New aide on the floor... HELP!!

[chwcbesteph, RN]

Let me preface this by saying... I adore and respect my aides. I know I could not do my job without them. I was an aide before becoming a nurse and it was HARD (and rewarding and I loved my patients/residents).

Okay. Now that we all understand that this is not a vent about aides getting in my way, here we go.

I am working with an aide who is on orientation, and she has never been an aide before. She is about to be put on the floor on her own and truthfully... I'm terrified.

She doesn't do anything dangerous. She simply just does not understand her role in the team. I appreciate her eagerness to learn, but she is not a nursing student and I do not have the time or bandwidth to educate her on why I am making the nursing judgments I am or to tell her not to interpret things concerning a patient for me. She also gives me insignificant updates (i.e. the amount of every single output) and acts confused when my pumps are going off as if she's trying to help me determine the issue.

I know this is all really small potatoes, but it points to a fundamental misunderstanding of her scope of practice. The biggest example of this is her wanting to speak with the doctor about a patient's nutritional needs. I had to stop her in her tracks on that one. (Another nurse had to pull her out of the report room because she was thought the provider was talking to her during his dictation!)

I am going to tactfully ask my leadership for some strategies to work with this person, and implore them to provider her some extra training. I thought I would mine this community for its wisdom first. I am not new to working with difficult people, but I'm a new nurse, and above all, want to stay professional and respectful.

Thanks in advance.

[Been there,done that, ASN, RN]

YOU are leadership in this situation. YOU will delegate when she is your CNA.

Management will not extend her orientation and they are NOT responsible for strategies for YOU to manage YOUR CNA. ( you will be shooting yourself in the foot , if you ask management how to handle this).

Give her direction at the start of the shift and make her accountable.

[chwcbesteph, RN]

I actually have great management who understand that when I ask for direction or strategies, I'm not trying to waste their time. They're more than happy to point me in the right direction- and have.

But I appreciate the reminder of MY role in the situation. I think this is probably one of the hardest things in becoming a nurse having been a CNA.

[quiltynurse56, LPN, LVN]

Take her aside and explain to her that communication with the Dr. is between Dr. and nurse. You may also have to be specific about what information you need when. If you need the I&O once a shift, tell her you need that information at a certain time. With the pumps remind her that you have in under control and she can go about her other tasks. She needs some guidance yet on what she should be doing as well as when. Maybe she can be paired with an experienced aid who knows the expectations for a few more days. Has her orientation been with different aids or with one?

Does you facility have a job description that can be gone over with her and in more detail at this time. The floor manager can do this with her. Am wondering if she had taken a CNA class. Sounds like she hasn't been taught or learned where her boundaries are as far as when she can and can not do.