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.
I think that boundaries should be set and priorities established for RN"S CNA"S both. If a call light is going on and CNA is not available, the nurse should of course answer it. Why shoudl the patient suffer due to ego's? If CNA's are going to Smoke and all they want to do is vitals, get rid of them, they are doing it for all the wrong reasons anyway.
I think this is an issue that can go on and on. Please remember, we are all busy and if we don't work together the patient suffers the most.
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.
I have to admit, I have, at times, found the supervisory side of nursing a bit problematic. I'm lucky to work with some very good aides, but there have been occassional stinkers, too. It's tough, because when I was a carpenter, my name was on the paychecks. If I didn't like the way an employee did his job, I just told him there would be no more paychecks. As a staff nurse in a hospital, I don't have that much leverage.
So I have to be more creative. One thing--and you're probably already doing it--is lead by example. When aides see you working hard and doing whatever needs done, the good ones are more inclined to respect you. But, as you've found, the bads ones may feel you can just do it all while they take it easy.
In the instance you describe, you might consider entering a nurse's note on the chart to the effect: "Asked _____, CNA, to perform hibiclens bath on patient. CNA refused, states, 'I have twelve pts, you only have seven.' Bath performed by nurse." Then have the aide initial the entry. If she has any further explanation for her insubordination, you could, in the interest of fairness, document that as well ("too busy with another task," if that's her response, for example) but I think seeing written documentation of her insubordination might give her pause, the next time.
It's easy to see from some of the responses that there are a lot of perspectives on this issue. I hope it's clear that asking someone to do the job they're paid to do is not disrespectful. Aides (techs, PCA's, whatever the title) aren't slaves, and we can't treat them as such. But, conversely, they aren't slaves--they have a choice whether to take the job or do something else for a living. Part of their job is taking direction from nurses, and if they don't want to do that, they should find another line of work. You have to--and I'm sure you will--get over being intimidated by your subordinates, because there are usually some who'll walk all over you, if you let them.
On the positive side, it's always good to appreciate those who do their jobs. If an aide calls with an abnormal vital sign, a simple thanks should be part of the acknowledgement. Recognizing their need to prioritize is important, too. I've been surprised, from time to time, that even some pretty hard-working aides don't always understand the relative urgency of a situation. I've asked for a set of vitals and been told they'll get them, as soon as they finish passing ice waters. So (when needed) I try to help with, "I need a set of vitals on pt X right away, while I'm paging the doctor." Or "patient Y could use some more ice water, if you get a chance before I do. Thanks."
I've been in the OP's shoes, and it sucks, no doubt. But I've concluded conversations with aides on our portable phones with, "I love you, too." I've worked with several who make me look like a better nurse than I am, and I let them know it. That has more to do with the quality of the aide than my genius leadership, but with a little common sense and a lot of trial and error, I've learned to get along pretty well with 90% of them.
Early in my nursing career, I heard one of our aides warn a newbie, "If Mike sees you sitting around, he'll ask you to do stuff." She meant it playfully, but it's true. If "my" aide is busy and I see another with nothing to do, I'll ask the one not doing anything. Luckily, most of the ones on my unit realize they're helping their coworker, as well as me.
I dont understand some of the nurses out there. I am not a cna. However, I have done Nursing Assistant work. I remember how the nurses treated me and I see the way some nurses treat thier cna's.I will never treat unlicensed employees that way. Maybe its cause they have never been a cna in thier shoes. You should be happy that they are there to help you. They are there to learn from you. Its called leadership!
I have been doing patient care for about 7 years now. Mostly emergency care. I have seen some of the nurses on the floor's bark orders to the cna's while they sit and drink thier coffee and act like thier doing charting. Let me tell you. I was in the military and I never talked to the junior troops as bad as you talk down to some of the cna's. Let me leave you with something and this may be why your getting no cooperation from your cna's. A quote from my favorite movie, " Attitude reflects leadership"
Then again, the reason they're not getting cooperation might be that they are actually afraid of the aides and the aides know it. And don't forget that the aides might be screw-ups, lazy, working 2 jobs, sick, or just plain evil/mean/vicious/jealous/bound and determined to see if they can rankle the nurse, break the nurse.
Some people are just mean. They are disrespectful, they are envious.
I think being male has helped me not to have much trouble getting aides to do whatever I ask. Also, they know that I never take a smoke break or a goof off break. I do use the restroom a time or 2 during a shift and I do grab a 20 minute meal break. That's it. They know I'm not internetting and they know I help lift, turn, clean, etc. They also know that I can do their work but they can't do mine and they, therefore, know that I sometimes have to fiddle with the paperwork, call doctors, do admits and discharges, and so on, so that I expect them to do the baths, VS, etc. I'd rather do it myself but there's just no time usually. I also am not afraid to talk to them about problems and, as a last resort, to do write-ups.
It's hard, OP, but you have to get hold of the reins and let them know that you can no longer accept their actions, let them know what you need and expect, and what the consequences will be if you are forced to go to the DOn about them.
Specializes in M/S, Tel, ER, Onc, Clinic, MH, Corrections, CC.
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.
Sometimes you may work with someone who is continually inappropriate and your interventions don't work. Then, you go up the chain of command. If that still doesnt work, then continue to document what is going on with that particular person and ask not to work with him/her because it is causing a hostile work environment.....THERE IS ALWAYS A SOLUTION!
As long as you know you're job functions and limits and do what is expected in a professional manner, then you will have little trouble with subordinates/co-workers.
As in my particular position, I am an LVN and therefore by law I am a subordinate nurse to the RN. If an RN asks me or tells me to do something (as long as it is legal and not in an unprofessional manner), then I have the responsibilty and am legally obliged to do what I am told. On the flip side, because I am a nurse, I can supervise and give direction to assistive personnel or other Vocational Nurses. Sometimes my CNA's will tell me what they want help with and I'll listen and do what they ask, if I am able. Some people do not like being told what to do....But that type of attitude does not fly in nursing. I can take, give direction and communicate very well...And you have to be able to, ESPECIALLY when we are dealing with people's lives and their health/well being!
On the other hand, some people have a "control" issue...They like to tell or "boss" everyone around....That doesn't work either...We need to have respect for each other's discipline and realize that sometimes we are asked and sometimes we will ask others to perform tasks.
One final thought...Everyone has their moments in nursing (usually often) when we are swamped with work; and sometimes the nurses can not help the CNA's and vice versa.....That is just the nature of the beast and we can't really get around it! If you are a nurse or CNA who gets upset that this happens, then you should rethink that because it's unavoidable! In that case, get another nurse, aide or family member to help if necessary. Again, there is always some kind of solution! Just be positive!
Just remember alot of it has to do with the facility and management. Some managers play on the side of everyone and that will cause conflict in situations like that. I found that even though I should not have to tell them what I am doing that if I start out with "so and so, I need this done and I am doing this right now will you go do this....." sometimes I get an excuse but most of the time they go do it. Management needs to get on the ball and show they will not put up with it. I hate delegation, I would rather do it myself as I just hate to have to tell someone to do something, but I have gotten good at to as I really got tired of staying 30-1 hour over my shift finishing things up when the techs are getting out on time because I was doing stuff myself. Explain to that tech that she may have more pts but you have more things to do with those pts so this is one of the things you need her to do for the pt.
do you have a nursing sup on your shift. If you keep letting them get a way with it , it will continue. If you call someone right then and you face them with the sup. maybe things will change.
I believe that I have insight from both perspectives seeing that I was a CNA/Nurse Intern (glorified aide) for 4 years prior to becoming an RN. As a CNA at certain facilities, there were wonderful nurses who helped and appreciated me, and then there were some who treated me like an uneducated slave (so not fair, nurses aides know a lot about each patient and are a HUGE help to you as a staff!). At the last hospital I worked at before I got my RN license, I was totally abused as a CNA. The nurses were so lazy and ungrateful. I would have 10-12 complete patients and as they would sit and talk about their kids and drink coffee they would add on more work that I didn't have time to do that they could have easily done. If I didn't get around to it I would get reprimanded by them. God forbid I EVER asked them for help I 99.9% of the time never received it, and if I didn't run to their beck and call for every little thing I was "a bad aide". It got so bad that one shift I was checking blood sugars and blood pressures for a nurse on a patient going down hill while she was on the phone with a doctor. Another nurse who was the worst (I called her nurse needy hehe) called me into a patients room in front of the family and started yelling how I was so terrible that I didn't even wash her hair and I was NEVER going to be a good nurse or a nurse at all for that matter. I was so embarrassed and devastated because I am a VERY hard working person I always have been and hello I had PRIORITIES! I had complained to management several times before and nothing had been done. I finally gave it my last try after this incident and nothing was done. I think it was a lot on management's part that the nurses were enabled to act this way. This particular floor by the way had the highest turn over rate of staff anyway. So I left that floor because I was so unhappy and did not need the additional stress besides nursing school.
Now that I am an RN I am so good to me aides because I swore I never wanted to be one of "those nurses" and make other people's day awful. I am so a do it myself person and I really don't like to delegate (which I'm working on), so my first week on the cardiac floor I am on I was in the midst of two transfers, an admit and had other very sick patients. I needed to have the foley emptied early of the patient I was ready to tx off of the floor but I physically could not do it I had too many other tasks at the time. I asked an older CNA if she could please do it for me and she looked at me, laughed, said no and walked away! I'm pretty sure she didn't like to take orders from a 21 year old new nurse while she had been doing this job her whole life, but honestly it was the only thing I ever asked for and she could see I was stressed! So what I tried to do was show all the nurses aides that IF I had the time I would bathe my own patients, take them to the commode, etc etc. I would ask the aides if they wanted me to go in and help them and wash everyone up together. I did my best to show them I will work with them and help them and I started to ask for small things I needed done from them little by little. Now that they see I am a hard working RN and am willing to help them, they love me! Even the older aide who blew me off will ask if I need help! I think its a total give and take relationship but as a new young RN it sometimes help to show them they type of nurse you will be and respect them and help them as much as you can to expect the same help in return! I work with some great aides and I am thankful for them : )
Specializes in Community Health, Med-Surg, Home Health.
I think it is even more difficult to deal with troublesome staff when there are unions involved, because they have a tendency to retain the good as well as the bad employees. My advice is to watch how management deals with these employees because that is a clear indication of how they would support their nurses. If they give you a run around, or if these people are old timers that have been around for a long, long time, then, that is a warning to look out.
You are very right....it just boils down to respect, very simply. Wherever you go in life (whether it's work or whatever), you are not always going to like every person nor is every person going to like you, for whatever reason(s). But as nurses, we are supervisors to ©NA's; sometimes we give kuddos and sometimes we have to perform "corrective action"....But like everything else, it is absolutely in the WAY that you do it......just as, you say to someone, "Please, be quiet" as opposed to "Shut Up!!!"....They both get the point across but you've just caused distention and evoked anger with the latter statement. All healthcare workers need to have respect for each other and the jobs and accomplishments that we do. We are all at different levels in healthcare for one reason or another; but we all help each other. A hospital can not be run on nurses alone or CNA's alone or RT's alone or RD's alone or XR/Lab Tech's alone....and so on...and there is always someone supervising over you.
KEEPSMILING66
6 Posts
I think that boundaries should be set and priorities established for RN"S CNA"S both. If a call light is going on and CNA is not available, the nurse should of course answer it. Why shoudl the patient suffer due to ego's? If CNA's are going to Smoke and all they want to do is vitals, get rid of them, they are doing it for all the wrong reasons anyway.
I think this is an issue that can go on and on. Please remember, we are all busy and if we don't work together the patient suffers the most.
Re: I fear my CNAs! lol
permalink
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.
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