New RN and CNAs are disrespectful

[nurseladybug12]

I am an RN and just started orientation last week. I look like I am fresh out of highschool but I am 26, which I think may be a part of the problem here...Anyways, on my 2nd day, one of my patient's call lights went on. A CNA went into the room then came out, I look in the room and see a tray of food untouched sitting in front of the patient, so I ask the CNA as shes turning around if she could feed the patient. She says "not my patient", she then says she will look for the aid assigned to that room, and proceeds to walk up and down the hall looking in every room for a good 10 minutes or so. I just cannot believe she is wasting her time looking for someone else to do it when she couldve been doing it the whole time. So, I stop following my preceptor and I go in and start feeding the pt. 5 minutes into it, the aid assigned to the pt pokes her head in and starts to leave. I ask her could you please feed the pt? she says "he told me he wasnt hungry" (he is nonverbal!) I say " he is eating just fine now I am trying to give meds with the RN" She totally disregards what I am saying and walks out into the hall and continues to put away linens off of a small linen cart...because that is such a priority over feeding a patient. So I didnt want to get into it with her I just fed the pt. It was only my 2nd day but I am so afraid now of getting walked all over by the aids and I am a new nurse I want to be sure I am getting the help I need from them. Should I nip this in the bud now and tell the clinical director of the floor or just see if this continues being a problem? What should I say to them when they are not doing what I am asking of them?

[Labrynth]

I am seeing that the nurses come and go but the gns's/cna's stay generally on the same hall/floor/wing. I am starting to identify a lack of concern for the RN's opinions/priorities/clinical decision making. I speculate this is due to high turn over in certain areas and inconsistent staffing. Under appreciated, under paid and over worked it is easier to bully/ignore/and fight the RN then it is to build a positive working relationship. There is a strong " I have been doing this longer attitude" which closes them off from new eyes on long standing routines and habits. Do not allow yourself to be walked on but do not bully/fight/demean or speak down to the gna/cna. Pick your battles wisely. Patient safety is always first. Yes they need to eat but did the client slap their hand away or throw something at them? Nonverbal does not mean non responsive. It is important to know your gnas names and which patients are theirs. Your the nurse, it is your job to know who is assigned where and what they are doing. Don't forget to say good morning, thank you and good night. These simple gestures open the door for communication. Good luck with your job! Keep in mind it will get easier as your learn how to manage your personality and theirs.

[jadelpn, LPN, EMT-B]

Ask your preceptor. That is what she is there for. How do you organize it so that a CNA will be doing patient care on the patient to which you are both assigned to when you need them to? Perhaps to say in report or right after report "room such and so is a full feed. Could you be sure that your priority with this patient is to be sure he is fed? I will take vitals when I do my assessment, don't worry about that. Lets find each other around 10 so that we can both do a bed bath. Sound reasonable?" CNA's are part of your team for your patients. But I would put a plan in place at the begining. Sometimes that means that when morning meds are given, then you and the CNA just go down the line and do am care together. And if patients need turn and repo's Q 2 hours, let your CNA know that as well, and it is easier and more efficient if you both do it together whenever possible. A good CNA is a treasure. You also need to acknowledge that--"thank you so much for your help" goes a long way.