lunch time insubordination

justme1972 · 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.

I disagree, you cannot ask someone to work off the clock. Asking someone to do ANYTHING when they are not clocked in, is working off the clock.

Is the nurse's fingers broke? Why can't she call someone else if she is ON the clock?

Keep in mind, you don't get paid for injuries if you are an hourly employee and get injured on the job if you are clocked out...and I guarantee if the CNA was "off the clock" helping a patient ambulate and they fell, the hospital insurance company would say, "You are on your own".

november17, ASN, RN · Jun 16, 2008

I'd just like to throw in that it is your job to make sure your subordinates get 100% of their breaks/lunch breaks. Especially if you are "charge."

If someone files a complaint that they're not getting their breaks, guess who's gonna get blamed?? And it's not the little old lady down the hall either!

If it is a problem then start mentally noting what time they leave on your watch and what time they should be "back."

Vito Andolini · 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? 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?

Being on lunch is a valid excuse not to work. My question is why they are on the floor if they're still on lunch. Can you verify what time they left and how long they have left? Maybe they're being less than truthful about that?

You can't expect an aide to desert the pt in the bathroom. That would be dangerous.

Don't ask...tell, would be one suggestion.

SDS_RN, RN · Jun 16, 2008

There was an easy solution to the problem and it's been mentioned several times. Either you wait until the CNA is done helping the pt in the bathroom then have her help the dc'd pt out or you help the pt on the toilet and let the CNA take the other to her car.

Knowing the status of the patient in the bathroom would be good to know because if A&O x3 then yes the pt could have been left w/out assistance. Since the CNA was waiting that makes me assume that the pt did require some sort of assistance whether that be an RN or CNA.

jessiern, BSN, RN · 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.

Wrong.

If we were talking about an emergency situtation, like a patient falling or becoming abusive, ect, then I would agree with you. But a patient going down for a discharge-they can wait till more pressing matters have been taken care of.

This nurse is perpetuating some of the basic problems we have in nursing. We work 12 hours, we should be allowed a break-or even a couple of breaks *shocking* . We are not matyrs, and we require food and rest as well as any other employeed person.

If a CNA is waiting for a patient to finish in the restroom, then I completely agree with her that she should wait for them to finish. I personally do not like filling out incident reports for patient falls because another nurse demanded the aides time while my patient was in the restroom. Some patient are are not going to wait to get back in bed, and falls do happen in cases just like that.

I think the OP, and many nurses, might need to remember that CNA's are people as well, and need to be treated as such. Would the nurse in question have cut her lunch break short to walk the patient down? Also, they are there to "aide" the nurse, not "serve without question".

Plagueis · Jun 16, 2008

About the lunch breaks: where I work, us aides split the 30 minute break. If there are 5 of us, no more than 3 aides go to lunch (dinner on my 3 to 11 shift), and lunch is served at specific times. In other words, there are always at least 2 aides on the wing. The split lunches also happens with the nurses. We also have assigned breaks. We can't just go the charge nurse and say, "I'm taking my 30 minute dinner break." Therefore, there should always be a CNA available to help residents, even during breaks.

As far as coming back to the wing early, I don't know how it is elsewhere, but our 30 minute break is not "over" when we come back to the unit, but when the half-hour is up. Also, us CNAs cannot be "summoned" if we are off the floor for our 30 minute break to take a resident to the toilet, for a transfer, etc., because there should be CNAs on the wing who can do that.

pagandeva2000, LPN · Jun 16, 2008

One of the main reasons for falls is because the patient has to use the toilet. I think that the patient should have trust that they will have assistance to get on and get off of the toilet, or they will take it upon themselves and cause an injury.

The OP didn't get into any details about the consistent behaviors of the CNAs, so, I was only able to base my opinion on what was actually stated, and for me, it was that the CNA was probably staying close to the patient because they must have needed some assistance (or even the patient asking that one stay close is enough to honor that). And, the reason we have staggered breaks is so that the unit is always covered by a nurse and a certain amount of CNAs.

Melinurse · Jun 16, 2008

I agreed with Baldee but want to add, if they say they can't help because they are waiting for another pt. who is in bathroom, I usually tell them I am capapble of getting the pt out of the bathroom but as the nurse I cannot leave the floor. ( esp. if only one ) If it's their lunch time, you can ask, but you can't get mad if they say no. If it is an emergency, tell them tough luck clock back in and give them an extra break later. Usually, CNAs will test limits with new staff or with someone they don't respect ( yet ). Be careful with warnings though, some CNAs go the extra mile for " nice " nurses. When I was a CNA I always was bothered by the RN who would spend all this time looking for me to tell me to put someone on a bed pan. Why couldn't the RN put the pt. on the bedpan and then come tell me they are on the bedpan so I could go get them off of it? Now that I am the nurse I get the pt into the bathroom or on the bedpan then look for my CNA. This also helps with pt. satisfaction and incont. pts. :up:

Vito Andolini · Jun 19, 2008

There was an easy solution to the problem and it's been mentioned several times. Either you wait until the CNA is done helping the pt in the bathroom then have her help the dc'd pt out or you help the pt on the toilet and let the CNA take the other to her car.
Knowing the status of the patient in the bathroom would be good to know because if A&O x3 then yes the pt could have been left w/out assistance. Since the CNA was waiting that makes me assume that the pt did require some sort of assistance whether that be an RN or CNA.

People can be A&O x3 and still need help in the bathroom, can't they? :confused:

litbitblack, ASN, RN · Jun 19, 2008

People can be A&O x3 and still need help in the bathroom, can't they?

Again, a and o *3 tells me they can use the call lite to call for assistance to get back to bed. The pts also have a responsibility in thier care and if they are with but know they are unsteady then they can call for assist to go back. some people take thier time in the br and sorry I have tons of other things to do. As for lunch, Dont be seen until its time for you to come back. In my case that doesn't work as i leave my cell # so if they need me I come, but we have 30min taken out regardless if we take it or not...

Kim O'Therapy, BSN, RN · Jul 10, 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.

Sorry to disagree, but if one is not on the clock, you have no right to demand anything unless it is an extreme emergency. I'm detecting a slight superiority complex here.

Sisukas · Jul 10, 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. :banghead: "

they are called nursing assistants because they assist the patient, in my opinion. they are not there to assist me and they do not work for me. they work for the patient, as do i.