It's sort of a bummer with some of these aids

minnymi · Jun 21, 2012

and this is why i wish every nurse had to be an aide before going to nursing school....

i could go on for days with examples, but i remember one time specifically when i had 3 nurses wanting me to do something at the same exact time as soon as i stepped on the floor basically for a morning shift. i had started getting vitals (had ten sets to get using a machine that i had to take room to room). i had gotten 4-5 sets when one of the nurses asked if i had put them into the computer. "no, i haven't finished getting them yet." she tells me that i should be putting them in after every set or two. yeah RIGHT! we aren't supposed to leave our computers unattended, so it makes more sense to me to get all 10 sets down on paper, sign into the computer ONCE and take just a few minutes to get them ALL in the computer instead of signing into the computer, charting two sets of vitals, signing out of the computer...taking two more sets, signing back in, charting two sets...etc, etc. i told her i was hurrying to get the rest of the vitals finished and when i had done that i would chart them. besides, if there was anything abnormal i would always report to the nurse with the paper copy even if they hadn't been entered yet. she knew this. not to mention....it was only a few minutes after 7am and technically the vitals didn't have to be taken/charted until 9am because they were 8am vitals. i don't know how it is at all facilities, but we could start at 7am for 8am vitals and had to be finished by 9am. as i said, it was only a few minutes after 7am so she was totally out of line which the charge nurse verified later when i questioned her about the nurse saying i should be charting after every set or two.

anyhow, i had that nurse wanting me to get the vitals finished and charted (even though i always had them done and charted BEFORE 8am). then, i had another nurse wanting me to go in and feed a patient who was total care RIGHT THEN. then, i had another nurse stop me (while still trying to get vitals) and ask me to sit with a patient who had a 1:1 sitter ordered, but the sitter hadn't shown up yet. she was like, "i have to start my assessments. i can't stay here with him." i'm thinking...okay, i get that, but all of you still expect me to have the vitals of these 10 patients taken and charted, you want me to sit in this room with your patient, and the nurse down the hall is mad because her patient wants to eat. uh....i can't be doing vitals, feeding a patient, and sitting with another patient all at the same time. when the charge nurse walked by i told her the situation and she told me to finish getting vitals. even though they didn't HAVE to be charted until 9...that was always our first task and priority when coming in. the charge nurse went down to start feeding the patient who needed help, and she told the 3rd nurse to do what i had suggested and have the nurses who were sitting right outside the door exchanging report watch her patient until either the sitter arrived OR i had finished vitals.

most of the nurses praised me for getting my work done and informing them of things, but even though i was a "good one" things like that happened fairly often. it wasn't unusual for me to have requests from 3 different nurses and 5 different patients at the same exact time with each and every person thinking that what they wanted/needed was top priority and none of them having a clue that i already had a list of requests/demands from others.

i would just about bet that while the OP thinks that the vitals were the top priority....there was another nurse who had gone to give medicine and picked up an empty water pitcher so asked the aide to fill the pitchers. there is always so much to be done and not enough hands.

beckster_01, BSN, RN · Jun 22, 2012

^ What she said. Being a tech/CNA/what have you is an awful job. They basically have 4-5 people delegating busy work to them. In addition, patients assume that they have no responsibilities. My floor has a pretty reasonable system. Vitals are q4h, so nurses do 8am vitals with our assessments, and 4am vitals since the techs are busy drawing blood for us. Techs do the rest. They also do all of the baths, all of the BG's, and all of the EKG's (most of our patients have daily EKG's). If I need anything stat, I do it myself. The only exception is if I need several things stat, then I will delegate the most appropriate item to the tech (are they great at drawing blood? They get the stat blood draw while I check a BG). All "tech work" is also "nurse work," so if I need it badly enough that it is a priority, then I do it myself. For the OP's scenario, if filling water pitchers is such a big issue at change of shift, then I would be making sure that when I entered a room to do any basic care that I am checking to see if the patient needs some fresh ice water. That way I am not making special trips, the patient is happy, and the tech is free to do their vitals at the appropriate time.

KimberlyRN89, BSN, RN · Jun 22, 2012

I think it also depends on the setting in which you work. Acute care CNAs/techs seem to be more knowledgeable than LTC CNAs. This is something I've noticed, starting out as a tech in med/surg, then becoming a LPN in a nursing home.
In my LTC facility, it seems like at least 75% of the aides are shaky at getting manual BPs. And I'm shocked how many of them think nothing of charting a temp of 95 degrees or lower. I blame those stupid tympanic thermometers for that. I have literally tried to hide the tympanic thermometer so no one can use it, LOL.

One of the aides at the nursing home where I did my clinicals at tried to argue with me b/c she couldn't comprehend that my patient's RR was 10. She thought I was making it up!! This patient had CHF & was on o2, but he kept pulling the cannula out of his nose. I tried my best to keep calm & tell her that everyone's RR isn't going to be 18 all of the time:uhoh3: :madface:

minnymi · Jun 22, 2012

One of the aides at the nursing home where I did my clinicals at tried to argue with me b/c she couldn't comprehend that my patient's RR was 10. She thought I was making it up!! This patient had CHF & was on o2, but he kept pulling the cannula out of his nose. I tried my best to keep calm & tell her that everyone's RR isn't going to be 18 all of the time:uhoh3:

i don't even like the idea of vital signs being designated to aides. they're way too important. i wouldn't want ANYONE ...CNA, LPN, RN, or doctor doing vital signs on patients that I'M ultimately responsible for. that's just my opinion, of course.

i mean, i did vital signs...tons and tons of vital signs when i worked as an aide at the hospital, but i was a little older and way more educated than most aides so i took the job seriously. i guess i just have trust issues.

besides, between all the call lights the nurses refused to answer, the patients that had to be bathed, turned, walked, and constantly use the bedpan (or the bed) they could've taken the vital sign responsibility away and i would have still probably not been able to take my breaks. oh, how i don't miss that job. it was the unit from hell.

minnymi · Jun 22, 2012

I think it also depends on the setting in which you work. Acute care CNAs/techs seem to be more knowledgeable than LTC CNAs. This is something I've noticed, starting out as a tech in med/surg, then becoming a LPN in a nursing home.
In my LTC facility, it seems like at least 75% of the aides are shaky at getting manual BPs. And I'm shocked how many of them think nothing of charting a temp of 95 degrees or lower. I blame those stupid tympanic thermometers for that. I have literally tried to hide the tympanic thermometer so no one can use it, LOL.

I agree. I started out on a med/surg floor also. I saw a lot of bad things happen after taking a blood pressure that was in the pits. Lots of rapid responses called. I learned quickly how VITAL those signs really were. For the most part...CNAs can't possibly know how important vital signs are. That's not an insult (hey, i worked as one) but without being educated about the human body and things like hypovolemia, shock, etc...they just don't realize. I know I didn't and as I said I was older than most of the other aides and college educated (not in the medical field) but I had a little bit of sense ya know...more than an 18 year old anyway. I've seen aides make up vital signs. RR is the WORST for being faked.

On the flip side of what you said about aides not being able to get a manual BP....I saw lots of RNs (lots of new nurses in the revolving door of med/surg) who couldn't do a manual BP for the simple fact that they relied on the aides to do them so they never had to. Some of them literally hadn't taken a BP since skills lab in school. Same went for blood sugars...no clue how to use a glucometer, or draw blood...or clean poop. haha.

frankie,RN · Jun 22, 2012

True story. Did 3 nights agency at a LTCF. First 2 nights, cna's were great, promptly got vitals. Bp's were wnl. Not concerned. They used a manual bp cuff on wheels. Third night. I have to get a bp on someone. I used the bp cuff that they had just used to get all of their vitals with.. The bp cuff didn't even work. I went out to my car and got mine and did more bp's. They weren't even close. It was as if they just made up some random number for vitals. Scary.

caliotter3 · Jun 22, 2012

Then there are those who have wisely learned to write down 98.6, 80, 18, and 120/80 for everybody on the VS list, every shift. VS that are not reliable aren't any better than not having anything written down. Explaining the importance of tasks gets a doe-eyed expression and 'yes, yes, yes,' but no real concern to do the job tasks as they are meant to be done. The one or two assistants that do their jobs right get fed up with being asked to do more than their fair share. It is too much of one situation and not enough of another, unless of course, you really have that management support we all look for. Heh.

BrandonLPN, LPN · Jun 22, 2012

I'm always amazed by the stupidity of aides (and even some nurses) who make up vitals by writing 120/80 and RR20 (or whatever) EVERY single time.

I mean, if you're going to lie, at least change it up a little. Throw a

136/78 or something in there for crying out loud! :)

caliotter3 · Jun 22, 2012

I'm always amazed by the stupidity of aides (and even some nurses) who make up vitals by writing 120/80 and RR20 (or whatever) EVERY single time.
I mean, if you're going to lie, at least change it up a little. Throw a
136/78 or something in there for crying out loud! :)

I've often thought the very same thing!

ldiva0808 · Jun 22, 2012

people do make typos, and i guess there are folks out there without enough cognition to think I meant the disease aids. get serious.

Thanks for your replies. :lol2:

jadelpn, LPN, EMT-B · Jun 22, 2012

people do make typos, and i guess there are folks out there without enough cognition to think I meant the disease aids. get serious.
Thanks for your replies.

My cognition is fine, my sarcasm level is not. Sorry, no offense meant.

ldiva0808 · Jun 22, 2012

no offense intended. and i wasnt offended at all. im sure your cognition is fine, my sense of humor might just be asleep at the moment, who knows. But thanks a bunch for your reply, i really appreciated it. :up: .