I dont handle lazy aides well

Nurses General Nursing

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Maybe I am not cut out for hospital nursing, I dont know. I cant seem to handle lazy aides well. Again I was assigned to the other side' on my unit, night shift, 2 rn's with one aide, 12 pts (6 patients each rn). If there is not a good aide, you drown at some point, usually later in the shift.

This float aide we had last night did his vitals, sat down in the hall with a portable computer for an hour or hour and a half. I got an admit, he balked at doing a sling weight (she is asleep, that can wait for days') (me: no it cant). Then he took over an hour break, when it is posted that they can take 2 15 min breaks and one 1/2 meal break. But that is the standard.

The night charges dont care. They dont give support. They just dont want trouble'. I told the aide upon his return of the above policy on our floor.

Then he started 0400 vitals, didnt answer call lights. I was trying to chart. I asked him to answer a call light. He did not, finally I went to answer it. I asked him why he didnt answer it, he said I could have answered it instead of coming to tell him to answer it. I told him I was charting, and that he was on the floor. He said he was in an iso room'. It seemed to me he took 15 minutes of so in that iso room to get VS, and was just waiting for ME to answer the call light. He got loud when I asked him this (about not answering) and argumentative. Then he went to the charge nurse to complain about me.

The chrage nurse said he's generally been a good guy'... I wrote my nurse mgr stating I am frustrated dealing with certain aides who seem to want to do only the minimum. I called insick for tonight. I am thinking of requesting not to be put back in this section especially if there is a marginal aide.

I left this morning with not enough time to do notes, ect. I just was so upset and wanted to get out of there.

I dont know what to do. Please advise.

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WOW, that is just wrong. I am not a nurse. I am a nursing student. I have however worked in a nursing home as a CNA. That type of behavior is unacceptable. Is he a new aide? Is this his first aide job? Well, it's true he may be a good guy in front of the nurse mgr, but he may not be a good aide or good worker. How old is he? That was a good thing that you told him about the policy, even though I'm sure he already knew it.

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Hollyberry678...this is going to sound pretty harsh but...

After browsing through the other threads you have started it becomes apparent that this is an issue that has been going on since you first started nursing. Not only with aides but with RTs, Drs, Nurse Managers and other nurses. There are at least half a dozen threads started by you all based on the "not happy with co-workers/team members" theme.

I don't know what the root of the problem is but maybe its time to investigate that rather then focusing on individual instances.

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Specializes in Not specified.

I too have a hard time handling bad aides. I will lavishly reward my good aides, the ones who keep my patients and their rooms sparkling and I will tell them so. I will bend over backwards to help my aides who show a hint of compassion and pride in their work.I love bedside nursing and will personally clean my patients and fetch their water, etc., if I see that my aide is legitamitly busy. I will drop everything to help him or her turn and clean my patients, not just to see their skin condition, but out of team work.

However, I am the RN and I call the shots. I prioritize my tasks and the tasks of my aides. I once asked an aide to clean a total care patient who was at high risk for breakdown. She used the excuse that she had to make a bed (for a patient who was off unit and would be for a very long procedure). I followed her into the room where she was making the bed and I explained to her what our priorities were. She refused to budge and gave me attittude.

Finally, I had enough and yes, it was extremely naughty of me, but I pointed to my name badge and said, "Do you see these letters, RN? It means that when I delegate a task to you, you better complete that task or I will relieve you of your duties to that patient." She continued to fuss and I said to her, "by the principals governing RN practice, I relieve you of duty to this patient. Do not go into her room or care for her anymore because you have demonstrated that you cannot be trusted to have nursing care delegated to you".

Like I said, I praise my house keepers, unit clerks, dietary workers, CNAs who care and take pride in their work, but I will not allow them to tell me how to prioritize or make nursing decisions that are unreasonable. I will listen to them and if they are reasonable and respectful and have the patients' best interest in mind I will make it so (they are our eyes and ears). But if they grossly neglect my patients, I will not have it. In the end, it is my license on the line, not their certificate.

I have not "investigated" hollyberry678's " posts, but I have to admit that in my experience as a clinical hospital nurse and a nurse manager in long term care, there is an epidemic of poor care being delivered by our aides. We as nurses are responsible for the care of our patients, regardlesss of whether or not it is an RT or a CNA, PCT. (I cannot tell you how many RT's have neglected to provide nebulizer treatments to my patients and I ended up doing the treatment). Unfortunately we don't reward our good aides enough by delegating more "prestigious" work to them or helping them out (I've seen enough nursing sitting around the nurses station reading magazines while the aides are cleaning up patients and applying protective barriers) so I don't think the problem is isolated to hollyberry

Maybe he/she does have interpersonal work problems, maybe he/she doesn't. But the fact of the matter is that the work of the people we delegate to, whether directly or indirectly through hospital policy, affects the way that we are percieved as a profession and our organizations. One CNA says to a patien who request something simple, "we don't do that," when it is grossly inaccurate, will make the patient think that the CNA is a nurse and give us poor Press Ganey reports and think ill of nurses.

I've been on both sides of the bed and a manager of nurses. I can tell you that some of the most concerned and caring advocates during my stay in the ICU have been CNAs who asked me with a worried look on their face why I didn't eat-- was the food bad? Or a CNA who suggested to the RN, "No, he's a man, we have to use alot of soap to clean him up" ( I was so grateful to her, to be clean and fresh, my one little luxury while I was in the ICU s/p craniotomy.

We need to reward the good with tangibles and demand that the administration allocate the resources for those rewards and we need to (especially in this economy with everyone scrambling for jobs) weed out or at least stand up to the bad/inefficient aides who think they own the unit because they have been working there longer than anyone else.

****Romie gets off soapbox*********

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airforcern is right. you started a thread about this already- "how do you get na's to help more? (those that want to do the minimum) "

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Specializes in Pysch, SN, Med-Surg.

I'm so speechless after reading that, and i'm not sure if its from the lack of support from the other nurses or that aide's audasity. Seems like you should take matter into your own hands and start to file formal complaints and also write and keep notes of everthing he does with date and times so that you have something to back you up.

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However, I am the RN and I call the shots. I prioritize my tasks and the tasks of my aides. I once asked an aide to clean a total care patient who was at high risk for breakdown. She used the excuse that she had to make a bed (for a patient who was off unit and would be for a very long procedure). I followed her into the room where she was making the bed and I explained to her what our priorities were. She refused to budge and gave me attittude.

Finally, I had enough and yes, it was extremely naughty of me, but I pointed to my name badge and said, "Do you see these letters, RN? It means that when I delegate a task to you, you better complete that task or I will relieve you of your duties to that patient." She continued to fuss and I said to her, "by the principals governing RN practice, I relieve you of duty to this patient. Do not go into her room or care for her anymore because you have demonstrated that you cannot be trusted to have nursing care delegated to you".

Are you for real? Did you really say that? If you said that to me, we would've had an exchange of words. That was very condescending , extremely egocentric, and unprofessional. The RNs on my floor don't even act that way towards lazy nursing assistants- everyone is an adult.

This thread needs to be closed because I have a feeling it will turn out ugly.

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As far as my posting my troubles, I tend to only post when I am feeling frustrated. I generally do not have a problem with coworkers, I am a great team player, work hard, and teach when I can with the few areas of experience I have. I do have an ongoing problem with aides, I admit, I do not know how to handle the above situations without getting realy frustrated, so if you want to blame me for that go right ahead. Thanks to those who can see my frustration and have some solution foor me. thanks

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Specializes in critical care, long-term care.

As an aide in a hospital, I can understand the frustrations of not getting help... but before you go on a rampage, look at it from an aides point of view. (If you've ever been an aide, you should already understand)...

I work in the CCU. The nurses I work with have a 2-3 patient to nurse ratio. On average... I have about 15 patients. What nurses don't seem to remember is that they only have a few patients to care for, yeah, I understand that you must pass the meds and do dressing changes, etc. However... you need to remember that we have the whole floor to care for.

When a nurse spends 'x' amount of time looking for me (while I'm in a patient's room) just to tell me that their patient (that they just left) needs a urinal, or water, or a box of tissues... that's ridiculous. Or, you think it's ok to continue to chart while a call light is going off, but it isn't ok for a aide to do that? Nurses are NOT above anything that an aide is 'assigned' to do... I am all about helping and team work, but when nurses do stupid things like that, it makes me not want to help them. I'd rather help someone that is willing to help me too.

One last thing... you can DEFINATELY tell a HUGE difference between nurses that have been an aide before and those that have not. I think it should be a requirement before you can become a nurse...

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Specializes in Operating Room Nursing.
Are you for real? Did you really say that? If you said that to me, we would've had an exchange of words. That was very condescending , extremely egocentric, and unprofessional. The RNs on my floor don't even act that way towards lazy nursing assistants- everyone is an adult.

This thread needs to be closed because I have a feeling it will turn out ugly.

Perhaps romie worded their post a little aggressively, but I have to agree with them that in the end the Registered Nurse is responsible for supervising and delegating tasks to patients. There are times when I think it's appropriate to remind CNA's of this fact of life, especially in the situation romie described i.e refusing to perform a task even after explaining the priorities to the CNA. If the CNA continues to ignore the RN's request then steps have to be taken. I might say something such as 'I cannot allow you to continue giving care because your clearly not following my instructions and you have decided to practice outside your qualifications.'

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I have found you generally get willing assistance if you work as a team, that is if your CNA feels they are a part of the team and not an RN's "underling". If someone took hour breaks and were actually off the floor, not ready to assist, this calls for a write-up. However, if you have the reputation of being difficult to work with (and that news will travel extremely fast), then you will have problems with a lot of the CNA's, after all we are all human, some will show their displeasure in different ways though it usually won't affect patient care, yet may keep some "hiding" from your view also. Yes, there are people working that are just in it "for their time" but there are more that have good ideals.......wanting to do the best they can for their patient. Keeping all the team informed of changes, even explaining why things need to be done a certain way, asking before going to chart if any problems, getting feedback on anything new with the patient etc. all helps.

As to the original post, if someone was going against facility policy they should be written up. Possibly it would help also to talk to other nurses and find out if they have problems, if so their recommendations. Perhaps you all can decide on a course of action?

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Specializes in A myriad of specialties.

Sounds like the aide was insubordinate as well as lazy. I, too, get really frustrated with lazy aides. I did work as an aide prior to nsg school and understand their care load. As nurses, we MUST delegate. I support the idea of helping the aides when possible but darn it, they were hired to do a job and should do it! If they refuse to comply, become loud,argumentative like that one described in the OP's post, it is only right to correct them(if you don't then you'll get labeled a "push-over") and if no improvement, write them up.

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