They are downright mean and bossy. I asked one ofem at night (around 3am) to do a hibaclens bath on a pt. that needed it.
Immediately belittled on how there was only two of them and they had 12 patients each (Med Surg unit at half census), whereas I had 7 patients doing my barbaric chart checks (yes we use paper still ).
And to do it myself if I wanted it done ha. Well I actually did do it myself, put me behind but hey its the principle of the matter, pt needed that care.
This is an everynight deal and all of our night techs (CNA's) are like this except two ofem.
As a former CNA turned Nurse I have a few suggestions that may help the Nurse-CNA relationship.
-if you are in a pt's room and they need vitals at that time and you are assessing pt. get the vitals and let the CNA know so that they don't do the work double and they can get on to something else.
-when you have downtime(lol) ask them if you can assist them with anything.
-keep communication open, let them know how important and time consumingcharting and chart checks are to pt. safety.
-if they say they are busy and they are not being rude, mentally step back, are they just setting up showers or doing full baths; placing meal trays or feeding; etc.
Remember pt care is a team effort and everyone has to be on board. Maybe at the start of shift give everyone a duty list (we do it works well) and remind them that the "MD's and pt's may throw in a few wrenches throughout the shift but we can handle it"
I am a CNA and a nursing student so I think I have a unique perspective. Let me first say that you should not "fear" your CNAs just as physicians should not "fear" nurses, all professional relationships should be based upon mutual respect and understanding. I would respond to the original poster that as a CNA I would NEVER tell the nurse that I was too busy to do a job that they asked me to and if you wanted something done to do it yourself. That, in my opinion is unprofessional. If I truly felt that I was overwhelmed and wouldn't have enough time to do the task that I was delegated by the nurse I would calmly and privately express my concern and see if there was someway it could be worked out so that what needed to be done could be done. I have seen where some nurses treat CNAs as little more then indentured servants (although in my area this is not so much the case) and if that situation was happening to me I would ask to speak to the nurse and address the issue, if I felt that the issue was not being resolved then I would take it to upper management. The fact is that nurses (NP, RN, LPN) and CNAs have their roles and scope of practice and we sometimes tend to forget what our roles and responsibilities are; just as an RN wouldn't be ordering for a prescription for a patient as an NP would, a CNA wouldn't be starting an IV as an RN would and so on. To the original poster I would say this, treat your CNAs with dignity and respect but remind them what their responsibilities are and that part of your position is delegation to them and that if they have an issue performing any of the tasks you have asked them to do then you would be happy to speak with management about the issue.
Keep in mind this is just an expression and I am not speaking poorly of CNAs when I say this...
They say that you catch more flies with honey than with vinegar but if you have a few bad flies sometimes you just need to put up some flypaper or pull out the flyswatter.
I have worked long-term care so I am used to having about 5-6 CNA's on the shift. They either do their job, or I ask them to clock out and walk. As the supervising nurse in long-term care I have that option. You, on the the other hand, probably don't have that option to tell them just to clock out and go home.
There is a definite change of the attitudes of CNA's since my days of being a CNA. We had respect for the charge nurse, or any other nurse for that matter, but of course I am 45 years old and things were different back when I was 18. I didn't dare talk back to my charge nurse or I knew I would be out of a job.
I feel for you in the situation you have. You have your job to do, they have theirs. I always say " the day the CNA can do my job, then I will help them do theirs''. Not to say I don't help turn and position patients/residents or give them water, etc. I will NOT do the CNA's job for them while they take 10 smoke breaks and I am overwhelmed with nurses work.
I have personnaly had few problems in this regard mainly because the majority of the PCA's I work with are very good. Last week however I had a painfull shift where I was getting tense due to my very increased workload due to a well known "person". This PCA is well known by staff on most wards in our facility as well as management, however due to the low unemployment in our area there are not many applying for the shortfall we already have.
My tension must have peaked because I asked her if she was worried about the recession everyone is predicting. Why? she asked. "Because in times of recession people get laid off from their jobs and apply for jobs that were previously "beneath" them, if that happens we will have a large number of people starting who are not scared to work hard, and what will happen to all of those who didn't put the effort in at work?"
For some reason she has been putting in a bit of effort since then.
A lot depends on attitude, not only CNA's, NA, I have seen in nurses also. Go to work for the money doing as little as possible to skim by then go home. OR..go to work to make a difference in someone else's life keeping your patient as comfortable and well as you know how working in your job capacity along with others trying to do the same.
i've worked with alot of cna's with many different personalities, backgrounds, etc. they know my expectations, i treat them with respect but i expect to be respected in return. if i do run across a cna who does not follow my instructions, i will give them a written warning; fortunately this doesn't happen often as they know i won't put up with that kind of an attitude. i am fortunate that the don supports me when i do write someone up. and if i do write someone up, i always make sure i have another nurse present as a witness & we both sign the warning form. sometimes the cna will refuse to sign those forms but that is ok, i tell them i will just add on the form that they refuse to sign. it doesn't matter if they sign it or not, it still goes in their file. i also offer them a copy of the warning form, if they choose not to take a copy, i will add "declined copy" on as well.
I have recently decided to persue a nursing career that I started 20 years ago. I am working as a CNA at a hospital while attending school. I have experienced the conflict between Nurses and Aids, and personally find it sad.
All of us are there to provide for the patient and there families. Not for the Nurse to pawn off unwanted duties or the CNA to make up her list of tolerable duties. WE all need to pitch in and help one another.
I have no problem doing most things until I am the only aid on the floor and running my bum off and noone says here let me help you, like you just helped me. If people would work together of the common goal. their jobs would be more enjoyable.
It shouldn't be about who is more educated, at the bare minimum have respect for one another.
I really think one thing that would help would be if every facility that has a problem with these things had an inservice/mandatory meeting where it was discussed.
This way, management could spell out exactly what tasks are the responsibility of the CNA, and exactly which ones are strictly the job of the nurse. I don't think some CNAs understand exactly how much is on a nurse's plate each shift and if they were made aware, things might improve. As it is, many think that since the nurses do less of the physical "grunt" work, their job is easier.
It's really easy for CNA to see a nurse working on her (abundant, I know!) charting and think, "why didn't she put this patient on the bedpan? SHE'S LAZY!" I have found this to be especially true among older "career" CNAs that I have worked with, but I've also heard similar things come out of the mouths of newbies and everything in between.
As a CNA, it frustrates ME to see these things happen...I can only imagine how it is for the nurses. Better education and more discipline are the only things I can think of that might help.
Our CNAs complain all the time. We get little notes from our nursing manager that we delegate to them too much and need to pay better attention to the call lights because the CNAs have better things to do.
One thing I will suggest is when you have procedures going out in the morning that need the CNA to do some sort of prep, warn them at the beginning of the shift. A simple "Hey Joe CNA, I need you to do a hibiclens scrub on a patient at about 3am. I'm just letting you know now so you can adjust your schedule."
As a CNA one of the things I hate is to be running around like a chicken with my head cut off and then have a nurse who's been surfing facebook all night come up to me and demand I do things I honestly don't have time to do.
I also tend to ask the nurses I work with if they have anything big they'll need help with in the morning. This way I can try to adjust my morning tasks to fit it in.
I was a CNA/PCT for 4 years prior to becoming a nurse back in January of this year.
During my "transition" we all talked and we all agreed that they would help me out and in return I would be an evil nurse.
Well fast forward 11 months later, I am on a different shift now, we have a load of new CNA's that have been employed for around 5 months or so and feel their duties include smoke breaks and vitals only hehe.
I hate to get anyone in trouble but it is becoming detrimental to patient care/safety and my own mental sanity. Everyone once in awhile I snap at one of them an they shapeup for the night but hrm.
Laught3r
74 Posts
As a former CNA turned Nurse I have a few suggestions that may help the Nurse-CNA relationship.
-if you are in a pt's room and they need vitals at that time and you are assessing pt. get the vitals and let the CNA know so that they don't do the work double and they can get on to something else.
-when you have downtime(lol) ask them if you can assist them with anything.
-keep communication open, let them know how important and time consumingcharting and chart checks are to pt. safety.
-if they say they are busy and they are not being rude, mentally step back, are they just setting up showers or doing full baths; placing meal trays or feeding; etc.
Remember pt care is a team effort and everyone has to be on board. Maybe at the start of shift give everyone a duty list (we do it works well) and remind them that the "MD's and pt's may throw in a few wrenches throughout the shift but we can handle it"