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 Peds/outpatient FP,derm,allergy/private duty.
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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.
Wow, Johnsboo, can you bottle your unit and sell it?? :chuckle No, really. These descriptions of a positive (mostly) work environment are like a breath of fresh air. I honestly don't know how the really bad ones become that way, and I know that sometimes it's so bad that a Nurse Manager can study and implement and understand, and therapeutically communicate 'til he/she drops over, a new one comes in, repeat. Makes us appreciate the good ones all the more, at least. You sound like you'll be a great nurse. :wink2:
Wow, thank you! I can tell you one thing, after being a CNA for so long, I will be very appreciative of my aides. Good ones that is, the not so good ones? well, quite frankly, they will be unhappy with me as a nurse. I know only too well what is expected of them, and I won't be tolerating the ones with attitude, and laziness won't be tolerated either. I am no harder on others than I am on myself. I believe that everyone has room for improvement, self included, and I am the first to point it out. Much to the chagrin of everyone around me sometimes LOL
Specializes in psychiatric, UR analyst, fraud, DME,MedB.
Wow, thank you! I can tell you one thing, after being a CNA for so long, I will be very appreciative of my aides. Good ones that is, the not so good ones? well, quite frankly, they will be unhappy with me as a nurse. I know only too well what is expected of them, and I won't be tolerating the ones with attitude, and laziness won't be tolerated either. I am no harder on others than I am on myself. I believe that everyone has room for improvement, self included, and I am the first to point it out. Much to the chagrin of everyone around me sometimes LOL
Johnsboo , I wish there are more people that thinks like you. I like the idea that you check first w/ yourself as to how you can improve or do better, before looking at others. With a method like this , it is more effective to manage people.
Well, one has to be an example to others in all things. And what right do we have to expect change in someone else if we are not willing to change ourselves? It only makes sense.
Actually, in all states the CNA works under the en license. People seem to forget that CNA is NURSEs ASSISTANT!!! They're not thier own job, I'm sorry to say. In nursing school you are taught that, legally, ALL patient care is your responsibility, and you can delegate certain particulars about said care to a CNA. But if that care isn't done, ie if VS aren't done or are made up, it's not the CNA that the BON will go after if something bad were to happen, it's the RN. A CNA has a difficult job, but honestly if they lose thier license they can find another. If an RN were to lose thier license bc of neglect by an aid, they just lost out on an entire career and those 4 years of schooling. There is a huge difference btw cna and rn, the the aides work directly affect the rn's job security.
And instructors need to make this EXTREMELY clear when educating future aides.
Aides are literally an extension of the RN they work under. When that RN is doing a task that CANNOT be delegated, the aide is given the RN's tasks that CAN be delegated.
The scope of nursing is so vast, the nurse cannot do it ALL without something left to suffer. The aide is available to make sure no task is left to suffer but done as well as it should be.
Aides are not slaves to be abused, but ASSISTANTS to be properly and respectfully used.
I think these lazy aides would be lazy anywhere. If they worked at Burger King, they'd complain it's not their job to flip a burger.
Oh but oh! Where did those mean old-school nurses go? LOL. I know the old gals who had charge over me would have served my butt up on a platter if I'd tried to pull any of that crap! When they said "jump" I jumped and if they said that wasn't high enough, I jumped until they were happy... and because they saw me jump that high, I was never again allowed to jump less than that. No kidding!
nursel56
7,122 Posts
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Wow, Johnsboo, can you bottle your unit and sell it?? :chuckle No, really. These descriptions of a positive (mostly) work environment are like a breath of fresh air. I honestly don't know how the really bad ones become that way, and I know that sometimes it's so bad that a Nurse Manager can study and implement and understand, and therapeutically communicate 'til he/she drops over, a new one comes in, repeat. Makes us appreciate the good ones all the more, at least. You sound like you'll be a great nurse. :wink2: