More CNA woes.

Nurses General Nursing

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Some of you are probably already familiar with the culture on my unit, where CNAs are permitted to perform abysmally with no consequences (this has been the culture for years). Float pool nurses and nurses from other floors have refused to float to our unit because of it. Good RNs have left the unit because of it.

Not very long ago, the aides made it clear that they expect RNs to *take turns* with the "toilet Q2s" and the "turn Q2s".

Well, now they're complaining that some RNs delegate all routine vitals to them, and we're going to reevaluate our VS protocol as a unit, and they're requesting that RNs help with passing and picking up meal trays.

It's one thing to help out with this stuff when I have time, and I totally don't mind, but this is getting ridiculous. It's not like I sit on my behind picking my nose while the aides scurry around. I have missed many a dinner break and have had to stay late to finish charting on many an occasion, yet the aides *always* get their breaks and get out on time.

They take a half an hour to give CNA to CNA report, while call lights go unanswered that entire time. What if the person is having chest pain? What if they are bleeding from their groin site?

I even recently overheard one CNA saying to another "We don't do VS. That's part of the RN's assessment."

Then, last night, while I was busy in a room with patient care, my wireless started ringing in the middle of what I was doing, so I looked at it before silencing it (instead of throwing it out the window, which is what I really wanted to do), and it was a text that read "Please help pass trays".

Is this normal? Am I crazy to think this is absurd?

Specializes in PCU/tele.
Stuff like this makes me very angry :madface: I'm a CNA, I work my a55 off, and still many RNs are convinced all aids are lazy because of the brat-like types Virgo has to deal with.

Since management knows and chooses to ignore it: RUN. It ain't gonna change.

I personally dont think that all aides are lazy... I know who I can rely on if I need something taken care of and who I cant. There are more cant's than can; but I dont think that all of them are lazy or whatever. I walked in their shoes, I know what they are supposed to do and how to do it. I am very gratefull for the aides that I work with that actually do their job, and are there bc they want to be and help pts, rather than "im here for the insurance and paycheck, i just put in my time and leave' mentality.

Specializes in Gerontology, nursing education.

why is mgmt supporting this?

I was wondering about that too. If nurses don't want to float to the floor, if nurses leave the floor, if care is not being done because certain CNAs are "in charge", why hasn't management done anything to change things? Is there a personal connection? Is the NM afraid of the CNAs who obviously wield a lot of power on that floor?

If the NM is incapable of restoring a more appropriate chain of authority to the floor, the NM should be replaced. It is clearly his/her fault that this intolerable and unprofessional situation has gone on as long as it already has. :twocents:

I was wondering about that too. If nurses don't want to float to the floor, if nurses leave the floor, if care is not being done because certain CNAs are "in charge", why hasn't management done anything to change things? Is there a personal connection? Is the NM afraid of the CNAs who obviously wield a lot of power on that floor?

If the NM is incapable of restoring a more appropriate chain of authority to the floor, the NM should be replaced. It is clearly his/her fault that this intolerable and unprofessional situation has gone on as long as it already has. :twocents:

totally agree.

it's time to go to the nm's boss, the adon?

seriously, write it up and have as many nurses as possible, sign it.

if not, clearly it is time to move on.

hell would freeze over before i would work in an environment like that.

leslie

Some of you are probably already familiar with the culture on my unit, where CNAs are permitted to perform abysmally with no consequences (this has been the culture for years). Float pool nurses and nurses from other floors have refused to float to our unit because of it. Good RNs have left the unit because of it.

Not very long ago, the aides made it clear that they expect RNs to *take turns* with the "toilet Q2s" and the "turn Q2s".

Well, now they're complaining that some RNs delegate all routine vitals to them, and we're going to reevaluate our VS protocol as a unit, and they're requesting that RNs help with passing and picking up meal trays.

It's one thing to help out with this stuff when I have time, and I totally don't mind, but this is getting ridiculous. It's not like I sit on my behind picking my nose while the aides scurry around. I have missed many a dinner break and have had to stay late to finish charting on many an occasion, yet the aides *always* get their breaks and get out on time.

They take a half an hour to give CNA to CNA report, while call lights go unanswered that entire time. What if the person is having chest pain? What if they are bleeding from their groin site?

I even recently overheard one CNA saying to another "We don't do VS. That's part of the RN's assessment."

Then, last night, while I was busy in a room with patient care, my wireless started ringing in the middle of what I was doing, so I looked at it before silencing it (instead of throwing it out the window, which is what I really wanted to do), and it was a text that read "Please help pass trays".

Is this normal? Am I crazy to think this is absurd?

Normal? HE11 NO! I would start looking for a different job. YOU are the RN. You spent several years in school to get that title and the CNA's need to start understanding that there is a BIG difference between your title and theirs. You can help them pass meal trays, turn and toilet patients, but can they do your charting? Your assessments? Do IV's? Meds? Can they sign off on medical legal documents? NO NO NO NO and NO. They are making your work harder for you. Tell them to read their job description and back off. No CNA is going to tell this RN what to do. I would be all over them for it. I was a CNA back in the 80's and I did what the nurse TOLD ME TO DO, not the other way around.

Sorry, but this just really ticks me off to hear about aides like this. I have taught basic nurse assistants and when I hear that some of my own nurse aide students who became CNA's are tattling on nurses (which happened at one of my jobs) and trying to get nurses in trouble it just makes me feel like it was all for nothing.

Get a different job, on a different unit or totally away from that. I wouldn't stand for it. :angryfire:angryfire

Specializes in Alzheimers, Geriatrics, phys. challenege.

What state are you in that "you" are paying the CNA and that the CNA is working directly under your license? Just curious. In Florida, the Agency, LTC facility, Hospice, or Hospital pays us, they are responsible for us, and we are responsible for ourselves and our actions as we are registered with the BON. You are going to have lazy employees whatever industry you are in. If CNA's are not doing the job they were hired to do, they should be let go, and the same goes for anyone else not doing their job. No one should have to tolerate the kind of behavior you have described, and I feel for you, but not to sure how I feel about the CNA bashing. We work our butts off for peanuts. I do it because I care about the patients/residents/clients, not for the money, but there are a lot of CNA's in this industry that have no business being in it. I can say the same for some Nurses too, it is all relative.

What state are you in that "you" are paying the CNA and that the CNA is working directly under your license? Just curious. In Florida, the Agency, LTC facility, Hospice, or Hospital pays us, they are responsible for us, and we are responsible for ourselves and our actions as we are registered with the BON. You are going to have lazy employees whatever industry you are in. If CNA's are not doing the job they were hired to do, they should be let go, and the same goes for anyone else not doing their job. No one should have to tolerate the kind of behavior you have described, and I feel for you, but not to sure how I feel about the CNA bashing. We work our butts off for peanuts. I do it because I care about the patients/residents/clients, not for the money, but there are a lot of CNA's in this industry that have no business being in it. I can say the same for some Nurses too, it is all relative.

I just have to say something here:

In Illinois the RN is responsible for the CNA's work, at least in many of the facilities that I have worked in. If the CNA did not do their work, guess who management comes down on? YES. THE RN. I work in LTC and I have been told repeatedly that it is MY responsibility as charge nurse to make sure the CNA's get their work done. I have to walk down the halls and check people after the aides have changed them because we have had CNA's who just throw a dry sheet over a wet resident.

Not trying to start an RN vs. CNA battle because I was once a CNA too, but I did my job and didn't have the nerve to tell a registered nurse or LPN to help me because they had their job and I had mine, and I respected the fact that they had went to school. If CNA's don't like doing their jobs, then they need to either get out of that line of work, go to nursing school, or just find something else. Teamwork is the answer, but there is also a little thing called chain of command. It's just like the military. You don't spout off at your CO. It's just the way it goes.

Time to leave, sweetie. The inmates are running the asylum and management is letting them. I fear you and the other nurses are fighting a losing battle here. And to be clear I blame management here for letting this happen. It would be a cold day in hell I would stop caring for a patient to pass meal trays and have that be part of my daily duties. I would be ignoring that message. lol And the CNAs are doing this because they are allowed to. This isn't normal. If management had a backbone they'd clean house.

Stuff like this makes me very angry :madface: I'm a CNA, I work my a55 off, and still many RNs are convinced all aids are lazy because of the brat-like types Virgo has to deal with.

Since management knows and chooses to ignore it: RUN. It ain't gonna change.

I don't feel that way. I work with wonderful CNAs that are a credit to their profession. They are beloved on my floor.

I don't feel that way. I work with wonderful CNAs that are a credit to their profession. They are beloved on my floor.

I happen to work on a unit that is famous for excellent CNAs. It's the floating RNs, accustomed to lazy aids, that assume we are just as bad as the ones they work with every day.

Somehow CNAs don't have an overall good opinion. There are numerous posts here complaining about aids who shouldn't be aids, and sadly, I have to agree with many of them. I sometimes feel too much is expected from CNAs, but a lazy CNA, a CNA who does not understand her role and constantly demands help from everyone should look for another profession. Sadly, the stink passes on to the good ones as well :(

Or maybe I'm just having a bad day ;)

In Illinois the RN is responsible for the CNA's work, at least in many of the facilities that I have worked in. If the CNA did not do their work, guess who management comes down on? YES. THE RN.

I too happen to work in Illinois and it isn't as you describe, at least not at my hospital. I answer to the management. The RN is the leader, but she is NOT responsible for what I do/don't do.

I work in LTC and I have been told repeatedly that it is MY responsibility as charge nurse to make sure the CNA's get their work done. I have to walk down the halls and check people after the aides have changed them because we have had CNA's who just throw a dry sheet over a wet resident.

If this happened on my unit there would be hell.

Not trying to start an RN vs. CNA battle because I was once a CNA too, but I did my job and didn't have the nerve to tell a registered nurse or LPN to help me because they had their job and I had mine, and I respected the fact that they had went to school.

I don't give a damn about their education - they get paid for it, and what does respect got to do with it? I do my job because it's my job. And yes, I sometimes ask the RNs for help, there are times I can barely manage and I see nothing strange in asking for help if I really need it. Since I'm a good CNA and always help others, I almost never get a flat refuse. Besides, I like the nurses I work with and they probably like me too :D

If CNA's don't like doing their jobs, then they need to either get out of that line of work, go to nursing school, or just find something else. Teamwork is the answer, but there is also a little thing called chain of command. It's just like the military. You don't spout off at your CO. It's just the way it goes.

We all know this. The problem here is the management. I cannot even imagine what would happen if this was my unit...

Specializes in Ortho, Neuro, Detox, Tele.

The problem is WITHOUT A DOUBT the management...they are too concerned with letting the CNAs feel "comfortable" in their jobs. If most are minorities, they are probably concerned about the race card.

I am responsible for the CNAs work, but I make sure it is known if they are not doing it.

I am NEVER too busy to take someone to the bathroom if they ask me after they get their meds and I assess them....I will usually put them in the bathroom and let the aide know.

I'll take a blood pressure if the aides tell me or chart that it's really high or really low....personally, I'm almost a fan of let me get my own vital signs....as long as I have the equipment. I'll take 2000 blood sugars if I have insulin for the patient, cause it's quicker than telling the aide to do it.

I was a aide before I became a RN, and used to have 14-16 patients, total cares, baths, changing ones, etc. some nights I didn't sit down except for a 30 minute meal break, I got people taken care of, vitals done, blood sugars, baths after putting knee machines on at 8PM, rounds started at 9-9:30, changed/checked people q2hrs, turning got done, PLUS I got the extra work done: glucometers (3 of them) qc'd, trash emptied, dirty utilities cleaned, break room cleaned, and any equipment wiped down in the back. some of my CNAs sit for hrs and I KNOW when patients aren't being turned....one even had the nerve to tell me I told her to turn a hip fracture patient from side to back to side(including on the fractured hip)...i told her there's NO way I told you that...it's basic care ever since...and if I did, would you do it just because I told you to?

They FB all night, and I get home after a rough night to see that they posted something about 5 hrs ago...and I know they were there!

It could always be worse....some are really good....some are not....it just depends.

Now, I usually just do my own care for the special things(turners, blood sugars, wounds, etc...) It's often easier

Specializes in Cardiac Telemetry, ED.
Stuff like this makes me very angry :madface: I'm a CNA, I work my a55 off, and still many RNs are convinced all aids are lazy because of the brat-like types Virgo has to deal with.

Since management knows and chooses to ignore it: RUN. It ain't gonna change.

No, no, noooo! I think any RN worth their salt can tell the difference between a great CNA, a CNA who could be great with a little coaching, and the CNAs that exhibit the kinds of behaviors I have described. Keep working your ass off and do the best job you can, and know that you are appreciated, even if you don't hear it often enough.

As for moving on, I already am. I start my position next week. I want to make it clear that I am not changing units because of this, it is for professional development, to get closer to my ultimate goal of becoming a flight nurse. But, I must admit that it would be harder to leave, and I might have stayed longer, were it not for these problems.

I have communicated my concerns to my manager eloquently on several occasions. I have done what I can to make a difference. I have not simply suffered in silence.

I thank you all for your feedback. It is good to know I am not alone, and that I am not crazy. :redbeathe

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