Bossy CNA's in LTC(long) - page 4

Hey all, I need some advice. I am an LPN working a skilled rehab unit in LTC. i recently joined the company so I am new to them, but have been a nurse for nearly 6 years. Yesterday, I had a floating... Read More

  1. by   LPNnurse
    You are not wrong at all, they should be doing their vitals. If they didn't it would be the same as you saying that you don't feel like doing your charting for the day. How are you going to deal with this?

    Quote from Malt123
    Am I wrong or were CNA's taught to do vital signs? Why can't they do routine vs like weekly's and monthlys, since when can a CNA refuse to do what is in her scope of practice?
  2. by   Malt123
    this is a problem in LTC, some nurses have given in and just do them, I couldn't tell you how many times I have walked in to answer a call light and found 3 aides sitting on the bed ( assisting an ambulatory pt. to the bath room) while all the other residents are on the call lights and management is blaming the nurses. I have seen this craziness drive nurses to fake documentation. one big disfunctional unit/facility. since other facilities are able to function in a better manner I am sure that even this place would be able to run a little smoother also. Remeber those bullies in school well they are now adults working in geriatrics with the same mentality are you going to manage them the same way that you would manage people that are not bullies. I am not a bully and I will not back down from them either.
  3. by   Chel
    Quote from LPNnurse
    All of you really are nurses? I am a nurse and without them life would be really hard. Try to treat them like people rather than treating them like they are below you and you would not consider them bad cna's. Maybe they think the same of you. My gosh ladies, you are nurses, stop acting like you are in highschool!

    I agree. Nursing assistants work their tails off. The long term care facilities I've worked at usually have a ratio of 1 nursing assistant to 10 - 15 patients, depending on the needed level of care. It's hard work. I did it for several years a long time ago. But they know the job description when they sign on. There are good nursing assistants, and bad. Just as there are good nurses and bad. I never treat nursing assistants (or housekeepers, dietary, etc) like I'm above them. I help on the floor when my duties permit ~ pass trays, feed, toilet, answer lights, etc. But I have a job description of my own.....and despite the fact that you see nursing assistants as nurses ...they can't help me with my work. It's out of their scope of practice.
    I've had nursing assistants tell me someone was dry, and I go right behind them and find the bed soaked ~ it was time for her to go home. I had a nursing assistant change the pad on a bed, but not the linen. Guess she didn't notice the huge brown stains down the side of the bed. I've seen patients get changed without benefit of being washed off when they've only urinated. Wonder why perineal areas stay red and irritated? I found out that one nursing assistant didn't turn resident's if they were asleep. Strictly my opinion, but for what it's worth, I don't consider those nursing assistants "good". A time or two I came on shift, the nurse was on the floor with a patient, lights going off, and I find three nursing assistants just sitting. I just plainly point out that there are lights going off. As a charge nurse I was ultimately responsible for the condition of the floor. I take that very seriously.
  4. by   lovingtheunloved
    Quote from LPNnurse
    Sorry, bad week. Not a grammar lesson just a personal opinion. I just get upset when people down cna's cause I think they do an incredible job. Don't take it to heart please.
    Ah, no worries. I was a little, um, under the influence when I posted yesterday. Bad day for me too. I understand where you're coming from. CNAs do need respect. But whether the nurse respects me or not, I'm not there for her, I'm there for the patient. And I'm going to give the best care I can regardless of how my superiors treat me. Which, I must say, the nurse's I work with are wonderful.
  5. by   Malt123
    there are some exceptional CNA's out there and to those I am ever so grateful, thank you to all the CNA's that care and don't stop caring we need more of you:chuckle
  6. by   LEL
    Quote from LPNnurse
    She is not a nurse? CNA in my eyes is a nurse. That was kind of rude of you. I have to back them up because I used to be there and if it was not for them you would be very unhappy. Lay off of them!
    Hello>>>> CNA is not a nurse. Get off your soapbox. Do you even know what CNA stands for? I bet the other nurses yes nurses not nursing assistants love working with you (not).
  7. by   blue chips
    did you use to be a cna before becoming a lpn? some of these lpn(s) feel they have to talk to the cna like their kids at home. while i was in nursing school i work as an na and the lpn(s) will try to talk rude to me, so i had to check them,

    Please tell us the real story.

    Quote from jaimemds
    Hey all, I need some advice. I am an LPN working a skilled rehab unit in LTC. i recently joined the company so I am new to them, but have been a nurse for nearly 6 years. Yesterday, I had a floating CNA on my wing, she was not used to the pace and routine of our unit and was struggling to keep up, so I asked one of the regular CNA's to give her a hand(the regula CNA only had three pts.!!!) i explaines to her that the other CNA was falling behind and was getting frustrated. She TOLD me in a rude tone of voice that" I gave her report this morning and I TOLD her, if she needs help to ask". I then said to her that I was asking for her. She proceeded with "WHAT DID I JUST TELL YOU !!!!" I was appalled! :angryfire Our unit treatment nurse was within ear shot and so was another CNA. I walked away at that time because I knew if I said anything at that point I would blow up! Also this CNA has been counseled for her tone of voice to pts. In my opinion, if she speaks to ME this way, how is she really speaking to the residents? I need advice on how to approach someone with this attitude, make my point and ensure that I am taking the correct action. PLEASE HELP!!
    Last edit by blue chips on Jan 7, '05
  8. by   blue chips
    this stuff is common sense. so stop trying to put people down. i know a cna right now who has a Bs in biology and is going to nursing school, not because you see a person working has an cna means that they do or do not have a ged, maybe if we learn how to speak to people like humans they will respect us. :stone

    Quote from Nici
    What you have here is what is exactly at the root of the overall problem with LTC. Nursing homes are the step-children of healthcare. And it's no wonder why. We are just so darn "disfunctional".
    Now, I don't want to bash my own people, so please don't misinterpret my words. But realistically, it is the LVN's that have primary responsibility for managing the care that the patients recieve. And let's face it folks, we have one year of education beyond a H.S. diploma...and how many of you received managment/leadership training in your LVN/LPN course. I dare to say none of us.
    So here we are, managing folks with less education than ourselves, sometimes not even a H.S. diploma or even a GED. It's the unprepared/undereducated, managing the uneducated.
    How many people in your facility actually have a four year degree, one that might actually include some management training? There's the administrator,social worker, possibly the DON (but not necessarily..might be an ADN), and the therapists.
    Solution? I thought you'd never ask.
    I believe we should ask for, no demand, the training for the task that we are required to perform. We are expected to have a nursing license to perform our function as a nurse, but exactly what training do we have in order to perform our function as a charge nurse/nurse manager? You try and tell me that it does not require some skill to deal with a surly aide.
    I say RISE UP LVN's and demand our rights to proper education for the responsibilities required of us. Are we not held legally liable for the well-being of our residents?
    OK, OK. I know. Although my words are tounge-in-cheek and meant only to help you smile, the sentiment is earnest. Our task to serve and protect the rights and dignity of our residents is a serious one. And truly, how can a nurse focus their attention on the very real needs of the residents when we are left to deal with some poor aide who carries around a chip on their shoulder the size of an evergreen? It's seems obvious to me that if we continue doing what we are doing, which is allowing people without management skills manage folks who desperatly need to be managed properly in order to succeed. There is a fairness to nurses AS WELL AS the CNA's that is not being met.
    Anyone with me here?
    Last edit by blue chips on Jan 7, '05
  9. by   jaimemds
    Last week my unit manager called a "department meeting" the supposed reason was for the tension on the floor, but what it really came down to was the CNA that i was having the problem with got to CONFRONT ME :angryfire in front of EVERYONE, she was in my face, pointing her finger, etc. I spoke up and asked why a personal issue was being discussed in front of 7 people who had no business knowing what was going on? i got no response. By the time it was over I was accused in front of everyone of being a racist!!!!!!!!!!!!! :angryfire Let me say that I am in no way,shape or form a racist, 6 of the 7 CNA's i work with are black and I have no problems with them of anysort! I was shocked, emarassed and angry, so much so that I couldn't speak. when I was finally able to defend myself, I couldn't get a word in. My manager just sat there and let it happen. The next day, one of the CNA's who was in the meeting, apologized to me for what the other CNA had said. I meant alot coming from her, as it let me know that I really do not give the impression that I am racist.(this CNA was black also). Now I am completely at a loss of what to do, it seems there is no where to go from here but down. I talked to Human resources, they stated they are surprised that this certain CNA is still here also. HELP!!!!
  10. by   Malt123
    this common practice. I was also told I was a racist because I told a CNA twice to go help pass trays. at the time I never noticed the color of her skin
  11. by   jaimemds
    The worst part I guess is the fact that now, everytime i look at a black person, i second guess myself thinking, "am I looking at them like I am a racist?" This whole situation has really, messed with my mind and confidence
  12. by   URO-RN
    I don't think that CNA's in long-term care are necessarily bossy. I think that they are very protective of their patients. They know their patients and have established deep bonds with them.

    Of course, there are bad apples everywhere.
  13. by   katlpn6
    Although I am not making excuses for her behavior, lets face it, CNA's get paid very little money to do very hard work. I can understand how an "attitude" can develope in an underpaid overworked CNA. Add into that the age factor. You didn't mention the age of this CNA but in the rehab center where I do perdiem all the CNA's that I have working with me are very young. It seems that the younger people these days don't have the maturity needed to do any work with the public much less as a personal care giver to a fragile elderly person. It seems like your CNA has gotten full of herself and needs a wake up call. Certainly it is not your place to give it to her but you are certainly well within your rights as her direct supervisor to let her know that her behaviour is not acceptable. I'm sure you can find it in you to tell her in an nonthreatening diplomatic way that it is important for everyone to work together for the common good of the residents you all are caring for. Rimind her why she is there in the first place, to care for people who cannot care for themselvs.