New Nurse: Delegation and CNA, PCA, PCT Issues

[NERD_RN]

Hello everyone. I am a new nurse working on a very busy medical-surgical telemetry unit and I have been on my own for about 4 months now. This has been a difficult transition for me and I have certainly experienced the "reality shock" of being a new nurse. I can generally talk myself down from the overwhelming anxiety that accompanies going into work for another shift. I tend to be hard on myself and can be a little self deprecating without realizing it.

My problem within the past week is related to delegation. Last week while waiting for my assignment a nursing assistant began saying rude comments that I'm 99% sure were directed towards me. One of these included, "Some people are book-smart, but ain't got no common sense" (and yes, I know "ain't" is not a word). There were other comments made, as well as an instance where I walked upon a couple of nursing assistants whispering, "Shhh, here she comes".

I have been trying to find a balance with the nursing assistants, being friendly, but also delegating tasks. I think the issues may be stemming from a combination of laziness on their part and a lack of confidence or maybe over-delegation on my part. I often thank my assistants and let them know how much their knowledge and experience help me as a new nurse.

Am I asking too much of them? How much is too much?

I know this shouldn't matter and that I'm not there to make friends, but I am really having a hard time getting past this. I go back to work in a few days and I'm not looking forward to it because I can't stop thinking about this situation. I don't really know who to trust at work or who to talk about this with, so I decided to vent here. Part of me is struggling with the thought that an experienced group of nursing assistants think that I have "no common sense". I've found myself wondering if they are right... and wondering what they have been whispering about. Ugh.

[hopeful_27]

You are not alone! I am a new grad and working in the med surg unit. I feel as though I am being bullied by the CNAs. One CNA even screamed and said that nursing school didn't teach me sh*t. I also asked her if she checked the blood sugar for a DKA patient because it wasn't documented on the computer. I told her if she hasn't done it yet, I would do it. The response I got? A hand to my face, and telling me to leave her the F alone. Alot of the nurses who saw how I was being treated told me I come off too friendly and I need to put them in there place. Everytime I come up to the CNA to ask a question, I stammer when asking questions because I am so scared she might blow up on me! Eventually I went and talked to the charge nurse about this but that did not help. Tired of homeless patient's coming in screaming at me in the middle of the night because the cafeteria is closed and there is no food other than crackers and milk. Tired of working with nurses who are not happy to be there. Tired of being bullied by CNAs. PRetty much tired of it all. I am looking for a new job at a another hospital.

[Nurse ABC]

I find this very frustrating as well. If they'd just do what they were hired for there wouldn't be a problem but there are some (not all by far) that try to get away with doing as little as possible and when you do ask them they get nasty. What I've found that helps is if I'm not busy I will just take care of call lights, bathroom trips, water, etc. I also tell the CNA's on my team to let me know if they need help turning or bathing patients that are total cares and I will help them. If I catch them trying to do it by themselves with hard to move patients I grab gloves and jump in right then and there. After doing this for the first few months I no longer get an attitude when asking one for help or to take care of a patient need. They know on my team we all help each other and work together. I also try to empathize with them abt difficult patients and how much they have to do and I thank them for their hard work. They make my day so much easier because there are days I don't get an aide on my team and I miss them. I now have people that request to work with me and the days I just can't help as much they are more understanding. Also, with those that are always behind and come up and start whining about how much they have to do even though they've had two breaks since lunch and have been in the back talking-you know the ones-I just say I would help you but... and then literally list everything I have to do including trying to find time to get a drink and pee. They usually walk away because it's usually more than they have to do and they know those aren't things they can help with. Hope this helps!!

[virgo,student nurse, CNA]

You can never allow your CNA'S or techs to see you sweat, don't ever feel you are less than a nurse, because you are having issues with your Aides. What I found has worked for me is to go in with the aide and help them with my patients as much as I can, this way I can learn from them, and they see me as a nurse who is willing to help. I always say thank you, and if I am done with all my stuff I do go and help the Aide if they are running behnd. People are going to talk about you, no matter what, but remember delegate to your Aides what you absolutely have to and remember you are new at this, it will get easier. Best of luck.

[lalopop86]

May I ask how you are delegating? When I say that, I mean your wording? I am a tech and while I try my hardest to do all of my tasks on time (blood sugars and vitals in the correct time window, etc) we all know things happen and we get behind. However I LOVE when my nurses make me feel like part of the care team by saying things like, "hey it's really important that WE keep this guys sugars normal. Can you make sure you let me know what his next sugar is when you're able to check it?" I know that with some people this approach will not work but sometimes it helps knowing that your nurse remembers your job is important too!:) I'm so sorry this is happening to you. Nobody deserves being spoken to in that way. I hope it gets better for you!

[Guest707336]

As a new CNA...I would never think this behavior would be acceptable...I'm prior military so I'm use to the chain of command and showing proper respect based upon rank. I have a bachelor's in Business and Management. I will be doing an accelerated second-degree BSN program soon. I recently got a chance to use my degree; I was a manager at a previous job and employees did not respect me either. It is hard to balance being nice and making sure job gets done. I found that employees respected the dictator/tyrant-like managers and disrespected the nice ones. I bought lunch for my staff and tried to help them advance and they had absolutely no respect for me and made my job hard. I decided to become strictly professional and dictated what needed to be done...if not done...verbal warning...then write-ups. They only seemed to react appropriately to this type of managing.

I think the CNAs' are testing you, jealous, and have problems with any type of authority. Although my personality is sweet, nice, mild-mannered...once I showed authority as a manager...they acted like they respected me...even if deep inside they still resented my authority. Hope things are better for you now:)