Hi. I almost hate to start another CNA thread, as so many degenerate into a nurse-vs.-cna thing....but that is not my purpose here.
We were talking in class today about how the trend in the hospitals (here in the Twin Cities, anyhow) seems to be working toward eliminating the CNA (PCA, aide, whatever.)
I work as a PCA on a cardiac step-down unit that recently re-worked their staffing grid. They lowered the patient ratios for the RN's (3-4pts) and greatly increased the patient ratios for the PCAs (~10pts on days/eves, and ~18 pts on nights.)
Many of the PCAs I work with (and some PCAs in my class) are angry about this. (Having to work harder...not feeling as valued.)
I actually think it makes a lot of sense. I think if you could get acceptable patient ratios, nurses might be better off doing all the cares for the patient themself. And I mean ratios that NURSES find acceptable, not management.
Then nurses would have the opportunity to examine/assess the patient during bath/changing/etc. Never again would the nurse have to worry if the vitals are accurate, or if the CNA measured urine correctly, or if the blood sugars will be done in time for insulin before breakfast. This appeals to me because I always prefer to do my own work....I always worry that it wasn't done "right" or well enough when I have to work with partners.
So...my question is...
Does this appeal to you at all? Why or why not? What kind of unit do you work on and what would your patient ratio (or accuity level) have to be in order for this to work for you?
At the LTC I work in part time, I saw the whole shift of CNA's sit around the desk and do NOTHING except they did put the people to bed, but basically they did nothing else after that......another nurse and I looked at their work schedules and they had several baths to give, but instead of giving them they sat around the desk and chit chatted, until they were told they had to go give those baths. It was 9PM when they were confronted with this bath schedule, and they said they couldn't find the schedule.....well, DUH. They sure didn't ask anyone to help them find it. It was on a shelf with some other books up above a computer.....they really looked hard, didn't they?
IMHO, they never intended to give those baths until they were told to. Sometimes, it's like dealing with little children....you must tell them now, it's time to eat, time to go potty....etc.
I know not all CNAs are like this...........so don't flame me..........I'm just telling you of a particular situation I observed at work.
And those CNAs are basically good to work with........but I do see that even they will avoid work if they think they can get away with it.
No way! No how! :angryfire A good nursing assistant is worth their weight in gold! I've worked where there were no CNA's and worked my you know what off. Just let me do the "nursing things" and pay the CNA more and give them the respect they deserve. Most of the one's I work with are way more than just "butt wipers".
At the LTC I work in part time, I saw the whole shift of CNA's sit around the desk and do NOTHING except they did put the people to bed, but basically they did nothing else after that......another nurse and I looked at their work schedules and they had several baths to give, but instead of giving them they sat around the desk and chit chatted, until they were told they had to go give those baths.
What you're describing is a problem with a particular person (or persons), not with NAs in general or their value to the healthcare team. What should be done in a case such as yours is they need to be counseled to either do their job or they'll be terminated.
I've known of some damned lazy nurses who sit on their tails and don't do their work, but I wouldn't suggest getting rid of all RNs.
I'm also from a Twin Cities hospital and we are actually doing the opposite. They recently did a big hire and have ADDED CNAs to the units. Instead of doing a general staffing of 1-2 CNAs on a unit during the day they've gone to team nursing. 2nurses and a CNA/8-10pt.
I work night shift on a unit that doesn't do this though. The nurses get a max of 5 patients and there is one CNA for the 25 bed floor. A lot of the nurses I work with do a lot of their own patient care. I as the CNA basically just answer call lights and do what I can.
I think the trouble with where you are, is people haven't adjusted to the change yet. Nurses maybe used to not looking up when there is a call-light because they are used to having a CNA's do the bulk of call light answering. They may not be used to doing a bath or two, because they are used to CNAs having the time. The CNAs also may not be used to the multi-tasking and saying no.
I work as a CNA/tech...and let me tell you, when I'm around, I make SURE my patients are taken care of.....
I get frustrated when I work with nurses that WON't do anything...if they can't that's a different story...
See my other posts for the latest issues with work....and I believe things would be WAYYYY different if I didn't work there. I always will remember how I got my start and NEVER overlook the good CNAs....
Total patient care is a nice idea in theory, but the extra labor costs of an all RN nursing staff would make healthcare costs skyrocket, and the nursing shortage even worse. In the end it would not be good for the patient.
On another note, I am a CNA. I run myself ragged every night, and get paid 11/hr. I don't feel I am underpaid, as I have nowhere near the knowledge that RN's do.
Specializes in Community Health, Med-Surg, Home Health.
I think it would be a bad idea to rid the facility of CNAs. There are more demands placed on nurses than ever before, and it is a bit easier to know that someone will have the time to do ADLs, turn and report any changes. Now, we have to be sure that these would be CNAs that care, as well as nurses who will be part of the team and help out when there is free time for them.
And, also, I am one that believes that there is room for everyone to eat at the table and if these positions were created, there is no reason to let them go.
A good tech is worth their weight in gold and a valuable part of the team. They often make the difference between simply a hectic, busy shift and The Shift From Hell.
Very true.
But by the same token, a bad one can drive you to quit.
I frequently work assignments where there are no techs. At times, it can be much easier. I have had techs that literally suck up more time and energy than the patients, MDs, AND administrative crap.
While there are many good ones and they do get seriously underpaid and underrespected, I would rather do the work myself than hear incessant kvetching from the bad ones about which tech got one more pt, who has the harder job, "I haven't had my afternoon break yet", etc. Especially when it is three in the afternoon and I have had nothing....no lunch, no breakfast, no bathroom stop at all.
Doing patient care is a nurse's job...and I don't mind doing, it given the appropriate ratio.
Specializes in Geri, Peds, Gastro, Cardiology, ER, NICU.
When I worked w/ the nursing assistants I never had problems w/ any of them. When their completed tasks were done, they would find things to do, not just sit in a patient's room and watch t.v. or hide out. Now that I work w/ Medical Assistant's, I miss the CNA's:o IMHO the M.A.'s are the "divas" of the medical field! I can't tell you how many M.A. 's I have had to get onto about "pretending" they were the nurse!:angryfire
Specializes in Jack of all trades, and still learning.
I wish it could get to be just RN's and LPN's.
I find this thread interesting, because I have never worked in a hospital with CNA's / PCA's as we call them here, that have their own patients.
We have only RNs and ENs = LPNs.
We can have up to 6 patients by ourselves in the morning, and I have had up to 7 - 8 in the evenings, depending on staffing (mind you that is extreme, 6 is the usual). At night time we can have between 8 and 9 patients by ourselves. That is normal. My hospital is backward. It will not allow ENs to do medications, even though they are trained at college to do so. So the RN does the ENs drugs, as well as her own patients, and the EN has her own patients, and helps with the RNs patients if she has time. ON most wards primary care is the mode used, though some use team nursing.
We have one PCA on the morning and afternoon shifts. That person takes patients to procedures, restocks, empties the linen skips, cleans beds for the next patient being admitted, delivers bloods, specimens and forms / drugs to and from pharmacy, and if they find the time, helps with care of full care patients. They are what I call quiet achievers. You don't know they are there, until they are not. And they are the gobetween should there be codes or emergencies. They even answer buzzers. They need roller skates
And there are none at night. No, let me rephrase that, there are two for 7 wards.
So, never ever take your CNAs for granted. They are special ppl.:redpinkhe
Specializes in Jack of all trades, and still learning.
While there are many good ones and they do get seriously underpaid and underrespected, I would rather do the work myself than hear incessant kvetching from the bad ones about which tech got one more pt, who has the harder job, "I haven't had my afternoon break yet", etc. Especially when it is three in the afternoon and I have had nothing....no lunch, no breakfast, no bathroom stop at all.
I dont think that is a CNA attitude. How many nurses have I heard like that!!!
catlynLPN
301 Posts
I wish it could get to be just RN's and LPN's.
At the LTC I work in part time, I saw the whole shift of CNA's sit around the desk and do NOTHING except they did put the people to bed, but basically they did nothing else after that......another nurse and I looked at their work schedules and they had several baths to give, but instead of giving them they sat around the desk and chit chatted, until they were told they had to go give those baths. It was 9PM when they were confronted with this bath schedule, and they said they couldn't find the schedule.....well, DUH. They sure didn't ask anyone to help them find it. It was on a shelf with some other books up above a computer.....they really looked hard, didn't they?
IMHO, they never intended to give those baths until they were told to. Sometimes, it's like dealing with little children....you must tell them now, it's time to eat, time to go potty....etc.
I know not all CNAs are like this...........so don't flame me..........I'm just telling you of a particular situation I observed at work.
And those CNAs are basically good to work with........but I do see that even they will avoid work if they think they can get away with it.