lunch time insubordination

Atheos · Jun 16, 2008

This is not the point. The point is that the CNA was asked to help the nurse and made excuses to do so. When a subordinate is asked to help, unless they are in an emergency situation, they should stop and help. I find that CNA's are reluctant to do alot of things for RN's especially if it interferes with lunch and smoke breaks. Unfortunately, the only one you can depend on is yourself and hopefully you get a good RN co-worker that will help you when you need it. This CNA should have been reported and written up.

OK, legally you CAN'T ask someone to interrupt an official lunch break without giving them ANOTHER uninterrupted lunch break. Labor law. As for the CNA in the bathroom, you are aware that we CAN'T leave a patient in there unless they are totally independant? If that patient falls then who are you going to blame? Why couldn't the RN take the patient? Or at least offer to watch the patient while the CNA went and helped the other one. The CNA is not your slave. Sometimes we can't stop something. Just like you can't interrupt a med pass. Of course emergencies are a different matter.

Oh and we pull nurses out of lunch when someone falls because we can't do anything about it. Try telling your aides that nurse X is to be notified in case of an emergency while you are at lunch. That might help :)

Cursenurse is totally correct. The patient could have waited to go outside. We can't and most likely won't jump if you just tell us to do something. We aren't mindless. If you tell us something because it is a priority and you need us to do it sure. If you tell me to stop what I am currently doing and go clean up the tube feeding YOU spilled I am going to say ok and finish my job first. After cursing you under my breath for being lazy and rude.

Of course good nurses work well with their CNAs and I will change 3 patients, escort 2 outside, feed 1 and do a 1 on 1 with another simultaneously on my lunch break for that good nurse.

Remember, CNAs work with nurses, not for them. Of course, no respectable CNA would refuse to help in an emergency. If I told my nurse I couldn't make copies I would expect to fired on the spot.

cursenurse · Jun 16, 2008

I still do not understand why the cna could not take the pt to the car after she finished getting the other pt off of the toilet. We're only talking about a few minutes here.

Atheos · Jun 16, 2008

I may have misunderstood. Did the nurse want them taken out that moment or when the CNA was done? That moment may have been out of the question. Afterwards though there would have been no reason for that CNA NOT to do it.

BTW - I talk a big game, but I have been brainwashed so long that when any supervisor tells me to do something I end up doing it a double time.

Who can imagine telling a supervisor no? My CNAs may end up hating me. Oh well...

nurseulove · Jun 16, 2008

The resident that was on the bathroom is Alert oriented X3 she was just standing out side the hallway.. i would understand if she was standing out side the residents bathroom door.. she was just there texting someone or checking her phone... and my cnas dont clock out during lunch we get 30 min deducted right away.. i think thats how it is for us.. and i was in the middle of a room change and an incoming admission.. it was very busy that day... are cna's suppose to be waiting on patients to finish on the bathroom?

SunnyAndrsn · Jun 16, 2008

I agree, I'm in LTC and we had a situation recently where a resident's pressure pad alarm was going off. I saw this very unstable resident standing up, and reaching out. I ran down the hall calling her name. Another nurse behind me was asking "where are the aides for that hall?" Three were assigned at that time, and the nurse for that hall was also nowhere to be seen.

The resident was safely seated, and I found out that one aide was giving a bed bath (unavailable to help with alarms), another was on her 30min. break, and the third was outside on a smoke break. Not sure where the nurse was. I told her what happened, and that she didn't have an aide covering the hall at that time. She replied with "Supervise your own hall, I'll take care of mine". WHAT?!?!

I was polite, professional, and trying to let her know that her aides were not communicating well with each other or with her! All three are great aides and simply needed a reminder to stay in tune with each other as to breaks, etc. I was totally blown away with her comment. I was trying to work as a team. My reply was "I'm not sure how to take that, I thought we were trying to work as a team?" Which was met with an eye roll.

I was totally frustrated, my hall has a low census right now and was very quiet. I was available to help, and did, but was told to buzz off!

Thanks pagandeva...I agree. I think we, especially at LTC, need to work as a team more. It just makes it harder on everyone when it's a dictatorship. I know my policy at work says that everyone! is to answer call lights...ummmm, I'll leave it at that. :stone

Virgo_RN, BSN, RN · Jun 16, 2008

i am a young charge nurse in a facility... everytime i ask them to do something like one example...
i was dcing a pt. pt ask if someone could help them go to the car.. i asked my cna to help them to the car she said no im busy while just standing in the hall way saying shes waiting for the pt to finish up in the bathroom is this right?

If the patient is a falls risk, then the CNA is doing the right thing by staying close by until the patient is safely back in bed. Simply ask the CNA to take the other patient to their car when they are finished toileting the one they are busy with.

and sometimes in lunch time they come back from lunch early and just ask them to assist a resident and they tell me their on lunch.. i mean wth?? a resident needs help... is that an excuse to not help them?

CNAs have a right to their breaks, just as much as you do. Ideally, they should not return to the floor until they are finished with their break, for precisely this reason. While one CNA is at lunch, another should be covering their assignment. Have you tried finding out who that is and asking them to assist the patient?

caliotter3 · Jun 16, 2008

When I was a CNA, one time it occurred to me that when I came into the nurses' station early from lunch or break, I was being asked to do things even though I was still on my time. I got a little perturbed because it was me getting asked; not the other CNAs who happened to be around. I figured out to get around this by not coming back until I was ready to go to work. I applied the same thought process when I would stay after my shift to finish my charting and visitors thought I was the only person who could help them, even though I told them I was not on duty. You can't be asked to do something while you are on your break or if you are off duty if you are not around. The CNAs are smart enough to figure this out for themselves. I suspect they mouth off like this out of spite.

LadyJRN1 · Jun 16, 2008

My point EXACTLY, was, what was the nurse doing after dcing the patient that she was completely incapable of walking the patient to the car? Did she have another pt in the bathroom? Was she not back from lunch yet? Or is it not 'her job' to walk the pt to the car?...regardless of how you feel about CNA's, her "excuse" was not that, it was a response of fact...one WAS waiting on a pt in the bathroom, and the other WAS NOT on the clock.

I beg to differ. Even if one is not on the clock and the person in the bathroom was OK, the CNA should have at least helped or found other help for the RN. That is why they are called "nursing assistants" to help the nurse. :banghead:

FireStarterRN, BSN, RN · Jun 16, 2008

I think the tone of the OP strikes me as being condescending to 'her CNAs' who are 'insubordinate' because they don't hop to while on their lunch break.

Just want to point out that good management of CNAs requires some finesse. They, like many people, don't take kindly to 'young charge nurses' ordering them around as if they are privates in the army.

Ruby Vee, BSN · Jun 16, 2008

i think the tone of the op strikes me as being condescending to 'her cnas' who are 'insubordinate' because they don't hop to while on their lunch break.
just want to point out that good management of cnas requires some finesse. they, like many people, don't take kindly to 'young charge nurses' ordering them around as if they are privates in the army.

that was my take on the situation as well. if they're on break, they're on break. unless it gets excessive (we have one cna who gets four breaks a day and they all seem to last an hour!) leave them alone on their break already. if the rn couldn't leave the unit for some reason, the cna who was waiting for a patient on the toilet could have helped after her patient was safely off the toilet, or the patient being discharged could wait until after the other cna was finished with her lunch break.

coltsgrl · Jun 16, 2008

I beg to differ. Even if one is not on the clock and the person in the bathroom was OK, the CNA should have at least helped or found other help for the RN. That is why they are called "nursing assistants" to help the nurse.

Yes, we are nursing assistants, not volunteers. The OP didn't say if the person in the bathroom was OK or not...so I can't answer that. So, a resounding #@!! no, I'm not working when Im off the clock, and I wouldn't expect anyone else to either. But...I EARN the right to say that, I work my tail off and no one will argue that!!!

....and I'm done now Have a wonderful day everyone, I'm going to see what sunshine looks like!!!!

:weathersunsmall:

justme1972 · Jun 16, 2008

If the CNA's have to clock out for their lunch, and you are asking them to work on their lunch break, that is asking them to work and not get paid for it. It's also against the law.

If the CNA is in the hallway and said she is waiting for a patient to get out of the bathroom...IF SHE TOLD that patient that she would be waiting outside in the hall and to "yell" when he or she was done....then what kind of message does that send to the patient if she isn't there? How do you know that the patient doesn't need assistance to go BACK to bed after finishing in the bathroom?

Sorry, I agree with the CNA's in these scenerios.

This isn't insubordination...not even close.