting for over 50 residents. LTC residents on the DEMENTIA ward.

I run. All. Night. Long. I almost cried when my HR lady told me that she was reviewing the security camera for an unrelated-to-me matter when she saw me, buzzing in and out of rooms - she thanked me for working so hard. I was so happy that someone had noticed.

My primary nurses do not lift a finger to help. Last night, I couldn't believe it when I saw one of them actually answer a call bell. I thought to myself, "Thank God, maybe she's changed her attitude and is going to help me!" Then she came and told me that the lady had to go to the bathroom. She then went back to the nurses station and ate some doritos.

When I told my two nurses how overwhelmed I feel, that it is physically impossible for me to follow resident care plans, and asked how in god's name I'm supposed to do two assists with no other aides, I was told exactly this: "When I was an aide, I had way more residents to do than that. It's not even that bad." When I asked if they could help me, I was told, "I can do your job, you can't do mine." I went to my supervisor who literally shrugged his shoulders and WALKED AWAY.

I've been at this facility for over two years. I get free health care, four weeks vacation which is basically unheard of for a CNA, and the other primary aides I work with need me. They really do need me. I cannot leave them, and I won't, so please don't reply with responses like, "you need to get out of there." Yeah, not happening. My loyalty is to my two other CNA's who have stuck with me through thick and thin.

My question is this: Why won't the nurses help me when my situation is so desperate I have resident family members asking me if there's any way they can help? (I know, it's crazy - I work at a magically facility where the family members are all understanding and aren't constantly yelling at me for not answering lights fast enough. Seriously, I'm not joking - I'm very fortunate when it comes to this). Why won't my nurses help me when they see me run, see me visibly sweating through my scrubs, see the fact that I'm being forced to break care plan / the LAW with these two assists?

[Jduffy1392]

This sounds like a proud war story. First 10-15 years ago, chemical restraints were far easier to get away with, double that time and lobotomies were the cure for dementia, it's not fair to compare times of the past. Pt's are bigger, regulations are stricter and patient rights are booming with litigation.

As a CNA, I would hope you find a lovelier job, I don't see facilities in this model standing the test of time. It really feels like your building and equipment is outdated +30 years, which goes to show an outdated combative mindset of nursing (nursing careers historically began during the civil war). First, don't bother with a 2 assist if your not getting hands, the best CNA's care for themselves, your ass is not on the line, the facility is.

But I honestly don't take anything bad away from what the nurse said. Truth hurts. Leaving my nurses at shifts end while they put in overtime hurts, sitting waiting for call lights as they chart for hours hurts. My job is to assist and sometimes I wish we could help ease the RN/LVN workload (paper pushing). But I can't. Respecting the fact that her job has a higher education and hourly workload will go farther than saying she's a bad nurse. Our pride as CNA's comes with our exorbitant effort in face to face, personal care with patients, more than doctors, PT's, OT's, dentists, nurses and the like, LTC CNA's are hands on with their patients. Being that goes a long way.

My only advice is DO NOT HURT YOURSELF. No patient is worth you, because you care for 60 people. If pts to heavy, give the nurse a heads up and be patient, play it off as no big deal. Just don't hurt yourself.

[OrganizedChaos, LVN]

If the nurse is not on a med pass, wound treatment or on the phone with a dr they need to help! Don't they care about the residents? 26:1 is impossible for a CNA. I would report to the state.

I'm not agreeing with nurses but some things other than med pass, wound care or being on the phone might keep a nurse busy.

Report it & have what happen? I'm sure the state is aware of those numbers. It's unbearable, yes, but it's a reality in nursing. Especially LTC.

[Yuppers21]

The nurse's comment is true and a valid point IF s/he is currently busy with a task that is delegated to nursing only. It is not an excuse to get out of helping the aides with patient care. I worked as a PCT for a short time before becoming a nurse so I am familiar with the struggles of both roles, though not in LTC. The next time you are in a situation where you need the nurse's help, try framing your request in a direct and polite way that does not make it easy to get out of the task. For example, next time you need to get a 2-assist patient up, try approaching the nurse with "The pt in 204 needs to get up to the commode and is a 2 person assist. When will you be available to assist me with her transfer?" This does not allow a "yes" or "no" answer. If the nurse responds with a "you can't do my job" answer, reply with "I understand you are busy. I am the only CNA here tonight and I must have another person help me with this transfer. When can I tell her that we will be available to help her up to the commode?" If the nurse is still resisting (without a valid excuse) calmly explain that both you as the CNA and she as the nurse are responsible for her care and right now is in need of both. If the nurse refuses to offer a solution, gently but firmly inform her that you will have to notify your supervisor/manager/DON that you are unable to complete necessary patient care due to the inability of staff to assist you and then follow through with it. Don't just use it as a tactic to "bully" staff into helping, actually notify someone (in writing)of the problem. It truly is putting the responsibility back on the facility to provide their residents with all the resources needed to give adequate patient care. Whether that means hiring more CNAs or retraining of nursing staff to help one another is up to them.

By the way, you are not paid nearly well enough to be expected to "manage up" your senior staff in this way, but since you won't leave and want to be loyal to the facility and other coworkers, this is the only way you can do that without sacrificing patient safety AND protect yourself.

[Paws2people]

You sound like the kind of CNA I always loved working with. I am sorry that you are having these issues, and that you aren't getting any support from tee nurses you work with. I would go to your DON and explain, calmly and objectively, the problems you're having. Remember, staffing is the facility's responsibility. Maybe if they realize that a hard working, valuable employee is at her wits end, they might make some intervention. I know you don't want to leave, but remember this: as much loyalty as you feel for your facility, I guarantee that it is not reciprocated. I'm not talking about your coworkers, I mean the administration that's forcing the staff to work short constantly without support.

I wish you the best, and I really hope things get better. Soon.

Exactly. It is not reciprocated. If you were to get hurt or quit, they would replace you. Would your replacement be as good as you? Odds are no. Would administration care? Odds are, NO.

Maybe you should of told that nurse, "You're correct. I can't do your job. I cannot do what you are doing... I would feel bad sitting here eating Doritos while my patients needed HELP." After all, it's not you the CNA who needs help, it's the patients who need help.

[Paws2people]

I have NEVER refused to help a CNA/Aide. I have helped the front desk and Hhousekeeping at times. It's is very rare that I am not already running around as you described, but when able, I believe we all should help one another. I have seen RN'S not even help each other at times. One nurse running around like a chicken with her head cut off while 2or 3 sit at the nursing station chatting away or on the internet. I offer to help when I see someone very busy. It is a sad statement of our times. I don't remember it being this way in years past, and I don't understand why it happens. Lazy is one thing, but if they care about the patients, let alone their co-workers, why not help? I am so sorry you are treated this way. NO EXCUSE FOR THIS!

One nurse running around while others sit and chat or are on the Internet?

I think we work together. Lol. Sadly, this is TOO common, and you as a helpful, diligent nurse, are in the minority.

[nursejoy1, ASN, RN]

I will agree with one thing the nurse said, she can do your job, you can't do hers. But to me, that means something different. It means she does know how to do your job and should get off of her butt and help you do it. I have seen way too many nurses act like they didn't know how to do something to get out of helping a CNA. To me that is absolutely ridiculous. I have been a CNA, an LPN and now an RN and there has never been a time, and never will be when I say no to a CNA simply because I don't want to. If I am in the middle of a task that has to be done at this moment, then I will say, I'm sorry, let me finish this and I will help you. But just say no, never gonna happen. Sounds like you are an awesome CNA and I would be honored to work with one such as yourself. And help you out when you needed it.

[Pca_85revived, LPN]

So, you're working in an understaffed environment you feel is unsafe. You feel a loyalty to them and are looking for alternatives to quitting? Tell them just that. Not the nurses who won't help, the nurse manager who shrugged his shoulders like a puppy confronted about pooping on the new carpet. Someone who actually cares about employee retention and safe care. If there's no one like that in your building, I really would quit at that point.