I'm going to nursing school-That's nice, DO YOUR JOB

LuckyinKY · Jul 27, 2011

I used to work with one of these nursing assistants. I would frequently hear "I don't understand why they don't let those of us who are nursing students help the nurses more."
My favorite was one of the times he was in the middle of this rant he said, "I don't see why we can't do your PICC lines for you. They are PICC lines, it's not like they are IVs." He got a lot of education on PICC lines and central lines that day.
And everytime I would pull him in a room when I had something interesting going on, his eyes would get wide and slightly scared and he would find a reason to leave the room.

:eek: Really? I hope he was not a nursing student.

xtxrn, ASN, RN · Jul 27, 2011

Really? I hope he was not a nursing student.

I don't remember the title of the book (I think it was the "Peter Principle") that discussed how people advance to the point where they surpass their true capabilities... looks like this guy maxed at CNA (nothing wrong with lifelong CNAs- I've worked with some who have done it for 30 years and were the BEST :) ). But for someone who harps about how PICCs aren't really IVs, I'd say he's tapped out !!

mazy · Jul 27, 2011

I guess I see a greater problem than the CNA out of his/her scope of practice, and it's regarding the OP nurse.
In my opinion, whenever someone of lesser authority is acting out of line, it's the responsibility of the one in greater authority to handle the situation. For instance, how many of you, if a child was acting outrageously disrespectful, would not immediately look to the parent to correct the situation. If the parent did nothing, you would probably think to yourself "wow, that child is disrespectful", but immediately afterward think, "what is wrong with that parent for not disciplining that child". Yes, the child is doing something wrong, but a greater wrong is what the parent is doing to society to allow their child to become a disrespectful adult.
In the same way in this situation the CNA is under the authority of the nurse. Hence "Certified Nursing Assistant". So our first thought should be "wow, that CNA did something wrong", then immediately afterward think, "what did the nurse do to correct the situation?" The greater wrong is what the nurse is doing to her patients by not repremanding the CNA.
I don't know if the OP did or did not do anything, but I hope that she did. The first comment was the best one and after that it seemed most people on this thread were more interested in talking about the fault of the CNA, or CNAs in general, rather than what was done to correct it. To me that's like the parent from our analogy posting on a parenting forum about how bad their kid is, and everyone raving about how bad kids are in general, rather than anyone disciplining their child.
My post seems really serious. I hope it's not offensive. I guess I'm in a serious mood. I'm just sick of people complaining about things that they do nothing to correct. I don't know if that's what the OP is doing, but it's the feeling I got. Maybe I am wrong. I hope nobody rants off this lol.
Peace and Love

I agree with the intent of this post, but not really with the parent/child analogy. My feeling is that the relationship between nurse and CNA should be one of equality and respect. Both are expected to act like mature adults and both are expected to act within the parameters of their job descriptions. The nurse does have a supervisory role, that is part of the job description, however, I would never take the attitude with a CNA that I am disciplining someone that I percieve to be a child. The CNA is a fully formed, autonomous individual who has her/his own parents who have or have not taught the myriad life lessons that parents teach their children. Or not.

The point is whether the CNA is doing the job that is expected, or whether they are overstepping the boundaries or not performing well. It's not my job as a nurse to parent CNAs, just to make sure they respect the job, and to follow up when they don't.

Anytime a CNA needs to be disciplined, and in this case the CNA needed to be made aware that her behavior was out of line, it should be done in a way that is respectful of the fact that this is a professional relationship.

Now, the whole thing may fall to pieces after that .....I'm not so naive as to think it's all that easy :rolleyes: ....but again, we are adults and the expectation is that we treat each other like adults, and if that doesn't happen, then the next step is up the chain of command.

joanna73, BSN, RN · Jul 27, 2011

I work with a couple of NAs like the OP describes. It gets annoying. I keep telling them: "Just go to nursing school already."

xtxrn, ASN, RN · Jul 28, 2011

For the most part I've been lucky... There was one poor kid who signed up to work as a CNA for the summer- took classes before school got out, and was all set to get going. The first day, she was helping to get someone out of bed and they peed on her shoes... she ran out of the room and threw up. :eek: But, she came back (I was impressed for a 16 y/o). The next day, she got poop on her scrub pants- but at least didn't puke. The staffing coordinator came to ask me how she was doing- told her the jury was still out- she was trying like crazy, but having some trouble with the 'finer points' of patient care. Well, she kept showing up for every assigned shift that summer. She turned out to be a great CNA. She never squawked about helping co-workers (had one CNA who had been there for over 25 years- VERY good, protective of 'her' patients, and also willing to take a willing newbie under her wing). She was a really good kid, and did a great job that summer. :yeah:

On the other hand, I had some chick show up who was intent on letting me know every little thing she was doing...including going to the bathroom, and essentially asking if she could go :uhoh3: Then she made the BIG mistake with how I view co-workers... she called me 'mama'.... it was an innocent enough comment on its own, but in her overall childish approach, that had to be stopped . She didn't last, but it was her choice to leave. As long as nobody calls me 'mama', and gets the job done, I can deal with weird quirks

One of my favorites was an experienced CNA who was seriously pregnant!! I told her that if her water broke, she could squat under the desk, heave the kid out, and I'd keep it warm in the med room while she finished her shift....she'd roll her eyes and grin. One day she started looking a bit odd...OH NO.... not on my shift, and not on my sparkly floor!! I told the staffing coordinator that she needed to go NOW :)....she had a healthy baby later that day .

Then, another roller coaster....I found a CNA yakking on the phone while lights were flickering like fireworks on her hall...it was after lunch, and the residents (Medicare, so really tired from PT/OT/ST) still a mess. I told her to get off the phone and I'd be back to follow up (I was the facility sup on weekends - 2 16 hour shifts). I went back down- she told me everything was fine- don't think she expected me to actually go LOOK.... nothing had been done. I told her to get her stuff and clock out. She told ME that I didn't have the authority. I let her know that I'd be glad to call the police to escort her to her car and we could take it up with the admin on Monday. She left. I helped the other CNAs get the folks back in bed, and watch for lights... On Monday, she gave some sob story to the admin- who called me in to ask what I thought (she was really good at backing up the nurses), and asked if I'd be willing to give the CNA probation. I told her I'd go along with that. The CNA hurt her knee (away from work) shortly afterwards, and was off for a while- but when she came back, she did a really good job. She ended up being one of the stronger ones. :)

allnurses Guide · Jul 28, 2011

May the Lord Bless good managers! Dealing with personalities is an art form I think! xtxrn - The last aide you mentioned obviously had the potential but needed to know she was accountable for what she said and that limits were going to be set - end of story. Someday she may even be thankful for the wake-up call. A person who can take criticism and use it to change instead of make the chip on their shoulder grow larger is showing a mature attitude and potential to grow. Sometimes people like that make the best employees.

Reading allnurses has made me appreciate the nurse managers I had in the early years of my career. I did not realize until reading stuff here just how bad some of them are and maybe part of it is that my managers had worked their way up through the trenches and understood every aspect of the job so were empathetic and willing (wellll most anyway. . .:)) to jump in the fray when things got hairy out there, and they knew how to make assignments. Nothing wrong with a degree or a bunch of classes in leadership and management at all, but I still feel the best were those with a thorough understanding of what it was to do the job -- and be out there observing at least part of the time instead of cloistered back in a cubicle all the time on the computer.

xtxrn, ASN, RN · Jul 28, 2011

Yeah, that last one surprised me.... the administrator had given me the option of having her canned, but suggested the probation (I asked for 6 months because of the argumentative and insubordinate behavior). She ended up being off for the first couple of months from the knee problem, but really became a great part of the team- I had a lot of respect for that. We got along well, and I was glad she was there :)