Not a strong charge LPN...

[Fancy Face]

Hi, I work as an LPN in LTC, 40 bed skilled floor. I am so flippin busy with meds/tx/documenting/nebs/tubefeeds/family members/ MDs dropping in/unexpected changes in condition/residents concerns...

It is hard to manage the floor and keep track of some CNAs who need babysitting to make sure the care is being given. For instance, I did not give report to one CNA who was an hour late and floating. I do not have time to give report twice as it is usually a big ordeal and by that time I was up to my eyeballs in the med pass, didn't even see said CNA come on the floor. Got reprimanded by supervisor cuz the CNA complained she didn't get report..CNAs are constantly complaining that one another disappear on an hour cigarette break and I am to busy to care/notice.

I feel I am fighting a losing battle and these residents deserve better. Any tips... I am not a good charge LPN obviously.

[lovelyladynurse]

From the sounds of it, your a great charge LPN. Health Care is a about being a part of a team while giving care. When one part of the team is lacking, it brings everybody down with it.

I know it's easier said then done, but don't get to discourage, we need people like you caing for my grandmother, grandfather, uncle, etc....

I hope futher days are brighter for you fancy face :)

[nightmare, RN]

Was the CNA who was an hour late reprimanded?! Is she had been on time then she would have got report with the rest of them.Do the CNA's who complain about cig breaks come and tell you at the time or later after the fact?Maybe your supervisor should be on the side of the trained staff not listening to whining CNA's!! You can't be everywhere and it sounds like your CNA's are well aware of this and take advantage.

[litbitblack, ASN, RN]

Yes it sounds like the supervisor needs to be more involved with the staff. I would require the cna's report when they are leaving for break and they also need to come notify you when they report to work if they are late. you do not have the time to be looking for them. they need to report to you.

[Straydandelion]

I would require the cna's report when they are leaving for break and they also need to come notify you when they report to work if they are late. you do not have the time to be looking for them. they need to report to you.

I fully agree! Why did the supervisor not ask the CNA why late or ask did she/he try to find you to get report? There has to be support and from the top..possibly suggesting certain rules you would like the floor to comply with to the supervisor may give the idea that procedures need to change in order for you to charge effectively.

[Lovely_RN, MSN]

It sounds like your supervisors aren't being supportive of you. My patient load is the same as yours and I don't have time to babysit the CNAs. Isn't your report written down? I would have directed the CNA to the nurse's station and told her to read the report since she is the one who was late. When the CNAs go missing I page them over the intercom...Ms ________ please report to the unit. I give them 2 minutes to call the unit or report then I call the nursing office and tell the supervisor that they have left the unit on a non-scheduled break. After that I let the supervisor deal with them. I used to have a hell of a time with the CNAs because many of them worked with my mother and thought I was just some dumb (and I'm 33 mind you) kid they were going to run around.

I know it's hard to get it all done and I am still learning as I go but try to take a minute to do a head count every hour or so. Also every now and again I will pick the sickest resident off of each of the CNAs assignments and check them for wetness and see if they are actually being turned and positioned. I find that some CNAs consistently do not give care and those are usually the trouble makers who leave the unit when they are not supposed to so I watch them closely. The CNAs who I find to do their jobs consistently don't hear a peep from me because I'm not going to ride a good CNA who does their job well...they are worth a million bucks and I love to work with a hardworking CNA. If they ask me I will say go ahead and take that smoke break and I will look out for your residents while you do etc. It's give and take...you give me a hard time and I'm going to give it right back to you...you make life easier for me and I do the same for you.

[cjcsoon2bnp, MSN, RN, NP]

The sad part is that you shouldn't have to be running around babysitting a few bad CNAs. We are all adults and we need to grow up and be professional, seriously. You sound like your doing your best to be a good manager, just keep up the good attitude and it will get better. You should suggest to your supervisor that they need to sit down and have a chat with a few of these bad CNAs and nip these problems right in the bud. As far as the time management goes, I think that if your supervisors can help get rid of the maturity problems with the staff you will be able to handle all the other stuff and it will get easier as it goes along. Good luck!

!Chris

[makes needs known]

When is mangmnt going to realize that 1 lpn is not enough for 40 pts?? On the ltc/rehab floor I work we usually have 2 ch nurses. That makes it so I can help the cna's when they are short and really busy. So on the nights when there is only one nurse they better be there to help me out because everyone has to work together. If you have an aide that doesn't know whats going on, for whatever reason, she better seek out some help. She's part of the team too.

[Batman24]

I'm sorry you are dealing with such immaturity. That makes a stressful and tiring day even more so. Here's what I would do...

Tighten the reins on the problem CNAs ASAP. Start writing them up when necessary and getting a paper trail in place. Let them know who is in charge because sadly it appears your supervisor is letting the inmates run the asylum at present. You need to take back control of the situation. A few necessary written notices and they will see you mean business.

It might take a few weeks but they will get it. The good CNAs will be happier knowing the poor ones are being penalized. The poor CNAs will either right their ship, quit or be fired. Get the ball rolling so you have the paperwork to do the latter need be.

[achot chavi]

It sounds like your supervisors aren't being supportive of you.

She's got that right. I would have a meeting with your CNA's and lay down the law- either the unit functions or you will let someone else who might not be so nice run the floor. They are adults and know their jobs so start acting like it.

A late CNA must be responsible to approach the nurse for report. Often I will direct them to another (responsible) CNA to give it over instead of me.

In any event you are not their babysitter. You must write up any staff who take breaks without informing you,

We got a pretty CNA and suddenly the male CNA's from other units are coming to bring her a cup of coffee. I wrote them all up after giving a warning. They got the message. Noone makes coffee for someone else here- not even the secretary for the CEO!!

I find that some CNAs consistently do not give care and those are usually the trouble makers who leave the unit when they are not supposed to so I watch them closely. The CNAs who I find to do their jobs consistently don't hear a peep from me because I'm not going to ride a good CNA who does their job well...they are worth a million bucks and I love to work with a hardworking CNA. If they ask me I will say go ahead and take that smoke break and I will look out for your residents while you do etc. It's give and take...you give me a hard time and I'm going to give it right back to you...you make life easier for me and I do the same for you.

Again- she's got it right. Some nurses "reward" good CNA's with better shifts. That might work for you if you are responsible for the scheduling.

GOOD LUCK