In your opinion, as a NM, how to present an idea to management...

[JaredCNA, CNA]

Hello all,

This is my first time to surf this forum. I do so because I'm looking to present an idea (suggestion) to management, which will probably have to include our nurse manager, clinical manager, the Director of Med/Surg nursing, and the VP of Patient Care Services.

I'm wanting to suggest that they add another member to the rapid response team: a BLS-certified CNA. I've heard of several other facilities with CNAs on their RRTs. They play the role of runner (much needed), do various other tasks as delegated by the RN or MD, and perform CPR (compressions and bagging) as needed...since some RRT calls actually turn into code blues.

What's your advice? I'm lost here because I feel like I'm just a CNA and all the higher-ups won't care what I have to say. Also, I get sorta choked up when talking to management and I always seem to feel a bit overpowered or like they want to interrupt and not listen to what I have to say first.

Any help is appreciated.

[nightmare, RN]

My advise...Write it down,refine it,give your reasons and rationales as you have in your post.Then take it to management.What have you got to lose?and if successful much to gain!

[JaredCNA, CNA]

Thanks. Do you see how it could be beneficial, or no?

[nightmare, RN]

An extra, knowledgeable body is always an asset to a team.The question is will management feel their hire and pay is warranted ,are you talking about an existing member of staff who can double in this role or someone who's only purpose will be the RRT?If it is an existing member of staff are they already trained or will management need to pay for training?

[JaredCNA, CNA]

I'm definitely going to suggest an existing member of the staff fills this roll. I believe the staff might feel as though their base rate of pay is warranted for the added responsibility because a lot of us which that we had a more important role in a pt's care and could provide more interventions than we already do. I work in a facility with 180 beds, not including our ER. I don't see the need for delegating the role of RRT to a CNA who only answers the calls and does nothing else. We don't have enough RRT pages for that anyway.

I was going to suggest a small inservice that all the CNAs must attend that goes over the role of the rapid response team, and specifically, the CNA's role. Maybe some addition training in BCLS...as most CNAs I know aren't like me and won't just be totally at ease to jump into a code and do compressions.

I'd want to also suggest that the RRT pager is assigned to unit that is properly staffed as far as CNA's. At night, we often have one on my unit and we are supposed to have two aides. Last week, when the RRT was paged for a patient and I got told to go help them out, I was the only aide working the floor and all of my patient's went without care for an hour and a half. This creates problems.

[nightmare, RN]

See,you've got all the ideas! You just need to refine them!BTW I am not NM but Charge nurse,One thing management likes is,if you give them a problem/suggestion also give them the solution!You have obviously thought about this in great depth.Block training is generally cheaper than individual training and gives a bigger pool of people to draw from.The risk situation of having a CNA away from patients is also a good point.

[JaredCNA, CNA]

Right, and if they trained all of the CNAs to be on the Rapid Response Team, then they would have more people to choose from when they assign the pager.