My perspective...

Lovely_RN, MSN · Jan 14, 2007

I don't think that the CNA will ever be able to understand just how much nurses have to know and do. I was a CNA and from our perspective it looks like the nurses are sitting on their humps doing paperwork or passing a few meds while we sweat our butts off doing the grunt work. I have just started nursing school and I was talking with a fellow student who was also a CNA. We have already had our "aha" :idea: moment. I told her that I had NO idea how much nurses had to know and how much responsibility came with the job until just then; she agreed emphatically.

We both have decided that we have a new-found respect for nurses and in the future when the CNA's complain about us we will tell them to go back to school and try it if they think it's so easy.

Other than that you just have to let their complaints roll off of your back because they will never get it until they are in your shoes.

Being a nurse aide previously, I vowed I would assist the aides when I became a nurse. HOWEVER, I never really fully understood all the work nurses do in a day. All the paperwork, charting, assessments, meds, research, calling docs, monitoring effects of meds, etc. etc. etc.

MIA-RN1, RN · Jan 14, 2007

I think that what you describe is everywhere to different degrees. Human nature tends to view the grass as greener on the other side of the fence.I work with some incredibly awesome techs and others who I have had to not only look for when I need help, but who will also tell me "I'm too busy" when I ask for a set of vitals or something (somehow I don't see how folding linens takes priority over patient care but hey...) Anyway, I go out of my way to be sure that I am not asking too much and I do what I can when I can. Our techs don't empty foleys, don't help patients up out of bed, don't do fingerstick bg's, don't generally draw blood, and unless asked specifically only do the 'routine' q4h vitals---and our surgical pts have vs WAY more frequently than that. Most will help if asked but 9 out of 10 times its easier to do it myself than go looking. Our techs mostly stock infant cribs, fold linens, make ice packs, stock various stuff, routine vitals, walk patients out, and answer the occasional call light. To me, its all backwards; patient care should come FIRST, and then the linens.

Some are real gems (especially the ones that are in nursing school!)and ask if they can help, others don't. One (who is awesome and beileves we are a team) recently told me that when she was being trained, one of the other techs told her never to ask the nurses if they need help because the nurses will run her ragged. That kind of burned. I know that sometimes I ask a lot, but that is never just because I am sitting around, its because I am running around myself and just need the assistance. Besides, they are there to help us, right?

wfperseus · Jan 15, 2007

Hi -- this discussion is really helpful! I'm a new grad nurse on a Tele. floor, never worked as a CNA, but am feeling confused as to how much, in particular, I'm supposed to be adding to my list of nursing chores (e.g., giving meds, answering call bells, emptying urinals & recording output, checking labs, paging docs per critical lab values/clarifying orders, completing paperwork, putting out fires, etc.) to help the CNAs give bed baths -- or even get to them before the CNAs do???? Last night (after three days straight of 8-12 hr shifts and no time for lunch), an aide mentioned that she and the others had just now been assigned by mgt. to additionalling record pt. vitals and I/O's to the flow sheets (nurses are responsible for charting these too), so she asked if I could also help out w/ bedbaths in the future to make it more equitable. I felt so guilty -- am I being a jerk for putting bed baths at the bottom of my list of duties and leaving it to the aides unless they specifically ask for help (which they do) or I need to check pt. skin quality? Should I be jumping in there ahead of them? I'm feeling confused and guilty.

Thanks!

marygirl · Jan 15, 2007

Hmm, I think you should find a nurse who can mentor you on the floor. As a new grad, I have found that some of the aids on our tele floor will actually try to get the new nurses to do some of their assigned duties just to see what they can get away with. Don't feel guilty. I can't tell you whose job it is because these things vary by unit. Where I work, each patient is expected to be bathed or to bathe themselves each 24 hours in the hospital. Management finally determined that one of the aids had to be assigned to do extra baths to help out the floor. The reality, some of the aids are always there helping with turns and boosts and call lights, and others are on smoke breaks or sitting down on a personal call.....just like some of the nurses.

Lovely_RN, MSN · Jan 15, 2007

I worked in a hospital as a CNA and never in my wildest dreams did I think of asking one of the RNs to do my job. The majority of them helped out when they had time to spare but there was never a question about whose job it was (mine) to give the bedbaths. Maybe I was a sucker? The most I would ever have a say in was if one of the RN's said that she was going to give a treatment at such and such a time and needed my help and then another RN said she needed my help at the same time. I would have to let the second RN know that I was already "booked" for that time slot.

I thought that was how it worked or maybe I was a doormat?

Oh, I was also responsible for doing the vitals and I/O and charting them q4 and whenever else I was asked too. Let me see what else? I had to hand out ice and water in the AM and after lunch to all of the patients. I gave out towels and linens after AM vitals and made half of the beds on the floor unless the patient was bedridden. I changed incontinient patients with or w/o assistance from another aide or RN. I was responsible for patient transport, answering call bells, and answering the telephones if I was passing by and it rang....feeding patients. I was also responsible for reporting things to the RN. Like if I was changing a patient and I saw a skin irritation or if the vitals seemed out of wack from the previous ones taken earlier...etc.

I can't really recall what else but there were other tasks that did not happen daily but if I was told to do it I did it.

MIA-RN1, RN · Jan 15, 2007

I hope I don't sound harsh but CNA means 'nurse assistant'. Our aides, techs, etc carry intrinsically in their job description the responsibility to help us. Yes we can do what we can to help make their load lighter but by the same token, we must not be so focused on 'helping the aides' that we lose track of the fact that we have other responsibilities as well.

This is such a hot topic for me, and something I have approached management about.

It so totally needs to be a team effort. Everyone's top priority is patient care and until everyone sees that, these kinds of issues will continue to happen. I wish I had an answer.

Lovely_RN, MSN · Jan 15, 2007

Hmmm wfperseus :idea: Maybe you should tell the CNA who is attempting to delegate to you that you are not in management and you were not the one who decided to add the additional tasks to her job duties. Next, maybe you should recommend that this CNA band together with her fellow CNA's and speak to management if she feels the work load needs to be more evenly distributed.

I have a feeling that the CNA will suddenly decide that she is fine with her duties as assigned and that will be the last of that discussion.

wfperseus · Jan 15, 2007

You are all so helpful -- thanks for the insight!

Tweety, BSN, RN · Jan 15, 2007

In 15 years I've never worked a unit where the CNAs thought the RNs did enough. I just do my best, help out when I can, but I know their job description and I know mine and I know the art of deligation.

There are some nurses that give us a bad name....you know the kind...the hunt up and down the halls looking for the CNA to put someone on the bedpan, or walk into the room and immediately out and get the aid to clean someone up, surf the net and read a book rather than get up and help a patient who needs something.

The problem is that some CNAs judge us all by them.

hlfpnt, BSN, RN · Jan 16, 2007

I also worked my way up & see both sides. I wasn't a CNA, but a MA. My experience includes clinics & hospitals. I've worked with both helpful nurses that were worth their weight in gold & those that just wanted to dump on somebody. I wouldn't trade my MA experience for anything...I feel it'll continue to help me be more aware of my coworkers. I agree with Lisa, I don't feel any job is beneath me & always try to help or do what I can when I can. I try to remember to say "thank you" & let my aides know I appreciate them. I see this job as a team effort. If I seek out my aide it's not to dump on them, it's to ask for help (unfortunately I'm not built to pull on large people by myself) or see if they need me. I also agree with Tweety that a couple bad apples can spoil the bunch & we all get judged because somebody had some bad experiences with lazy coworkers. I've also seen the reverse where nurses have been treated poorly & so they have little respect for any aide. I would like to add that I don't like being assigned an aide with an all around bad attitude. This happened just this week...I was done with my work & offered to help her finish up...she bit my head off :angryfire !!! I can promise she won't get the same offer twice!

RNLisa · Jan 16, 2007

When I was first working there, off orientation, I was trying to do it all, sort of. We had low census, so I was getting ice water, emptying urinals, foleys, etc., and I even was cleaning up spills, changing linens; all because I had time. Then, the nurse aide on duty that day told me: "Lisa, I can do that, it's my job; I don't want you to think we don't do anything". Unfortunately, it's that same aide that is also talking about us nurses not answering call lights. It's amazing how things change in a few short months. I get my "nurse" job done first, then I do the other tasks if I have time. The PATIENT comes first!

Thanks for all the replies.