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?
What kind of nastyness is that, are you a professional.I was a CNA I am not longer one. But, that does not give the right to humilate people and if you are not able to understand that. I am sorry for you that's called "ethics" did you ever took that in college I did. I am also a christian and because I am one I want to treat people as I would like to be treated including patients and co-workers. Yes, I do not know you but you response reflect a lot of who you are. I'll pray for you.
I want to thank everyone for their constructive responses. I can't tell you how frustrating this situation has been, because I am a big fan of teamwork and I'm not afraid to get shoulder to shoulder with my coworkers to get even the dirtiest work done. That is not the issue. The issue is the culture that has been permitted to flourish for so long that nobody can remember a time when it hasn't been that way, and the efforts on the part of nurses like myself have fallen completely flat.
I have left the unit, but not because of this issue. I have other reasons. But, I probably would have stayed longer had it not been for this, and I know that other good nurses have left specifically because of it. It stinks because I really love this unit.
Anyway, I think it's probably time to close this thread....whaddaya think, mods?
I have left the unit, but not because of this issue. I have other reasons. But, I probably would have stayed longer had it not been for this, and I know that other good nurses have left specifically because of it. It stinks because I really love this unit.
Maybe it's for the best. If more nurses start leaving the unit, there is a chance the management might finally respond to the problems you're dealing with.
I'd like to think so, but this place has been hemorrhaging great nurses for years. They never stick around, with the exception of a few who don't seem to care about the CNA situation.
Specializes in Home health care, CNA (nursing home).
Wow! I was a CNA before becoming a nurse as well and it never crossed my mind to tell anyone that "it's not my job" to do anything that I was delegated to do. I have sometimes wished though that I could do the CNA work because it was so much more hands on than being a nurse is, but with the nurses pay. I am a little confused at why you call the CNA's a culture?
I'd like to think so, but this place has been hemorrhaging great nurses for years. They never stick around, with the exception of a few who don't seem to care about the CNA situation.
Which would be a problem if you had any powerful clique running the show rather than the nurse manager who is SUPPOSED to be in charge.
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.
I would just like to point out, regardless of state, the RN IS RESPONSIBLE for the CNA/NA (PCT, UAP, or whatever title is used by a facility) even in Florida. This has nothing to do with who "pays" you. Regardless of whether or not they're certified by the BON, the RN can be held responsible by the BON and by law for the actions or inactions of assistive personnel. I guarantee that there is language in the NURSE PRACTICE ACT in the state of Florida to that effect and the SBON in Florida could hold an RN accountable for the actions/inactions of a CNA. Like it or not all SBONs consider the RN to be in a supervisory position regarding CNA/NAs. If a CNA is registered by a SBON, than yes, they can held accountable and face disciplinary action from that SBON, separately or in conjunction with an RN depending on the circumstance. I just wanted to clarify this point. Suffice it to say, we are all accountable to whomever employs us.
The fact that the SBON considers an RN a supervisor to CNAs leads to problems. There are CNA/NAs that do not consider an RN to be their supervisor in the workplace. RNs will always have the responsibility and accountability of a supervisor but without the authority and autonomy that goes with it in most workplaces. That authority and autonomy lies with the unit manager, and if you have a manager that refuses to deal with employee issues, regardless of whether it's related to CNA/NAs or RNs, it exacerbates those issues.
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
The rest of your post I'm in agreement with. The OPs situation has more to do with a manager that refuses to deal with the issues.
If you have seen my posts you know I am a CNA instructor in NY. Here isa a list of the clinical skills My students must pass to sit for the state exam AMBULATION; BEDPAN; CATHETER CARE; CHANGE AN OCCUPIED BED; CHANGE OF POSITION; DRESSING; FEEDING(THIS INCLUDES TRAY PRESENTATION); FOOT CARE; HAIR AND NAIL CARE; MEASURE AND RECORD URINARY DRAINAGE BAG; MEASURE AND RECORD PULSE AND RESPIRATION (B/P IS NOT REQUIRED AND BECAUSE OF TIME CONSTRAINTS USUALLY NOT PRACTICED ENOUGH TO BE PROFICIENT); MEASURE AND RECORD HEIGHT AND WEIGHT; MOUTH CARE - BRUSH TEETH; MOUTH CARE - DENTURES (THIS ONE INCLUDES MOUTH CARE SO IT IS THE MORE COMMON SKILL TESTERS USE); PARTIAL BED BATH(FACE, EARS, NECK, CHEST, BACK WASHED AND DRIED THEN A 2-3 MINUTE BACK MASSAGE WITH LOTION), PERINEAL CARE - FEMALE (BETTER TEST OF INFECTION CONTROL TECHNIQUE); ROM UPPER EXTREMITIES (SHOULDER -3 EXERCISES, ELBOW - 1, WRIST - 2,HANDS 2 INCLUDES FINGERS); ROM LOWER EXTREMITIES (HIP - 3 EXERCISES, KNEE - 1, ANKLE 2, FOOT 1); TRANSFER FROM BED TO CHAIR; WAIST RESTRAINTS. All of these skills must include infection control, hand washing and indirect care skills (how to enter a pt room, identify yourself, HIPPA, and how to maintain pt rights at all times.) I hope this answers some questions. If you are in a different state you can just go online to find out what each state requires of its CNAs. IT HAS ALWAYS BEEN MY POLICY, IF IT WAS ON YOUR TEST IT IS YOUR SKILL TO OWN AND SHARE!!!!)
wow, sounds just like my job. i work at a health and rehab center, and i swear, these cna's think they run the place.
when i first started there, i was almost too scared to even ask them to do something for me, because of the attitude i knew i would be lashed back at with.
one day, i hat put out my vs sheet, as usual, and about 3/4 of the way through the shift, my aide passed by me an said, "oh, hey, did you get all your vital signs? or do you really need me to do them?" i was shocked. they know perfectly well that is part of their job description, and of course, i take a bp or pulse before giving meds with parameters, but i honestly don't know why they think i have the time to run around and take twenty peoples vital signs, on top of meds and wound care. i am frankly tired of it, too.
i agree with what you said also, just last night, working 3-11 shift, i had an admission. i had no dinner break at all, and did not leave until after 1 am because i made sure all of my work was done, rather than leaving it for the next nurse to complete. yet my cna got her dinner break, had time to sit in the lounge and watch tv, and made it clear it was a big inconvenience when i asked her to help me roll my new admit in bed to do a skin check, who is ext assist and total care, and stiff as a board. i try to do as much as i can on my own, but it has gotten to the point where if i need help, and you disrespect me or plain out say "no" (it has happened before), i write them up. i am not playing games anymore, not when it comes to my patients and the care they receive.
It seems this is a wide spread issue and I'm sad to say I have seen many of these bahaviors on my unit as well. We are working hard to eliminate the "trouble makers" and reward the ones who do their job and enjoy caring for and about people. There must be consequences for bad behaviors and if it continues we too will eliminate all cna's and replace them with nurses. I have done this before and we liked the team work and results.
Talk to your manager and if she doesn't want to do anything positive, I'm sure another unit will welcome you with open arms.
What about a nurse to CNA report? So before hitting the floor one can say "I need this from you before 10am..." Or charge nurse on floor sits in on CNA to CNA report, and says "you all need to get your sugars and vitals first. Anything out of the ordinary, you are to find the nurse to report it or find me, and I will need this done and reported by 8am" If it is not done, then the next day at report, again make it abundantly clear that these things were asked and not done. Firmly state that in fact should it again not be done correctly, CNA's will be reported to the nurse manager. The first priority is patient care. Perhaps a couple of the CNA's do trays and stocking and garbage a couple of afternoons a week and they rotate. The others 100% patient care--they could even work in pairs and do daily care together. It is irritating when a CNA insists that they should not be doing any patient care. Perhaps then they should look into being in housekeeping or a diet aide--but if they are not doing that either, not sure what the issue is.
tbel1ma
4 Posts
What kind of nastyness is that, are you a professional.I was a CNA I am not longer one. But, that does not give the right to humilate people and if you are not able to understand that. I am sorry for you that's called "ethics" did you ever took that in college I did. I am also a christian and because I am one I want to treat people as I would like to be treated including patients and co-workers. Yes, I do not know you but you response reflect a lot of who you are. I'll pray for you.