My VENT and Salute!

cb_rn · May 25, 2010

Seems like you're in a place where management tolerates that sort of behavior from the nurses. Hopefully they aren't all in that mindset.

When I was still a psychiatric aides our night supervisor (not the one that hit a mobile home high on oxycontin, if you've ever read any of my posts!) told one of our nurses she didn't need to help the 2 PAs clean up an incontinent, screaming, combative patient that had ****** so much there was a giganto puddle in the entire bedroom floor. "Nurses don't need to do that stuff."

Excuse me?

(She later took a second job at a LTC and was aghast to find out that she had to do manual nursing labor. heeheehee)

I've been a visiting hospice nurse in places where the techs and CNAs get to do whatever they want. The ones with senority sit around and watch TV with residents screaming that they are wet or have had a BM and make the new girls run around and change the patients once a shift. It makes me sick, I am not allowed to help with any of the patients that I am not contracted to provide hospice care for.

I have also had these girls come in and put a patient on the commode while I waited, both talking on a cell phone as they sat her down, stood her up, and wiped her. First of all, I didn't even have the upper body strength to even help move that patient to a standing position - they just moved her around like she was 100 lbs or something. These girls were like Shera from Heman! Never mind doing it with a cell phone. BTW, we did speak up at this facility and nearly got my company banned from coming in anymore because the owners didn't appreciate our interference.

I'm sorry you're having a rotten experience. Chances are management is already aware of this nursing mentality if it really is such a widespread issue and they don't really care to upset the status quo. On the other hand, sometimes all the seedy stuff happens on weekends and nights, the "off" shifts. Guess you won't know until you work on a weekday.

If you're stuck with this, just tough it out. Use it as a tool to remember not to forget your CNA once you're done with school.

If you aren't, see if you can't find a place where you're better apprciated but be forewarned that there aren't very many places I've ever worked where I think any of the CNAs get the respect they deserve. I was lucky enough to be a psych aide so I didn't have nearly the load of turning, cleaning up, etc (though I had to ride pts down the hall until someone could do an ativan IM and dodge thrown feces and go to the ER with not guilty by reason of insanity psychotic patients so...maybe it evened out?) but I still have the utmost respect for that job. I don't know that I could have done it.

westmidwest · May 25, 2010

completely agree. I just started and and RN on the same unit as I worked as a PCT. I never sat down as a PCT and now (its not easy street by any means) but I do get to take a lunch. So many of the nurses never even think of answering their call lights, its supposed to be a team working for the patient but a ton of the nurse don't break a sweat. Its crazy.

what are you going to do but be the best pct/nurse/person you can be?

Hopeful2011 · May 25, 2010

Seems like you're in a place where management tolerates that sort of behavior from the nurses. Hopefully they aren't all in that mindset.
When I was still a psychiatric aides our night supervisor (not the one that hit a mobile home high on oxycontin, if you've ever read any of my posts!) told one of our nurses she didn't need to help the 2 PAs clean up an incontinent, screaming, combative patient that had ****** so much there was a giganto puddle in the entire bedroom floor. "Nurses don't need to do that stuff."
Excuse me?
(She later took a second job at a LTC and was aghast to find out that she had to do manual nursing labor. heeheehee)
I've been a visiting hospice nurse in places where the techs and CNAs get to do whatever they want. The ones with senority sit around and watch TV with residents screaming that they are wet or have had a BM and make the new girls run around and change the patients once a shift. It makes me sick, I am not allowed to help with any of the patients that I am not contracted to provide hospice care for.
I have also had these girls come in and put a patient on the commode while I waited, both talking on a cell phone as they sat her down, stood her up, and wiped her. First of all, I didn't even have the upper body strength to even help move that patient to a standing position - they just moved her around like she was 100 lbs or something. These girls were like Shera from Heman! Never mind doing it with a cell phone. BTW, we did speak up at this facility and nearly got my company banned from coming in anymore because the owners didn't appreciate our interference.
I'm sorry you're having a rotten experience. Chances are management is already aware of this nursing mentality if it really is such a widespread issue and they don't really care to upset the status quo. On the other hand, sometimes all the seedy stuff happens on weekends and nights, the "off" shifts. Guess you won't know until you work on a weekday.
If you're stuck with this, just tough it out. Use it as a tool to remember not to forget your CNA once you're done with school.
If you aren't, see if you can't find a place where you're better appreciated but be forewarned that there aren't very many places I've ever worked where I think any of the CNAs get the respect they deserve. I was lucky enough to be a psych aide so I didn't have nearly the load of turning, cleaning up, etc (though I had to ride pts down the hall until someone could do an ativan IM and dodge thrown feces and go to the ER with not guilty by reason of insanity psychotic patients so...maybe it evened out?) but I still have the utmost respect for that job. I don't know that I could have done it.

They have some kind of weird formula which states for x number of patients they only need x number of techs on the floor... yes cause if you have 24 patients... then only 2 techs are needed.. that was the rationale of one of the nurses (i'm assuming she was a charge nurse or something.. didn't see much of her on my side of the floor)... number of patient's isn't what should be determining the number of techs.. it really should be their weight.. if only that were the case!!!! goodness some of these patients...

I'm just going to tough it out because the floor supposedly gets patients who have illnesses that I want to work with once I graduate... no experience is bad experience... or so I've been told.. lol...

All I know is me and the Motrin bottle are becoming fast friends..

Hopeful2011 · May 25, 2010

completely agree. I just started and and RN on the same unit as I worked as a PCT. I never sat down as a PCT and now (its not easy street by any means) but I do get to take a lunch. So many of the nurses never even think of answering their call lights, its supposed to be a team working for the patient but a ton of the nurse don't break a sweat. Its crazy.
what are you going to do but be the best pct/nurse/person you can be?

I definitely know no matter how long I am a bedside nurse I will never ever be a nurse that treats my tech as my maid/servant... it just makes me not want to go back knowing that perhaps on my next shift I'm supposed to "shadowing" one of these nurses and I have to act as though these people are competent and knowledgeable... which they may be but they surely aren't wonderful people to spend 12 hours with... and that's what I have to work on getting over... finding some way to put a smile on my face and listening to these nurses while the voice in my head is saying "YOU SHOULD SOOOOO NOT BE A NURSE!"

LoveMyBugs, BSN, CNA, RN · May 25, 2010

I am sorry that you had such a bad experience and there is a lack of communication with managment

I have worked as a CNA for over 4 years now and know that it can be back breaking work. I worked in a LTC for a year where the average patient load would be 12-15 with 2-3 total care/ hoyer lifts. I now work as a tech in an ER.

I know that it can appear that the nurses are just sitting around and that they should be able to come and help you out.

Let me offer you a different persepective. I am getting to do my final preceptorship clinical in the same unit that I work as a CNA, doing this has opened my eyes as to the role of the RN and apperences can be deciving.

The amount of paperwork and charting that the RN does is unbelieveable alsmot more time charting than actual time with the patient. You are always thinking about the how and the why and the what if when you are doing something, where as a CNA you tend to look at things as a task, must get the next task done and on to the next.

The RN is looking and thinking about the whole picture of the patient where they CNA may just be thinking get the CBG done or vitals done, and then on to the next task, where the RN is looking at everything differently.

I am sorry you had a bad expereince, I know when I first started as a CNA things took me forever to get done, I remeber being in the LTC and I would get off at 11pm and I would still be putting my residents to bed at 10:55pm, while the other aids on the floor would go into a patients room and watch TV.

I have learned that if you need help don't be afraid to ask for it. If the patient is inconitent and you need help getting the patient clean, ask the nurse if she has time to come help you.

Don't look at the RNs and become frustated with how little you percive that they are doing, ask for thier help if you need it, it is unfourtnante that there is not a team atmosphere on the unit you worked on, not every unit is that way.

NightOwl0624 · May 25, 2010

It's not like that everywhere, sorry it is happening where you work!

I think it has to do with an "integrity" thing. At the end of the day, these patients need to be cared for.

In my hospital, the techs have really been shortstaffed lately. (One quit, one on medical leave, hiring freeze, ...) I am completely in awe at the amount of work they have to do, and how efficient they are. I try to help out as much as I can.

I can tell you that it can work both ways, though. When I first started, one of the techs made my life miserable. (she's the one on medical leave :) she seemed to enjoy watching me rush around, pretend not to hear me when I asked for help, disappeared for looooong breaks, etc.

I wish everyone would just treat each other the way they would like to be treated!

cb_rn · May 25, 2010

The amount of paperwork and charting that the RN does is unbelieveable alsmot more time charting than actual time with the patient. You are always thinking about the how and the why and the what if when you are doing something, where as a CNA you tend to look at things as a task, must get the next task done and on to the next.
The RN is looking and thinking about the whole picture of the patient where they CNA may just be thinking get the CBG done or vitals done, and then on to the next task, where the RN is looking at everything differently.
I am sorry you had a bad expereince, I know when I first started as a CNA things took me forever to get done, I remeber being in the LTC and I would get off at 11pm and I would still be putting my residents to bed at 10:55pm, while the other aids on the floor would go into a patients room and watch TV.
I have learned that if you need help don't be afraid to ask for it. If the patient is inconitent and you need help getting the patient clean, ask the nurse if she has time to come help you.
Don't look at the RNs and become frustated with how little you percive that they are doing, ask for thier help if you need it, it is unfourtnante that there is not a team atmosphere on the unit you worked on, not every unit is that way.

I agree to a point. Sure, there are times when you have to sit there and chart or review or even just plan the next few things on your to-do list BUT OP is refering to nurses looking at MSN programs. That's totally inappropriate if someone is struggling to get their work done. I've seen nurses sit on facebook playing sorority life or whatever the heck its called who couldn't be bothered to wheel their chair over 2 feet and answer the call light while the secretary is in the bathroom. There's no room for that in teamwork. Sure, sometimes we are too busy (though we may not look it on the outside) but I think everyone that reads this thread knows that there are just some nurses who don't help with "non-licensed" tasks unless there is no choice. That's not picking on nurses, its just fact. You can find those kind of unmotivated people in every single occupation. There are also plenty of CNAs that don't do what they're supposed to unless you practically ride them down the hall with a flog. And doctors that don't answer their pages because whatever reason. I've seen doctors ignoring repeated pages while they chat with another doc about what they did last weekend or because they were checking their email.

And if you're "on break" you shouldn't be in the hall or visible at the nurse's station. That is just inviting resentment from people that don't know your on break and interuption from your break because they don't know.

At one of my hospitals we instituted a mandatory off-floor or in a closed, seperate lounge for lunches and breaks and the manager also told us we were welcome to access read papers or magazines or use the internet at work for personal things like facebook but it was not to be done on the floor (we had open air decentralized NS pairs) where patients and families could see. Only things for patients (like mapquesting where the nearest Walmart was for a family member from out of town) could be looked at outside our lounge. It made a ton of difference in the amount of work some of the nurses were doing. Suddenly they didn't have the benefit of having their nose in a newspaper or magazine or glued to a computer screen. It was either pretend you were perpetually charting (trust me, they weren't) or stay in a patient's room if you didn't want to help. Teamwork went way up. Most of the nurses that had no interest in being more involved ended up leaving before the year was out.

We still had time to giggle and chat while we worked and I have to say my patient care activities didn't really change. I didn't see myself wiping any more booty than usual or doing any more positioning than I ever did. Many of my closer peers on the unit felt the same way but I don't know if it was because we were the newer nurses and were already helping out as needed. I do know that the workload didn't seem so heavy after this implementation because the CNAs were free to help the patients do their daily tid walks (post CT surgery) instead of us. It took a lot less time to help clean an incontient patient and make an occupied bed so the CNA could go to the next room than to walk 3 patients 3-4 laps around the floor 3 times on the day shift because the CNA was always cleaning someone up.

I think I digress from the topic by just a hair. My point is that sure we're busy but not always so busy we can't lend a hand. Esp if we have time to text or get on the phone or use the internet at a non break time.

Ruby Vee, BSN · May 25, 2010

in my experience, it's usually the nurses who are running themselves ragged while the secretary ignores the ringing phone to update her facebook status, the housekeeper is on her break (smoking pot in the janitor's closet) when a patient has just peed all over the floor and a mopping is needed and the cnas are sitting at the computers looking up nursing schools. in 33 years, i've seen a few nurses who are flat out lazy and won't help, and i've seen a few cnas who are flat out motivated and will.

i've never worked in long term care and perhaps that's the difference. i'm very grateful that the nursing home where my mother-in-law currently resides and the assisted living facility where my mother lives both have staffs that are committed to teamwork -- and it shows.

cb_rn · May 25, 2010

It just depends on the work environment, I guess.

The last hospital I did prn work for had a very on-top-of-it manager. If a CNA that didn't like to work somehow got hired on, they didn't last out of orientation. Ever. I never saw a woman fire so many people.

I'm very greatful for the fact that, for the most part, I've had CNAs that will do their job with very little to no prompting. There are exceptions but they never stuck around long at any job I've held.

I have worked with a few nurses that might as well be potatoes wearing stethoscopes and doctors that would have been more useful as doorstops. And those "seasoned" CNAs that I spoke of earlier made me shiver. To sit there watching TV and eating or playing cards while people complain about how they're soiled...I don't like to wipe butts either but I couldn't, in good conscience, just leave someone sitting in their own excretement. Thank goodness this is mostly the exception and not the rule. I feel badly for anyone that is stuck (esp with the shortage of jobs lately) in an environment where teamwork isn't a part of the culture.

cb_rn · May 25, 2010

i've never worked in long term care and perhaps that's the difference. i'm very grateful that the nursing home where my mother-in-law currently resides and the assisted living facility where my mother lives both have staffs that are committed to teamwork -- and it shows.

i'm so glad you've had reallly great experiences with the facilities. i've gone into quite a few different asl, snfs, and ltc doing hospice and hh at the asls. those were always just as visiting agency, i never worked for one. unfortunately in the area i was working only those that could afford the $$$$ homes were well taken care of. it was heart breaking. its such an important area of nursing and so many of those places are only driven by the dollar and patient care falls to the wayside because family doesn't know to speak up or is afraid to rock the boat because they can't find another facility thats affordable and close by.

i have never done ltc myself either, i am sure it has its challenges, but as another healthcare professional going in those facilities, it looked chaotic. i tried not to judge but having to get on my knees on a dirty floor to be with a dying patient because they put the mattress on the floor so the patient couldn't get up due to repeated falls, it was nearly the end of my work there. i don't know what the answer was to keeping that patient from falling but it reminded me of the mental institution i once worked at where the violent, suicidal patients had a thin mattress laid right on a tile floor. maybe it was the emotion of the moment or maybe it was because my own grandfather died in a long, torturous code immediately after aspirating at a facility where he had already aspirated his food 3 times. it felt very much like nobody cared and just wanted to get the beds re-filled. (please don't let this offend anyone in ltc, i'm sure there are plenty of great people and great facilities)

i'm sorry i hijacked the thread, i'm not going to post off topic anymore, cross my heart.

Quidam · May 25, 2010

Hard working techs are awesome! But I have come in contact with some who are just as bad as the lazy nurses. As for being a student nurse...keep your head about you and always remember there is much to learn from good and not so good nurses. I learned what kind of nurse I did not want to be from some not so good nurses I encountered in my school and externship.

Now that I am working as a nurse, I do realize many of my responsibilities limits my time with the patients. When I do find the need to call for a tech, it is because I am so behind with what I have to get done that if I take the time out to do whatever it is, that I will fall farther and farther behind. As a student, I was not aware of all these "nursing responsibilites" that get in the way of direct patient care.

So...just learn what you can, make every interaction a learning experience, and continue to praise those great techs. They really do deserve more recognition.