New nurse needing help with being assertive when delegating task to CNAs

[NurseMari22]

Hi everyone, I been working as a nurse for probably 3 months now and I am having a really difficult time delegating. Everytime I delegate a task I get a am busy right now or a few times I got a do it yourself response. I have no probably cleaning patients or filling up ice pitchers but I feel like I have way more important task to do then to be giving someone a bath. I have left 4 hours after my shift a few times because of time management. I am starting to feel anxiety when going to work. Not to mention the bullying some of the senior nurses have been doing to me. I don't know if it's because they are overworked, but am starting to think why I got into nursing in the first place, if the people treat you like crap. I have families upset at me cuz the patient is incontient and wasn't clean, and patients trying to hit me curse me out, help what should I do, I don't like to be that person who runs and tattles for every little thing I want to handle things on my own.

[elijahvegas, ASN, RN, EMT-P]

Well it sounds like you can't handle it on your own, so before it gets to the point where it falls on you, you are going to have to bring it to someone else's attention.

I find being assertive and insistent helps. There are some good eggs, and some bad eggs. With the good eggs I'll say something like "can you assist room 9 with the bathroom please? Thanks" and once I know it's done when I see them again I'll ask if it was done, followed by "thanks I appreciate it".

If it becomes a pattern that every time I delegate something to be done there's some kind of excuse, it will turn more into a, "I need you to assist room 9 with a bath please, Thanks." Without being rude I make it clear that it's not exactly a request at this point, and if I get hit with a "I'm busy blah blah excuse" I respond with, "well when you're done , please assist with room 9 after, and please come find me after." That way they know I'll be looking for them, and once encountered I'll ask about it, and ask why hasn't it been done yet.

It's important not to be demeaning, rude, or belittling because cna staff are your lifelines at time and if they wanna give you hell, they will. Just as you've seen you can end up stuck for hours after shift if they leave you hanging. But it's also important to let them know there are things that you need done, because it eventually falls on you whatever ends up missing.

Also, be mindful of your time management. Work on prioritizing care so that it doesn't creep up on you and you find yourself totally behind when a cna starts getting squirrely on you

[Hollybobs]

Welcome to AN, I am also new. I hear what you are saying about finding a number of things, not just time management, difficult. Can you think of any solutions or approaches?

Also..."more important tasks than giving someone a bath"? That sentiment may have just been typed badly or could be at the heart of your current problems.

[traumaRUs, MSN, APRN]

Moved to First Year After Nursing Licensure

[amb218, BSN, RN]

Welcome to AN, I am also new. I hear what you are saying about finding a number of things, not just time management, difficult. Can you think of any solutions or approaches?

Also..."more important tasks than giving someone a bath"? That sentiment may have just been typed badly or could be at the heart of your current problems.

I don't think the OP meant it in that sense...think about it for a minute. As the nurse, if you have one patient requiring a lot of meds that need to started on time like IV meds or maybe something even more time consuming and as important as a blood transfusion, than it is completely realistic to delegate a bed bath for another patient to the CNA. Sure, of course the nurse can give a patient a bed bath but it would be improper time management to give that bed bath when another patient needs something more pressing...in this scenario, the bed bath should most definitely be delegated to the CNA.

[Hollybobs]

I don't think the OP meant it in that sense...think about it for a minute. As the nurse, if you have one patient requiring a lot of meds that need to started on time like IV meds or maybe something even more time consuming and as important as a blood transfusion, than it is completely realistic to delegate a bed bath for another patient to the CNA. Sure, of course the nurse can give a patient a bed bath but it would be improper time management to give that bed bath when another patient needs something more pressing...in this scenario, the bed bath should most definitely be delegated to the CNA.

Yes, as a nurse I am well aware of that and I thought that time management seemed like a challenge for the OP but the original query was regarding how to delegate better. The problem wasn't which tasks were appropriate to delegate, bed baths are, of course, appropriate, it was the response of the CNA's.

Anywhere I have worked it is important not to give the wrong impression, through poor choice of language, that the nurse sees personal care as "a less important task". I have seen that happen with new nurses, the CNA's would resent this and the behaviour described in the original post of resentment, rudeness and refusing to help would result. If the OP can give that impression when writing a post where there is time to consider meaning and choice of words it is not a large stretch of the imagination to guess that might be where colleagues have been rubbed up the wrong way.

I would have given a fuller explanation in my first post but the lack of proofreading and "poor me" didn't make me feel v inclined. My response, if taken on board, might potentially help the OP's situation and make work life easier for her or it might not. But it might be something to consider rather than me saying "oh no, that's horrid, they should help you" which doesn't move anyone further on.