Major venting about some CNA's

[michelle95]

First, let me say that I am not venting against all CNA's or even most...I've been one myself. I know how hard they work. I applaude the good ones.

My problem is the majority of the ones at where I work. They talk back, they leave people in messes...it's really making me mad. Just this morning, I told a CNA that was going to get my blood sugars at 5:30, to wait until at least 6:00 because I didn't feel comfortable giving insulin at 7:00 on a 5:30 accucheck. I had originally told her 6:30, but, after she explained to me that she couldn't at that time, I told her I would compromise and make it 6:00. (Sometimes our patients don't get their breakfast trays until almost 8:00 and 11-7 is responsible for the insulin at 7:00) She flat out refused. She told me that the boss said it was ok. I told her, she's not here right now, is she? You're working on MY license, not her's.

She told me no and went and got them at quarter of 6 in defiance.

I told the 'boss' when she came in, but, this is the same boss that let another CNA get away with telling me to 'shut the hell up', as well as, telling a patient to shut up. (Which is why the CNA told me to shut up...I was getting on to her for doing that)

I am so SICK of not being backed up when I tell a CNA to do something. I know I am just a little 'ole LPN at this time, but, I still expect the CNA's to do what I tell them.

I try to be fair. Like I said, I was a CNA, I know how hard the work can be....but, I didn't talk to my nurses any old way I feel, much less, tell them no when they told me to do something.

If the big bosses won't do anything, what am I to do? Go over their heads?

This is my last night tonight. I've done decided that the next place I work, I am not going to be so nice. I've got an interview tomorrow and I am going to explain to the administrator that I DEMAND back up. If I tell someone to do it, and, they snap off, I EXPECT there to be repercussions.

I hate to be so down and dirty, but, I had an spiritual experience a couple of weeks ago that made me see that every patient I come in contact with, is someone's loved one. I don't expect to see them laying in pee or dried food for hours. That is soooo undignified. If I don't take up for them, who will?

Any advice? Should I go to the ombudsman if the bosses won't do anything about these CNA's with an attitude?

I hope any CNA's that read this don't take offense. If you do your job honorable, I am not talking about you.

[RN auditor]

I did hav ethat kind of time when I worked in a nursing home. I loved it and truly felt I could give individual attention. Maybe I worked in a place that was better staffed.

[lateblumer]

I can understand your point. Some of the CNA's at my place, won't do anything I ask them to do because I started out there being trained by some of them. I got my license and now work as an LPN in our unit. They are rude and disrespectful about everything. If I ask them to help me do something, they look at me as if I asked for their firstborn. If I say Please and Thank You, they ask me why I'm being so nice to them. If I tell them to do something for the second or third time , they say I am a -----well you know. I can't win either. They swear, eat, and flat out say they won't do something in front of our residents.

Management???? What a joke! She is only concerned about filling the beds. If the CNAs go to her with a complaint, she listens and reprimands those accordingly. If one of the nurses' goes to her with a complaint, we are told that we are being to hard on them, or maybe we don't realize the complexity of their positions. (?)

Any suggestions for this?

[Riseupandnurse]

There are definitely two different issues here. The first issue has to do with lack of cordiality and proper intraemployee relations. This is a matter for administration. The second has to do with the duty of a nurse towards a patient. If a nurse believes a patient must have a blood sugar done at a certain time, and has good reason to think a CNA won't do it, then the nurse must do it. The welfare of the patient comes first, and the nurse owes the patient the performance of the duties that secure that welfare. This is totally independent of what a facility does or doesn't want a CNA to do. The nurse is physically present, has assumed care of the patient, and must make the minute-to-minute decisions for that patient, based on education and experience and founded on what specifically is going on with that patient at any given time.

The standard here is your state Nursing Practice Act, not what a nurse personally believes, or even what a facility's policies are. A nurses's right to practice is granted by the state Board of Nursing, and a nurse's duties and responsiblities are strictly defined according to the Nursing Practice Act. All job classifications addressed in the Act are clearly related in terms of who is responsible for supervision.

I used to be a CNA and now have been a nurse for 11 years. Some nurses are rude, and so are some CNAs. None of this really matters in terms of what the duty to the patient is. A CNA may not abrogate the determination of what a patient needs from the nurse, and the nurse remains personally responsible for the appropriate delegation and execution of all nursing functions that involve a patient's health and welfare. This includes functions that either the nurse or the facility have delegated down to the CNA. It's still the nurse's patient, and the nurse must accept that all acts directed toward the patient by nursing or nursing assistants are ultimately the nurse's responsiblity.

[rebelwaclause, ASN, RN]

Originally posted by gojack

And I, cannot actually get mad at the CNAs for dumping on the patients in this madhouse (one aide said it was like the Jerry Springer Show). Any advice from all the experts out there, other than suggesting I just go out and find another job? Actually, I have heard that this is one of the better nursing homes in the area!

Advise? Remember its all about the patient, and really not about us at all. We get a paycheck and the thought that we can walk outta some heinous looking stuff we see in nursing people - With our legs, eyes, heart, blood and all working just fine. Patients aren't this privileged, so it makes me a little more humble when I don't get "props" for the work I've done during my shift.

[cargal]

Originally posted by lateblumer

I can understand your point. Some of the CNA's at my place, won't do anything I ask them to do because I started out there being trained by some of them. I got my license and now work as an LPN in our unit. They are rude and disrespectful about everything. If I ask them to help me do something, they look at me as if I asked for their firstborn. If I say Please and Thank You, they ask me why I'm being so nice to them. If I tell them to do something for the second or third time , they say I am a -----well you know. I can't win either. They swear, eat, and flat out say they won't do something in front of our residents.

Management???? What a joke! She is only concerned about filling the beds. If the CNAs go to her with a complaint, she listens and reprimands those accordingly. If one of the nurses' goes to her with a complaint, we are told that we are being to hard on them, or maybe we don't realize the complexity of their positions. (?)

Any suggestions for this?

You took the words right out of my mouth.

[michelle95]

RN auditor, did you even read my post? I believe I said that I take people to the bathroom, put them on the bedpan and have even put every one of my patients in the bed because the CNA couldn't be found. Please reread what I wrote. I think I see a lot of 'communication problems' on this board.

jan, as a matter of fact, the next day, I made sure to get my own blood sugars to keep any confrontations from happening. The CNA? I think she was a little upset about that. Oh well. I didn't have to bother her, now did I?

[michelle95]

Rn auditor, did you happen to be a floor nurse when you were painting nails or were you a supervisor, by any chance?

[Ortho_RN]

michelle95.. if you reread RNauditors post she said the she was able to paint nails when she worked at a Nursing Home..

[kids]

Originally posted by nurs2b

michelle95.. if you reread RNauditors post she said the she was able to paint nails when she worked at a Nursing Home..

Having spent my first 6 years as a nurse in nursing homes I have to ask...why does it make it different if she was working in a nursing home when she was painting nails?

[BrandonRN2004]

Can we say demanding AND RUDE?

[Ortho_RN]

Originally posted by kids-r-fun

Having spent my first 6 years as a nurse in nursing homes I have to ask...why does it make it different if she was working in a nursing home when she was painting nails?

Umm, one post above mine, Michelle95 asked RNauditor where she worked when she was able to paint nails... So I answered her question..

[longtimecoming]

Michelle - I am a CNA (and SN starting Spring '03) and was not offended at all by your post. It is appalling to think that any employee would tell ANYONE on the job to "shut the hell up" but in Washington State (where I work in LTC) talking to a patient like that is ABUSE. There is a special number you are required to call to report it to the state AND you are required to report it to the employee's supervisor. You had every right to reprimand the CNA for it - I would reprimand ANYONE talking to a pt like that - I don't care how many letters are behind their name!! People come to hospitals, LTCF and ACFs because they NEED us, not to be left in their own urine or with food caked to their faces!! As for the blood sugar thing, CNAs in our facility can't do the accumeter - the LN checks the BS and gives the insulin at the same time - I mistakenly assumed it was the same everywhere.

Maggie7 - Where I work, anyone caught sleeping on the job should immediately be written up for the 1st offense and fired for the second. Of course, the nurses are the ones who have to report it, and since our facility has only 1 nurse on NOC shift, they prolly aren't very eager to report their CNAs. It's ones CHOICE to work NOC (usually) so be responsible and sleep on your time off. I do.

Alison

CNA, RN student starting April 2003, Future CRNA