New PCNA, need a nurses input/advice

[ChipNurse]

Hi, I am a new (within 90 days of orientation) PCNA on an ortho floor in Cleveland, Ohio. I received a 45 day review that said that I was doing very well and that there were no concerns at this time. The only thing the manager said was that scheduling could be an issue as I am in nursing school. I have worked in management in retail, so I realize you have to put SOMETHING down as a potential "needs improvement." So after that review I felt pretty good and have continued working as I normally do. Fast forward to almost my 90 day review and I was called into the office and I was given a laundry list of grievances from 6 RN's (which would be all of the nurses that I work with on my shift). The list basically encompassed my ENTIRE job description. I was in shock and very upset. I would say that 90% of that list was not true. They said that I didn't answer call lights (I am the first to answer a light- mine or someone else's), I don't take vital signs in a timely manner (which I take at 1500 and 1900- yes, I could get them into our charting system earlier, but I find answering call lights more important as our patients do not have bathroom privileges and I do not want to make the patient wait, so I will make it an effort to get them in the computer faster (i can work on this); I was told that I do not fill ice bags or water pitchers (which I do, but I do admit that when all of our patients are 2nd days post-ops and they all need to use the bathroom and each pt takes 10-15 minutes to toilet- ice bags can get behind...when it is not as hectic, those ice packs are filled 3-4 times on my shift- and I refill water pitchers when I come on 1500, dinnertime 1700, usually around 2 vitals 1900 and usually once more before I leave; I was told that I do not turn patients, do not do accuchecks in a timely manner, I have an attitude (this really made me upset because I do every/anything the nurses ask me to do without protest... so maybe it could be non-verbals???). Basically, I was told by management that they were extending by probationary period for 30 days and if I do not show improvement then I will be terminated. I am very upset because I LOVE this job, the patients, and I really like the nurses (even though they are notoriously tough). I DO NOT want to get terminated and the people that I talked to about it said that I should just quit, and I do not want to do that either. I spoke to one of the RN's that night I had the talk with management and she basically said she had never complained about anything of those things and that she felt ALL the PCNAs could do a better job filling ice packs and water pitchers. That was my only advice. So yes, I will be all over the ice packs and water pitchers, but I am at a loss on the stuff that I already do but am being told that I do not do. Also, I guess that the nurses do not like it when we sit down to chart- which I do. It was recommended that I do the charting in the patient room. I am bothered by this a lot. I do not get on facebook or check my email, I am using the computer for work-related things that are to be done. I talked to all of the other evening PCNAs and they said they all have went through this as well... so I guess that makes me feel a little better, but I work my butt off all night (sometimes I don't take a lunch) and I feel like it's all for nothing. I guess my questions for all of you nurses is: What makes a great PCNA at your job and any suggestions for improving. I am open to any advice at all that will make me a better PCNA. Thanks! (sorry this is so long winded)

[bluemorningglory]

Talk to me about the other aides

[ChipNurse]

There was one evening aide that was the favorite. He just recently transferred to another position. I honestly never worked too much with him. The first time I worked with him, I helped clean out his pt room after a d/c and pt belongings were still in the room, so I ran down to the ER where the pt was leaving from but they already left. No one thought that was a big deal even though part of our job is getting all the pt belongings together before being discharged. He DID put in his vitals ASAP. He was an ortho tech before the position became obsolete, so he is VERY knowledgable with all the ortho contraptions. His ice packs and water pitchers were rarely filled. He told me to watch out for the evening shift RNs. All he told me was the be 5 steps ahead of them so they won't complain about anything. I really didn't think much of it, since they have never said anything to me. Another girl has been on the unit for 2 years. She actually trained me. She told me that she was pulled into the office just as I was and was told she was too slow. She told me that her opinion is that evening is too demanding, as she works AM and PM. The rest of us are new. I am the quietest and the only female out of the new bunch. The one guy is on yahoo checking/writing e-mails all the time and he never fills up pitchers. In wouldn't call him lazy, but he isn't getting everything done either. He is very chummy with management and the RNs. I think management likes it, but I don't think the RNs do. The RNs are usually asking me questions about his patients which makes me think he is communicating with them at all. Management also had a conversation with him, but he told me that basically they asked how they can help him better with time management and that if an RN asks you to do something and he is in the middle of filling an ice pitcher then he is to drop the ice pitcher and do whatever they say.... not just for high acuity tasks. The other guy seems to be doing just fine. I thought that we were performing on the same lines. We're new, still getting our routine down.

[bluemorningglory]

Male aides are gold because they can lift

[karamarie91]

Can you chart as you take your vitals? I am a pct on a med-surg/ortho floor and that's what I do when a computer is accessible. I just take it room to room. Others just have their clipboard or piece of paper(that's what I use. I can't keep up with a clipboard) and take the vitals before going to sit down and document them. Also, sometimes you can take your accucheck at the same time you're doing vitals.

[ChipNurse]

Karamarie91,

I can document in each room as we have a computer in each room, so I will definitely start taking advantage of that. Accuchecks are interfaced into the charting system, so I do not need to chart it. I just let the nurses know what the values are.

[chels14]

If you are new, you are definitely going to be slower at things because you are still learning your routine and they should understand that. When I first started out it was easy for me to get "stuck" in a pt room because you want to make sure you do everything perfectly and don't leave anything out and sometimes the patient can be very chatty and you don't want to cut them off. These are some very thirsty patients if you are having to refill their water pitchers every two hours! When you refill it be sure you have plenty of water in the pitcher and not just a whole bunch of ice that has to melt. Also, know when your nurses typically go into the room to give meds, because this is probably when they are going to be looking for a pitcher of fresh ice water to pour their patient a drink. Also, you might try to make yourself a little more visible when you are hard at work. If you have been in a patient room for thirty minutes giving a bath and taking him/her to the bathroom and changing the bed, etc. the nurses may wonder where you are. Pop out to the desk between patients and ask them if there is anything they need you to do and let them know where you are so they know you aren't just hiding out somewhere. And you know to be more prompt when charting vital signs..I think it is a great idea to print off a paper copy for your nurses so they will have a quick reference to their patients' VS. You sound like you are doing a great job, just remember sometimes the nurses' priorities are a little different than yours or even the patients' at times. It's a balancing act and you will get quicker, just hang in there!

[ChipNurse]

Thanks! That was one of the comments I did receive... the nurses don't know where I am all night. I'm helping with the patients! haha. We have electronic trackers that we wear so that they know where we are 24/7....so I would think they could just track me. I guess I can pop out of patients rooms more often and see what they would like me to do. Thanks for the feedback!