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?
"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."
While what you type here is true, the other truth is that if something drastic happened to the client/patient, the RN/LPN will have their license at stake. The primary responsibility falls on the RN/LPN for the care of the patient/client. Yes, the CNA will get consequences for negligence or whatever, but the RN/LPN suffers at the hands of the BON. That is only in drastic situations. Otherwise, your statement is very true.
What amazes me is that , considering the amount of people who must want jobs and would be willing to bend over backwards to prove that they are hard workers, why on earth is management not firing people who don't work or are insubordinate? What are they afraid of?
This post is exactly why I work in the NICU. I learned, many years ago, as an LPN student/nursing assistant, that there is an eternal controversy between assistants and nurses.
You also need to understand that today, it is not as easy to fire or even discipline someone as it used to be. There are rules and laws and for good reason. BUT, and it's a big but, it does make it more difficult. Management has to be keeping complete records and crossing every 't' to be sure they can 'make it stick'. There's nothing worse than dealing with a lazy, rude, 'that's not my job' employee with a discrimination lawyer.
As a new CNA (but also a nursing student), I am floored by the attitude of the CNA's where I work. My impression has always been that the CNA's are there for patient care AND to ASSIST the RN's.
It seems like the RN's tip toe around the CNA's(?). I don't know - but in school I've been taught a little something called "chain of command".
Sure, there are some RN's -- less than a handful -- that delegate too much to CNA's. The other 99 1\2% are very busy with meds, doctors, charting,etc. Why should they have to take vitals? If a CNA doesn't consider that part of their job, maybe I should re-read my text and ask more questions in class?!
I'm speaking for myself - not all CNA's.
For now, I work hard and appreciate all that the nurses do. Hopefully, in the very near future I'll go from CNA to RN.
My real question is whether the environment on my floor is par for the course, or whether it is an exception. According to the nurses and aides I have chatted with, my floor is the only one in the entire hospital where the CNAs "get away with murder". Whenever a CNA floats from another unit, my routine VS get done, my patients get walked, meal trays are delivered and picked up, patients get HS care; everything is done without my having to "delegate" it or do it myself. Somehow, these aides find the time to do all of this, and I don't have to ask. They just know what to do and they do it, no whining, no huffing, no problem."
I would like to comment on this issue, even though i am just a new CNA. I have one year of nursing school experience, and that combined with the CNA course teachings, further more combined with what i hear from my better half when she gets off her med/surge floor, i would like to say that this issue is not an uncommon one happening in the hospitals, and many managers are familiar with. However, IT IS their problem as they MANAGE the floor, and the RN IS the one in charge, THE TEAM LEADER during the shift, so, a CNA is not only supposed to do his/her job, but was also instructed when he/she obtained that Certificate that the RN is the one managing the floor during the shift, period. A CNA is only to prioritize his/her tasks. You can try to help the communication in between the RN's & the CNAs by NOT making the issues personal, and just relate them strictly to the job tasks. It will take you a while to straighten issues out, but you would have to gather up resources and continue the battle, involving the CNAs, the supervisors, the managers, and guess what, perhaps the local chapter of the governing Union. This is where i have a probem with the Unions. They are just not helping. But that is just my personal opinion. Thanks for reading my post. Doug
I am a CNA and have been for 20 years. I have worked in LTC and in hospital settings and I feel that my two cents is just as important as an RN's.
As a nursing school student, I can see both sides of this "argument".
As a CNA, I have to say that we work very hard to make it easier for the RN to carry out her responsibilities. We bathe, toilet, turn, answer call lights, pass hall trays, feed, and act as maids, housekeepers, and garden variety slaves for many of our patients. Giving time to the RN's to assess, pass meds, chart, etc. We usually have 3 to 4 times the number of patients as the RN's. And the same amount of hours in a shift to perform all of these duties as well as make sure that the wall cubbies have all the necessary items the nurses need for IV flushes, specimen collections, starting IV's, etc. We also have to make sure that the nurses get their lunches and breaks before we can even think about taking one. On a typical day I get about 15 minutes of my lunch break before I get called back to answer a call light. And I have yet to get breaks. So in that I think we are equal.
I always appreciate when a nurse helps me out with some small task and I never forget to thank them for their hellp. Most nurses are happy to help when they can. Some nurses just can't be bothered to do aide work, and will tell you so. They really don't have to I suppose, although on the unit I work on, we do work as a team, so it is expected that nurses help out if they possibly can.
As a student nurse on the other hand, I am well aware that the RN has a very busy day. Not only do they have patient care assessments, admits, discharges, meds to pass, charting to do, consults to get in, orders to check and implement, patients that go bad and require large amounts of time, and many other things that pop up and must be addressed in a timely manner. These things are all laid on the nurse and cannot be addressed by the aide, as it is out of their scope of practice. So the more the aide can possibly to do keep the RN from having to step away from his/her responsibilities the better. I also know from the RN side of things, that the nurse relies heavily on her aide to get the more mundane things out of the way so that the patient is comfortable and cared for.
There shouldn't be a fight between the your job, my job aspect, and there needs to be a mutual respect for one another. The one thing that should always be foremost in the mind of both the aide and the nurse is the care of the patient, and the effect this has on patient outcome.
This is something that really cannot be taught to a nurse, or an aide. It is something innate in the individual. If the aide or the nurse or both are just out to complete tasks, or if they are just there for a job, then they are not in it for the patient and need to go work at burger king where human lives are not at stake.
Lets work together, not against one another. Remember, the patients are counting on us, and they don't need to be made to feel they are a burden.
As a student nurse on the other hand, I am well aware that the RN has a very busy day. Not only do they have patient care assessments, admits, discharges, meds to pass, charting to do, consults to get in, orders to check and implement, patients that go bad and require large amounts of time, and many other things that pop up and must be addressed in a timely manner. These things are all laid on the nurse and cannot be addressed by the aide, as it is out of their scope of practice. So the more the aide can possibly to do keep the RN from having to step away from his/her responsibilities the better. I also know from the RN side of things, that the nurse relies heavily on her aide to get the more mundane things out of the way so that the patient is comfortable and cared for.
There shouldn't be a fight between the your job, my job aspect, and there needs to be a mutual respect for one another. The one thing that should always be foremost in the mind of both the aide and the nurse is the care of the patient, and the effect this has on patient outcome.
This is something that really cannot be taught to a nurse, or an aide. It is something innate in the individual. If the aide or the nurse or both are just out to complete tasks, or if they are just there for a job, then they are not in it for the patient and need to go work at burger king where human lives are not at stake.
Lets work together, not against one another. Remember, the patients are counting on us, and they don't need to be made to feel they are a burden.
very well said, johnsboo! All a person needs to do is CARE for the PT. Not to mention that, just like you mentioned in your "2 cents" , it's the RNs who remain in the first line of fire taking the heat when a PTs V.S. go down or requires CPR, or the critical thinking required by an RN to develop in order to save that life!
Specializes in psychiatric, UR analyst, fraud, DME,MedB.
wow -with some of the comments made on here,(by RN'S)you would think that,they are God,or doctors or something.
See this is the kind of attitude that gets in the way of team work ! Rn's could not do without CNA's , but like I said if the situation is such as the above ...I can embrace the primary care nursing ---this is w/o the CNA's and each nurses is only given so much patient and they take care of the patient totally ! CNA's are very valuable w/o the attitude, and of course that goes for some nurses as well ! CNA's you are there for a specific reason ----to do the work and services and alleviate the floor work that nurses do not have the time to do..........maintatin patients hygiene, change beddings, pass the trays ,assist patient to bathroom or hand out the bed pan. If the nurses are running between medication, ,piggy backs , pain shots, taking Md orders-------these can be overwhelming and life threatening in some cases. There should be a description of your duties in the floor and q2's is definitely one of them ! If you have a thing about being a CNA and have this attitude towards the nurses, then go to school and earn it!!
I have one last comment to make on this issue. If you don't like the way things are, find ways to change them. Your happiness in all aspects of life, is your responsibility. Always place the first blame on yourself, and look for ways to improve YOU. Best advice I have ever been given, and it works every time. Self improvement is what it is all about.
See this is the kind of attitude that gets in the way of team work ! Rn's could not do without CNA's , but like I said if the situation is such as the above ...I can embrace the primary care nursing ---this is w/o the CNA's and each nurses is only given so much patient and they take care of the patient totally ! CNA's are very valuable w/o the attitude, and of course that goes for some nurses as well ! CNA's you are there for a specific reason ----to do the work and services and alleviate the floor work that nurses do not have the time to do..........maintatin patients hygiene, change beddings, pass the trays ,assist patient to bathroom or hand out the bed pan. If the nurses are running between medication, ,piggy backs , pain shots, taking Md orders-------these can be overwhelming and life threatening in some cases. There should be a description of your duties in the floor and q2's is definitely one of them ! If you have a thing about being a CNA and have this attitude towards the nurses, then go to school and earn it!!
Alexsys
125 Posts
"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."
While what you type here is true, the other truth is that if something drastic happened to the client/patient, the RN/LPN will have their license at stake. The primary responsibility falls on the RN/LPN for the care of the patient/client. Yes, the CNA will get consequences for negligence or whatever, but the RN/LPN suffers at the hands of the BON. That is only in drastic situations. Otherwise, your statement is very true.