Incompetent nursing assistants

[ICU, RN, BSN, B.S.]

Hi nurses.

Anyone else feel like many of the PCAs/CNAs/LNAs- whatever, do not have approriate training and competency for their job?? I did while I was working on a medical/tele floor for almost 3 years. Fortunately, I'm in the ICU now, and we do all of our VS and such. While on the med/tele floor, I encountered EVERY PATIENT had a RR of 18 or 20. I repeatedly told my manager about this; she addressed it in staff meetings a few times and sent out an email or 2, but it was never resolved. The problem continued. It annoyed me soo much because the interns/residents/attendings go by the patients vital signs. They are so important. One of the attendings actually said, "when the RR is different from 18-20, then I worry". I counted many pts that were in the 30s-40s and informed the PCAs about this; or vice versa, one patient had RR 10.

Another issue was one of the CNAs forgot to record the diastolic for my pts BP. I told her she forgot to write down the diastolic and she replied "what is that?" I explained it was the bottom number ( I guess that is all they know, about bottom or top number on blood pressure). I always thought they had much more training and understanding of what they were doing!!

I'm venting---but when it comes to patient care, safety- I can't stand the fabrication and laziness. It was absolutely ridiculous!:mad:

[boogalina, ADN, ASN, BSN, MSN, LPN]

Ummmmm...where are the aides receiving their training. If it's in-house at your facility, that might be the problem...also length of time on the job and aide to patient ratio could be factors...

[ICU, RN, BSN, B.S.]

Yea, i'm not sure where they are being educated on PCA stuff?? As far as job experience, most of them have many many many years on the job; which is even more scary. There were a good handful of really good PCAs- most of the really good ones were in nursing school to become nurses, and a couple who just were really good PCAs.

[danh3190]

What you're describing might not be poor training, but a lack of desire to work.

[ICU, RN, BSN, B.S.]

What you're describing might not be poor training, but a lack of desire to work.

I think it's a combination of both. They don't understand the significance of how important accurate VS are to the plan of care for the patient. They also don't understand basic knowledge of vital signs itself.

You are right- many are very unmotivated, and it's really sad, frustrating, annoying to have to work with.

[DizzyLizzyNurse]

Maybe you can give them a quick education on why it's important and what can happen if they aren't "careful" about accuracy?

I loved where I worked as an aide because the nurses answered my questions. Maybe if you have a couple minutes you can do the same?

[skylark, BSN, RN]

Bet you can't beat this -

I recently raised concerns about a CNA becuase she was taking over two hours to complete VS on 10 patients, and could never remember what the VS were, when I asked if any abnormal readings, so I ended up doing them all again myself.

She had been in post around 10 years, but I was new to the hospital, and I don't want problems on my watch, so . . . a quick email to our manager.

Turns out she cannot read or write.

She had somehow worked there all those years, and had been basically scribbling vague dots and lines on the charts, nobody ever said anything.

Since my email she has been moved to a LTC facility where VS is no longer part of her job.

[leslie :-D]

i agree, that it's incredibly frustrating to work with unreliable employees.

and it's not ltd to cnas.

i've worked with some incredibly shabby nurses...

and come to think of it, throw a few doctors in the pool as well.

btw and fwiw, this very frustration, is what i note as my weakness in an interview...

that i have little patience for those who don't aspire to the high standards of nsg care.

and as my strength, i note same: that i aspire to the highest standards of nsg care.:)

back on top, op, you'll eventually realize that you're fighting a losing battle.

to date, this crap still bothers me but if i want something important done, i do it myself.

that's just the way it is, and i'm not going to expend all this neg energy for nothing.

maybe we should start a thread about overall incompetence in the medical field...

just sayin'.

leslie

[lrlat]

Had to weigh in on this one as I am a CNA with 8 years experience and I will begin nursing school in the Fall. I have seen this trend with my own eyes..the CNA's lately have changed considerably. There is a lack of "professionalism" overall. I feel the training is adequate, however...it usually ends there. After training ...there are no CEU's or additional training. I think the position should pay more also...our pay in Texas ranges from 7.25-10.00...which is low when you consider that we really are the "frontline". You can make that working at McDonalds...I mean come on. There still are a few of us ..that give it every thing we have..and understand the importance of our job...but they are few and far between. I personally ...find it a HUGE incentive when I am working with a nurse that shows my position some respect...and listens when I do report something of concern... instead of "being bossy and too busy to listen to me".

[ICU, RN, BSN, B.S.]

Maybe you can give them a quick education on why it's important and what can happen if they aren't "careful" about accuracy?

I loved where I worked as an aide because the nurses answered my questions. Maybe if you have a couple minutes you can do the same?

Yea I did that a bunch of times, explaining the signifcance that accurate VS have in the plan of care for the patient. It didn't do much obviously.

I'm in an ICU now, so we don't really have PCAs- sometimes we will. So far they seem motivated, always asking to help, which is nice.

[ICU, RN, BSN, B.S.]

Bet you can't beat this -

I recently raised concerns about a CNA becuase she was taking over two hours to complete VS on 10 patients, and could never remember what the VS were, when I asked if any abnormal readings, so I ended up doing them all again myself.

She had been in post around 10 years, but I was new to the hospital, and I don't want problems on my watch, so . . . a quick email to our manager.

Turns out she cannot read or write.

She had somehow worked there all those years, and had been basically scribbling vague dots and lines on the charts, nobody ever said anything.

Since my email she has been moved to a LTC facility where VS is no longer part of her job.

OMG! how can you work and not know who to read or write. isn't that illegal!???!

[ICU, RN, BSN, B.S.]

Had to weigh in on this one as I am a CNA with 8 years experience and I will begin nursing school in the Fall. I have seen this trend with my own eyes..the CNA's lately have changed considerably. There is a lack of "professionalism" overall. I feel the training is adequate, however...it usually ends there. After training ...there are no CEU's or additional training. I think the position should pay more also...our pay in Texas ranges from 7.25-10.00...which is low when you consider that we really are the "frontline". You can make that working at McDonalds...I mean come on. There still are a few of us ..that give it every thing we have..and understand the importance of our job...but they are few and far between. I personally ...find it a HUGE incentive when I am working with a nurse that shows my position some respect...and listens when I do report something of concern... instead of "being bossy and too busy to listen to me".

Yea, I think they should have to do CEUs too. we have peoples lives in our hands; even though they aren't hanging blood, or titrating a dopamine drip, doesn't mean things can't happen. Simple things like helping turn patients so they decrease their risk of developing pressure ulcers. Or HOB up 90 degrees for pts that just had a stroke and are just starting to feed again. This stuff can save lives! It isnt all just about meds and stuff like that.